The feasibility of using a computer database management system based on an 8·bit microcomputer for storing, retrieving and analysing patient data in a limited setting (oesophago·gastro-duodenoscopy records from a peripheral general surgical department over a 1 year period) is presented. A program developed by the author was used to enter the relevant records of 208 patients undergoing the above examination, and to retrieve and analyse any desired data. Compatible statistical and graphics software packages can be used to access and analyse the data and display or print out the results. The limitations and scope for further expansion of the system are discussed.
The emphasis on cow records in Malaysian dairy extension programmes reflects the importance of herd fertility in the economics of dairying. Manual record keeping has not been able to make an impact on management due to difficulties experienced in quality control of the data and in analysing the data to produce useful information for farm managers. Computerised recording systems have been in use in Malaysia since 1985, both on government farms and in the small-holder dairy sector. The aim of both systems is firstly to improve farm efficiency by the provision of information to managers and extension workers and secondly to provide information for departmental planning purposes. The systems used in Malaysia are outlined, and the results over the first three years of operation are summarised.
We describe the design and management of a 35 mm slide database using a menu-driven dBASE III PLUS programme and a microcomputer in a large department of pathology that also caters for the individual pathologist. Existing systems described in the literature are geared towards slides of general medicine and do not address the needs of the individual pathologist. A total of 11,481 slides in the Department of Pathology, Faculty of Medicine, University of Malaya, were filed into a single database with each record representing one slide. Nine fields which comprised the slide accession number, reference number, slide category, SNOMED codes, and a description of the slide in natural language, seemed adequate for slide definition. The menu-driven programme had functions which included the abilities to add, delete, edit and back-up records, and to search for desired slides. Although slides may be searched for in various fields, we found that searches using natural language alone were both comprehensive and efficient, provided a standard format of description was adhered to and data entries scrutinized carefully for errors. We believe therefore, that for the pathologist working alone, coded language fields are not absolutely necessary, as manual coding and additional data entry can be time consuming. As expected, for databases larger than 10,000 slides, a 80286 microprocessor-based microcomputer was more efficient. We are of the opinion that a system such as ours is very useful for a large department of pathology or the individual pathologist to file and retrieve 35 mm slides.
A system for computerising histopathology records developed in-house using dBASE IV on IBM-compatible microcomputers in a local area network is described. The software package uses a horizontal main menu bar with associated pull-down submenus as interface between the machine and the user. It is very easy to use. The package provides options for selecting databases by years, entering/editing records, browsing data, making multi-characteristics searches/retrievals, printing data, and maintaining databases that includes backing-up and repairing corrupted databases.
We used OPT to estimate individual and population pharmacokinetics for carbamazepine (CBZ) in Malaysian epileptic patients attending our Neurology Clinic. We noted that plasma CBZ concentrations and clearances correlated poorly with daily doses and body weights respectively but we found the values for clearance, volumes of distribution, elimination rate constants and half lives to be in good agreement with earlier reports. We conclude that OPT is a simple yet useful program to derive individual and population pharmacokinetic parameters for CBZ for use in dosage adjustments. We also conclude that although the Malaysian population do not differ substantially in handling CBZ, available data for the pharmacokinetic parameters must be used cautiously in applying it to the therapeutic drug monitoring for CBZ in our patients.
We estimated individual and population Michaelis-Menten pharmacokinetic parameters for phenytoin (DPH) in epileptic patients attending our neurology clinic using the computer programme. OPT. Our results agreed well with literature values but were lower than those we obtained earlier in a smaller number of patients. The Km was independent of age, weight and sex but there was a weak, correlation between Vm and body weight. We conclude that the use of population Vm and Km in normograms could lead to errors in DPH dose estimations as they correlated very poorly with patient characteristics. OPT was easy to use and sufficiently accurate for deriving dose estimates in routine patients. Its use would enable practitioners to generate their patients' own parameters for use in individual dosage adjustments. The estimates can subsequently be updated as more data become available.
A system for computerising full blood picture reporting developed in-house using dBASE IV on IBM-compatible microcomputers in a local area network environment is described. The software package has a user-friendly interface which consists of a horizontal main menu bar with associated pull-down submenus. The package captures data directly from an automatic blood cell counter and provides options to modify or delete records, search for records, print interim, final or cumulative reports, record differential counts with an emulator, facilitate house-keeping activities which include backing-up databases and repairing corrupted indices. The implementation of this system has helped to improve the efficiency of reporting full blood picture in the haematology laboratory.
PIP: The great deal of documentation which was prepared for the recent TSS/CST Population IEC (information, education, and communication) meeting from research, field experiments, and action projects will be useful to TSS/CST advisors and individual countries undertaking IEC and population education work. This article summarizes the 12 sessions held during the open forum. To illustrate some of the latest trends in population and health communication, the "enter-educate" approach and use of the interactive computer software called SCOPE (Strategic Communication Planning and Evaluation) were discussed. Next, ways in which to apply research effectively in IEC and population education were considered. Examples were provided of 1) a workshop methodology used to help a multidisciplinary group design a problem-solving communication strategy in Malaysia and Dominica; 2) the counseling training evaluation technique based on the GATHER (greet, ask, tell, help, explain, and return for follow-up) model; and 3) four types of evaluation of population education in schools. The third session was concerned with the program approach used in IEC and population education. Session 4 dealt with the implication of UNFPA support to family planning (FP) IEC. Counseling skills training and interpersonal communication were next on the agenda, followed by a consideration of how knowledge and policies are applied in the area of youth. The seventh session concentrated on ways to involve men in FP and reproductive health and included a discussion of a case study on the attitude and behavior of men with regard to FP which had IEC implications. The next session described the need to reconceptualize population education and what such a reconceptualization would entail. Session 9 was devoted to a consideration of gender issues and the education of girls. The tenth session covered the use of participatory approaches and community involvement in population communication programs. Innovative methodologies for school-based population education were described next, and the last session was concerned with new information technologies such as navigating the Internet and using new software for establishing databases.
A description is given of the numerical integration method for the calculation of the mean kidney dose for a Co-57 external radiation source. Based on this theory, a computer program was written. Initial calculation of the kidney volume shows that the method has a good accuracy. For the mean kidney dose, this method gives a satisfactory result, since the calculated value lies within the acceptable range of the central axis depth dose.
Satu huraian diberikan tentang kaedah pengkamiran berangka untuk mengira dos buah pinggang purata untuk satu sumber sinaran luar Co-57. Berdasarkan teori ini, satu program komputer ditulis. Pengiraan awal isipadu buah pinggang menunjukkan yang kaedah ini mempunyai ketepatan yang baik. Untuk dos buah pinggang purata, kaedah ini memberikan keputusan yang baik, kerana nilai kiraan terletak diantara julat dos kedalaman paksi pusat yang diterima.
A study was conducted to examine the usage of application software and its development practices in Malaysia. The study has shown that the use of application software is greatly emphasized by organizations in their respective businesses. And for most organizations, the application software is supplied by a vendor or through in house development. For the software development practices, the deployment of a current technique and technology is still inadequate. Therefore, most of the existing information technology practitioners should be given additional training on the latest techniques of software development. Other aspect of improvement on software development practices is also discussed.
Satu kajian terhadap status pemakaian dan kegiatan pembangunan perisian gunaan di Malaysia telah dijalankan. Kajian ini menunjukkan yang aspek pemakaian sangat diberi penekanan oleh organisasi. Manakala proses perolehan perisian gunaan pula terbahagi secara setara di antara buat sendiri dengan menggunakan pihak ketiga. Namun begitu yang ketara ialah kadar penggunaan teknologi dan teknik terkini dalam kegiatan pembangunan perisian masih berkurangan. Oleh itu disarankan supaya aspek latihan teknik kakitangan teknologi maklumat organisasi perlu dipertingkatkan secara berterusan. Di samping itu kajian ini memaparkan beberapa aspek amalan pembangunan perisian yang boleh diperbaiki lagi.
The 21st century promises to usher in an era of Internet based healthcare services--Tele-Healthcare. Such services augur well with the on-going paradigm shift in healthcare delivery patterns, i.e. patient centred services as opposed to provider centred services and wellness maintenance as opposed to illness management. This paper presents a Tele-Healthcare info-structure TIDE--an 'intelligent' wellness-oriented healthcare delivery environment. TIDE incorporates two WWW-based healthcare systems: (1) AIMS (Automated Health Monitoring System) for wellness maintenance and (2) IDEAS (Illness Diagnostic & Advisory System) for illness management. Our proposal comes from an attempt to rethink the sources of possible leverage in improving healthcare; vis-à-vis the provision of a continuum of personalised home-based healthcare services that emphasise the role of the individual in self health maintenance.
In this paper, we present a Java-based framework for the processing, storage and delivery of Electronic Medical Records (EMR). The choice of Java as a developmental and operational environment ensures operability over a wide-range of client-side platforms, with our on-going work emphasising migration towards Extensible Markup Language (XML) capable Web browser clients. Telemedicine in support of womb-to-tomb healthcare as articulated by the Multimedia Supercorridor (MSC) Telemedicine initiative--which motivated this project--will require high-volume data exchange over an insecure public-access Wide Area Network (WAN), thereby requiring a hybrid cryptosystem with both symmetric and asymmetric components. Our prototype framework features a pre-transaction authentication and key negotiation sequence which can be readily modified for client-side environments ranging from Web browsers without local storage capability to workstations with serial connectivity to a tamper-proof device, and also for point-to-multipoint transaction processes.
The healthcare enterprise requires a great deal of knowledge to maintain premium efficiency in the delivery of quality healthcare. We employ Knowledge Management based knowledge acquisition strategies to procure 'tacit' healthcare knowledge from experienced healthcare practitioners. Situational, problem-specific Scenarios are proposed as viable knowledge acquisition and representation constructs. We present a healthcare Tacit Knowledge Acquisition Info-structure (TKAI) that allows remote healthcare practitioners to record their tacit knowledge. TKAI employs (a) ontologies for standardisation of tacit knowledge and (b) XML to represent scenario instances for their transfer over the Internet to the server-side Scenario-Base and for the global sharing of acquired tacit healthcare knowledge.
Health-Level (HL) 7 message semantics allows effective functional implementation of Electronic Medical Record (EMR)--encompassing both clinical and administrative (i.e. demographic and financial) information--interchange systems, at the expense of complexity with respect the Protocol Data Unit (PDU) structure and the client-side application architecture. In this paper we feature the usage of the Extensible Markup Language (XML) document-object modelling and Java client-server connectivity towards the implementation of a Web-based system for EMR transaction processing. Our solution features an XML-based description of EMR templates, which are subsequently transcribed into a Hypertext Markup Language (HTML)-Javascript form. This allows client-side user interfaceability and server-side functionality--i.e. message validation, authentication and database connectivity--to be handled through standard Web client-server mechanisms, the primary assumption being availability of a browser capable of XML documents and the associated stylesheets. We assume usage of the Internet as the interchange medium, hence the necessity for authentication and data privacy mechanisms, both of which can be constructed using standard Java-based building blocks.
The abundance and transient nature to healthcare knowledge has rendered it difficult to acquire with traditional knowledge acquisition methods. In this paper, we propose a Knowledge Management approach, through the use of scenarios, as a mean to acquire and represent tacit healthcare knowledge. This proposition is based on the premise that tacit knowledge is best manifested in atypical situations. We also provide an overview of the representational scheme and novel acquisition mechanism of scenarios.