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At least 487 records · Page 27Linked to original sources

PubMed2000

Orius software: calculation of rates and epidemiologic indicators, and preparation of graphical output.

Orius software produces disease surveillance statistics, including output for the Health Canada Web site "Cancer Statistics Online" and on-demand statistics at the Web site for the North American Association of Central Cancer Registries. It allows flexibility in accessing data; storing, modifying and customizing requests; and producing statistical results and graphical output. Results include age-standardized or age-sex-standardized rates, standardized incidence/mortality ratios (observed-to-expected ratios) in which one area is optionally selected as the reference, potential years of life lost, average annual percent change, Mantel-Haenszel and maximum likelihood rate ratios, and the comparative incidence figure.

Epidemiologic Methods↗

PubMed1979

A modified approach to small area estimation.

The ever-growing need for good estimates of the health, social, political, and economic parameters of local areas has served as the motivating force for new developments in methodology. Due to the constraints of sample size, design, and cost, accessible data from large areas for criterion variables of interest is often used jointly with local data on symptomatic variables. Furthermore, several procedures have derived local area estimators by combining symptomatic information and sample data into a multiple regression format. In those situations where assumptions are too strict or unrealistic, as when a nonlinear model is more appropriate, the merits of a more flexible approach are obvious. Our research focuses upon a further investigation of an alternative strategy for which the most limiting assumption is the availability of good symptomatic information. A more formal representation of the model is developed within the framework of a poststratification scheme. The methodology involves ratio estimation of the respective stratum means via indicator variables which serve the purpose of classification. To determine the accuracy of the proposed small area estimator and allow for comparisons of precision with respect to other strategies, we express the relationship between criterion and symptomatic variables by relevant continuous multivariate distributions. Specifically, comparisons are made with the results obtained using a regression estimator which is applicable to the same general setting. The theoretical framework considers multivariate stratification, where boundary determination is achieved by application of practical methods which use minimum variance stratification as a criterion.

Demography↗

PubMed2001

Uses of internet technology in clinical practice.

The practice of medicine has extended itself to vast areas and requires active clinicians to systematize and organize their workload through the use of the most up-to-date digital and computer communication technologies. Computerization and worldwide accessibility of information has especially provided great assistance in this regard. The explosive growth of medical information increases the need for the use of these new methods of organizing and accessing data. This article briefly summarizes a few of the vital tools that internet technology has provided clinical practice, with the aid of basic concepts of internet, database systems, hospital systems and data security and reliability.

Clinical Medicine↗

PubMed2001

Shared experience in 13 local Danish EPR projects: the Danish EPR Observatory.

In 1996 a national strategy for the development of electronic patient records (EPR) for the Danish hospitals and primary care was launched. An element in the strategy was to support a number of regional EPR development projects. The EPR-Observatory has in the two recent years collected data from the regional projects, dealing with the expectations in four areas: 1) Impact on organisational issues, 2) Benefits of EPR, 3) Integration of EPR with other information systems and 4) security aspects of EPR. Among the observations an increasing teamwork and im-proved knowledge about the patient was found. What was expected, but not found, was resistance to EPR, as a result of changes in skills and power. The most obvious benefits are increased data accessibility and improved decision ma-king. The most considerable disadvantage is an enormous growth in discontent with the systems performance and the fact, that all the projects are delayed. Many different types of integration solutions are chosen, because of a lack of a common model for integration. Generally the projects find, that EPJ yields increased security, but logistical problems arise in having the systems running 24 hours 7 days a week. Economical benefits cannot be documented. This relates to the fact, that the regional projects are stand-alone projects. The ongoing growth in discontent with the EPR-systems and the fact, that all the projects are delayed must be subject to further exploration.

Attitude to Computers↗

PubMed1982

The World Fertility Survey: charting global childbearing.

Interviewing some 350,000 women in 42 developing countries and 20 developed countries representing nearly 40% of the world's population, the World Fertility Survey (WFS) is in a unique position to document the historic 1970s slowdown in global population growth. This Bulletin describes efforts begun in 1972 to ensure high quality, internationally comparable, accessible data, the data's importance for policymakers, planners and researchers, and major findings available by early 1982 from directly assisted WFS surveys in 29 developing countries and contraceptive use data from WFS-type surveys in 16 developed countries. Marital fertility has declined in all developing regions except Africa but still averages from 4.6 children/woman in Latin America to 6.7 in Africa, while preferred family size ranges from 3.0 children in Turkey to 8.9 in Senegal--far above the average 2.2-2.5 children/woman needed to end developing countries' population growth in the long run. However, women ages 15-19 prefer nearly 2 children fewer than the oldest women ages 45-49; 3.8 vs. 5.7 on the average. Nearly 1/2 (48%) of married women surveyed in 27 countreis said they wanted no more children. Preventing all unwanted births would reduce birth rates up to 15 births/1000 population in these countries. Overall, 32% of married, fecund women in developing countries are using contraception compared to an average 72% in 16 developed countries. Education, literacy, and more available family planning services increase contraceptive use. Age at marriage is rising in Asia, but this factor alone has little effect on fertility. Infant mortality is higher in many developing countries than previously thought. Breastfeeding is an important restraint on fertility in most developing countries but is declining among more educated, employed, and urban women which could raise fertility if not compensated for by gains in contraceptive use.

Africa↗

PubMedDate not supplied

Modern information technologies in environmental health surveillance. An overview and analysis.

In recent years we have witnessed the massive introduction of new information technologies that are drastically changing the face of our society. These technologies are being implemented en masse in developed countries, but also in some pockets of developing nations as well. They rely on the convergence of several technologies such as powerful and affordable computers, real-time electronic measurement and monitoring devices, massive production of digital information in different formats, and faster, wireless communication media. Such technologies are having significant impacts on every domain of application, including environmental health surveillance. The current paper provides an overview of those technologies that are having or will likely have the most significant impacts on environmental health. They include World Wide Web-based systems and applications, Database Management Systems and Universal Servers, and GIS and related technologies. The usefulness of these technologies as well as the desire to use them further in the future in the context of environmental health are discussed. Expanding the development and use of these technologies to obtain support for global environmental health will require major efforts in the areas of data access, training and support.

Decision Support Systems, Management↗

PubMed2002

[Telemedicine and general practice--future or present. Telemedicine, a way to strengthen the gatekeeper role?].

Electronic communication and data-processing are by no means a new phenomenon in general practice. The next logical step might be to include telemedicine, i.e. images, sound, video, and other kinds of medical information in the communication process. The potential for applying telemedicine in the adjoining areas between the general practice and the hospitals and patients is reviewed. We assume that an increase in the use of electronic communication and telemedicine will strengthen the central role of general practice. A representative sample of international literature is reviewed. The findings are that patients have no substantial misgivings against the use of telemedicine, but scientific documentation of the influence on the patient-doctor relationship, on the quality and quantity of the medical work, and on the job satisfaction of general practitioners is still not available. We present a number of suggestions regarding the use of electronic communication between the general practitioner and the patient. The importance of providing clear, in-depth information to the patient about the use of medical IT communication is underlined. The aspect of data-security is evaluated, and for lack of precise guidelines from health officials it is our suggestion that the report from the Danish Ministry of Finance regarding data-security in public administration is consulted. As to data-access, doctors and patients should be placed on two different safety-levels. It's suggested that doctors should be equipped with a digital key, whereas patients should use a pin code and their social security number. The use of traditional e-mail is dissuaded when exchanging sensitive, person-related information. The importance of valid evaluation of new IT functions is underlined.

Computer Communication Networks↗

PubMed2003

The population approach to stroke prevention: a Canadian perspective.

OBJECTIVES: To contrast the population and clinical approaches to stroke prevention and to review Canadian data relevant to estimating disease burden, assessing risk factors, designing preventive strategies and organizing health services. METHOD: A narrative review of the published literature and statistical data accessible through the Internet. MAIN FINDINGS: Unlike the clinical approach, which emphasizes individual patients at high risk diagnosed and treated intensively, usually by medical or surgical means (or both), a population approach focuses on the entire population and bases interventions on behavioural and environmental changes. Stroke offers a particularly promising target for prevention. It represents a leading cause of serious disability, death and reduced quality of life. The aging of our population threatens to increase the already considerable burden. Stroke shares several risk factors with other chronic diseases, especially ischemic heart disease. These risk factors vary in their impact on Canadians (population attributable risk proportion), which is a function of their prevalence and strength of association with the occurrence of stroke. Although effective preventive measures are available for people at high risk, they are not being applied systematically among potential beneficiaries. Small reductions in the exposure to risk factors in the entire population offer an alternative, where even modest success may translate into major gain. CONCLUSIONS: The clinical and population approaches to stroke prevention are complementary. Existing national strategies directed at promotion of healthy life-styles (especially physical activity) and hypertension control, when fully implemented, will reduce the frequency, severity and impact of stroke on Canadian society.

Canada↗

PubMedDate not supplied

Expression of neutral amino acid transporter ASCT2 in human prostate.

The neutral amino acid transporter ASCT2 has been associated with increased metabolism in malignant tumors. Its biological significance in tumor proliferation, progression, and its impact on cancer patients' survival remains largely unknown. Tissue microarray (TMA) technology was used to build arrays from 640 cases of radical prostatectomies (triplicate normal prostate, benign prostatic hyperplasia (BPH), and prostate adenocarcinoma (PCa)). Slides were immunostained with an antibody to ASCT2 and scored using a 0-3+ semi-quantitation scoring system for both intensity and percentage. Correlation of ASCT2 expression with patients' clinical and pathological variables was analyzed by the Spearman correlation test. Kaplan-Meier analysis and log rank test were used to determine the probability of disease recurrence. Cox regression model was also used for multivariate analysis. 497 PCa had accessible data. ASCT2 was localized in the cytoplasm of epithelial cells of normal prostate, BPH and PCa. High-level expression of ASCT2 was significantly higher in normal tissues (49%) as compared to BPH (25.8%) or cancer (25.3%) (p < 0.001). ASCT2 expression was weakly but significantly correlated with preoperative PSA (Pre-PSA), Gleason score (GS), lymph node status (LN) (p = 0.019). ASCT2 expression was significantly associated with shorter time to biochemical recurrence only on univariate analysis (p = 0.046). ASCT2 appears to be required for the glutamine metabolism in both nonmalignant and malignant prostate. ASCT2-positive PCa seems to be related to a more aggressive biological behavior. ASCT 2 seems to be involved in tumor progression.

Amino Acid Transport System ASC↗

PubMed2003

Kinetics of degradation of diclofenac sodium in aqueous solution determined by a calorimetric method.

An isothermal heat conduction microcalorimeter has been used to study the stability of diclofenac sodium both alone and its inclusion complex with beta-cyclodextrin in aqueous solution. The rates of heat evolved during degradation of diclofenac sodium have been measured by a highly sensitive microcalorimetric technique as function of concentration, pH and temperature. The calorimetric accessible data have been incorporated in the equations for determination of rate constants, change in enthalpy and order of reaction. The decomposition of diclofenac sodium both alone and its inclusion complex with beta-cyclodextrin in solution corresponds to a pseudo-first order reaction. The values of rate constants, k's at 338.15 K, (calculated from the variation of heat evolution with the time) for the degradation of diclofenac sodium at pH 5, 6, 7, 8 and its inclusion complex with beta-cyclodextrin at pH 7 are found to be 4.71 x 10(-4), 5.69 x 10(-4), 6.12 x 10(-)4, 6.57 x 10(-4) and 4.26 x 10(-4) h(-1) respectively. There is good agreement between calorimetric determined t(0.5) and literature values. It has been found that beta-cyclodextrin retards the degradation of diclofenac sodium. The kinetic parameters have been calculated for the reaction. The negative entropy of activation suggests the formation of an ordered transition state.

Algorithms↗

PubMed2003

Virtual rehabilitation--benefits and challenges.

OBJECTIVES: To discuss the advantages and disadvantages of rehabilitation applications of virtual reality. METHODS: VR can be used as an enhancement to conventional therapy for patients with conditions ranging from musculoskeletal problems, to stroke-induced paralysis, to cognitive deficits. This approach is called "VR-augmented rehabilitation." Alternately, VR can replace conventional interventions altogether, in which case the rehabilitation is "VR-based." If the intervention is done at a distance, then it is called "telerehabilitation." Simulation exercises for post-stroke patients have been developed using a "teacher object" approach or a video game approach. Simulations for musculo-skeletal patients use virtual replicas of rehabilitation devices (such as rubber ball, power putty, peg board). Phobia-inducing virtual environments are prescribed for patients with cognitive deficits. RESULTS: VR-augmented rehabilitation has been shown effective for stroke patients in the chronic phase of the disease. VR-based rehabilitation has been improving patients with fear of flying, Vietnam syndrome, fear of heights, and chronic stroke patients. Telerehabilitation interventions using VR have improved musculo-skeletal and post-stroke patients, however less data is available at this time. CONCLUSIONS: Virtual reality presents significant advantages when applied to rehabilitation of patients with varied conditions. These advantages include patient motivation, adaptability and variability based on patient baseline, transparent data storage, online remote data access, economy of scale, reduced medical costs. Challenges in VR use for rehabilitation relate to lack of computer skills on the part of therapists, lack of support infrastructure, expensive equipment (initially), inadequate communication infrastructure (for telerehabilitation in rural areas), and patient safety concerns.

Cognition Disorders↗

PubMed2003

Modelisation of consumer health information in a quality-controlled gateway.

The amount of health data accessible on the Web is increasing and Internet has become a major source of health information. Many tools and search engines are available but medical information retrieval remains difficult for both the health professional and the patients. In this paper we describe CISMeF-patients. It is a sub-part of CISMeF, a structured quality-controlled subject gateway. CISMeF-patients has been designed for the patients, their families and the general public who are often unfamiliar with the medical domain and the medical vocabulary. The resources included in CISMeF-patients are described using the Dublin Core metadata format. To index them, CISMeF-patients and CISMeF share the same terminology, which 'encapsulates' the MeSH thesaurus with a layer of synonyms. Unlike Medline-plus and Medline, sharing the same terminology allows to a CISMeF-patients end-user the possibility to extend his query to the CISMeF catalogue (e.g. for searching teaching resources or clinical guidelines).

Abstracting and Indexing↗

PubMed2004

[Trends in diet and nutritional status in elementary school children in the Tuzla Canton].

Harmonious physical and mental development of children and youngsters depend on the proper diet as one of the basic conditions of growth and development. Feeding to a great extent effects children's health and their future working capability. Feeding process can be perceived through nutritive status whose most valuable and accessive data are on body mass, height and thickness of skin wrinkles. On the basis of BMI, i.e. its centile values, critical values of overweight and obesity can be easily determined. The research aim was to see nutritional status and habits in the secondary school children in Tuzla Canton, then to analyze anthropometric parameters (body weight, body height); to determine BMI values, to standardize curves, to establish obesity frequency in children. The research was performed on the sample of 1544 children both sexes, in the first, third and seventh class involving four Tuzla-Canton municipalities: Tuzla, Lukavac, Gracanica and Kladanj. The research was performed by a questionnaire and anthropometric measurements in respect to IBP (International Biological Programme). Presence of brown bread in the primary school pupils' food is insufficient (5.8-10.7%). They consume fruit and vegetables mostly two times a day, milk is not consumed by 7.5-12.3% of boys and 8.4-28.4% of girls. As for meat, chicken is mostly consumed, fish a little and insufficient. Period between the third and seventh class is characterized by expressive increase in height and weight, what is the outcome of the adolescent jump. BMI value increases with age and exceeds limits of normal weight, thus obesity increases with age. In the seventh class obesity is present in 48.35% of boys and in 30.77% of girls. The above discussed trends in nutrition and obesity presence as the risk factors, require an urgent pass of the Action Programme for food and feeding on the state level, which would give a special importance to health promotion from this point of view.

Anthropometry↗

PubMed2004

Architecture of a grid-enabled research platform with location-transparency for bioinformatics.

The recent advance in information technologies has bought about the borderlessness in every field of both science and business. The borderlessness has increasingly made activities in interdisciplinary field more important. This current situation produces a strong demand that people want to establish a virtual group, organization and society for their business and scientific purposes irrespective of the actual structure formed by organizations. Remarkably, bio sciences require a research platform that satisfies such demand for further development. In this paper, we present a research platform for bioinformatics in detail. The prominent feature of the research platform is the use of Grid and its location transparency, which means that bio scientists and researchers are able to utilize a large amount of computational power for their analysis and to access data of their interest without being aware of where data and computational resources are located. The usefulness and feasibility of the architecture of the research platform is shown as well as future issues to achieve toward the final goal of our research in this paper.

Biomedical Research↗

PubMedDate not supplied

[Children from families with mental illness. Case study].

The article reveals the influence of mental illness of one or both parents on the emotional and psychosocial development and possible adjustment disturbances of their children on the example of 3 patients. The patients (all females) were treated in the 4th Psychiatric Clinic of the Institute of Psychiatry and Neurology in Warsaw in the all-day clinic, and in the out-patient clinic with community mobile teams and specialised social help services. The analysis of the history of their mental illnesses was done and compared with the analysis of their family situation and accessible data about the emotional and psychosocial development of their children. Each of these patients was at some time a single parent due to different reasons. In each case the adjustment and emotional disturbances of patients' children occurred on a different level of their development (boy and girl of the primary school age, teenager and young adult). In all presented cases there is a need of help and support apart from the family, which indicates a need of early diagnosis of situations demanding proper systemic interventions.

Adolescent↗

PubMed2005

[Percutaneous procedures for the repair of iatrogenic occlusion or stenosis of peripheral vessels in children--report of 5 cases].

Invasive percutaneous diagnostic or therapeutic procedures are associated with the risk of thrombosis and occlusion of peripheral vessels which are used for vascular access. Data on the transcatheter therapy of vascular complications in children are scarce. We described five children in four of whom percutaneous transluminal balloon angioplasty of occluded peripheral vessels was successfully performed. Technical aspects of this treatment and indications are discussed.

Angiography↗

PubMedDate not supplied

Medical errors: computers are no panacea.

Increased patient loads, time pressures, and heightened public awareness of medical errors are forcing many physicians and clinical administrators to consider acquiring computerized physician order entry (CPOE) systems and clinical information systems. The recent revelation that CPOE systems can facilitate medical errors, however, is a call to physicians to remain vigilant despite the new technologies. By attending to specific data-capture and data-access errors associated with clinical information systems, physicians can minimize errors associated with clinical information systems and maximize the potential benefits to their patients.

Computer Security↗

PubMed2003

A personalized and automated dbSNP surveillance system.

The development of high throughput techniques and large-scale studies in the biological sciences has given rise to an explosive growth in both the volume and types of data available to researchers. A surveillance system that monitors data repositories and reports changes helps manage the data overload. We developed a dbSNP surveillance system (URL: http://www.pharmgkb.org/do/serve?id=tools.surveillance.dbsnp) that performs surveillance on the dbSNP database and alerts users to new information. The system is notable because it is personalized and fully automated. Each registered user has a list of genes to follow and receives notification of new entries concerning these genes. The system integrates data from dbSNP, LocusLink, PharmGKB, and Genbank to position SNPs on reference sequences and classify SNPs into categories such as synonymous and non-synonymous SNPs. The system uses data warehousing, object model-based data integration, object-oriented programming, and a platform-neutral data access mechanism.

DNA↗