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PubMed2006

A model driven approach for the German health telematics architectural framework and security infrastructure.

Shared care concepts such as managed care and continuity of care are based on extended communication and cooperation between different health professionals or between them and the patient respectively. Health information systems and their components, which are very different in their structure, behavior, data and their semantics as well as regarding implementation details used in different environments for different purposes, have to provide intelligent interoperability. Therefore, flexibility, portability, and future orientation must be guaranteed using the newest development of model driven architecture. The ongoing work for the German health telematics platform based on an architectural framework and a security infrastructure is described in some detail. This concept of future proof health information networks with virtual electronic health records as core application starts with multifunctional electronic health cards. It fits into developments currently performed by many other developed countries.

Computer Security↗

PubMedDate not supplied

Information technology and public health management of disasters--a model for South Asian countries.

This paper highlights the use of information technology (IT) in disaster management and public health management of disasters. Effective health response to disasters will depend on three important lines of action: (1) disaster preparedness; (2) emergency relief; and (3) management of disasters. This is facilitated by the presence of modern communication and space technology, especially the Internet and remote sensing satellites. This has made the use of databases, knowledge bases, geographic information systems (GIS), management information systems (MIS), information transfer, and online connectivity possible in the area of disaster management and medicine. This paper suggests a conceptual model called, "The Model for Public Health Management of Disasters for South Asia". This Model visualizes the use of IT in the public health management of disasters by setting up the Health and Disaster Information Network and Internet Community Centers, which will facilitate cooperation among all those in the areas of disaster management and emergency medicine. The suggested infrastructure would benefit the governments, non-government organizations, and institutions working in the areas of disaster and emergency medicine, professionals, the community, and all others associated with disaster management and emergency medicine. The creation of such an infrastructure will enable the rapid transfer of information, data, knowledge, and online connectivity from top officials to the grassroots organizations, and also among these countries regionally. This Model may be debated, modified, and tested further in the field to suit the national and local conditions. It is hoped that this exercise will result in a viable and practical model for use in public health management of disasters by South Asian countries.

Artificial Intelligence↗

PubMed2002

Multichannel digital transmission in an optical network of communicating molecules.

In present telecommunication networks, information transfer relies on the interplay of optical and electrical signals. Data are communicated optically but processed electronically. Methods to maintain the propagating signals solely at the optical level must be developed to overcome the transmission capacities and speed limits imposed by the electronic components. We have demonstrated that molecular switches can be used to gate optical signals in response to optical signals. We have realized a simple optical network consisting of three light sources, one cell containing a solution of three fluorescent molecules, one cell containing a solution of a three-state molecular switch and a detector. The light emitted by the three fluorophores is absorbed by the three states of the molecular switch. Using this simple operating principle, we have shown that multichannel digital transmission can be implemented on an ensemble of communicating molecules relying exclusively on the interplay of optical inputs and optical outputs.

Journal Article↗

PubMed2003

A dynamic Web application within an n-tier architecture: a Multi-Source Information System for end-stage renal disease.

A Multi-Source Information System (MSIS) has been designed for the Renal Epidemiology and Information Network (REIN) dedicated to End-Stage Renal Disease. Interoperability has been considered at 4 levels: semantics, network, formats and contents. An n-tier architecture has been chosen at the network level. It is made out of a universal client, a dynamic Web server connected to a production database and to a data warehouse. The MSIS is patient-oriented, based on a regional organization. Its implementation in the context of a regional experimentation is presented with insights on the design and underlying technologies. The n-tier architecture is a robust model and flexible enough to aggregate multiple information sources and integrate modular developments. The data warehouse is dedicated to support health care decision-making.

Data Display↗

PubMed1999

Networking for career planning.

Formal networking approaches should be prepared for meticulously. If you waste your contact's time waffling around a subject, you may find that the person is not so willing to talk with you another time. Have your questions ready, be as specific as you can, and be businesslike. And remember, no one can wave a magic wand and have a solution to all your queries. You should not expect anything from informal networking situations--if you do, you will give out unconscious signals that might put people off. Just enjoy yourself, meet new people, share ideas and thoughts, and maybe you will be able to help them or they will be able to help you in the future. Your career is in your own hands--but others are often willing to lend a hand.

Career Mobility↗

PubMed2001

Putting the pieces together: using "off-the-shelf" software to safely transfer medical data.

We describe a new computer-based, network-driven system for administering, transferring, and evaluating reports of spontaneous adverse drug reactions and serious adverse events. The system consists of three regional centers, one coordinating center, and a central database at the national drug regulatory authority. In view of its high level of data security, reliability, easy expandability, and inexpensiveness due to the use of standard shareware products, the system can serve as a model for a clinical health information network.

Adverse Drug Reaction Reporting Systems↗

PubMed2004

Does computation provide a model for creativity? An epistemological perspective in neuroscience.

In 1939 Alan Turing, a major scholar in the field of mechanical computation, described a system whose computational power was beyond that of a discrete, finite state machine (Turing Machine). The composition of this system was likely the first example of what is now called an hybrid computational system. Since then, development of neural networks and brain automata has made aware that forms of computation might exist that are likely to go beyond Turing's limits. Natural systems, like the central nervous system in Mammals and man, are likely to use such a type of computation, especially to perform highly integrating activities, like feedback controls and mental creative processes. The latter are usually understood as processes that involve infinitary procedures, ending up in a complex information network, the computational maps, in which both digital, Turing-like computation and continuous, analog forms of calculus are expected to occur. Pictorial representation may be a fruitful example, mostly metaphorical, to analyze the use of this hybrid forms of computation by higher order computational maps, and the possible role of these types of computational processes in painting creativity is briefly analyzed in comparing 15th vs 16th century Renaissance Art. An open challenge for neuroscience in the 21st century is to clarify whether a hybrid neural learning network might represent a reasonable clue to scientifically interpret the theme of "creativity".

Art↗

PubMed1996

Connectionist modeling of the recovery of language functions following brain damage.

This paper reviews the contribution of connectionism to our understanding of behavioral changes in language functions after brain damage. Connectionism is founded upon a neural metaphor in that connectionist networks are made up of many simple, neuron-like units. It is possible to lesion these networks and explore the effects of that damage. It is widely held that damaging connectionist networks informs our understanding of neuropsychology and cognitive psychology. To what extent then does it currently tell us, or is likely to tell us, anything about behavioral change following brain damage? Current connectionist models simulate either spontaneous recovery or the effects of retraining, and I discuss both approaches. Which is taken at present partly depends upon the connectionist framework used as the starting point. Most simulation work involving back-propagation has focused upon retraining lesioned networks, while work involving interactive activation has focused upon making inferences about the time course of spontaneous recovery. I discuss research in modeling deep dyslexia, aphasia, and dementia. I argue that further research on modeling spontaneous recovery is limited by the fixed architecture of most current connectionist networks.

Brain Damage, Chronic↗

PubMed2002

[Biovigilance, a vigilance exercised on the utilization of products obtained from the human body].

Organ transplantations and tissue/cells grafts are efficacious in many diseases. Nevertheless, beside the risk due to the technology which permits to carry out transplantations and grafts (surgery, tissue and cells collection, preservation, storage, cell expansion technics, immunosuppressive regimen,...), the microbiology risk must be controlled throughout the process leading to the transplantation or the graft. The structures, the organizations, the procedures, the information network and the controls assure the control of the risk. It is the main objective of human product vigilance. Future regulations will define the objectives of this sanitary vigilance more precisely.

Algorithms↗

PubMed2000

Results of a gender-climate and work-environment survey at a midwestern academic health center.

UNLABELLED: AND CLIMATE determine how faculty's perceptions of medical school gender climate differ by gender, track, rank, and departmental affiliation. METHOD: In 1997, a 115-item questionnaire was sent to all University of Wisconsin Medical School faculty to assess their perceptions of mentoring, networking, professional environment, obstacles to a successful academic career, and reasons for considering leaving academic medicine. Using Fisher's exact two-tailed test, the authors assessed gender differences both overall and by track, rank, and departmental cluster. RESULTS: Of the 836 faculty on tenure, clinician-educator, and clinical tracks, 507 (61%) responded. Although equal proportions of men and women had mentors, 24% of the women (compared with 6% of men; p < .001) felt that informal networking excluded faculty based on gender. Women's and men's perceptions differed significantly (p < .001) on 12 of 16 professional environment items (p < .05 on two of these items) and on five of six items regarding obstacles to academic success. While similar percentages of women and men indicated having seriously considered leaving academic medicine, their reasons differed: women cited work-family conflicts (51%), while men cited uncompetitive salaries (59%). These gender differences generally persisted across tracks, ranks, and departmental clusters. The greatest gender differences occurred among clinician-educators, associate professors, and primary care faculty. CONCLUSIONS: Women faculty perceived that gender climate created specific, serious obstacles to their professional development. Many of those obstacles (e.g., inconvenient meeting times and lack of child care) are remediable. These data suggest that medical schools can improve the climate and retain and promote women by more inclusive networking, attention to meeting times and child care, and improved professional interactions between men and women faculty.

Career Mobility↗

PubMed1996

Strategy for D-Country Ear Care.

The last decade's voluntary Global Ear Care work-lobbying and networking, using different strategies-in the whole has been positive, reflected by the creation of an appropriate instrument to launch concrete programmes and has also given good WHO-HQ relations, though without budget and adequate governmental involvement. The long-term goal is to get D-country Ear Care up to the same level as D-country eye care. One important step on this way-hopefully facilitated by the Bari workshop as an example of 'informal' networking and linkage of people after personal initiatives-is to develop an Ear Care structure in Eastern Europe and the Mediterranean countries functioning as successfully asd the one in Asia.

Audiology↗

PubMed1996

Measures implemented to project personal privacy for an on-line national patient index: a case study.

Increasing use of electronic data storage and exchange is inevitable. Although of considerable benefit to all concerned, they pose a potential threat to personal privacy. Measures to protect personal privacy in national information networks are essential. These and related security issues require the highest priority in strategic planning because experience shows that poor handling of security is the single factor most likely to lead to rejection of a system. It is increasingly important to be able to identify individuals uniquely for health-related purposes, and implementation of an on-line master index is the approach that has been adopted in New Zealand to address this need. Such an index, however, contains personal information, the privacy of which must be respected. Substituting the unique identifier for all personal details in electronic messages can provide a degree of security as long as access to the index is controlled and usage is monitored. The article outlines the measures, technical and otherwise, implemented to manage security concerns successfully in that context.

Computer Security↗

PubMed1998

Program for surveillance of causes of death of dogs, using the Internet to survey small animal veterinarians.

OBJECTIVE: To develop a prototype program for surveillance of causes of death of dogs, using resources developed for the World Wide Web, to enable collection of data from veterinarians in small animal practice and dissemination of results in a timely manner at minimal expense. DESIGN: Epidemiologic survey. SAMPLE POPULATION: Small animal veterinarians who were members of NOAH, Veterinary Information Network (VIN), or VetPlus-L. PROCEDURE: Internet electronic communications and Web pages were used for solicitation and collection of data, dissemination of results, and follow-up discussions with participants. Data were stored in a relational database. RESULTS: 25 veterinarians actively submitted case material. On the basis of analysis by region and school of veterinary medicine attended, these veterinarians were representative of all small animal practitioners in the United States. During the 6-month study, 621 case reports were submitted. Analysis of results included determination of number of dogs, with proportions calculated for primary reason for death, primary clinical sign, and breed, as well as creation of a map depicting distribution of the practitioners. Additional data were obtained for analysis to provide information of interest. CLINICAL IMPLICATIONS: A national database representative of dogs examined by small animal practitioners would be a valuable source of information. Rapidly and easily accessible return of information and results is important for any surveillance system. The program described here appears to be a successful method for collecting data from practitioners.

Age Distribution↗

PubMed1981

The cooperative information project: Part 2: some initial clinical, quality assurance, and practice management studies.

Many of the obstacles inherent in the conduct of primary care research have been overcome by an experimental program in northern New England, the Primary Care Cooperative Information Project. This project uses a medical information network in 44 rural medical practices to carry out both clinical and management research. This paper describes the developmental problems encountered and the results of some initial clinical, quality assurance, and practice management studies conducted by the network and presents observations on its future research directions.

Adolescent↗

PubMed2004

Does a population survey provide reliable influenza vaccine uptake rates among high-risk groups? A case-study of The Netherlands.

All European countries have recommendations for influenza vaccination among the elderly and chronically ill. However, only a few countries are able to provide data on influenza uptake among these groups. The aim of our study is to investigate whether a population survey is an effective method of obtaining vaccination uptake rates in the different risk groups and to find out what reasons people give as to why they have accepted or refused influenza vaccination and whether this varies among the risk groups. A mail questionnaire was sent out to households in The Netherlands, the response rate was 73%. This resulted in data for 4037 individuals on influenza and influenza vaccination during the 2001-2002 influenza season. The uptake rates and size of different risk groups from the panel survey were comparable with other national representative sources (from the National Information Network of GPs (LINH) and Statistics Netherlands (CBS)). The main reason cited for undergoing vaccination was the existence of a chronic condition. The main reasons for refraining from vaccination were having enough resistance to flu and ignorance about the recommendations. In The Netherlands, the GP is the main administrator of influenza vaccines. We believe that population surveys may be useful for revealing influenza vaccination uptake rates for the groups at risk. When combined with questions about reasons for undergoing vaccination, the results may provide useful policy information and can be used to direct vaccination campaigns at under-vaccinated risk groups or to target the information campaign more effectively.

Adolescent↗

PubMed2003

Biomedical informatics: precious scientific resource and public policy dilemma.

Biomedical informatics includes the application of computers, information networks and systems, and a growing body of scientific understanding to a range of problems. As skill in this field increases and as progress in virtually all modern biomedical science becomes more data intensive, informatics becomes a precious resource. Applications areas include access to knowledge, discovery in genomics, medical records, mathematical modeling, and bioengineering. At the same time, progress in informatics is deeply dependent on resolution of four major public policy issues: digital intellectual property rights, genetic testing protection, medical data privacy, and the role of biomedical data in the context of information warfare and homeland security.

Anatomy, Cross-Sectional↗

PubMed1999

Regional reporting of adverse drug reactions: a new computer-based network.

The use of drugs is always accompanied by the risk of adverse drug reactions (ADRs) and adverse events (AE). Generally physicians, pharmaceutical manufacturers, and pharmacists use a paper-based form for sending spontaneous ADR and AE reports to the national drug regulatory authority. Besides underreporting, reporting lag-time and errors through data transformation are a major issue. In order to improve the current reporting situation we have set up a new computer-based, network-driven system for storing, transferring, and evaluating ADR reports. The system consists of three regional centres, one coordinating centre, and the central ADR database of the national drug regulatory authority. In the regional centres, clinical pharmacologists collect ADR data in local databases. There is a comfortable user-interface with an online help-function available. New reports are sent automatically to the Federal Agency using EUROSCAPE as a standardized electronic report form of the EU. The coordinating centre in Munich is responsible for overall performance and quality assurance. This model for a clinical health information network is of a high level of data security, is reliable and easily expandable through the use of standard tools, is fast and also inexpensive by using standard shareware products.

Journal Article↗

PubMed1995

Unconventional conceptions and HIV.

The condom is widely recommended as the principal method for preventing HIV transmission, but such advice obviously does not apply to women who are seeking to become pregnant. In this sense, 'safer sex' is incompatible with reproduction. Existing research into HIV transmission has examined the choices made by those wishing to conceive within a sexual relationship; such research shows that HIV is not a highly significant factor in their decision-making processes. This study aims to extend the debate by exploring the decision-making processes of women seeking to become pregnant with donated sperm. In particular, we focus on women outside the fertility clinic system who do not have access to sperm screened for HIV to see whether HIV is a significant factor in these women's decisions. The study involved in-depth interviews with 20 women (14 lesbians, one bisexual and five heterosexuals) recruited through informal networking and snowball sampling. HIV was a salient concern for our sample, largely because of their contacts with gay men, but nonetheless most of these women took some risks. On the one hand, the conscious deliberations necessary to conceive through self-insemination facilitated risk reduction, as did factors such as 'stranger-danger'. On the other hand, factors such as the scarcity of suitable sperm donors and the women's own feelings of gratitude and loyalty to their donors mitigated against their requesting that their donor take an HIV test. This study highlights the need to provide information for women seeking self-insemination, and to remove restrictions on access to fertility clinics, in order to reduce their risk of HIV infection and subsequent vertical transmission.

AIDS Serodiagnosis↗