Use cases and DEMO: aligning functional features of ICT-infrastructure to business processes

A natural immune modulator attenuates stress hormone and catecholamine concentrations in polymicrobial peritonitis

BACKGROUND

Activated hexose correlated compound (AHCC), derived from shiitake mushrooms, increases resistance to infection in immunocompromised hosts with positive effects on dendritic cells, natural killer cell function and interleukin 12 production. It may also be attenuating the systemic inflammatory response by regulating the secretion of cortisol and norepinephrine (NE).

METHODS

Female Swiss-Weber mice were pretreated with AHCC (Amino Up Chemical Co., Sapporo, Japan) or water by gavage for 10 days before undergoing cecal ligation and puncture (CLP). Peritoneal exudate cells and blood samples were harvested at 4 hours and 24 hours following CLP. Plasma and peritoneal concentrations of cortisol and NE were obtained using enzyme-linked immunosorbent assay. Peritoneal bacteria were quantified by colony counts after 4 hours and 24 hours. Significance was denoted by a p < 0.05.

RESULTS

Plasma and peritoneal cortisol concentrations were increased 4 hours after CLP compared with normal controls, with no difference between the pretreated groups. Concentrations of cortisol decreased from 4 hours to 24 hours after CLP with AHCC (plasma, p = 0.009; peritoneal, p < 0.001), and peritoneal cortisol at 24 hours was lower with AHCC as compared with water (p = 0.028). There was no change in plasma or peritoneal NE concentrations at 4 hours. At 24 hours, higher concentrations of NE were detected in both plasma and peritoneal fluid, with lower plasma concentrations in those gavaged with AHCC (p = 0.015). There was no significant difference in peritoneal bacteria counts.

CONCLUSION

Enhanced immune function observed with AHCC could be caused by attenuated concentrations of stress hormones and catecholamines.

Overcoming structural constraints to patient utilization of electronic medical records: a critical review and proposal for an evaluation framework

There are constraints embedded in medical record structure that limit use by patients in self-directed disease management. Through systematic review of the literature from a critical perspective, four characteristics that either enhance or mitigate the influence of medical record structure on patient utilization of an electronic patient record (EPR) system have been identified: environmental pressures, physician centeredness, collaborative organizational culture, and patient centeredness. An evaluation framework is proposed for use when considering adaptation of existing EPR systems for online patient access. Exemplars of patient-accessible EPR systems from the literature are evaluated utilizing the framework. From this study, it appears that traditional information system research and development methods may not wholly capture many pertinent social issues that arise when expanding access of EPR systems to patients. Critically rooted methods such as action research can directly inform development strategies so that these systems may positively influence health outcomes.

A model for interpreting work and information management in process-oriented healthcare organisations

BACKGROUND

To increase productivity, management in healthcare organisations have introduced different types of process-oriented organisational configurations. Few studies have addressed clinical practice and information management in these settings.

METHODS

A case study was performed at a paediatric clinic. Data was collected from archives, through interviews, by participatory observation, and by performing a focus group session. The collected data was analysed using a qualitative and interpretative research strategy.

RESULTS

A model was developed of care practitioners' daily work in process-oriented organisations. The model shows that clinical work was deeply integrated; the care activities were dependent on supply activities and tightly connected to management routines.

CONCLUSION

The resulting model can be used to support development of health information system (HIS) embedded in process-oriented healthcare work.