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PubMed1998

An intense light source. The photoderm VL-flashlamp as a new treatment possibility for vascular skin lesions.

BACKGROUND: Up to now, vascular diseases were treated with various lasers, such as argon, pulsed dye, and copper vapor lasers, which can lead to side effects like hypopigmentations, hyperpigmentations, and scarring. We treated patients with vascular lesions with an incoherent intense light source, the PhotoDerm VL-flashlamp. OBJECTIVE: The aim of the study was to test the effectiveness and safety of the PhotoDerm VL for vascular skin lesions. METHODS: One hundred and twenty patients with facial or leg telangiectasias, spider nevi, erythrosis interfollicularis, and senile angiomas were treated with the PhotoDerm VL. RESULTS: In 73.6% of patients there was an immediate clearing, and in 84.3% a clearing after 1 month was found of leg telangiectasias up to 1 mm in diameter. Facial telangiectasias and erythrosis interfollicularis colli showed clearance up to 90%. Spider nevi and senile angiomas often only needed to be treated once. CONCLUSION: From our experience we conclude that the PhotoDerm VL is an excellent device to treat vascular lesions as there were hardly any side effects seen, however, the user needs a sufficient experience to get good results.

Cicatrix↗

PubMed1998

Use of the WWW for distributed knowledge engineering for an EMR: the KnowledgeBank concept.

Developing automated tools for clinical information management requires an appreciation of user needs and capabilities. To address the reality of practice style variation, and the varying degree of comfort with computers in clinical users, we developed the KnowledgeBank concept. The KnowledgeBank concept includes an end-user authoring tool for clinical content in the EMR, and a web-based repository of content for sharing clinical content. We describe the early experiences of end-users using the KnowledgeBank.

Artificial Intelligence↗

PubMed2001

RNAPack: an integrated NMR approach to RNA structure determination.

Over the last decade, a vast number of useful nuclear magnetic resonance (NMR) experiments have been developed and successfully employed to determine the structure and dynamics of RNA oligonucleotides. Despite this progress, high-resolution RNA structure determination by NMR spectroscopy still remains a lengthy process and requires programming and extensive calibrations to perform NMR experiments successfully. To accelerate RNA structure determination by NMR spectroscopy, we have designed and programmed a package of RNA NMR experiments, called RNAPack. The user-friendly package contains a set of semiautomated single, double, and triple resonance NMR experiments, which are fully optimized for high-resolution RNA solution structure determination on Varian NMR spectrometers. RNAPack provides an autocalibration feature that allows rapid calibration of all NMR experiments in a single step and thereby speeds up the NMR data collection and eliminates user errors. In our laboratory, we have successfully employed this technology to solve RNA solution structures of domains of the internal ribosome entry site of the genomic hepatitis C viral RNA in less than 3 months. RNAPack therefore makes NMR spectroscopy an attractive and rapid structural tool and allows integration of atomic resolution structural information into biochemical studies of large RNA systems.

Automation↗

PubMed1998

Frail bodies, courageous voices: older people influencing community care.

Involving frail older users of health and social care services in decision making presents particular challenges for those committed to hearing the voices of service users. Age Concern Scotland initiated a project in Fife, the User Panels project, intended to enable older people who were unable to leave their homes without assistance to meet together to develop a collective voice expressing the needs and experiences of older service users. This paper reports on an evaluation of that project. It considers methodological questions posed by the evaluation of projects which aim to empower users, as well as discussing key findings from the evaluation. Older people were recruited through contacts in service agencies and other local organizations. The largest group was aged between 86 and 90 years and all were experiencing difficulties relating to poor health, physical frailty or disability. The project was based on a belief in the value of meeting together as a means through which people could develop the confidence to express their views. Those who became members of the panels valued this experience and reported intrinsic benefits related to the social contact, opportunities for learning and development of self-esteem. Evidence concerning enhanced capacity to exercise control over key aspects of their lives was less convincing. The work of the panels was generally well received by local social work and health agencies and had influenced local action in some areas. Responses to some issues raised by the panels generated a less positive response and the article considers reasons for this. The model is considered to demonstrate benefits both for the older people who become involved and for officials seeking to improve the sensitivity of services to the needs of older people.

Journal Article↗

PubMedDate not supplied

An expert system for guiding image segmentation.

Application of image segmentation to biomedical research is now customary. Due to the existence of a rich heuristic knowledge, many users have no deep experience in this field. It is therefore necessary to integrate knowledge-based techniques with image segmentation operators. The purpose of our expert system is to guide users in image segmentation. Its main functions are: suggest a reasonable overall scheme of processing and recommend appropriate operators and algorithms at each stage. The characteristics of this expert system are presented: (a) interaction with users: through "conversation," the expert system acquires the informations about a given problem; (b) use of belief values which indicate users' descriptions about the image characteristics. By associating image features with belief values, the system gets the informations about the image appearance and makes inference more effectively; (c) local backtracking strategy, which allows the expert system to repeatedly search for a better solution until a satisfactory result is obtained; (d) integrating with an image analysis package, users can directly execute the operations recommended by the expert system. A practical application of the system is then shown in details. Finally, our opinions in designing such a system are discussed.

Algorithms↗

PubMed2002

Vaginal wetness: an underestimated problem experienced by progestogen injectable contraceptive users in South Africa.

This paper reports on the common experience of vaginal wetness amongst South African users of progestogen-only injectable contraceptives. The observations emerged in the course of a community-based cross-sectional household survey undertaken in a rural district of KwaZulu-Natal in South Africa. The purpose of the survey was to elicit self-reporting on side effects of injectable contraceptive methods. Eight hundred and forty-eight women aged 15-49 were interviewed and 22.1% reported current use of an injectable contraceptive method, either depot medroxyprogesterone acetate (Depo-Provera) or norethisterone oenanthate (Nur-Isterate). Other modern methods used were oral hormonal contraceptives (4.5%), male condoms (1.3%), the intrauterine device (0.1%), and tubal ligation (0.1%). Vaginal wetness was reported by 18.4% of users and was one of the most common side effects, second only to amenorrhoea (62.5%). It was also what 17.5% of the women liked least about using this method. According to almost half the respondents, men regard women who use the injectable contraceptive as "wet", "cold" and/or "tasteless". These survey findings were supported by participants of 14 focus group interviews held in the sub-district. Since some South African men may prefer dry sex the perception that the injectable contraceptive increases vaginal wetness may be problematic for women who use it. Whilst vaginal wetness can only be classified as a subjective side effect at this stage, further investigations are needed as many South African women opt to use this method.

Adolescent↗

PubMed2002

Canadian illicit opiate users' views on methadone and other opiate prescription treatment: an exploratory qualitative study.

Although methadone treatment has been available in North America for decades, only a small proportion of opiate addicts (some 25% of estimated opiate users in Canada) are receiving methadone treatment. Many users have tried methadone treatment, often multiple times, but leave treatment prematurely. Others would not consider it as a worthwhile treatment option for themselves. This exploratory study examines regular opiate users' attitudes towards and experiences with methadone treatment in Canada, primarily setting out to determine what makes methadone an unsuccessful or even an undesirable treatment option for considerably large groups of opiate users. This empirical effort to explore the limitations of existing methadone treatment comes at an appropriate time, when alternative forms of opiate pharmacotherapy treatment are being proposed in Canada as complementary modes of intervention that hope to address the shortcomings of methadone treatment. The rationale for this study were feasibility questions and development efforts for a clinical trial in North America evaluating the effectiveness of using injectable opioids (heroin, dilaudid) in attracting and engaging treatment-resistant opiate users into treatment. Data for this exploratory qualitative study was collected in 1999 through a series of focus groups involving 47 treatment-experienced and treatment-naive opiate users in Vancouver, Montreal, and Toronto, with the objective of identifying key themes and issues on the described topic as a basis for further systematic research.

Adult↗

PubMed2005

Cannabis and suicidal behaviour among adolescents: a pilot study from Trinidad.

Cannabis use and suicidal behaviour are causes of adolescent morbidity and mortality worldwide. Changing trends in these behaviours in younger age groups, higher incidence, gender differences and sociocultural variations present an enormous challenge. There is no consensus whether these complex relationships are either a direct or an indirect effect due to other mental disorders, or a social response of disclosure of drug taking habits to family members and school authorities. This paper reviews the epidemiology of suicidal behaviour and cannabis use among adolescents and looks at the relationship of these behaviours regionally and internationally. The Caribbean islands have an established use of cannabis with higher suicidal rates, which provides an ideal setting to investigate the interrelationship of these disorders. Preliminary research findings in Trinidad indicate high rates of cannabis use among school students with higher rates in vocational schools compared to grammar schools. Utilising the CAPE questionnaire, depressive and psychotic experiences were common findings in adolescent cannabis users with a significant preponderance of depressive experiences (p<0.01). Our findings suggest that there is a convincing relationship between suicidal behaviour and cannabis use, the latter awakening depressive experiences. Suicidal behaviour and cannabis use are major public health problems and require a multidimensional approach with culturally competent preventive interactions. School based prevention programmes are necessary at the levels of parent-teacher partnership and classroom intervention. The treatment of adolescent disorders remains a major challenge of the future. Double disorders such as cannabis use and suicidal behaviour are uncharted areas and need novel approaches.

Adolescent↗

PubMed2026

From complexity to clarity: Building dashboards for hit selection in high throughput screens.

High throughput screening produces large, complex datasets that are difficult to interrogate without programming expertise, making hit selection time-consuming and inflexible. While instrument software and commercial tools offer partial solutions, they often lack adaptability or require costly infrastructure. Interactive dashboards provide an effective alternative by enabling dynamic filtering and integrated visualization within a single interface. Here, we present simple R Markdown-based templates for creating customizable, modular dashboards for screen data analysis. Built using the flexdashboard and crosstalk R packages, and HTML widgets, these lightweight, easy-to-build HTML dashboards require no complex installation process or installation of licensed software. They support linked visualizations, threshold-based filtering (e.g., Z-score, p-value, fold change), and interactive data exploration and are shared as a standalone HTML file. This framework enables rapid, flexible hit selection across diverse high throughput screening applications and is designed for users with basic R experience.

High-Throughput Screening Assays↗

PubMed1992

Risk perception, risk taking and risk management among intravenous drug users: implications for AIDS prevention.

The risks associated with AIDS transmission among intravenous drug users overlap with a constellation of other risk events common in the use of IV drugs. This paper explores the subcultural definition, meaning and use of risk from the experience of the active user. In assessing the extent and nature of risk among IV drug users, street-based ethnographic research was conducted over a sixteen month period and a survey was administered to sixty-six individuals in two drug treatment facilities. Risk-taking, risk perception and strategies for minimizing risks associated with maintaining a drug habit are analyzed in the context of how IV drug users are responding to the risks associated with HIV transmission. The research indicates that risk needs to be viewed within the context of the subculture to effect strategies to reduce HIV-related risk behavior.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Medical specialists' accounts of the impact of the Internet on the doctor/patient relationship.

In the context of health service delivery, deprofessionalization denotes a trend towards a demystification of medical expertise and increasing lay scepticism about health professionals, suggesting a decline in the power and status of the medical profession. This process has been linked to increasing consumerism, the rise of complementary medicine and the emergence of the Internet. Drawing on data from in-depth interviews with prostate cancer specialists, this article explores their experiences of the Internet user within the context of the medical consultation. Results suggest that the deprofessionalization thesis is inadequate for capturing the complex and varying ways in which specialists view, and respond to, the Internet-informed patient. It is argued that the ways in which these specialists are adapting to the Internet and the Internet user should be viewed as strategic responses, rather than reflecting a breakdown in their authority or status. 'Enlistment' and 'translation' are presented as useful conceptual tools for understanding specialists' experiences of the Internet.

Humans↗

PubMed1982

The oral contraceptive pill: use, user satisfaction, side effects and fears among Manawatu women.

The 1978 Manawatu Family Growth Study included questions on the oral contraceptive pill to gauge aspects of its use, user satisfaction and the experience of side effects and fears. Of the 1390 women aged 16-44 interviewed, 1085 (78 percent) had ever used the pill--411 and 674 were current and previous users, respectively. Among the current users 45.2 percent stated they sometimes forgot to take the pill and 50 percent reported they were not entirely happy about using the pill. For dissatisfied current users and all previous users it was found that: (a) various side effects were experienced by substantial percentages in each group, the most common being weight gain or swelling; and (b) a fear of permanent damage to health was acknowledged by more than half of each group. Concern caused by publicity on side effects was reported by 46.9 percent of those who had ever used the pill. These and other results, and their implications, indicate a need for instruction, guidance and counselling for oral contraceptive users.

Adolescent↗

PubMed1995

Information, intelligence, and interface: the pillars of a successful medical information system.

This paper addresses three key issues facing developers of clinical and/or research medical information systems. 1. INFORMATION. The basic function of every database is to store information about the phenomenon under investigation. There are many ways to organize information in a computer; however only a few will prove optimal for any real life situation. Computer Science theory has developed several approaches to database structure, with relational theory leading in popularity among end users [8]. Strict conformance to the rules of relational database design rewards the user with consistent data and flexible access to that data. A properly defined database structure minimizes redundancy i.e.,multiple storage of the same information. Redundancy introduces problems when updating a database, since the repeated value has to be updated in all locations--missing even a single value corrupts the whole database, and incorrect reports are produced [8]. To avoid such problems, relational theory offers a formal mechanism for determining the number and content of data files. These files not only preserve the conceptual schema of the application domain, but allow a virtually unlimited number of reports to be efficiently generated. 2. INTELLIGENCE. Flexible access enables the user to harvest additional value from collected data. This value is usually gained via reports defined at the time of database design. Although these reports are indispensable, with proper tools more information can be extracted from the database. For example, machine learning, a sub-discipline of artificial intelligence, has been successfully used to extract knowledge from databases of varying size by uncovering a correlation among fields and records[1-6, 9]. This knowledge, represented in the form of decision trees, production rules, and probabilistic networks, clearly adds a flavor of intelligence to the data collection and manipulation system. 3. INTERFACE. Despite the obvious importance of collecting data and extracting knowledge, current systems often impede these processes. Problems stem from the lack of user friendliness and functionality. To overcome these problems, several features of a successful human-computer interface have been identified [7], including the following "golden" rules of dialog design [7]: consistency, use of shortcuts for frequent users, informative feedback, organized sequence of actions, simple error handling, easy reversal of actions, user-oriented focus of control, and reduced short-term memory load. To this list of rules, we added visual representation of both data and query results, since our experience has demonstrated that users react much more positively to visual rather than textual information. In our design of the Orthopaedic Trauma Registry--under development at the Carolinas Medical Center--we have made every effort to follow the above rules. The results were rewarding--the end users actually not only want to use the product, but also to participate in its development.

Artificial Intelligence↗

PubMed1985

Improving the accuracy of burn-surface estimation.

A user-friendly computer-assisted method of calculating total body surface area burned (TBSAB) has been developed. This method is more accurate, faster, and subject to less error than conventional methods. For comparison, the ability of 30 physicians to estimate TBSAB was tested. Parameters studied included the effect of prior burn care experience, the influence of burn size, the ability to accurately sketch the size of burns on standard burn charts, and the ability to estimate percent TBSAB from the sketches. Despite the ability for physicians of all levels of training to accurately sketch TBSAB, significant burn size over-estimation (p less than 0.01) and large interrater variability of potential consequence was noted. Direct benefits of a computerized system are many. These include the need for minimal user experience and the ability for wound-trend analysis, permanent record storage, calculation of fluid and caloric requirements, hemodynamic parameters, and the ability to compare meaningfully the different treatment protocols.

Body Surface Area↗

PubMed2003

Virtual reality applied to procedural testing: the next era.

OBJECTIVE: To establish the construct validity of a virtual reality-based upper gastrointestinal endoscopy simulator as a tool for the skills training of residents. SUMMARY BACKGROUND DATA: Previous studies have demonstrated the relevance of virtual reality training as an adjunct to traditional operating room learning for residents. The use of specific task trainers, which have the ability to objectively analyze and track user performance, has been shown to demonstrate improvements in performance over time. Using this off-line technology can lessen the financial and ethical concerns of using operative time to teach basic skills. METHODS: Thirty-five residents and fellows from General Surgery and Gastrointestinal Medicine were recruited for this study. Their performance on virtual reality upper endoscopy tasks was analyzed by computer. Assessments were made on parameters such as time needed to finish the examination, completeness of the examination, and number of wall collisions. Subjective experiences were queried through questionnaires. Users were grouped according to their prior level of experience performing endoscopy. RESULTS: Construct validation of this simulator was demonstrated. Performance on visualization and biopsy tasks varied directly with the subjects' prior experience level. Subjective responses indicated that novice and intermediate users felt the simulation to be a useful experience, and that they would use the equipment in their off time if it were available. CONCLUSIONS: Virtual reality simulation may be a useful adjunct to traditional operating room experiences. Construct validity testing demonstrates the efficacy of this device. Similar objective methods of skills evaluation may be useful as part of a residency skills curriculum and as a means of procedural skills testing.

Computer Simulation↗

PubMed1990

Understanding strategic usage of 'on-the-job' reference aids.

The present set of studies examined how reference aids are collectively used to resolve problems. In addition, the present research investigated the strategies employed by documentation users as they resolved work-related questions. Subjects were given a series of questions and asked to locate the answers in a number of different types of documentation. Results of the first experiment indicated that the users' success was largely determined by their adopting an appropriate search heuristic. In the second study, the users were provided with a heuristic during training and their performance was compared with that of an expert user of the documentation. Findings from the second study revealed no difference in accuracy between the subjects and the expert; however, important qualitative strategy differences did exist between the subjects and the expert. The implications of the present results to the design of on-line computerised documentation are discussed.

Journal Article↗

PubMed1991

Oral contraceptives, androgens, and the sexuality of young women: I. A comparison of sexual experience, sexual attitudes, and gender role in oral contraceptive users and nonusers.

Female undergraduates (108) volunteered for a study of hormones and sexuality, 55 of whom were oral contraceptive (OC) users. In this paper, OC users and nonusers are compared on measures of sexual attitudes and behavior, use of erotic fantasy, and gender role. In the second paper, the effects of OC on androgen levels and the relationship between androgens and behavioral measures within each group are reported. OC users were more likely to have a current sexual partner and less likely to be virgins. The two groups did not differ in frequency of masturbation or use of erotic fantasies. OC users reported less restrictive sexual morality and more interest in erotic images. These differences persisted when women without current partners were excluded. Among those in active sexual relationships, OC users reported more frequent sexual intercourse, higher psychosexual motivation and enjoyment, and were more positive in their evaluation of their partners than OC nonusers.

Adult↗

PubMed2006

Our recent experiences with sarin poisoning cases in Japan and pesticide users with references to some selected chemicals.

Attention has been paid to neurobehavioral effects of occupational and environmental exposures to chemicals such as pesticides, heavy metals and organic solvents. The area of research that includes neurobehavioral methods and effects in occupational and environmental health has been called "Occupational and Environmental Neurology and Behavioral Medicine." The methods, by which early changes in neurological, cognitive and behavioral function can be assessed, include neurobehavioral test battery, neurophysiological methods, questionnaires and structured interview, biochemical markers and imaging techniques. The author presents his observations of neurobehavioral and neurophysiological effects in Tokyo subway sarin poisoning cases as well as in pesticide users (tobacco farmers) in Malaysia in relation to Green Tobacco Sickness (GTS). In sarin cases, a variety effects were observed 6-8 months after exposure, suggesting delayed neurological effects. Studies on pesticide users revealed that organophosphorus and dithiocarbamate affected peripheral nerve conduction and postural balance; subjective symptoms related to GTS were also observed, indicating the effects of nicotine absorbed from wet tobacco leaves. In addition, non-neurological effects of pesticides and other chemicals are presented, in relation to genetic polymorphism and oxidative stress.

Agricultural Workers' Diseases↗