The read-write Linked Data Web

This paper discusses issues that will affect the future development of the Web, either increasing its power and utility, or alternatively suppressing its development. It argues for the importance of the continued development of the Linked Data Web, and describes the use of linked open data as an important component of that. Second, the paper defends the Web as a read-write medium, and goes on to consider how the read-write Linked Data Web could be achieved.

A sophisticated mechanism for enabling real-time mobile access to PHR data

Faced with rapid changes, such as growing complexity in care delivery, health systems nowadays fall short in their ability to translate knowledge into practice. Mobile technology holds enormous potential for transforming healthcare delivery systems which currently involve cumbersome processes that slow down care and decrease rather than improve safety. However, the limited computing, energy and information storage capabilities of mobile devices are hampering their ability to support increasingly sophisticated applications required by certain application fields, such as healthcare. This paper is concerned with a framework which provides ubiquitous mobile access to comprehensive health information at any point of care or decision making in a way that efficient utilization of mobile device resources is achieved. To this end, a cloud-based push messaging mechanism is utilized which draws upon and enhances Google Cloud Messaging service.

National electronic medical records integration on cloud computing system

Few Healthcare providers have an advanced level of Electronic Medical Record (EMR) adoption. Others have a low level and most have no EMR at all. Cloud computing technology is a new emerging technology that has been used in other industry and showed a great success. Despite the great features of Cloud computing, they haven't been utilized fairly yet in healthcare industry. This study presents an innovative Healthcare Cloud Computing system for Integrating Electronic Health Record (EHR). The proposed Cloud system applies the Cloud Computing technology on EHR system, to present a comprehensive EHR integrated environment.

A biomedical information system for retrieval and manipulation of NHANES data

The retrieval and manipulation of data from large public databases like the U.S. National Health and Nutrition Examination Survey (NHANES) may require sophisticated statistical software and significant expertise that may be unavailable in the university setting. In response, we have developed the Data Retrieval And Manipulation System (DReAMS), an automated information system to handle all processes of data extraction and cleaning and then joining different subsets to produce analysis-ready output. The system is a browser-based data warehouse application in which the input data from flat files or operational systems are aggregated in a structured way so that the desired data can be read, recoded, queried and extracted efficiently. The current pilot implementation of the system provides access to a limited amount of NHANES database. We plan to increase the amount of data available through the system in the near future and to extend the techniques to other large databases from CDU archive with a current holding of about 53 databases.

Development of the regional EPR and PACS sharing system on the infrastructure of cloud computing technology controlled by patient identifier cross reference manager

A Newly developed Oshidori-Net2, providing medical professionals with remote access to electronic patient record systems (EPR) and PACSs of four hospitals, of different venders, using cloud computing technology and patient identifier cross reference manager. The operation was started from April 2012. The patients moved to other hospital were applied. Objective is to show the merit and demerit of the new system.

Integrating online communities and social networks with computerised treatment for insomnia: a qualitative study

BACKGROUND

Insomnia is a common psychological complaint. Cognitive behavioural therapy for insomnia (CBT-I), although effective, is little used because of lack of trained providers. Computerised CBT-I (CCBT-I) may be a solution to this shortfall in access.

AIM

To explore patient and health professional perspectives and the role of social networking, to develop a novel CCBT-I programme to increase access to this form of intervention.

DESIGN AND SETTING

Qualitative methods underpinned by the theory of planned behaviour in primary care in Lincolnshire and Nottinghamshire.

METHOD

Semi-structured interviews and focus groups with a purposive sample of health professionals and adults with insomnia.

RESULTS

A total of 23 health professionals and 28 patients were interviewed. Features designed to engender trust and improve functionality were perceived to improve uptake and adherence to CCBT-I. Trust lay in programme accreditation; for professionals, trust derived from evidence of effectiveness; for patients, trust depended on the doctor-patient relationship, professional support, the quality of online peer support, and perceptions of risk. Patients wanted mobile applications; access in short periods; self-assessment; interactive, personalised information on sleep; and moderated contact with other users. Patients and practitioners differed over whether useful information could be distinguished from less useful or potentially incorrect information.

CONCLUSION

Improving uptake and adherence to online programmes for insomnia requires design features focusing on trust and functionality. Enabling greater patient control and interaction with other users and professionals may stimulate positive experiences of online therapy. CCBT-I would enable greater access to treatment but is limited by lack of online access or poor computer literacy.

Connecting research discovery with care delivery in dementia: the development of the Indianapolis Discovery Network for Dementia

BACKGROUND

The US Institute of Medicine has recommended an integrated, locally sensitive collaboration among the various members of the community, health care systems, and research organizations to improve dementia care and dementia research.

METHODS

Using complex adaptive system theory and reflective adaptive process, we developed a professional network called the "Indianapolis Discovery Network for Dementia" (IDND). The IDND facilitates effective and sustainable interactions among a local and diverse group of dementia researchers, clinical providers, and community advocates interested in improving care for dementia patients in Indianapolis, Indiana.

RESULTS

The IDND was established in February 2006 and now includes more than 250 members from more than 30 local (central Indiana) organizations representing 20 disciplines. The network uses two types of communication to connect its members. The first is a 2-hour face-to-face bimonthly meeting open to all members. The second is a web-based resource center (http://www.indydiscoverynetwork.org ). To date, the network has: (1) accomplished the development of a network website with an annual average of 12,711 hits per day; (2) produced clinical tools such as the Healthy Aging Brain Care Monitor and the Anticholinergic Cognitive Burden Scale; (3) translated and implemented the collaborative dementia care model into two local health care systems; (4) created web-based tracking software, the Enhanced Medical Record for Aging Brain Care (eMR-ABC), to support care coordination for patients with dementia; (5) received more than USD$24 million in funding for members for dementia-related research studies; and (6) adopted a new group-based problem-solving process called the "IDND consultancy round."

CONCLUSION

A local interdisciplinary "think-tank" network focused on dementia that promotes collaboration in research projects, educational initiatives, and quality improvement efforts that meet the local research, clinical, and community needs relevant to dementia care has been built.

Internet-based Support for Rural Caregivers of Persons with Stroke Shows Promise

The purpose of this pilot study was to test the feasibility of providing Internet-based education and support intervention to caregivers living in rural settings, including caregivers' satisfaction with the intervention. A secondary aim was to explore their experience of caring. Nine adult caregivers of persons with stroke were enrolled in this descriptive study from rehabilitation centers in northwestern Ohio and southeastern Michigan. They were given access to the intervention, Caring-Web, for three months. Data were collected from participants' bimonthly interviews, as well as e-mail communications. Procedures were tested and found valid, and caregivers were willing and able to use Caring-Web. Using Friedemann's framework of systemic organization, a coding system was developed for analyzing the qualitative data on the experience of caring. Five main themes emerged from these data. These findings help expand knowledge about caregivers dealing with stroke.

4Children for parents and for midwives

This article outlines the launch of a new website which will bring together the rich, but sometimes difficult to access, body of best practice, research and evidence, that parents and professionals need when dealing with children aged from birth-five. The article sets out the scale, type and quality of information that is available, highlights what midwives could helpfully share with parents to help them deal with their children's developments, and what they could access themselves to develop their practice and ensure they remain as up to date as possible with early years developments.

Technical support for Life Sciences communities on a production grid infrastructure

Production operation of large distributed computing infrastructures (DCI) still requires a lot of human intervention to reach acceptable quality of service. This may be achievable for scientific communities with solid IT support, but it remains a show-stopper for others. Some application execution environments are used to hide runtime technical issues from end users. But they mostly aim at fault-tolerance rather than incident resolution, and their operation still requires substantial manpower. A longer-term support activity is thus needed to ensure sustained quality of service for Virtual Organisations (VO). This paper describes how the biomed VO has addressed this challenge by setting up a technical support team. Its organisation, tooling, daily tasks, and procedures are described. Results are shown in terms of resource usage by end users, amount of reported incidents, and developed software tools. Based on our experience, we suggest ways to measure the impact of the technical support, perspectives to decrease its human cost and make it more community-specific.

A few thoughts on evidence in social work

Social work practitioners must act every working day in the face of uncertainty. This uncertainty arises in part because knowledge is often difficult to locate or sometimes lacking regarding: the systems context the population being served; the particular client system; the set of problems the client system is experiencing; as well as the various interventions that could be selected. It seems reasonable to explore ways to reduce the experience of uncertainty, and narrow, if not eliminate, the knowledge gaps that arise in such situations. The generic idea of evidence-based practice has been advanced for some time as an approach to support practitioners in their day-to-day work. This article has two foci. First, it will briefly and selectively review attempts to make social work practice more evidence based. Second, it will describe one stage in the evolution of a Web-based service (information for practice [IP]). IP is a long-term project with the mission of keeping practitioners informed about news and new scholarship in the field, so that they can more easily make their practice more evidenced based.

Adolescent health literacy: the importance of credible sources for online health information

BACKGROUND

Little research has examined adolescent health literacy and its relationship with online health information sources. The purpose of this study is to explore health literacy among a predominantly Hispanic adolescent population and to investigate whether exposure to a credible source of online health information, MedlinePlus(®), is associated with higher levels of health literacy.

METHODS

An online survey was administered to a cross-sectional random sample of high school students in South Texas. Self-reported sociodemographic characteristics and data on health-information-seeking behavior and exposure to MedlinePlus(®) were collected. Health literacy was assessed by eHEALS and the Newest Vital Sign (NVS). Linear and binary logistic regressions were completed.

RESULTS

Of the 261 students who completed the survey, 56% had heard of MedlinePlus(®), 52% had adequate levels of health literacy as measured by NVS, and the mean eHEALS score was 30.6 (possible range 8-40). Health literacy was positively associated with self-efficacy and seeking health information online. Exposure to MedlinePlus(®) was associated with higher eHealth literacy scores (p < .001) and increased the likelihood of having adequate health literacy (odds ratio: 2.1; 95% CI: 1.1, 4.1).

CONCLUSION

Exposure to a credible source of online health information is associated with higher levels of health literacy. The incorporation of a credible online health information resource into school health education curricula is a promising approach for promoting health literacy.

Closing the gap: eliminating health care disparities among Latinos with diabetes using health information technology tools and patient navigators

Latinos have higher rates of diabetes and diabetes-related complications compared to non-Latinos. Clinical diabetes self-management tools that rely on innovative health information technology (HIT) may not be widely used by Latinos, particularly those that have low literacy or numeracy, low income, and/or limited English proficiency. Prior work has shown that tailored diabetes self-management educational interventions are feasible and effective in improving diabetes knowledge and physiological measures among Latinos, especially those interventions that utilize tailored coaching and navigator programs. In this article, we discuss the role of HIT for diabetes management in Latinos and describe a novel "eNavigator" role that we are developing to increase HIT adoption and thereby reduce health care disparities.

An online course in clinical education - experiences of Australian clinicians

AIMS

We aimed to understand clinicians' experience of online training in the area of clinical education.

METHODS

We conducted semistructured in-depth interviews with a purposive sample of 20 clinicians studying clinical education online. Interviews were transcribed verbatim into N-Vivo qualitative analysis software. Data were analysed against a template derived from open coding merged with a priori themes from a program logic model.

RESULTS

Clinicians in this study found learning online convenient but there was a trade off between this convenience and developing an authentic online community of learners. Optional intensives were important for developing relationships with staff and other students. Clinicians faced significant time pressures when adding study to their busy workloads and lives. Protected study time, assistance with course fees, information technology support, facilitated discussion and a flexible approach to assignment submission dates were cited as useful.

CONCLUSION

Clinicians can develop as educators online if given appropriate time and support.