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PubMed2004

Interactive Health Communication Applications for people with chronic disease.

BACKGROUND: Interactive Health Communication Applications (IHCAs) are computer-based, usually web-based health information packages for patients that combine information with at least one of social support, decision support, or behaviour change support. These are innovations in health care and their effects on health are uncertain. OBJECTIVES: To assess the effects of IHCAs for people with chronic disease. SEARCH STRATEGY: We designed a four-part search strategy. First, we searched electronic bibliographic databases for published work; second, we searched the grey literature and third, we searched for ongoing and recently completed clinical trials in the appropriate databases. Finally, researchers of included studies were contacted, and reference lists from relevant primary and review articles were followed up. As IHCAs require relatively new technology, the search commenced at 1990 where possible. SELECTION CRITERIA: Randomised controlled trials (RCTs) of Interactive Health Communication Applications for adults and children with chronic disease. DATA COLLECTION AND ANALYSIS: One reviewer screened abstracts. Two reviewers screened all candidate studies to determine eligibility, apply quality criteria, and extract data from included studies. Authors of included RCTs were contacted for missing data. Results of RCTs were pooled using a random effects model and standardised mean differences (SMDs) were calculated to provide net effect sizes. MAIN RESULTS: We screened 24,757 unique citations and retrieved 958 papers for further assessment, yielding 28 RCTs involving 4042 participants. One of these had an inadequate method of concealment of allocation, and sensitivity analyses were performed to determine the effects of including or excluding these data in the meta-analyses. Results in the abstract are from the meta-analyses excluding data from this study.IHCAs were found to have a positive effect on knowledge (SMD 0.49; 95% confidence interval (CI) 0.14 to 0.84) and on social support (SMD 0.47; 95% CI 0.28 to 0.66). IHCAs were found to have no effect on self-efficacy (SMD 0.15; 95% CI -0.13 to 0.43) or behavioural outcomes (SMD -0.09; 95% CI -0.49 to 0.32). IHCAs had a negative effect on clinical outcomes (SMD -0.32; 95% CI -0.63 to -0.02). REVIEWERS' CONCLUSIONS: The number and range of IHCAs is increasing rapidly; however there is a shortage of high quality evaluative data. Consumers who wish to increase their knowledge or social support amongst people with a similar problem may find an IHCA helpful. However, consumers whose primary aim is to achieve optimal clinical outcomes should not use an IHCA at present. Further research is needed to determine the reason for this negative effect on clinical outcomes, whether an optimal IHCA can achieve behaviour change and improved health outcomes, and if so, what are the essential features of such an IHCA, and the extent to which they differ according to patient group or condition.

Retraction of Publication as Topic↗

PubMed1994

Histological assessment of sintered metal-fibre-web materials.

Recently it has been shown that flexible metal fibre mesh structures can be used for the subcutaneous stabilisation of percutaneous devices. However, for the safe application of fibre mesh structures, it is necessary that these materials possess certain biological properties. The purpose of this paper is to discuss surgical, statistical and histological methods for the testing and evaluation of metal fibre web materials for soft tissue application. The use and potential of the described techniques are demonstrated with two examples.

Alloys↗

PubMedDate not supplied

Success with Web-based image access.

The University of Mississippi Medical Center in Jackson, Miss., is the only medical school in the state. We performed 235,000 procedures in the 2001-02 fiscal year. All imaging services within the radiology department are networked to a PACS and are filmless. The elimination of film required that we decentralize our traditional file room to allow easy access to our radiology network across the campus. In our facility, there are three levels of image access: Diagnostic Quality, Review Quality and Web Access. Diagnostic Quality requires top-of-the-line workstations and monitors and is the most expensive. Review Quality workstations represent some savings over Diagnostic and are used in the ICU, orthopedics and surgery. Web Access appears to satisfy most areas outside the main diagnostic department. The account set-up procedure is simple because it uses our intranet email system. Images are easily pasted into presentation applications for articles and conferences. However, the main advantage of Web Access is the low cost. The downside of Web Access is that the images are for review only and are limited by the quality of the monitor in use. It is also somewhat cumbersome to retrieve old or comparison images via this method. The Web only holds approximately 45 days of the most recent images, therefore older studies may not be available. The deployment of this Web-based service has aided in our efforts to reduce the amount of film we print and has also been beneficial in improving patient care through faster service.

Computer Communication Networks↗

PubMed2003

Wireless application for complex wound management.

This project was to develop a web based wireless system to be used by community care nurses. Wound care constitutes approximately one half of home health care nursing visits. The system was implemented with a digital camera and a handheld computer with a wireless connection to a web based server. A database was used to control access to the clinical cases and to serve as a data repository. When new images were uploaded to the server a wound expert was notified via pager. The images and data could be viewed from any computer with an internet connection.

Community Health Nursing↗

PubMed2003

Enabling virtual emergency healthcare enterprises using Web services.

Emergency healthcare delivery involves a variety of activities performed from the time of a call to the ambulance service till the time of patient's disposal from the emergency department of a hospital. As these activities are performed in at least two organizations (i.e. ambulance service and hospital) and they are interrelated to form inter-organizational healthcare processes, collaboration and coordination become a vital issue for patients and for emergency healthcare service performance. Web-based workflow systems in conjunction with web services present a new way for service-oriented integration (SOI) of disparate systems and for developing distributed applications within and between organizations. Thus, through process automation and the use of web services ambulance service and hospital emergency departments can automate their operations by making information available where and when needed and by providing an infrastructure for the integration of pre-hospital and in-hospital emergency healthcare. A prototype implementation of this approach is presented in this paper.

Computer Systems↗

PubMed2000

[Current internet technology for gynecology--from hypertext transfer protocol to embedded web server].

The scientific and commercial use of the internet has caused a revolution in information technologies and has influenced medical communication and documentation. Web browsers are the becoming universal starting point for all kinds of client-server applications. Many commercial and medical systems--such as information reservation systems--are being shifted towards web-based systems. This paper describes new techniques. Security problems are the main topics for further developments in medical computing.

Computer Security↗

PubMed1997

Experiences in deployment of a Web-based CIS for referring physicians.

Improving the timeliness and efficiency of information exchange between the hospital and clinicians in the health care community is an area of active interest at the Massachusetts General Hospital (MGH). Providing computer-based access to referring physicians who are not formally affiliated with the hospital is a particular challenge since these offices are not connected to the hospital network and lack the standard hospital workstation hardware and software. Installing clients for the hospital's clinical applications at these sites has been a difficult and costly proposition. The emergence of Web technology yields an alternative method for developing clinical applications for this remote, diverse user population. We present our experiences during the first six months of deployment of a Web-based clinical information system designed for use by referring physicians.

Computer Communication Networks↗

PubMed1999

Mr Lewis on the Web--how to convert learning resources for intranet technology.

OBJECTIVES: Intranet technology is the application of Internet tools in local networks. Due to the diversification of hardware and the need for international cooperation, cross-platform systems with network access are required for computer-based training (CBT). The latest advances in Web technology make it feasible to have interactive CBT on the Web: Web-based training (WBT). It is possible to convert existing interactive learning programs to Intranet technology. This approach combines the evaluated contents of excellent learning resources with the technical advantages of Web technology. DESIGN: 'Mr Lewis' is a case about pulmonary embolism, developed by Harold Sox, M.D., working with one of the authors, and peer-reviewed at Dartmouth Medical School (DMS), where it is now being used in the third-year clerkship in Internal Medicine as one of several CBT programs assigned to students in the clerkship. RESULTS: The process and the tools necessary to convert an interactive learning program to Intranet technology are described. CONCLUSIONS: International cooperation for CBT development is much more effective with this technique than with conventional platform-dependent stand-alone software. Web-based training can play an important role in the education of medical students and doctors.

Clinical Clerkship↗

PubMed2026

Sechium edule: Phytochemistry, Biological Activities, Potential Health Effects, Food-Industry Applications, and Future Perspectives.

Sechium edule (Jacq.) Sw. (chayote), a neglected and underutilized Cucurbitaceae crop widely cultivated across tropical and subtropical regions, has drawn growing interest as a source of health-promoting food components. This review critically synthesizes studies published between 2000 and 2026 on its botanical features, genome characterization, nutritional value, phytochemistry, bioactivities, safety, and food-industry applications, based on literature retrieved from PubMed, Scopus, Web of Science, ScienceDirect, and the Cochrane Library. Different plant parts (fruits, leaves, seeds, tuberous roots, and peels) contain diverse bioactive compounds, including flavonoids, phenolic acids, cucurbitacins, pectin polysaccharides, and carotenoids. Reported bioactivities include antioxidant, anti-inflammatory, hypoglycemic, cardioprotective, antiproliferative, and geroprotective effects, mediated in part through Nrf2-mediated antioxidant signaling and sirtuin (SIRT1/3/5/6) upregulation. Notably, a systematic meta-analysis demonstrated a significant reduction in serum glucose (MD = -20.56; 95% CI: -29.35 to -11.77) and HbA1c following three months of chayote intake in patients with metabolic syndrome and type 2 diabetes. Industrially, chayote has been developed into fermented products, starch- and peel-derived bioactive films, ultrasound-extracted pectin, α-amylase inhibitory seed protein isolates, and probiotic encapsulation systems. Recent genomic work has further revealed a chromosome-level genome assembly, whole-genome duplication events, and a domestication history tracing to Mexico's Oaxaca region. Collectively, this evidence positions chayote as a promising underutilized resource for food, nutraceutical, and biomedical use, while highlighting key gaps: the need for standardized clinical trials, bioavailability studies, and comprehensive safety evaluation.

Sechium edule↗

PubMed2005

ProGenGrid: a grid-enabled platform for bioinformatics.

In this paper we describe the ProGenGrid (Proteomics and Genomics Grid) system, developed at the CACT/ISUFI of the University of Lecce which aims at providing a virtual laboratory where e-scientists can simulate biological experiments, composing existing analysis and visualization tools, monitoring their execution, storing the intermediate and final output and finally, if needed, saving the model of the experiment for updating or reproducing it. The tools that we are considering are software components wrapped as Web Services and composed through a workflow. Since bioinformatics applications need to use high performance machines or a high number of workstations to reduce the computational time, we are exploiting a Grid infrastructure for interconnecting wide-spread tools and hardware resources. As an example, we are considering some algorithms and tools needed for drug design, providing them as services, through easy to use interfaces such as the Web and Web service interfaces built using the open source gSOAP Toolkit, whereas as Grid middleware we are using the Globus Toolkit 3.2, exploiting some protocols such as GSI and GridFTP.

Computational Biology↗

PubMed2006

Web-accessible scientific workflow system for performance monitoring.

We describe the design and implementation of a web-accessible scientific workflow system for environmental performance monitoring. This workflow environment integrates distributed automated data acquisition with server side data management and information visualization through flexible browser-based data access tools. Component technologies include a rich browser-based client, a back-end server for methodical data processing, user management, and result delivery, and third party applications which are invoked by the back-end using web services. This environment allows for reproducible, transparent result generation by a diverse user base, and provides a seamless integration between data selection, analysis applications, and result delivery. This workflow system has been implemented for several sites and monitoring systems with different degrees of complexity.

Databases, Factual↗

PubMed2003

Characteristics of international medical graduates who applied to the CaRMS 2002 match.

BACKGROUND: International medical graduates are an important component of the Canadian physician workforce. For most international medical graduates, the principal route to obtaining a residency position in Canada is to apply through the second iteration of the Canadian Resident Matching Service (CaRMS) match. In order to help inform the work toward integrating unlicensed international medical graduates into Canada's health professional workforce, our objectives were to describe the demographic and educational characteristics of international medical graduate CaRMS applicants and identify their preferred clinical disciplines and practice locations. METHODS: A 37-item Web-based questionnaire survey was offered to all 659 international medical graduate second-iteration CaRMS 2002 applicants. We collected data on their demographic and educational background and preferred clinical discipline and practice location. Up to 2 follow-up email reminders were sent to nonrespondents. RESULTS: The survey response rate was 70.3% (463/659). Of the respondents, 71.9% had obtained their medical degree in Asia, the Middle East or Eastern Europe: 36.5% had graduated with a medical degree since 1994, and 17.3% since 1997. Most respondents (74.3%) were aged between 30 and 44 years. More than half (54.6%) had completed their medical education in English. Most (69.3%) had done postgraduate training outside Canada. Before coming to Canada, 42.8% had practised medicine for 1-5 years and 45.6% had practised for 6-20 years. The top 5 choices of clinical discipline in Canada were family medicine/general practice (45.6%), internal medicine (14.9%), surgery (7.3%), obstetrics/gynecology (6.7%) and pediatrics (4.8%). Of those who resided in the 4 Western provinces or Nova Scotia, between 76.8% and 86.7% preferred to stay in their own province, and 60%, 51.4% and 37% of those who resided in Newfoundland, Ontario or Quebec respectively preferred to practise in their own province. INTERPRETATION: Second-iteration international medical graduate CaRMS applicants are a heterogeneous group of physicians, some with substantial medical training and experience and others at an earlier stage of their medical career.

Adult↗

PubMed2005

From XML to RDF: how semantic web technologies will change the design of 'omic' standards.

With the ongoing rapid increase in both volume and diversity of 'omic' data (genomics, transcriptomics, proteomics, and others), the development and adoption of data standards is of paramount importance to realize the promise of systems biology. A recent trend in data standard development has been to use extensible markup language (XML) as the preferred mechanism to define data representations. But as illustrated here with a few examples from proteomics data, the syntactic and document-centric XML cannot achieve the level of interoperability required by the highly dynamic and integrated bioinformatics applications. In the present article, we discuss why semantic web technologies, as recommended by the World Wide Web consortium (W3C), expand current data standard technology for biological data representation and management.

Algorithms↗

PubMed1995

A web-based architecture for a medical vocabulary server.

For health care providers to share computing resources and medical application programs across different sites, those applications must share a common medical vocabulary. To construct a common vocabulary, researchers must have an architecture that supports collaborative, networked development. In this paper, we present a web-based server architecture for the collaborative development of a medical vocabulary: a system that provides network services in support of medical applications that need a common, controlled medical terminology. The server supports vocabulary browsing and editing and can respond to direct programmatic queries about vocabulary terms. We have tested the programmatic query-response capability of the vocabulary server with a medical application that determines when patients who have HIV infection may be eligible for certain clinical trials. Our emphasis in this paper is not on the content of the vocabulary, but rather on the communication protocol and the tools that enable collaborative improvement of the vocabulary by any network-connected user.

Computer Communication Networks↗

PubMed2005

Interactive Health Communication Applications for people with chronic disease.

BACKGROUND: Interactive Health Communication Applications (IHCAs) are computer-based, usually web-based, information packages for patients that combine health information with at least one of social support, decision support, or behaviour change support. These are innovations in health care and their effects on health are uncertain. OBJECTIVES: To assess the effects of IHCAs for people with chronic disease. SEARCH STRATEGY: We designed a four-part search strategy. First, we searched electronic bibliographic databases for published work; second, we searched the grey literature; and third, we searched for ongoing and recently completed clinical trials in the appropriate databases. Finally, researchers of included studies were contacted, and reference lists from relevant primary and review articles were followed up. As IHCAs require relatively new technology, the search time period commenced at 1990, where possible, and ran until 31 December 2003. SELECTION CRITERIA: Randomised controlled trials (RCTs) of IHCAs for adults and children with chronic disease. DATA COLLECTION AND ANALYSIS: One reviewer screened abstracts for relevance. Two reviewers screened all candidate studies to determine eligibility, apply quality criteria, and extract data from included studies. Authors of included RCTs were contacted for missing data. Results of RCTs were pooled using random-effects model with standardised mean differences (SMDs) for continuous outcomes and odds ratios for binary outcomes; heterogeneity was assessed using the I(2 )statistic. MAIN RESULTS: We identified 24 RCTs involving 3739 participants which were included in the review.IHCAs had a significant positive effect on knowledge (SMD 0.46; 95% confidence interval (CI) 0.22 to 0.69), social support (SMD 0.35; 95% CI 0.18 to 0.52) and clinical outcomes (SMD 0.18; 95% CI 0.01 to 0.35). Results suggest it is more likely than not that IHCAs have a positive effect on self-efficacy (a person's belief in their capacity to carry out a specific action) (SMD 0.24; 95% CI 0.00 to 0.48). IHCAs had a significant positive effect on continuous behavioural outcomes (SMD 0.20; 95% CI 0.01 to 0.40). Binary behavioural outcomes also showed a positive effect for IHCAs, although this result was not statistically significant (OR 1.66; 95% CI 0.71 to 3.87). It was not possible to determine the effects of IHCAs on emotional or economic outcomes. AUTHORS' CONCLUSIONS: IHCAs appear to have largely positive effects on users, in that users tend to become more knowledgeable, feel better socially supported, and may have improved behavioural and clinical outcomes compared to non-users. There is a need for more high quality studies with large sample sizes to confirm these preliminary findings, to determine the best type and best way to deliver IHCAs, and to establish how IHCAs have their effects for different groups of people with chronic illness.

Adaptation, Psychological↗

PubMed2004

Structure determination of an organometallic 1-(diazenylaryl)ethanol: a novel toxin subclass from the web of the spider Nephila clavipes.

A novel chemical subclass of toxin, [1-(3-diazenylphenyl)ethanol]iron, was identified among the compounds present in the web of the spider Nephila clavipes. This type of compound is not common among natural products, mainly in spider-venom toxins; it was shown to be a potent paralytic and/or lethal toxin applied by the spider over its web to ensure prey capture only by topical application. The structure was elucidated by means of ESI mass spectrometry, 1H-NMR spectroscopy, high-resolution (HR) mass spectrometry, and ICP spectrometry. The structure of [1-(3-diazenylphenyl)ethanol]iron and the study of its insecticidal action may be used as a starting point for the development of new drugs for pest control in agriculture.

Animals↗

PubMed2006

Structural e-bioinformatics and drug design.

Nowadays the in silico scenario for drug design is totally dependent on structural biology and structural bioinformatics. A myriad of free bioinformatics applications and services have been posted on the web. This mini-review mentions web sites that are useful in structure-based drug design. The information is given in a logical manner, following the drug design process i.e. characterization of a protein target, modelling the protein using sequence homology, optimization of the protein structure and finally docking of small ligands into the active site.

Amino Acid Sequence↗

PubMed2001

An evaluation of a computer-based psychiatric assessment: evidence for expanded use.

The purpose of this study was to examine the psychiatric diagnoses of depression made using the structured interview, the Computer-Based Diagnostic Inventory Schedule for Children-Revised (CDISC-R) and diagnoses of depression made by pediatric psychiatrists. One hundred and twenty-two adolescents who were admitted to an inpatient psychiatric treatment unit agreed to participate in the study. All participants completed the CDISC-R structured diagnostic interview and independent measures reflecting depressive symptoms. The admitting pediatric psychiatrists' diagnoses were also recorded. Even though there were more females in the sample, males (n = 38) and females (n = 84) had similar results. The computer-based CDISC-R and physician diagnoses agreed in 76% of the cases. These results were confirmed by the independent measures of depressive symptoms, which were higher for those with diagnoses of depression and lower for those without depression. In the 24% of the cases, where the CDISC-R and physician diagnoses disagreed, the computer-based CDISC-R was more accurate in assigning a diagnosis of depression in terms of the independent measures of depressive symptoms. The CDISC-R, a computer-based diagnostic interview, efficiently and precisely diagnoses depression. This finding indicates that the use of computer-based diagnostic interviews in applied research will provide more objective and precise results, especially in clinical trials. It follows from these findings that computer-based diagnostic interviews could have important clinical applications and play a central role in web-based mental health and Telemedicine by facilitating triage, referral, and monitoring treatment outcomes through remote electronic assessment.

Adolescent↗