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PubMed1989

A knowledge-based system for data analysis and interpretation.

Traditionally, statistical packages are employed to derive or infer facts about a Universe of Discourse through data analysis and interpretation. It is analysis that serves to transform data into information. Statistical packages provide the users with relatively easy-to-use and powerful mechanics of data analysis, but up to now they do not provide much help with the design and strategies of the analysis. As such, there is a risk of misuse of these packages by statistically inexperienced users. We propose the use of knowledge-based interfaces to support this category of users in statistical evaluations. This paper discusses our experiences from the implementation of a knowledge-based system called MAXITAB. It provides guidance in the processes of data analysis and interpretation and has been programmed as an interface to the statistical package MINITAB.

Data Interpretation, Statistical↗

PubMed1988

[Experience with the SIMEDOS radiology information system in a central department for x-ray diagnosis].

Implementation of the radiological information system SIMEDOS in the central department of diagnostic radiology in the Marburg University Hospital is discussed. Special attention is given to the clinical and organizational problems of the department, as well as the planning and preparation phases of system implementation. This system has been in use for 10 months and our experience concerning problem-solving and the various user groups is described.

Germany, West↗

PubMed1982

Being there: the effect of the user's presence on MEDLINE search results.

An evaluation was conducted at the University of Iowa Health Sciences Library to determine what effect the user's presence had on MEDLINE search results. One hundred users participated over a four-month period. Three main criteria were used: search precision, search recall, and user satisfaction. Each MEDLINE search was processed twice, once prior to the user's arrival and a second time during the scheduled appointment with the user. The two searches for each user were processed by different searchers, and four searchers alternated processing the user-absent or the user-present search. Users were asked to compare the citations on the two searchers by checking each printout for relevant citations. A short questionnaire was administered to determine general information about users and satisfaction measures for each search. The extensiveness of the interview for the user-absent search was varied in order to determine if the depth of the initial interview would affect the search results. Evaluation of the findings indicated an increase in precision, recall, and user satisfaction for the user-present search. Some difficulties in designing the experiment are discussed and implications of the evaluation results are considered.

Consumer Behavior↗

PubMed1995

Marijuana smoking: effects of varying puff volume and breathhold duration.

Two studies were conducted to quantify biological and behavioral effects resulting from exposure to controlled doses of marijuana smoke. In one study, puff volume (30, 60 and 90 ml) and in a second study, breathhold duration (0, 10 and 20 sec) were systematically varied while holding constant other smoking topography parameters (number of puffs = 10, interpuff interval = 60 sec and inhalation volume = 25% of vital capacity). Each study also varied levels of delta 9-tetrahydro-cannabinol marijuana cigarette content (1.75% and 3.55%). Regular marijuana users served as subjects (n = 7 in each experiment). Subjects smoked 10 puffs in each of six sessions; a seventh, nonsmoking session (all measures recorded at the same times as in active smoking sessions) served as a control. Variations in puff volume produced significant dose-related changes in postsmoking plasma delta 9-tetrahydro-cannabinol levels, carbon monoxide boost and subjective effects (e.g., "high"). In contrast, breathholding for 10 or 20 sec versus 0 sec increased plasma delta 9-tetrahydro-cannabinol levels but not CO boost or subjective effects. Task performance measures were not reliably influenced by marijuana smoke exposure within the dosing ranges examined. These findings confirm the utility of the controlled smoking technology, support the notion that cumulative puff volume systematically influences biological exposure and subjective effects, but cast doubt on the common belief that prolonged breathholding of marijuana smoke enhances classical subjective effects associated with its reinforcing value in humans.

Adult↗

PubMed1993

[Management of patient data in an intensive care unit with Macintosh and Filemaker Pro--extra effort or facilitation of routine care with improved information flow?].

A documentation system for patients in ICU is presented. The programming is based on Filemaker Pro from Claris. Two files have been created: the first "1 Eintritt" contains all the patients data like name, address, the patients history, diagnosis, therapies as the planned procedures. All these data can be imported into the second file "2 KG Unfallchirurgie" with a personal identification number. Complications, new results or further procedures can be added. Different layouts allow the user to print summaries or duty reports. The experience with 300 patients showed, that this system is easy to learn and to use, that it has a good compliance with the medical staff and that is gains a lot of time writing summaries or reports used for transferring patients to other units.

Attitude of Health Personnel↗

PubMed1993

Analysis of phencyclidine and cocaine in human hair by tandem mass spectrometry.

A confirmation procedure for the analysis of cocaine, benzoylecgonine, ecgonine, and phencyclidine (PCP) in human hair using tandem mass spectrometry has been developed. This procedure requires no solvent extraction and thus can examine the metabolites of drugs such as cocaine. Hairs from six cocaine users were examined and the amount of cocaine and its ratio to the metabolites was not correlated to the reported use pattern. Only PCP was detected in the hair from a PCP user, no metabolites were found. In passive exposure experiments, hair was found to tightly absorb PCP from aqueous solutions, which mimics the incorporation of PCP by the body. These results indicate that drugs may be absorbed onto the hair of nonusers and become tightly bound.

Cocaine↗

PubMedDate not supplied

Skilled iv therapy clinicians' product evaluation of open-ended versus closed-ended valve PICC lines: a cost savings clinical report.

The IV therapy clinician team at Florida Hospital has become active product selectors of IV therapy materials for the institution. It is recognized for its expertise, experience, and knowledge in IV therapy. As end users of many IV therapy products, members are well-qualified to act as principal product selectors of these patient care items. These clinicians identified costly problems with the performance of a conventional open-ended peripherally inserted central catheter (PICC) product being used. A market search for a better product was done and the Bard Groshong closed-ended valve PICC (Bard Access Systems, Inc., Salt Lake City, UT) was selected. These PICCs were used for a 6-week trial period. The 58 inserted Groshong closed-ended valve PICCs were compared with the last 58 open-ended PICCs inserted. Greater quality assessment was apparent in its performance. A substantial cost savings of 21% also was achieved by using the Groshong closed-ended valve PICCs. A clinical report comparing these two products was presented to the value analysis committee. The validated superior performance of the Groshong closed-ended valve PICC with the cost savings for the 6-week trial period won the committee's approval and the change was made to the Groshong closed-ended valve PICC.

Catheterization, Central Venous↗

PubMedDate not supplied

A systematic approach for coupling user satisfaction with product design.

A fundamental assumption in this paper is that user satisfaction depends on product design. The approach consists of 5 steps: (1) define user satisfaction, (2) decompose product design elements, (3) conduct experiments, (4) develop relationship models, and (5) analyse critical design features. In order to demonstrate the practicability of this approach, relationship models were developed based on experimental data using a total of 60 subjects (30 American and 30 Korean subjects). In addition, critical design features and their common properties were identified for audio/visual consumer products. Similarities and differences between American and Korean consumers were discussed. The resulting relationship models can be used to predict user satisfaction and provide significant remedies for design change.

Adult↗

PubMed2006

Multi-template approach to modeling engineered disulfide bonds.

The key issue for disulfide bond engineering is to select the most appropriate location in the protein. By surveying the structure of experimentally engineered disulfide bonds, we found about half of them that have geometry incompatible with any native disulfide bond geometry. To improve the current prediction methods that tend to apply either ideal geometrical or energetical criteria to single three-dimensional structures, we have combined a novel computational protocol with the usage of multiple protein structures to take into account protein backbone flexibility. The multiple structures can be selected from either independently determined crystal structures for identical proteins, models of nuclear magnetic resonance experiments, or crystal structures of homology-related proteins. We have validated our approach by comparing the predictions with known disulfide bonds. The accuracy of prediction for native disulfide bonds reaches 99.6%. In a more stringent test on the reported engineered disulfide bonds, we have obtained a success rate of 93%. Our protocol also determines the oxido-reduction state of a predicted disulfide bond and the corresponding mutational cost. From the energy ranking, the user can easily choose top predicted sites for mutagenesis experiments. Our method provides information about local stability of the engineered disulfide bond surroundings.

Bacterial Proteins↗

PubMed1995

A computer program for the study of synaptic transmission at the neuromuscular junction.

The study of synaptic biopotentials at the neuromuscular junction has proven to be an invaluable tool in understanding the pre- and post-synaptic mechanisms underlying chemical synaptic transmission and exploring the pathogenesis of neuromuscular disorders. Computer technology has become an important part of these experiments as it increases accuracy and automates the process, allowing more data to be collected and quantitatively analysed. This paper presents a computer program for IBM PC compatible computers capable of recording and analysing the spontaneously occurring miniature end-plate potentials (MEPPs), neurally evoked end-plate potentials (EPPs) and muscle fiber action potentials (APs). The program performs its basic analysis immediately following the sampling of biopotentials from a muscle fiber, thus providing the user with immediate feedback on the status of the experiment; 45 parameters of neuromuscular transmission are computed on-line and displayed on the monitor along with the signal-averaged waveforms. After a series of fibers has been recorded, the program will compile the data into summary tables. The program is designed to provide an experimenter with an easy-to-use, comprehensive method of performing electrophysiological measurements and analysis at the neuromuscular junction.

Action Potentials↗

PubMed1975

Divided attention performance of cannabis users and non-users following cannabis and alcohol.

The effects of delta9-tetrahydrocannabinol (delta9-THC) and alcohol, and their combination, on divided attention performance were compared for cannabis users and non-users of both sexes. Performance by all subjects was significantly impaired following 2.6 and 5.2 mg delta9-THC but not at blood alcohol concentrations of 48 and 96 mg/100 ml. The combined effect of the 2 drugs depended upon prior experience with cannabis. A synergistic action occurred in non-users while an antagonistic effect occurred in the group of users. Differences in the alcohol effects between users and non-users provided evidence of cross-tolerance between cannabis and alcohol.

Adult↗

PubMed1998

The use of evidence by health care user organizations.

OBJECTIVES: To explore the use of research evidence by consumer and patient organizations and the extent to which their goals and activities are consistent with evidence-based health care and patient-centred care. DESIGN: A mailed survey, telephone and face-to-face interviews of leaders of organizations representing health care users. SETTING: Norway. PARTICIPANTS: Sixty-nine of 109 questionnaires that were mailed were included in our analysis and approximately 20 interviews were conducted with representatives of general consumer and patient advocacy groups and interest groups that focus on particular diseases or disabilities. MEASUREMENTS: Information was collected on the goals of the organizations, the nature of their everyday work, the extent to which research information is required in this work and how research information is accessed and appraised. RESULTS: An important focus of many user groups is peer support. They tend to emphasize experience-based knowledge. A total of 82% of the respondents said that they often or sometimes had use for research results in their work. Research-based information is most often obtained indirectly through physicians or researchers. CONCLUSIONS: Norwegian health care user organizations do not appear to promote evidence-based health care. To the extent that they help to disseminate scientific information, they appear to do so uncritically, relying on few sources and traditional authorities.

Journal Article↗

PubMed2003

The female condom: attitudes and experiences among HIV-positive heterosexual women and men.

The female condom is a potentially effective method for the prevention of HIV, other sexually transmitted disease, and pregnancy. This study describes attitudes toward and experiences with the female condom of 89 HIV-positive individuals (n = 56 women; n = 33 men) reporting heterosexual behavior. Qualitative interviews were conducted to inform the design and implementation of a cognitive-behavioral risk-reduction and health-promotion intervention. Most respondents (n = 78) had seen or heard of the female condom. However, relatively few (n = 14 women; n = 5 men) had used it at least once. Reactions from both women and men across user groups, regardless of favorable or unfavorable attitude or experience with the female condom, centered around a similar set of factors: aesthetics, difficulties with the male condom, male partner reaction, beliefs about efficacy, and lack of training. These findings underscore the need for additional research and comprehensive education efforts aimed at both technical use and communication skills-building in order to realize the potential of the female condom as an alternative barrier method.

Adult↗

PubMed2006

Case report: Taiwan's experience in adopting IHE technical framework to integrate systems.

Though more and more hospitals adopt PACS in Taiwan, they all meet the same problem of system integration. The Integrating the Healthcare Enterprise (IHE) association proposes an integrated technical framework and process profiles to solve problems of heterogeneous system integration in medical environment for information sharing. Therefore, this paper reports the experience of a case hospital that successfully applied IHE framework to integrate its HIS, RIS and PACS in Taiwan. This paper indicates that using the IHE can help evaluate the integration ability of PACS vendors, enhance staff's ability, shorten the PACS implementation time, reduce the cost, and reserve system's expansibility. The case hospital was able to successfully implement it's PACS because of executive's full support, using the standard, and providing complete training to reduce user's resistance. This paper not only shares the experiences of IHE adoption of a case hospital but also summarizes key factors to implement PACS successfully. Again, this paper confirms that standard is helpful to integrate heterogeneous system.

Diffusion of Innovation↗

PubMed2005

Content validation on the Work Performance Rating Scale for sheltered workshop workers.

The purpose of this study was to revise the content of the Work Performance Rating Scale (WPRS) as a valid assessment tool for sheltered workshop workers. A focus group of 11 sheltered workshop workers was recruited to collect their opinions about the relevance of the WPRS from the service users' perspectives. A panel of 23 frontline practitioners who had experience in using various work assessment instruments provided at their work setting was recruited to review the content of the WPRS. A 14-item amended version of the WPRS with five new items added was proposed based on the opinions of service users, frontline practitioners, and the concept of the Minnesota Theory of Work Adjustment (MTWA). An expert panel of 12 professionals at the senior level from various vocational rehabilitation settings was recruited to comment on the content validity of the 14-item amended version of the WPRS. The expert panel agreed that the amended version of the WPRS was related to the concept of job satisfactoriness which could be used to assess the work performance of sheltered workshop workers. Thus, the use of the MTWA for improving the content validity of the WPRS to assess the employability of sheltered workshop workers was supported by the findings of the study.

Adult↗

PubMed2000

Association of adolescent cigar use with other high-risk behaviors.

OBJECTIVES: To describe the association of cigar use with use of cigarettes, smokeless tobacco, and alcohol among adolescents; and to examine the association of self-esteem, physical activity, and use of tobacco promotional items with cigar use. METHODS: A cross-sectional study of 7104 girls and 5499 boys 10 to 15 years of age in 1997. Data were collected from self-report questionnaires. RESULTS: The prevalence of cigar use increased with age among both girls and boys. Among 11-year-olds, only 1% of girls and 3% of boys had used a cigar, whereas among 15-year-olds, 11% of girls and 25% of boys had used a cigar. Cigar users were much more likely than nonusers to have experimented with cigarettes (girls, odds ratio [OR]: 23.6; 95% confidence interval [CI]: 17.2-32.3; boys, OR: 21.3; 95% CI: 17.1-26.6), smokeless tobacco (girls, OR: 7.5; 95% CI: 4. 5-12.4; boys, OR: 13.0; 95% CI: 9.8-17.4), and alcohol (girls, OR: 6. 6; 95% CI: 4.8-9.1; boys, OR: 6.8; 95% CI: 5.3-8.8). There was a strong association between cigar use and binge drinking, especially among boys (girls, OR: 11.6; 95% CI: 7.9-16.9; boys, OR: 34.8; 95% CI: 19.4-62.3). Cigar users reported more hours of weekly physical activity than did nonusers. Additionally, cigar users were more likely to report high social self-esteem and to possess a tobacco promotional item. CONCLUSIONS: Adolescents who use cigars are more likely to use other tobacco products and alcohol, to report high social self-esteem, and to possess tobacco promotional items. Health care professionals and teachers should include cigar use in discussions with adolescents addressing substance use.

Adolescent↗

PubMed2001

Monitoring the care of lung cancer patients: linking audit and care pathways.

Clinical audit plays an important role in monitoring the provision of care for patients whatever their condition. Care pathways define the steps and expected course of events in the care of patients with a specific clinical problem over a set time scale. This paper describes a study undertaken in a multisite cancer unit to develop a tool for monitoring the progress of lung cancer patients through a care pathway and auditing key standards within the pathway. Important issues associated with the development of this tool are highlighted. The process of developing this tool involved the following steps: a review of the literature dealing with the management of lung cancer patients; interviews with key personnel in primary, secondary, tertiary and palliative care; development of a paper-based series of forms representing key steps in the patient's care pathway; 3-month trial of the paper-based tool; analysis of completion rates and interviews with form users to evaluate effectiveness; and recommendations for creating an electronic record using the experience and lessons learned from the paper version. The paper forms developed through this multistage process were found to be acceptable to users and have the potential to provide accurate information at key points for audit throughout the patient's time within the health-care system for their lung cancer condition. The flexibility of this methodology allows it to be adapted readily to a variety of clinical situations and conditions.

Cancer Care Facilities↗

PubMed1997

Concepts of drugs: differences in conceptual structure across groups with different levels of drug experience.

Seventy-seven college students varying in degree of drug use experience rated the perceived similarities of all possible combinations of 16 drugs classes (cigarettes, other tobacco, alcohol, marijuana, barbiturates, minor and major tranquilizers, amphetamines, amphetamine derivatives, cocaine, heroin, opiates, hallucinogens, inhalants, PCP, anti-depressants). Multi-dimensional scaling (INDSCAL) and network models (PFNET) indicated that abstainers had only one pharmacological category involving sedatives/depressants, and that they attached more importance to whether drugs were licit vs. illicit than to whether they were depressants vs. stimulants. Conceptions became more coherent, differentiated and based on pharmacological properties for more experienced drug users. In line with previous work, groups with greater experience with drugs had more sophisticated conceptions not only about the drugs they had used, but also about drugs they had not used. These findings suggest that early on in drug behavior sophisticated and interrelated concepts are developing that should be taken into account when designing interventions and information campaigns.

Adult↗