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PubMed1979

The implementation of a large-scale self-instructional course in medical information resources.

The implementation of library orientation and bibliographic instruction in health sciences centers presents some interesting as well as perplexing problems. The Rowland Medical Library at The University of Mississippi Medical Center had to confront and reexamine these problems when faced with the requirement to teach 298 freshman and sophomore medical students in one ten-week quarter. This paper outlines the development and implementation of a large-scale self-instructional approach to library instruction. The package consisted of an audiotape, a videotape, a written program, self-teaching quizzes, a performance test, and a student evaluation. Performance test results and student evaluation data are presented which indicate that this format can successfully be employed to meet course objectives and to be accepted by students.

Audiovisual Aids↗
PubMed1989

A parallel implementation of the ALOPEX process.

Optimization techniques have found many applications in science, engineering, and industry. In all applications, the best value of a "cost function" is sought in a well-defined domain; this cost function in general depends on many parameters. An iterative optimization technique has been developed (ALOPEX) that uses feedback in order to optimize the response of a system. The cost function for this process is problem dependent and therefore quite flexible. The method has been applied successfully to different optimization problems such as pattern recognition, receptive field studies in the visual system of animals, curve fitting, etc. We present two special purpose hardware implementations for ALOPEX. The first method takes time O(logN + logm) and uses O(mN2) processing elements. The second method takes O(logN + m) time and uses O(N2) processing elements. Our basic architecture is a binary tree with N2 leaves (equal to the length of the vectors) and therefore had depth O(logN). Different implications of the two approaches will be discussed including similarities with the biological visual process.

Algorithms↗
PubMed1991

The impact of economic issues on Nigerian health sciences libraries.

Economic issues are among the most important factors affecting health sciences libraries in Nigeria. These issues are influenced by the political, cultural, geographic, and demographic characteristics of the country. Significant economic issues are the dependence of the national economy on a single commodity, large foreign debt and spiraling inflation, stringent foreign exchange control measures, and inadequate realization by authorities of the role and importance of health sciences libraries. With shrinking budgets, resources, and staff, health sciences libraries can neither grow nor afford library automation. Health sciences librarians must take initiatives for cooperative activities to increase and make the most of resources, pursue nontraditional methods of fund-raising, educate authorities about the role and importance of libraries, and develop and implement a plan for the development and growth of health sciences libraries in the country.

Financing, Government↗
PubMed1989

The science of public health surveillance.

Improved public health surveillance can lead to earlier implementation of prevention and control measures. Better surveillance data lead to a more rational establishment of priorities. More timely and accurate data facilitate earlier epidemic detection and control. With better surveillance data, the impact of intervention activities and other public health programs can be evaluated more accurately. In this paper we describe how to improve the science of surveillance in terms of data collection, analysis, and dissemination and its application to public health practice. We then discuss the potential benefits and costs of such efforts and suggest methods for evaluating alternative approaches. The argument for science in surveillance, on the other hand, may be subject to excess. Surveillance is not an end unto itself, but rather a tool. This tool should be refined and modified to adapt to the goals of a particular public health program. It is the development of methods to apply creative ideas to surveillance, and the rigorous assessment of the process, that will benefit from the application of scientific principles.

Data Interpretation, Statistical↗
PubMed1983

Clinical instruction in medicine: a national survey.

In this paper the authors report on the medicine phase of three parallel studies undertaken to investigate clinical teaching skills in medicine, dentistry, and nursing. The intent of the overall study was to gather and assess broad-based information useful in the design and implementation of clinical teaching improvement programs in the health sciences. A 14-member consortium representing five schools each in medicine and dentistry and four in nursing collaborated by using a modified Delphi technique to resolve conflict and differences, through group judgments, in preferences to choices among educational goals and activities. Based upon an educational needs assessment, the design of the study and of the research methodology allows replication at individual institutions and provides a systematic approach for designing and implementing faculty development programs with specific skill emphasis at the clinical level.

Clinical Competence↗
PubMed1994

Applications of medical informatics in antibiotic therapy.

The Infectious Disease Society of America is concerned about the excessive and inappropriate use of antibiotics in U.S. hospitals. Applications of Medical Informatics can help improve the use of antibiotics and help improve patient care by monitoring and managing enormous amounts of patient information. Monitoring the duration of every antibiotic ordered in the hospital or keeping tract of the antibiotic susceptibilities for five years are examples of tasks better performed by computers. The impact of computers in medicine is seen by some as disappointing. The computer revolution has not had the impact in medicine experienced by other areas. The acceptance and use of computers by medicine will be evolutionary rather than revolutionary. In 1979, the MYCIN project demonstrated that the computer could aid physicians in the selection of antibiotics. However, MYCIN was never clinically used because physicians were require to enter all patient information into the computer. The development of computerized medical records is an essential step to further the development and implementation of computer-aided decision support. The science of Medical Informatics is still relatively new but is emerging as a distinct academic field. A few hospitals are now installing information systems and have determined that these systems will play an essential role in their ability to survive into the next century. The telephone and the automobile have been recognized as two of the most important tools for improving medical care during the past 100 years. People could more readily get medical care and the time to transmit medical information was greatly reduced through physician use of the telephone and automobile. The computer is a tool that can be used to help physicians manage the great amount of medical information being generated every day. The computer can also alert the physician of patient conditions that need attention. However, it is the physician who must use and apply the computer provided information. Thus, the computer will assist but not replace physicians in providing medical care.

Anti-Bacterial Agents↗
PubMed1986

Preliminary experiment with computerized anamnesis in gynecology and reproductive health.

The Hospital of the Faculty of Medical Sciences of the State University of Campinas is implementing an Integrated Health Care Programme, whose objectives are early detection of risk factors of several diseases and the evaluation of the patient's reproductive health at the moment of the first visit to the Hospital. The initial results of this program encouraged us to try to apply it all to our own clientele. The present lack of material resources and qualified manpower leads us to concentrate all our attention on the patient's immediate complaints. This situation indicated to us that the only way to implement the program should be by means of a computerized questionnaire able to detect diseases and risk factors early. This paper presents the preliminary results of the application of computerized questionnaires to evaluate health risks. The authors conclude: The application of a computerized questionnaire met with very favorable reception by the clientele; In some segments of the population, the questionnaire can be answered by the patients in direct interaction with the computer; Programmes which evaluate risk factors need to be carefully revised before being put to use; The system operates on a relatively low cost basis, which could bring undeniable benefits to primary health care.

Computers↗
PubMed1986

Establishment of medical surveillance in industry: problems and procedures.

The establishment of standard history-taking will be discussed and will include examples of such histories developed in the clinic. The development of a protocol for performing and recording physical examinations will also be described. Special tests, such as pulmonary function and sputum cytology, will then be discussed. The integration of medical data into a data base will also be discussed with examples taken from the program in Pittsburgh. Presentation of the problems of obtaining adequate early medical information leads to the conclusion that medical surveillance programs must be integrated with industrial hygiene surveillance. The use of exposure measures to make and implement preventive medical decisions is essential until medical science provides tests with enhanced sensitivity and specificity for use in early detection of workplace disease.

Clinical Laboratory Techniques↗
PubMed1995

Recent advances in pediatric HIV.

Pediatric human immunodeficiency virus (HIV) infection is a disease of mother-to-infant transmission. The World Health Organization estimates there will be ten million HIV-infected children by the end of this century. It is now thought that both intrauterine and intrapartum transmission of HIV occurs. Infants infected in utero develop clinical signs and symptoms at an earlier age than those who are infected at the time of delivery. We describe two cases that demonstrate early-onset and late-onset pediatric HIV disease, respectively. Recently, it was determined that perinatal transmission of HIV can be significantly reduced by the administration of the antiretroviral drug, zidovudine (ZDV), to HIV-positive pregnant women and their newborns, making HIV screening of pregnant women more desirable than ever. A program of universal voluntary HIV testing for pregnant women has been successfully implemented at the University of Arkansas for Medical Sciences. Details of this program are described herein.

Fatal Outcome↗
PubMed1994

[Assessment of the community health nursing curriculum in relation to the modified Stake curriculum evaluation model].

The modified Stake curriculum evaluation model was implemented in practice to evaluate the Community Nursing Science curricula of three Nursing Colleges and the method used is outlined. Some of the results obtained regarding the model's description matrix are: . students are not familiar with the philosophy of Community Nursing Science; . students doubt their readiness for clinical work directly after training; . only one of the tutors in Community Nursing Science had applicable clinical experience in community nursing; . satisfaction regarding the content and evaluation of Community Nursing Science exists amongst students. The purpose of the evaluation was to identify shortcomings in the curricula and and to facilitate curriculum improvement.

Clinical Competence↗
PubMed1991

Developing a quality assurance program for online services.

A quality assurance (QA) program provides not only a mechanism for establishing training and competency standards, but also a method for continuously monitoring current service practices to correct shortcomings. The typical QA cycle includes these basic steps: select subject for review, establish measurable standards, evaluate existing services using the standards, identify problems, implement solutions, and reevaluate services. The Claude Moore Health Sciences Library (CMHSL) developed a quality assurance program for online services designed to evaluate services against specific criteria identified by research studies as being important to customer satisfaction. These criteria include reliability, responsiveness, approachability, communication, and physical factors. The application of these criteria to the library's existing online services in the quality review process is discussed with specific examples of the problems identified in each service area, as well as the solutions implemented to correct deficiencies. The application of the QA cycle to an online services program serves as a model of possible interventions. The use of QA principles to enhance online service quality can be extended to other library service areas.

Computer Systems↗
PubMed1992

Medical school libraries' handling of articles that report invalid science.

In 1989-90 the authors conducted a nationwide study to examine how academic medical libraries handled articles that report invalid science and to determine the effectiveness of any policies implemented to limit the use of such articles. Ninety-five of the 127 medical school libraries the authors surveyed completed questionnaires analyzing policy and attitude issues. Eighty-four of these libraries manually reviewed the available copies they held of ten retracted articles. Of the 811 copies of the retracted, invalid articles reviewed, 742 (91.5%) were not tagged as being invalid. Seventy-nine percent of the libraries had tagged none of the retracted studies and only 16% had policies for managing articles that report invalid science. Academic librarians reflected a common attitude against perceived library censorship and emphasized the user's role in assuring validity. The nation's medical libraries, at least in part by intent, do not commonly identify or have policies to handle the invalid articles they hold. The authors conclude that biomedical researchers, clinicians, and teachers should not assume published studies held in libraries are inherently valid. The lack of stated policy and the disparate assumptions about the role libraries play in this area may perpetuate the use of invalid articles.

Data Collection↗
PubMed1994

Behavioral science in translational research and cancer control.

Behavioral science plays an integral, essential role in cancer control. This review examines that role in two broad areas: (1) in the development and implementation of cancer control technologies, and (2) in the emerging focus on the process of translating cancer research into clinical practice. In developing and implementing cancer control technologies, what we know of human processes as a result of behavioral science is identified as the common link in all stages of the cancer process (prevention, detection, treatment, rehabilitation, terminal care). The value of behavioral science is shown in conservative projections (incorporating likely rates of patient noncooperation) of the health benefits obtainable by the year 2000 if effective behavioral strategies in three key areas were broadly implemented. Smoking prevention and cessation programs could lead to 7.2 million fewer smokers; application of cancer screening programs might result in 45,000 additional 5-year cancer survivors each year; and behavioral programs could lead to improved quality of life in 150,000 patients per year who experience treatment side effects despite the use of antiemetics. Behavioral science also is shown to contribute to translational science by providing a pragmatic conceptual model for clinical practice and facilitating collaborative research between basic scientists and clinical researchers. As an example of behavioral science's contribution to translational research, behavioral issues in genetic screening for cancer risk are outlined based on the experience of several families with the BRCA1 genetic marker and patients with Huntington's disease.

Behavioral Sciences↗
PubMed1987

A computerized information management system for educational programs in the health sciences.

The Physician Assistant Program at the University of Florida has developed and implemented a computerized information management system that eliminates time-consuming duplication of effort in record-keeping and covers all functional components of the educational program. Data-base files for admissions, curriculum and/or evaluation design, student records, graduate follow-up, and research activities and a master file for administrative activities permit rapid accessing and transfer of information across files, continual updating of information, and efficient generating of records and reports pertaining to all program functions. Research about the program is enhanced through the correlation of data available in the five data-base files. This comprehensive system facilitates the audit of the program's educational process and the evaluation of its accomplishment of its stated objectives. The system can be easily adapted for use by other educational programs in medicine and the allied health sciences.

Allied Health Personnel↗
PubMed2026

Current knowledge in pharmacogenomics and precision medicine: perspectives of the PGRN global PGx committee on improving drug therapies in underrepresented ethnic populations.

A precision medicine strategy is likely to be more impactful, when pharmacogenomics (PGx) guided selection of drugs and dosage wherever applicable is implemented across the globe. In regions where resources are disproportionately distributed, PGx implementation in routine clinical care can play a critical role in ensuring the optimal use of limited healthcare infrastructure. At present, PGx data from the majority of the distinct ethnic populations across Asia, Africa, and South America is limited. While international consortia, working groups, and scientific bodies have made significant contributions toward evaluating the evidence for PGx implementation, the majority of existing guidelines and recommendations are derived primarily from studies conducted in a limited number of ethnic groups. Precision Medicine Initiatives in countries like Korea, Taiwan, and Malaysia and PGx organizations like the African Institute of Biomedical Science and Technology (AiBST), Consortium for Genomics & Therapeutics in Africa (CGTA), implementation of pharmacogenetic testing for the effective care and treatment in Africa, Greater Middle East (GME) whole exome sequencing program, Ibero-American Network of Pharmacogenetics and Pharmacogenomics (RIBEF), Latin American Society of Pharmacogenomics and Personalized Medicine (SOLFAGEM), Latin American Network for Validation and Implementation of Pharmacogenomic Clinical Guidelines (RELIVAF), IndiGen initiative, Southeast Asian Pharmacogenomics Research Network (SEAPharm), are working toward consolidating the PGx presence in these regions.

Precision Medicine↗
PubMed2026

PanForest: predicting genes in genomes using random forests.

MOTIVATION: The presence or absence of some genes in a genome can influence whether other genes are likely to be present or absent. Understanding these gene co-occurrence and avoidance patterns reveals fundamental principles of genome organization, with applications ranging from evolutionary reconstruction to rational design of synthetic genomes. RESULTS: PanForest, presented here, uses random forest classifiers to predict the presence and absence of genes in genomes from the set of other genes present. Performance statistics output by PanForest reveal how predictable each gene's presence or absence is, based on the presence or absence of other genes in the genome. Further, PanForest produces statistics indicating the importance of each gene in predicting the presence or absence of each other gene. The PanForest software can run serially or in parallel, thereby facilitating the analysis of pangenomes at Network of Life scale.A pangenome of 12 741 accessory genes in 1000 Escherichia coli genomes was analysed in around 5 h using eight processors. To demonstrate PanForest's utility, we present a case study and show that certain genes associated with resistance to antimicrobial drugs reliably predict the presence or absence of other genes associated with resistance to the same drug. Further, we highlight several associations between those genes and others not known to be associated with antimicrobial resistance (AMR), or associated with resistance to other drugs. We envisage PanForest's use in studies from multiple disciplines concerning the dynamics of gene distributions in pangenomes ranging from biomedical science and synthetic biology to molecular ecology. AVAILABILITY AND IMPLEMENTATION: The software if freely available with a full manual and can be found with at www.github.com/alanbeavan/PanForest DOI: https://doi.org/10.5281/zenodo.17865482.

Software↗
PubMed1982

Development of on-line real-time menu management system.

An on-line, real-time menu management system was developed as a module of the integrated computer-assisted food management system implemented at the University of Missouri-Columbia Health Sciences Center Department of Nutrition and Dietetics. This system supplants a former automated form generating system and permits flexibility in menu design. The major data base in the system is the Master Menu File, which is updated using real-time processing. This file contains data about each occurrence of menu items and is interfaced with existing recipe files to produce numerous printed documents and to display the menu on a video display terminal. The major benefits of the system are flexibility and elimination of typing of worksheets. Entering a new menu or changes to the menu require only a brief amount of time; new revised documents relative to the menu can be generated on the same day. Some of the types of documents available from this system are: master menu, nutrient syllabi, menu audit, and food production forms. The menu is available on-line at all times for reference by dietitians and supervisors. The Master Menu File will be utilized more fully as new modules are designed to interface with the Menu Management System. Production forecasting, patient menu printing, and individualized diet planning are three potential enhancements to the system which will utilize data in the Master Menu File. The file was designed to accommodate additional data as the system in further matured.

Food Service, Hospital↗