Computer-based Application Research Articles

Cooperative Problem Solving with Personal Mobile Information Tools in Hospitals

Health-care professionals have a broad range of needs for information and cooperation while working at different points of care (e.g., outpatient departments, wards, and functional units such as operating theaters). Patient-related data and medical knowledge have to be widely available to support high-quality patient care. Furthermore, due to the increased specialization of health-care professionals, efficient collaboration is required. Personal mobile information tools have a considerable potential to realize almost ubiquitous information and collaborative support. They enable to unite the functionality of conventional tools such as paper forms, dictating machines, and pagers into one tool. Moreover, they can extend the support already provided by clinical workstations. An approach is described for the integration of mobile information tools with heterogeneous hospital information systems. This approach includes identification of functions which should be provided on mobile tools. Major functions are the presentation of medical records and reports, electronic mailing to support interpersonal communication, and the provision of editors for structured clinical documentation. To realize those functions on mobile tools, we propose a document-based client-server architecture that enables mobile information tools to interoperate with existing computer-based application systems. Open application systems and powerful, partially wireless, hospital-wide networks are the prerequisites for the introduction of mobile information tools.

Design and development of a computer-based clinical referral system for use within a physician hospital organization.

The process of creating a clinical referral for a patient and the transfer of information from the primary care physician to the specialist and back again is a key component in the struggle to deliver less costly and more effective clinical care. We have created a computer-based clinical referral application which facilitates 1) identifying an appropriate specialist; 2) collecting the clinical, demographic, and financial data required to generate a referral; and 3) transferring the information between the specialist and the primary care physician. Preliminary results indicate that the new computer-based process is faster.

Virtual reality: Opening the way

After the entertainment potential of virtual reality (VR), the last years have seen a rapid growth of industrial, educational and scientific applications for virtual environments (VE). In theory, the virtual reality or virtual environment computer technology is imitating real world objects and environments and the user may even feel to be ‘present’ in the stimulated world. Disabled people can use normal computers for many purposes, such as learning, education, environment control, rehabilitation etc. relatively free from the limitations imposed by their disability. The next step may be the use of virtual environment computer technology. The paper: Virtual Reality, Disability and Rehabilitation’ focuses on the possibilities of the VR applications for disabled persons. Only some limitations of the technology and ethical concerns are discussed. Those aspects are however important in practice and should be discussed before the VR is an important part of the rehabilitation practice for disabled persons. This paper is a good start for discussions of the value of VR and its applications for rehabilitation purposes. The author has collected a very good list of references for further studies. Various learning programmes are now mainly used for rehabilitation purposes. People can orient themselves in virtual environments, learn shopping, crossing the road etc. There are already first papers concerning the most important question: does skill or knowledge acquired by a disabled person in a VE transfer to the real world? However, more studies and papers are needed to consider various aspects of the use of VR. There are unsolved difficulties how to measure the real effect of use of VR. Systematic knowledge about the efficacy of rehabilitation intervention for an individual is almost entirely dependent on research conducted within experimental or a quasi-experimental framework. Rehabilitation research often yields an ambiguous mix of results and all papers have not yielded convincing support for the efficacy of rehabilitation interventions. Mildly disabled persons may get easier benefits of rehabilitation, also of the use of the VR, but those, who are multiply disabled, have more difficulties with social life and interactions. Without new technology they may live really in a social isolation. The possibilities of the VR are fascinating but somehow also very dangerous. What kind of virtual environments and who does make the decision of the use, programmes and applications? The disabled people are perhaps the last ones when discussing about the power and ethics of new technology and its applications. At the same time one can ask very seriously, are all people, including disabled ones, divided into two groups : those who can use and those who have no resources to use new technology? World wide the use of VR is nowadays possible only for a very small elite group of disabled people. Many of the disabled people have problems with the social environment and the rehabilitation of the social competence is therefore very important. Is there a real fear, that human-human interactions are replaced by new technology? In the metaphysical stage only very young children can wonder whether computers can think, feel and be alive. But new applications of VR can give even tactile, force, taste and smell feedback. There is a danger that some people become addicted to virtual reality experience and withdraw from real world interactions increasing their social isolation. The ‘ good ’ use of the new technology will however provide the disabled with more freedom, independence and possibilities to participate. One must however remember that all problems concerning disabled persons cannot be solved by using new technology. I suspect that the use of VR is too late for those people suffering from a persistent vegetative state. As a member of a rehabilitation team also my next questions are very practical. When and how can one choose those disabled children who can be potential users of advantaged technology? This paper does not give any exact answer. The provision of a computerbased application includes evaluation of needs, testing, providing, and teaching how to use and maintain them. This process may be very difficult, consuming many kinds of resources. The user interface may be increasingly complex styles of interactions between the user and the

Metabolic support of the gastrointestinal tract: potential gut protection during intensive cytotoxic therapy.

Potentially curative options involving cytoablative therapies are now available for the treatment of almost all human tumors, but major toxicities represent the rate-limiting step in achieving a cure with these therapies. With successful hematoprotective strategies now in use, it is apparent that the gastrointestinal tract will be the rate-limiting organ system that prevents further dose escalation in many cancer patients. A review of the English language literature was conducted. Paperchase, a computer-based application that reviews the data bases of the National Library of Medicine and the National Cancer Institute, was used to obtain pertinent literature. A variety of gut-protective nutrients and growth factors were identified. These substances may be useful in preventing dose-limiting gastrointestinal symptoms. Animal studies and some patient data suggest that the amino acid glutamine stimulates mucosal growth and promotes gut health. When nutrient administration is coupled with growth factors, such as growth hormone, insulin-like growth factor-1, glucagon-like peptide-2, and interleukin-11, a high level of bowel protection should be attained. Therapy is evolving that may be useful in protecting the intestinal mucosa and preventing dose-limiting gastrointestinal symptoms.

Positioning Analysis with Self-Organizing Maps

Various techniques of multivariate analysis are applied to locating hotel chains' positions on perceptual maps based on consumers' views of those chains. Measuring and accounting for the many attributes used to develop positions is intensive and usually the analysis is segment-specific. Instead of complex methods that are hard for managers to apply, the use of self-organizing maps may be appropriate. The self-organizing map is a computer-based application of neural-network models that treat data as nodes with connections. Data are sorted to arbitrarily positioned nodes that represent a map of positions. In the simplest approach, the result is that the positions of hotels that fall on the same node are not different, while those that fall on adjacent nodes are different. In actuality, a hotel's position falls on one node sometimes and other nodes other times, depending on the market segment. The higher the frequency of a hotel's being located on a given node, the more focused its image. A hotel that finds itself widely distributed on many modes has a fuzzy image. An example of luxury hotels in Vienna demonstrates the hotels' positions for different guest segments.

Steady-state rate analysis: application to biological transport

A novel method for defining the steady-state unidirectional rates of complex reactions has previously been developed (Wagg, 1988 Ph.D. Thesis, Monash University, Australia). This methodology is based upon the method of Wagg (1987, J. theor. Biol. 128,375–385) for defining the steady-state unidirectional fluxes of chemical species through branched chemical, osmotic and chemiosmotic reactions. It offers a number of distinct advantages over existing approaches to steady-state rate analysis: it is relatively simple to apply to complex reactions and is readily amenable to computer-based application. The method is demonstrated by direct application to a number of hypothetical models for biological transport phenomena.

Interface structures: conceptual, logical, and physical patterns applicable to human-computer interaction

Structural patterns are known to be important to human memory and cognition. They are essential to the knowledge representation of conceptual, logical and physical entities. At the same time, computer interfaces are implemented using a variety of logical and physical structures that have implications for human use. These two categories of structures, representing both sides of the human-computer partnership, are characterized and compared. Emphasis is on identifying a basic set of structures amenable both to the user's mind and to the computer-based application. The user is capable of conceiving and visualizing structures in each of several different representation “spaces” behind the interface surface. Careful structural mappings between these spaces and the user-visible interface are essential. To aid interface designers in these tasks, a formal definition of interface structure is proposed and an example specification is presented. Expected benefits and required research are discussed.

A survey of instructional technology in dental education

Little is known about current use of hardware and non-hardware instructional technologies in dental education. To address this area, the investigators designed a questionnaire to assess support for the development of instructional technology and determine the extent to which different instructional technologies are used in North American dental schools. Responses were received from 59 of 65 dental schools (91 percent). Respondents at most schools judged the administration at their school to be supportive of the development of instructional technology, but in general, did not feel faculty were enthusiastic about or rewarded for developing innovative methods. The most common computer-based application involves testing and record keeping, which is used extensively in about half the dental schools. Individualized instruction and paper and pencil simulations are used in at least some courses at a majority of dental schools. Schools with available support services apply certain technologies to a significantly greater extent than schools without available support services.

Toepassing van 'n lineêre regressiemodel op verskillende inligtingstelselfasette

Application of a linear regression model to different information system facets Evaluation techniques with regard to the information system function in organizations could well be used to serve as a tool to identify problem areas and the corresponding corrective actions to be taken. In the past quite a number of computer-based application systems have failed in large as well as small organizations not because of inadequate technical quality but because some important non-technical factors of critical importance for the success of the system have not been diagnosed timely. In a previous research project (Bruwer: 1983) a restricted linear regression model method has been used to evaluate the success of the information system function in organizations. In this article the same model is applied on three different areas of the information system function. These areas are: Aspects of strategic planning of information systems; evaluation of the use of micro-computer systems and the evaluation of computer facilities in organizations.

Acquisition of the curves of the human crystalline lens from slit lamp images: an application of the Hough transform

To accurately model lens-based functions such as accommodation and image formation on the retina, it is essential to know anterior chamber depth, anterior segment length, lens thickness, and, most importantly, lens curvature both on the surfaces and internally. With the exception of lens curvatures, all these data can be obtained with a high degree of precision by one or more techniques (i.e., A-scan ultrasonography and pachymetry). Lens curvatures can be collected by Scheimpflug slit lamp photography, but the curvature data must be extracted from these images, a problem complicated by both linear and nonlinear image distortion. Previous approaches have involved significant magnification of the image combined with major subjective input and judgment. We present here a computer-based application of the Hough technique for measurement of curvature of lens surfaces observed in Scheimpflug slit lamp photography and related evaluation of (and solutions for) the associated image distortion. Minimal user input is required for successful application of this method, but the time required to obtain a fit for each surface is >1 min. Results obtained by this technique on test images compare favorably with those obtained by independent methods.

Measuring implementation outcome: beyond success and failure

This paper proposes a framework for measuring the impact of a computer-based application in an organization. Recognizing the complexity of the implementation process, the framework is multi-dimensional: it seeks to measure the outcome of an implementation effort on both the people and tasks affected as separate from user's definition of “success”. The framework can be used to support either the quantitative or case study methodologies used in implementation research. Finally, the authors describe a field test of the framework to demonstrate its usefulness in an organizational setting.

An application of the Sentinel Health Event (Occupational) concept to death certificates.

This article describes a computer-based application of the Sentinel Health Event (Occupational) [SHE(O)] concept, developed in conjunction with five states, to monitor deaths which are occupationally related. The states have coded their state death certificate files for industry and occupation, using the decedent's usual occupation and industry as reported on the death certificate. From these files, the SHE(O) computer program selects deaths which are likely to be work-related, based on a previously published SHE(O) list of 50 disease rubrics and associated industries and occupations. The computer program matches the SHE(O) list with the recorded industry, occupation, and underlying cause of death. The program has been tested using 1984 death certificate data from Maine, upstate New York (excluding New York City), North Carolina, Pennsylvania, and Rhode Island. Approximately 1 to 2 per cent of all deaths were selected by the program, with lung cancer and coal workers' pneumoconiosis being the most frequent cause of death. The SHE(O) program may be useful for identifying deaths which are potentially occupationally related, but its utility and its application to death certificates needs further evaluation before recommending widespread use. Limitations are discussed, as well as plans for improving the application of the SHE(O) concept to death certificates.

The nature of inter-phase relationships in application system development

This study examines the relationships among the component phases of the development life cycle of computer-based application systems. Results indicate that these relationships not only occur but contribute significantly to the consumption of resources during development. The investigation of these interactions presents a general discussion of the nature of the tradeoffs involved, outlines the form of the interaction models to be tested, and finally, marshals empirical evidence to assess the appropriatenes of the proposed models and the integrity of their structure. Implications drawn from this research for the management and control of application system development are presented.