XML, Ontologies, and Their Clinical Applications.

The development of information technology has resulted in its penetration into every area of clinical research. Various clinical systems have been developed, which produce increasing volumes of clinical data. However, saving, exchanging, querying, and exploiting these data are challenging issues. The development of Extensible Markup Language (XML) has allowed the generation of flexible information formats to facilitate the electronic sharing of structured data via networks, and it has been used widely for clinical data processing. In particular, XML is very useful in the fields of data standardization, data exchange, and data integration. Moreover, ontologies have been attracting increased attention in various clinical fields in recent years. An ontology is the basic level of a knowledge representation scheme, and various ontology repositories have been developed, such as Gene Ontology and BioPortal. The creation of these standardized repositories greatly facilitates clinical research in related fields. In this chapter, we discuss the basic concepts of XML and ontologies, as well as their clinical applications.

Eduación profesional de los técnicos de la salud en Argentina: Formación superior terciaria y universitaria / Professional Education of Health Technicians in Argentina at Tertiary and University Level

INTRODUCCIÓN: Investigar la formación profesionalde los técnicos en salud en Argentina es prioritaria dada la heterogeneidad de la oferta educativa que complejiza la inserción laboral y la regulación del ejercicio. OBJETIVO: Analizar la situación y características de la educación profesional de nivel superior para los trabajadores técnicos en salud en Argentina. MÉTODOS: Se realizó un estudio descriptivo, cuantitativo y transversal, con fuentes de datos secundarias y primarias durante 2010-2011. RESULTADOS: Se relevaron 370 instituciones educativas concentradas en la Región Centro (64%). La formación en el nivel terciario era del 87%, con una mayoría de gestión privada (71,3%). La formación universitaria dependía principalmente del sector público (73,9%). De las 852 carreras relevadas, casi el 30% correspondía a Enfermería, 12,4%a Laboratorio, 11,9% a Sanidad, 11,6% a Radiología y 10,1% a Instrumentación Quirúrgica. Se registraron 78.972 alumnos, con una cantidad predominante en Enfermería (39%) y Radiología (12%). CONCLUSIONES: La formación de técnicos en salud se distribuye en toda Argentina, aunque con una oferta desigual. Las diferencias estructurales entre las instituciones terciarias y universitarias obstaculizan la circulación entre ambos subsistemas. La complejidad del sistema de educación superior presenta una serie de desafíos que exigen el involucramiento conjunto de las carteras educativa y sanitaria para planificar y desarrollar estos recursos a nivel nacional.

INTRODUCTION: The research of the professional training of health technicians in Argentina is apriority area because of the heterogeneous educational offer that makes entry into the labor market and regulation of exercise more difficult. OBJECTIVE: To analyze the situation and characteristics of professional high education for health technicians in Argentina. METHODS: A descriptive, quantitative and cross-sectional study was conducted, with secondary and primary data sources during 2010-2011. RESULTS: The 370 educational institutions included in the survey were concentrated in the Central Region (64%).The training at tertiary level was 87%, mostly privately managed (71.3%). University education depended mostly on public sector (73.9%). Of the 852 careers surveyed, almost 30% were Nursing, Lab 12.4%, Health 11.9%, Radiology 11.6% and Surgical Instrumentation 10.1%. There were 78972 students, most of them in Nursing (39%) and Radiology (12%). CONCLUSIONS: The training offer for health technicians is unequally distributed in Argentina. Structural differences between tertiary institutions and universities make it difficult to move from one subsystem to the other. The complexity of high education system poses different challenges requiring the involvement of both Education and Health ministries for planning and development of these resources at national level.

Medical devices; Medical Device Data Systems. Final rule.

The Food and Drug Administration (FDA), on its own initiative, is issuing a final rule to reclassify Medical Device Data Systems (MDDSs) from class III (premarket approval) into class I (general controls). MDDS devices are intended to transfer, store, convert from one format to another according to preset specifications, or display medical device data. MDDSs perform all intended functions without controlling or altering the function or parameters of any connected medical devices. An MDDS is not intended to be used in connection with active patient monitoring. FDA is exempting MDDSs from the premarket notification requirements.

Unnotified deaths and hospital admissions for tuberculosis in the municipality of Rio de Janeiro.

OBJECTIVE: To analyze underreporting of deaths and hospital admissions from tuberculosis to the Information System for Notifiable Diseases (SINAN). METHODS: Cases with tuberculosis as basic or associated cause of death were selected from the Brazilian Mortality Information System (SIM) and hospital admissions for tuberculosis as main or secondary cause from the Hospital Information System of the Brazilian Unified Health System (SIH-SUS), for residents in the municipality of Rio de Janeiro in 2004. Probabilistic record linkage was carried out between the SIM and SIH-SUS databases and the SINAN for the years 2002 to 2004. RESULTS: Out of the 542 deaths from tuberculosis in the period, 234 (43.2%) were not registered in the SINAN for the two previous years. As for the 1,079 admissions, 238 (22.1%) failed to be notified. Seventy-one deaths were related to these admissions: 47 were registered out of the SIH-SUS by death, 24 occurred after discharge and seven remained unnotified in the SINAN. The elderly were 1.6 times (95%CI 1.074;2.516) less likely to be notified than younger patients, and those with at least a college education were 3.6 times (95%CI 1.384;11.022) less likely to be notified than those with no formal education. Patients under 15 were 4.8 times (95%CI 2.757;8.452) less likely to be notified than those aged between 15 and 59 years. Some regional health administration divisions showed a percentage of unnotified deaths of over 50% and this percentage ranged from 37.8% to 12.7% for hospital admissions. CONCLUSIONS: The data suggest problems in the detection of cases and point to obstacles in adequate and timely treatment, as well as to quality flaws in the information system, with differences among regions in the municipality.

Sistema de información para la gestión clínica / Informative system for clinical management

As an organizative company, a sanitary institution must take in a charge the coordination of activities tending to achieve the recovery or relief of a concrete suffering in the less time possible and also with the smallest degree of rupture of the patient with the surrounding domestic and social environment...

Telemedicine taxonomy: a classification tool.

Telemedicine allows medical doctors and specialized skilled experts to provide services to patients who are in remote locations using advanced telecommunications. This paper presents a taxonomy that systematically classifies various telemedicine efforts worldwide using five major dimensions: application purpose, application area, environmental setting, communication infrastructure, and delivery options. To identify relationships and patterns between these different dimensions telemedicine programs survey data from the Telemedicine Information Exchange (TIE) was analyzed using multiple regression and path analysis. Major findings indicate that interactive video is the most preferred modality. Store-and-forward technology is preferred for ophthalmology, radiology, and pathology. However, a negative correlation exists between store-and-forward and interactive video with mental health application. The study also indicates that the Internet is still not the dominant communications infrastructure when it comes to telemedicine. We showed that these dimensions can capture almost all efforts in telemedicine and also help program planners to understand the issues in telemedicine deployment. Our findings indicate that the taxonomy is useful for categorizing and comparing existing programs, and can be used for planning future programs.

[Development of a multidimensional system for classification and management of health information: applying to clinical information]. / Desenvolvimento de um sistema multidimensional para classificação e gestão de informação em saúde: aplicabilidade à informação clínica.

INTRODUCTION: The large amount of information in the medical area creates management problems, being necessary systematic methods for filing and retrieval. With information on the context of clinical records, methods must integrate controlled biomedical terminologies and desirable characteristics oriented to the structure, content and clinical results. The objective is to test the applicability and capacity for retrieval of a multidimensional system developed for classification and management of health information. METHODS: Three hundred questions were randomly selected, by computerized method, from the questions received in six years (Medicine Information Service, Pharmaceutical Department, Coimbra University Hospitals). They were characterized and applicability evaluated by classified amount and need to alter the system, which is composed of various independent dimensions, incorporating concepts sometimes hierarchical. Questions retrieval was tested searching information in a dimension or between dimensions. RESULTS: All questions were classified: 53% are clinical cases with illnesses incidence in the genitourinary system; metabolic, nutritional and endocrine disease; cancer; infections and nervous system. In 81%, the object is a drug, mostly anti-infectious and anti-neoplastic agents. The therapeutic and safety areas had been the most requested, regarding the subjects: use, adverse reactions, drug identification and pharmaceutical technology. As to applicability, it was necessary to add some concepts and modify same hierarchical groups, that didn't modify the basic structure, nor had collided with the desirable characteristics. The limitations were related with the incorporated external classification systems. The search in the subject dimension of the concept drug administration retrieved 19 questions. The search between two dimensions: antiinfectious (external) and teratogenicity (subject) retrieved three questions. In the two examples, it was possible to retrieve information from any one of the levels of the hierarchy, from the most general to the most specific and even from external dimensions. CONCLUSIONS: The use of the system in this sample showed its applicability in clinical information classification and filing, retrieval capacity and flexibility, supporting modifications without interfering with desirable characteristics. This tool allows retrieval of patient-oriented evidence that matters.

IT proposals competing for attention? Learn how to prioritize.

There will always be more demand for IT projects than an organization can afford or manage.

Resource guide 2004. Blood glucose. Monitors and data management systems.

Before you buy a blood glucose monitor (also known as a blood glucose meter), check with your doctor and diabetes educator. Make sure the one you choose is well suited to your particular needs. You might want to have one at home and one for use at school or the office.