Solving Interoperability in Translational Health. Perspectives of Students from the International Partnership in Health Informatics Education (IPHIE) 2016 Master Class.

BACKGROUND: In the summer of 2016 an international group of biomedical and health informatics faculty and graduate students gathered for the 16th meeting of the International Partnership in Health Informatics Education (IPHIE) masterclass at the University of Utah campus in Salt Lake City, Utah. This international biomedical and health informatics workshop was created to share knowledge and explore issues in biomedical health informatics (BHI). OBJECTIVE: The goal of this paper is to summarize the discussions of biomedical and health informatics graduate students who were asked to define interoperability, and make critical observations to gather insight on how to improve biomedical education. METHODS: Students were assigned to one of four groups and asked to define interoperability and explore potential solutions to current problems of interoperability in health care. RESULTS: We summarize here the student reports on the importance and possible solutions to the "interoperability problem" in biomedical informatics. Reports are provided from each of the four groups of highly qualified graduate students from leading BHI programs in the US, Europe and Asia. CONCLUSION: International workshops such as IPHIE provide a unique opportunity for graduate student learning and knowledge sharing. BHI faculty are encouraged to incorporate into their curriculum opportunities to exercise and strengthen student critical thinking to prepare our students for solving health informatics problems in the future.

A description of common mental disorders in men who have sex with men (MSM) referred for assessment and intervention at an MSM clinic in Cape Town, South Africa.

Men who have sex with men (MSM) have a higher prevalence of common mental disorders (CMD), as compared with heterosexual men. HIV infection is independently associated with higher rates of CMD. Given this context, and the high background community prevalence of HIV in South Africa, MSM are at even greater risk of developing CMD. The aim of this research was to investigate neuropsychiatric symptoms and disorders in MSM who were referred for assessment and management of mental health problems, in an MSM Clinic in urban Cape Town, South Africa. Twenty-five men were screened using the MINI, AUDIT, DUDIT, and IPDE Screener. Depression, suicidality, as well as alcohol and drug use disorders were highly prevalent in this group (44, 56, 48, and 56 % respectively). The personality disorder screening was suggestive of a high prevalence of personality disorders. The high prevalence of neuropsychiatric disorders in this sample supports the idea that integrated mental health services are needed to address the complex needs of this population. Adequate input into the mental health needs of this population could reduce the potential for HIV acquisition and transmission, improve adherence to treatment and care, and ensure the provision a comprehensive health service for MSM.

Anesthetic technique (sufentanil versus ketamine plus midazolam) and quantitative electroencephalographic changes after cardiac surgery.

OBJECTIVES: Cardiac surgery involving cardiopulmonary bypass is associated with neurologic deterioration. Several interventions, including anesthetic techniques, have been designed to limit ischemic brain damage and have been evaluated in animals. Markers of neurologic injury may facilitate the assessment of these interventions in humans. DESIGN: A blinded randomized prospective study comparing 2 anesthetic techniques (one sufentanil-based, the other ketamine and midazolam-based) in patients undergoing cardiac surgery. Quantitative electroencephalography was used to detect postoperative neurologic injury. SETTING: Major teaching hospital. PARTICIPANTS: Forty-two patients aged 18 to 70 years undergoing cardiac surgery. INTERVENTIONS: Patients were anesthetized with either a sufentanil-based or a ketamine and midazolam-based technique for cardiac surgery with cardiopulmonary bypass. Quantitative electroencephalography was performed preoperatively as well as 5 to 6 days postoperatively. MEASUREMENTS AND MAIN RESULTS: Quantitative electroencephalography outcome did not differ (p > 0.05) between the 2 groups. It showed significant deterioration between preoperative and postoperative assessments with a decrease in faster and an increase in slower frequencies. In addition, the alpha attenuation index decreased. This may reflect a decrease in alertness. Both the intergroup comparisons and the assessment of individual changes failed to reveal significant differences between the anesthetic techniques. The adjuvant use of isoflurane correlated with less deterioration of quantitative electroencephalographic variables. CONCLUSIONS: The use of either sufentanil-based or ketamine and midazolam-based anesthetic techniques for cardiac surgery with cardiopulmonary bypass had no effects on a marker of postoperative neurologic injury (ie, quantitative electroencephalography).

Prescribing patterns of tricyclic and selective serotonin reuptake inhibitor antidepressants among a sample of adolescents and young adults.

PURPOSE: There are few studies that document antidepressant prescribing in young patients. Although tricyclic antidepressants (TCAs) are considered equal in efficacy to selective serotonin reuptake inhibitors (SSRIs), the latter have an improved side effect profile. The aim of this study was to investigate the prescribing patterns of TCAs and SSRIs among adolescents and young adults, with reference to prescribing frequency, cost and dose. METHOD: A retrospective drug utilization study was conducted over a 14-month period, from January 2000 to February 2001. RESULTS: There were 166 antidepressants prescribed to 98 adolescents and young adults. TCAs were prescribed more frequently than SSRIs, with amitryptiline and fluoxetine being the two most frequently prescribed antidepressants. Fluoxetine accounted for a higher ratio of cost to prescribing frequency than amitryptiline. Amitryptiline was issued in small quantities of tablets, resulting in a low average calculated prescribed daily dose (PDD). Duration of treatment was not considered optimal for SSRIs or TCAs. CONCLUSION: This study elicits prescribing patterns that contribute to the relative scarcity of data on antidepressant drugs for young patients.