Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2010
Finite element comparison of different growth sparring instrumentation systems for the early treatment of idiopathic scoliosis.
Fusionless growth sparring implants seek to restore spinal alignment through the early intervention of pediatric scoliosis. Amongst a growing number of concepts, the stainless steel (SS) staple, flexible tether and shape memory alloy (SMA) staple have demonstrated their validity by retarding convex vertebral growth while modifying spinal alignment. The purpose of this study was to explore the biomechanics of these devices in a human scoliotic finite element model (FEM) constructed from patient data. ⋯ Initial and long term modifications of coronal spinal alignment following simulated growth was respectfully 28 degrees to 62 degrees in non-instrumented model and patient data, 28 degrees to 31 degrees with SS staple, 23 degrees to 31 degrees with flexible tether, and 27 degrees to 34 degrees with SMA staple. The interpretation of such methods suggests that the long term correction, achieved via growth modulation, would benefit from improved control of asymmetrical stresses within the growth plates. From a biomechanical perspective, fusionless growth sparring techniques for the early treatment of idiopathic scoliosis show promising preliminary results.
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Hospitalized patients receive countless doses of medications through manually programmed infusion pumps. Many medication errors are the result of programming incorrect pump settings. When used appropriately, smart pumps have the potential to detect some programming errors. ⋯ Acceptable programming limits of dose rate increases in addition to initial drug doses for 23 high-risk medications are monitored. During 22.5 months in a 24 bed ICU, 970 alerts (4% of 25,040 doses, 1.4 alerts per day) were generated for pump settings programmed outside acceptable limits of which 137 (14%) were found to have prevented potential harm. Monitoring pump programming at the system level rather than the pump provides access to additional patient data in the EMR including previous dosage levels, other concurrent medications and caloric intake, age, gender, vitals and laboratory results.
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Stud Health Technol Inform · Jan 2010
The IT-infrastructure of a biobank for an academic medical center.
For high quality research in biomedicine an operable biobank is essential. In order to make optimal use of the material and the huge amount of data a sustainable IT-infrastructure is indispensable. Therefore, we developed a concept for the IT-infrastructure of a biobank for an academic medical center. ⋯ Our results indicate that the IT-infrastructure plays a pivotal role in successfully establishing a biobank. Several aspects of the IT-infrastructure are similarly found in other areas as, e.g. data protection and storage and quality management. Finally, we conclude that although a research database is not required for operating a biobank, the need for it will definitely emerge, especially with regard to personalized medicine and high-throughput gene expression analysis.
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Stud Health Technol Inform · Jan 2010
Discuss now, document later: CIS/CPOE perceived to be a 'shift behind' in the ICU.
Effective communication is essential to safe and efficient patient care. We aimed to understand the current patterns and perceptions of communication of common goals in the ICU using the distributed cognition and clinical communication space theoretical frameworks. ⋯ These perceptions that the CIS/CPOE is a "shift behind" may lead to a further reliance on verbal information exchange, which is a valuable clinical communication activity, yet, is subject to information loss. Electronic documentation tools that, in real time, capture information that is currently verbally communicated may increase the effectiveness of communication.
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Stud Health Technol Inform · Jan 2010
The illusion of presence influences VR distraction: effects on cold-pressor pain.
This study investigated whether VR presence influences how effectively VR distraction reduces pain intensity during a cold-pressor experience. Thirty-seven healthy students underwent a cold pressor task while interacting with a VR distraction world. ⋯ Results showed that the amount of VR presence reported correlated significantly and negatively with ratings of pain intensity. The importance of using an appropriately designed VR to achieve effective VR analgesia is highlighted.