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PubMedDate not supplied

Integration of a multimedia teaching and reference database in a PACS environment.

In one radiology department, a computerized authoring and editing environment was developed and integrated with the picture archiving and communication systems (PACS) for creation of image-based electronic teaching files to replace a collection of printed film images. This multimedia database and authoring environment allows physicians to create reference databases for teaching and research directly from clinical cases being reviewed on PACS diagnostic workstations. The database engine allows users to generate stand-alone CD-ROMs (compact disks, read-only memory) and World Wide Web-based teaching files. The system is fully compliant with the Digital Imaging and Communications in Medicine (DICOM) standard and supports a large number of standard multimedia image file formats. The focus of the development was on convenience and ease of use of a generic system adaptable to all users. The software was integrated on the PACS workstations to allow users to add new cases to the database at any time and anywhere in the department. A pilot system was implemented in clinical operation, with a central server and several client units.

CD-ROM↗
PubMedDate not supplied

Integrating the healthcare enterprise: a primer. Part 6: the fellowship of IHE: year 4 additions and extensions.

Recently, one of my friends, a computer wizard, paid me a visit. As we were talking, I mentioned that I had recently installed a picture archiving and communication system and a radiology information system. I told him how happy I was with the system and showed him a compact disk (CD) from it. To my surprise, he threw it into my microwave oven and turned it on. Instantly I got very upset, because the System had become precious to me, but he said, "Do not worry, it is unharmed." After a few minutes, he took the CD out, gave it to me and said, "Take a close look at it." To my surprise, the CD was quite cold to hold and it seemed to be heavier than before. At first, I could not see anything, but on the inner edge of the central hole, I saw an inscription, an inscription finer than anything I had ever seen before. The inscription shone piercingly bright, and yet remote, as if out of a great depth: 12413AEB2ED4FA5E6F7D78E78BEDE8209450920F923A40Eel0E50CC98D444AA08E324. "I cannot understand the fiery letters," I said in a timid voice. "No, but I can," he said. "The letters are Hex, of an ancient mode, but the language is that of DICOM, which I shall not utter here. But in common English, this is what it says: Two integration profiles to schedule work flow. Five for radiology with room to grow. One for the bacon to bring it home. One for HIPAA all alone. And one for results for those who would know. One technical framework in which to find them. One technical framework to guide them. One technical framework to bring them all. And in the Connect-a-thon bind them. In the Land of Lincoln where no shadows are. We continue the saga of the fellowship of the IHE: clinicians, radiologists, informaticians, administrators, technologists, imaging system vendors, and non-imaging system vendors, as they begin their year 4 transactions.

Computer Communication Networks↗
PubMed1991

Comparison and evaluation of nine bibliographic databases concerning adverse drug reactions.

Few evaluations and statistical comparisons of bibliographic databases have been published. As a drug information center, we were particularly interested in databases providing references on adverse drug reactions (ADRs). Ten drugs were randomly chosen from the 2000 files at our center. Nine databases were selected according to the high frequency of references concerning ADRs: eight online systems (MEDLINE, BIOSIS, TOXLINE, Iowa Drug Information System, PASCAL, EMBASE, PHARMLINE, and International Pharmaceutical Abstracts [IPA]), and one Compact Disk Read Only Memory (CD-ROM) system (Core MEDLINE). The total number of references, the number of references from 1987 to 1989, and the number of relevant references from 1987 to 1989 were analyzed using the Friedman two-way ANOVA by ranks. The overlap between databases for only one drug, carboplatin, and the quality:cost ratio were also studied. Considering the total number of references, TOXLINE and EMBASE were significantly superior to IPA, PHARMLINE, PASCAL, and Core MEDLINE. For the period 1987-1989, EMBASE was significantly superior to PASCAL, IPA, PHARMLINE, and Core MEDLINE with regard to total number of references, and significantly superior to PASCAL, Core MEDLINE, and IPA with regard to relevance. MEDLINE, TOXLINE, and EMBASE had the best quality:cost ratio. EMBASE had the slightest overlap of references, with 53 percent of the unique references on carboplatin. This comparative evaluation showed that the ability of bibliographic databases to provide information on ADRs is dependent on both the size and the quality of each database.

Databases, Bibliographic↗
PubMed2002

Developing an AIDS prevention intervention for incarcerated male adolescents in Brazil.

The objective of this study was to investigate knowledge, attitudes, and practices regarding AIDS among incarcerated male adolescents in Brazil and to develop an AIDS prevention intervention for this population. A questionnaire administered to 275 boys in São Paulo covered demographic and social characteristics, drugs, and HIV risk perception and behavior. Subsequently, we collected qualitative data on the development and implementation of a prevention program. Ninety-eight percent of adolescents were sexually experienced, most initiating by age 13; 22% were fathers. Injection drug use was reported by 5.5%, 12% had exchanged sex for money, 35% had more than 15 partners and 8% had homosexual experience. Although 72% had used condoms, only 9% used them consistently, and only 35% used one in their last intercourse before incarceration. Predictors of condom use included carrying condoms and endorsing the statement "I would use condoms with my girlfriend." Many said their lives include other risks more important than AIDS, such as survival in the crime scene. Initial efforts at prevention based on commonly used approaches of providing information to guide future rational decisions generated limited participation. However, when we worked with them to develop interventions based on their interests and needs, using modalities such as music, hip-hop arts, graffiti, and helping them to create an AIDS prevention compact disk, they responded with enthusiasm. These incarcerated adolescents are at extremely high social risk and report high levels of risk behavior for HIV infection. Interventions for these youth were better received when developed in collaboration with them and based on their beliefs, aspirations, and culture. The intervention that resulted went beyond AIDS to include issues such as violence, drugs, sexuality and human rights.

Adolescent↗
PubMed2001

Developing regional workplace health and hazard surveillance in the Americas.

An objective of the Workers' Health Program at the Pan American Health Organization (PAHO) is to strengthen surveillance in workers' health in the Region of the Americas in order to implement prevention and control strategies. To date, four phases of projects have been organized to develop multinational workplace health and hazard surveillance in the Region. Phase 1 was a workshop held in 1999 in Washington, D.C., for the purpose of developing a methodology for identifying and prioritizing the top three occupational sentinel health events to be incorporated into the surveillance systems in the Region. Three surveillance protocols were developed, one each for fatal occupational injuries, pesticide poisoning, and low back pain, which were identified in the workshop as the most important occupational health problems. Phase 2 comprised projects to disseminate the findings and recommendations of the Washington Workshop, including publications, pilot projects, software development, electronic communication, and meetings. Phase 3 was a sub-regional meeting in 2000 in Rosario, Argentina, to follow up on the progress in carrying out the recommendations of the Washington workshop and to create a Virtual Regional Center for Latin America that could coordinate the efforts of member countries. Currently phase 4 includes a number of projects to achieve the objectives of this Center, such as pilot projects, capacity building, editing a compact disk, analyzing legal systems and intervention strategies, software training, and developing an internet course on surveillance. By documenting the joint efforts made to initiate and develop Regional multinational surveillance of occupational injuries and diseases in the Americas, this paper aims to provide experience and guidance for others wishing to initiate and develop regional multinational surveillance for other diseases or in other regions.

Accidents, Occupational↗
PubMedDate not supplied

Brazilian Portuguese speech material and its application in occupational audiology.

Brazilian Portuguese speech test material consisting of nine monosyllabic 25-word lists was developed and digitally recorded on one channel of a compact disk with a speech-weighted modulated broadband noise on the other channel. Speech recognition functions in quiet and in noise, with word and phoneme scores, were obtained, and normative speech recognition data were standardized by determination of the psychometric function in 21 normally-hearing volunteers in quiet, and in 30 normally-hearing subjects in noise. The homogeneity of the nine lists was investigated in phoneme recognition data with 30 normally-hearing subjects. Speech recognition functions in quiet and in noise, with word and phoneme scores, were obtained in 65 noise-exposed workers. These results were very close to normative data, when tested in quiet, but significantly worse when tested in noise. It is concluded that the speech test material can be useful for estimating the communication performance of noise-exposed workers.

Adolescent↗
PubMedDate not supplied

Research-oriented image registry for multimodal image integration.

To provide multimodal biomedical images automatically, we constructed the research-oriented image registry, Data Delivery System (DDS). DDS was constructed on the campus local area network. Machines which generate images (imagers: DSA, ultrasound, PET, MRI, SPECT and CT) were connected to the campus LAN. Once a patient is registered, all his images are automatically picked up by DDS as they are generated, transferred through the gateway server to the intermediate server, and copied into the directory of the user who registered the patient. DDS informs the user through e-mail that new data have been generated and transferred. Data format is automatically converted into one which is chosen by the user. Data inactive for a certain period in the intermediate server are automatically achieved into the final and permanent data server based on compact disk. As a soft link is automatically generated through this step, a user has access to all (old or new) image data of the patient of his interest. As DDS runs with minimal maintenance, cost and time for data transfer are significantly saved. By making the complex process of data transfer and conversion invisible, DDS has made it easy for naive-to-computer researchers to concentrate on their biomedical interest.

Computer Communication Networks↗
PubMedDate not supplied

A debunking of the myth of healthy Asian Americans and Pacific Islanders.

PURPOSE: To present evidence that the model of healthy Asian Americans and Pacific Islanders (AAPIs) stereotype is a myth. SEARCH METHOD: The authors retrieved literature from the National Library of Medicine's compact disk databases (Cancerlit, CINAHL, Health, and MEDLINE), and examined pertinent federal government publications supplemented by the authors' knowledge of other published materials. IMPORTANT FINDINGS: This review paper presents three reasons why AAPIs are underserved: (1) the population growth rate has been unusually rapid and recent; (2) data regarding the health status of AAPIs are inadequate; and (3) the myth that AAPIs are model minority populations in terms of their health status was promulgated. MAJOR CONCLUSIONS: The conclusions are as follows: (1) AAPIs are heterogenous with respect to demographic factors and health risk factors; (2) because the current databases on the health status of AAPIs include small sample sizes, both the quantity and quality of these data need to be improved with respect to appropriate gender and ethnic group representation; (3) Risk factor and mortality data for AAPIs suggest that the burden of certain preventable diseases, namely, tuberculosis, hepatitis-B, liver cancer, and lung cancer may be higher than those of any other racial and ethnic population. The model healthy AAPI stereotype is a myth.

Asia↗
PubMed1992

Instructing occupational therapy students in information retrieval.

The effectiveness of a brief program designed to teach occupational therapy students enrolled in a graduate research methods class to conduct searches of four electronic databases was investigated. Students in the experimental class read an instructional booklet and received approximately 1 hour of supervised practice time using compact disk--read-only memory (CD-ROM) equipment. Questionnaire data revealed that compared with the students in the control class, the students completing the training program reported being significantly more familiar with six of seven key concepts and indicated significantly higher levels of usage of the four databases studied in the program.

CD-ROM↗
PubMed2002

Musculoskeletal disorders and skin disease among workers in a Japanese CD manufacturing plant.

We investigated the prevalence of musculoskeletal disorders (MSD) and skin disease within a Japanese compact disk (CD) manufacturing plant. For this study, a stratified cross-section of workers completed self-reported questionnaires distributed over a 6-month time period. Low back pain (LBP) was the most commonly reported category (affecting 20.1%), followed by MSD of the shoulder (15.4%), neck (10.1%) and head (5.4%). Dermatitis was the most frequent skin disease (affecting 8.1%), followed by eczema (3.4%), acne (3.4%) and xerosis (2.7%). The odds of suffering neck MSD was 10.8 times higher among staff who sat in a chair all day (95% CI 1.8-112.8, P < 0.05). Standing all day was also a risk factor for this condition (OR 8.2, 95% CI 1.2-81.7, P < 0.05). Female gender increased the risk of shoulder MSD 4.3 fold (95% CI 1.4-13.7, P < 0.05), as did alcohol consumption (OR 3.3, 95% CI 1.1-11.9, P < 0.05). The odds of suffering any skin disease were significantly enhanced by working longer than 12 months in one's current job (OR 10.7, 95% CI 1.5-7.3, P < 0.05) and having a history of atopic disease (OR 7.2, 95% CI 2.6-21.4, P < 0.001). Overall, the staff within our study reported generally lower levels of MSD and skin disease than in previous investigations of other workplaces.

Adult↗
PubMed1999

Environmental air sampling to detect biological warfare agents.

The rapid and unequivocal detection and identification of biological warfare agents is a major goal of military and civilian defense authorities. To identify agents of concern in an environmental sample, a reliable, region-specific characterization of the microorganisms found naturally at the sampling location is required. We have analyzed environmental air samples from Korea, Kuwait, and Bahrain by polymerase chain reaction and temporal temperature gradient electrophoresis and have produced genetic fingerprints of the natural microbial flora in these regions. Results are displayed as specific bar code patterns against which the unique patterns of potential biological warfare agents appearing in a sample can be quickly discriminated. Data are stored on compact disk, along with other laboratory analyses and relevant meteorological data, and are available to appropriate authorities and researchers.

Air Microbiology↗
PubMed2001

Virtual healthcare delivery: defined, modeled, and predictive barriers to implementation identified.

Provider organizations lack: 1. a definition of "virtual" healthcare delivery relative to the products, services, and processes offered by dot.coms, web-compact disk healthcare content providers, telemedicine, and telecommunications companies, and 2. a model for integrating real and virtual healthcare delivery. This paper defines virtual healthcare delivery as asynchronous, outsourced, and anonymous, then proposes a 2x2 Real-Virtual Healthcare Delivery model focused on real and virtual patients and real and virtual provider organizations. Using this model, provider organizations can systematically deconstruct healthcare delivery in the real world and reconstruct appropriate pieces in the virtual world. Observed barriers to virtual healthcare delivery are: resistance to telecommunication integrated delivery networks and outsourcing; confusion over virtual infrastructure requirements for telemedicine and full-service web portals, and the impact of integrated delivery networks and outsourcing on extant cultural norms and revenue generating practices. To remain competitive provider organizations must integrate real and virtual healthcare delivery.

Delivery of Health Care↗
PubMed2000

[Computer-aided compose panoramic arthroscopic images of the temporomandibular joint].

OBJECTIVE: The computer-aided image processing method is established to compose arthroscopic images of temporomandibular joints(TMJs). METHODS: Arthroscopic images were input directly into a personal computer and recorded at a compact disk. By using the software- Photoshop 5.0 for Window 95, the images were edited and adjusted to form sagittal and/or coronal panoramic images of articular surfaces. RESULTS: The normal sagittal and coronal two-dimensional integrated panoramic arthroscopic images of TMJ were obtained, and qualities of these images were satisfied. CONCLUSION: The arthroscopic panoramic images established by using this method can demonstrate integrated structures of articular surfaces directly.

Arthroscopy↗
PubMed1991

Computer applications in diagnostic imaging.

This article has introduced the nature, generation, use, and future of digital imaging. As digital technology has transformed other aspects of our lives--has the reader tried to buy a conventional record album recently? almost all music store stock is now compact disks--it is sure to continue to transform medicine as well. Whether that transformation will be to our liking as physicians or a source of frustration and disappointment is dependent on understanding the issues involved.

Diagnostic Imaging↗
PubMed1990

Improving access to computer-based library and drug information services in patient-care areas.

A project to increase access to drug and biomedical information through electronic linkage of drug information and library services to three patient-care areas is described. In February 1987, microcomputer work stations were installed in the Bexar County Hospital District's hospital emergency department, medical residents' office, and ambulatory-care clinic, as well as in The University of Texas Health Science Center's library reference area and drug information service office. Drug information was available on compact disk through the Micromedex Computerized Clinical Information System (CCIS) database, which includes DRUGDEX, POISINDEX, EMERGINDEX, and IDENTIDEX. Each work station was also connected to the library's computer via modem, allowing access to the Library Information System, books, journals, audiovisual materials, miniMEDLINE, and an electronic mail system. During the six-month project, the system was used 5487 times by 702 people. The system was successful in providing drug and other information in clinical settings and in introducing clinical staff members to new information technology. To increase access to the system after the project ended, the CD-ROM version was discontinued, and the distributed tape version of CCIS for VAX computers was added to the library's online information system, making drug information more available throughout the campus and teaching hospitals. In 1988-89 an average of 200 people accessed the tape version of CCIS each month. Although it is difficult to replace the convenience of an onsite library, at least some drug and biomedical information needs in the clinical setting can be met through computer networking.

Computer Communication Networks↗
PubMed1993

CD-ROM: a primer for physicians.

Compact disks with read-only memory (CD-ROM) are a powerful storage medium and are rapidly becoming standard equipment on personal computers. Each disk has the capacity to store 680 million bytes (megabytes or MB) of text, graphics, photographic images, audio, animation, and full-motion video. Many medical reference texts are currently available in CD-ROM format, with the advantage of improved search, retrieval, cross-referencing, and printing capabilities.

CD-ROM↗
PubMedDate not supplied

[Soft-drinks and health].

OBJECTIVE: To analyze published papers about soft drinks use, and to describe possible health benefits, risks, and damages related to soft drink consumption. INFORMATION SOURCE: A search was done in the MEDLINE compact disks, from January 1970 to January 1997, with the keywords soft drink, beverages, carbonated beverages, cola, Coca-Cola and sweetening-agents. STUDY SELECTION: Ninety nine papers reporting health-related damages or benefits in clinical or experimental studies were reviewed. DATA EXTRACTION: All articles with a clear description of at least one beneficial or harmful effect related to soft drink consumption were considered. RESULTS: There were reports on 25 harmful effects and of 7 possibly beneficial effects. Data are classified in prophylactic and therapeutic uses, dental caries and other dental disorders, mineral metabolism disorders, acid-peptic disease, neoplasm, risk factors for cardiovascular disease, effects on central nervous system, reproduction, allergy, and miscellaneous. CONCLUSIONS: High prevalence of exposure and excessive consumption of soft drinks may represent a public health problem in Mexico. Data analysis shows that soft drink consumption may not be as harmless as generally believed. Many of the reports are anecdotal, without a suitable methodological design. A wide field for research is present in this area.

Caffeine↗