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Data Mining for Predicting Pre-diabetes: Comparing Two Approaches 预测糖尿病前期的数据挖掘:两种方法的比较
Pub Date : 2015-07-01 DOI: 10.4018/IJUDH.2015070103
K. Farahmand, Guangjing You, Jing Shi, S. S. Wadhwa
Many individuals who are at risk for type 2 diabetes do not experience symptoms of diabetes, and therefore are not aware of this condition. Screening for type 2 diabetes can identify individuals at risk for type 2 diabetes, and prevent or delay complications. A total of 13 risk factors, out of 17 variables of NHANES', were selected as predictors. In this study, a comparison of two data mining methodology showed that Decision Tree has a higher ROC index than Logistic Regression modeling. All ROC indexes for two data mining models were greater than 77% indicating both methods present a good prediction for pre-diabetes. The final results of comparison indicated Decision Tree modeling is a better indicator to predict pre-diabetes.
许多有2型糖尿病风险的人并没有经历糖尿病的症状,因此没有意识到这种情况。2型糖尿病筛查可以识别有2型糖尿病风险的个体,预防或延缓并发症的发生。从NHANES的17个变量中选取13个危险因素作为预测因子。在本研究中,两种数据挖掘方法的比较表明,决策树模型比Logistic回归模型具有更高的ROC指数。两种数据挖掘模型的ROC指标均大于77%,表明两种方法均能较好地预测糖尿病前期。比较结果表明决策树模型是预测糖尿病前期的较好指标。
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引用次数: 3
Can Travel and Trade Affect the Global Epidemiology of Rabies?: A Short Review 旅游和贸易会影响狂犬病的全球流行病学吗?:简短回顾
Pub Date : 2014-10-01 DOI: 10.4018/IJUDH.2014100105
K. Gokul Kumar, A. Chatterjee
Rabies is an acute, progressive, universally fatal encephalitis, caused by a zoonotic Lyssavirus belonging to the family Rhabdoviridae. Although an infectious disease, traditionally, it has not been considered to be spread through international trade and travel owing to the absence of human-to-human transmission. However, cross-border animal migration, animal trade, and travel to areas endemic for rabies pose a chance of emergence of travel-associated rabies as a public health threat. Additionally, the fact that the developed world has eradicated canine variant of the rabies virus impresses the imperative that adequate surveillance is maintained to prevent re-entry and re-establishment of the virus. The current review looks at evidence around outbreaks of travel-associated rabies and examines the various levels at which travel-associated rabies poses a threat and proposes policy recommendations which could be adopted in a local setting to combat the emerging public health challenge.
狂犬病是一种急性、进行性、普遍致命的脑炎,由一种属于狂犬病毒科的人畜共患狂犬病毒引起。虽然它是一种传染病,但传统上认为,由于没有人际传播,它不会通过国际贸易和旅行传播。然而,跨境动物迁徙、动物贸易以及前往狂犬病流行地区的旅行,都有可能出现与旅行相关的狂犬病,成为一种公共卫生威胁。此外,发达国家已经根除犬类狂犬病毒变种的事实表明,必须保持充分的监测,以防止病毒再次进入和重新建立。目前的审查着眼于与旅行相关的狂犬病暴发有关的证据,审查与旅行相关的狂犬病构成威胁的各个层面,并提出政策建议,这些建议可在地方环境中采用,以应对新出现的公共卫生挑战。
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引用次数: 2
E-Healthcare Disparities Across Cultures: Infrastructure, Readiness and the Digital Divide 跨文化的电子医疗差异:基础设施、准备和数字鸿沟
Pub Date : 2014-10-01 DOI: 10.4018/IJUDH.2014100101
S. Biswas, Keren Mazuz, R. Mendes
As e-healthcare becomes a reality for healthcare service provision across the world, challenges in acceptance, implementation, usage and effectiveness have begun to emerge. The infrastructure, readiness and literacy levels required for the effective delivery of e-healthcare services may be prohibitive in providing access to those most in need. As research brings to light the real effectiveness of e-healthcare programmes across the globe, this paper explores how e-healthcare has been implemented worldwide and how populations have been served by an innovation in Information Technology and healthcare that has sought to bring health services to remote areas, improve access to healthcare and narrow the divide between healthcare providers and patients. While notable achievements have seen real time clinical data captured and medical records digitalised, the very determinants responsible for actual health and social disparities are equally responsible for disparities is access to e-healthcare.
随着电子医疗保健成为全球医疗保健服务提供的现实,在接受、实施、使用和有效性方面的挑战已经开始出现。有效提供电子医疗保健服务所需的基础设施、准备情况和识字率水平可能不利于向最需要的人提供服务。由于研究揭示了电子医疗保健计划在全球范围内的真正有效性,本文探讨了电子医疗保健是如何在全球范围内实施的,以及信息技术和医疗保健方面的创新是如何为人口提供服务的,这种创新旨在将医疗服务带到偏远地区,改善获得医疗保健的机会,缩小医疗保健提供者和患者之间的鸿沟。虽然在实时临床数据采集和医疗记录数字化方面取得了显著成就,但造成实际健康和社会差异的决定因素同样是电子医疗保健的可及性。
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引用次数: 8
The Importance of Raising Chronic Kidney Disease (CKD) Awareness for Young People and Parents: Young People with Chronic Kidney Disease (CKD) 提高年轻人和家长对慢性肾脏疾病(CKD)认识的重要性:患有慢性肾脏疾病(CKD)的年轻人
Pub Date : 2014-10-01 DOI: 10.4018/IJUDH.2014100106
S. Muhammad, B. Sen
Chronic Kidney Disease (CKD) in young people is complex, with many requiring Renal Replacement Therapy (RRT). Young people may be disenfranchised by perceptions of helplessness and feelings of powerlessness against a backdrop of diminished health, consequently impacting on their capacity for effective coping. Not surprisingly, young people and parents/ guardians seek online support through social media which offers advantages over standard forms of engagement/ education. The claim here is that future clinicians are unable to best practice unless they get more involved in patient-led initiatives and better appreciate how young people with CKD and their parents use the internet/ social media as an effective learning resource. Social media can positively influence young people, parents/ guardians to gather resources, supporting them to develop self-care and enhance shared-decision-making, empowering them to adopt coping strategies. Health professionals should have an understanding of what resources are available to young people and parents/ guardians.
慢性肾脏疾病(CKD)在年轻人中是复杂的,许多人需要肾脏替代治疗(RRT)。在健康状况下降的背景下,年轻人可能会被无助感和无力感剥夺权利,从而影响到他们有效应对的能力。毫不奇怪,年轻人和家长/监护人通过社交媒体寻求在线支持,这比标准的参与/教育形式有优势。这里的主张是,除非未来的临床医生更多地参与到以患者为主导的倡议中,并更好地了解患有慢性肾病的年轻人及其父母如何将互联网/社交媒体作为有效的学习资源,否则他们无法实现最佳实践。社交媒体可以积极影响年轻人、父母/监护人收集资源,支持他们发展自我照顾和加强共同决策,使他们能够采取应对策略。卫生专业人员应该了解年轻人和父母/监护人可以获得哪些资源。
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引用次数: 2
Application of Radiology Techniques and Technologies in Forensic Investigations 放射学技术在法医调查中的应用
Pub Date : 2014-10-01 DOI: 10.4018/IJUDH.2014100104
R. Vidua
Forensic radiology is a specialized area of medical imaging which is used for the purpose of evaluation by the forensic experts, physicians, pathologists and anthropologists in cases related with the law. The imaging technologies and techniques can be potential and powerful tools in solving the medico legal cases in the field of Forensic Medicine & Toxicology. Here Forensic experts evaluate the medico legal cases by effectively utilizing their knowledge and experience of recent radiological techniques and technologies. In this article along with the brief history, different modalities of Radiology which have various applications in medico legal investigations with certain advantages and disadvantages, record keeping of data produced, the safety aspects of these technologies, economical aspect of using them along with its current status in a global perspective and its future role and challenges have been discussed.
法医放射学是医学成像的一个专门领域,用于法医专家、医生、病理学家和人类学家在与法律有关的案件中进行评估。影像技术是解决法医学和毒理学领域的医学法律案件的有力工具。在这里,法医专家通过有效地利用他们对最新放射技术和技术的知识和经验来评估医学法律案件。在这篇文章中,随着简要的历史,放射学的不同模式,在医学法律调查中有不同的应用,有一定的优点和缺点,产生的数据的记录保存,这些技术的安全方面,使用它们的经济方面,以及它在全球范围内的现状和未来的作用和挑战进行了讨论。
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引用次数: 3
Free Resources for Conducting Learning Sessions for Undergraduate Medical Students About Pharmaceutical Promotion 为本科医学生举办药物推广学习课程的免费资源
Pub Date : 2014-10-01 DOI: 10.4018/IJUDH.2014100103
P. Shankar
Pharmaceutical promotion has been shown in various studies to be an important influence on the prescribing behavior of doctors. Undergraduate students should be aware of promotion, be introduced to various tactics adopted by the industry and be able to respond to promotion. A survey conducted in 2004 showed most medical schools devoted only one to two hours of curriculum time to this topic. A number of free internet resources are available for faculty members interested in conducting sessions on this topic for students. This article discusses selected resources including the Ethical criteria for medicinal drug promotion, Understanding and responding to pharmaceutical promotion a practical guide, Healthy Skepticism website, Pharmedout website, No free lunch website, the website of the Citizen's Commission for Human Rights, the book Drug promotion: What we know, what we have yet to learn and resources dealing with disease mongering.
各种研究表明,药物促销对医生的处方行为有重要影响。本科学生应了解促销,了解行业采用的各种策略,并能够应对促销。2004年进行的一项调查显示,大多数医学院只花了一到两个小时的课程时间来讨论这个话题。有兴趣为学生举办这一主题会议的教师可以使用许多免费的互联网资源。本文讨论了一些资源,包括《药品推广的伦理标准》、《理解和应对药品推广实用指南》、《健康怀疑主义网站》、《Pharmedout网站》、《没有免费午餐网站》、《公民人权委员会网站》、《药品推广:我们知道什么,我们还需要学习什么》以及与疾病贩卖有关的资源。
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引用次数: 1
Electronic Patient Records (EPR), Library Services (LS) and Multidisciplinary Team (MDT) Meetings: Is it Not Time to Integrate Primary Care for the Better? 电子病历(EPR)、图书馆服务(LS)和多学科小组(MDT)会议:整合初级保健的时机还不够好吗?
Pub Date : 2014-10-01 DOI: 10.4018/IJUDH.2014100102
S. Muhammad, M. Rigler, Meshia Adams
Patients with Long-Term Conditions (LTCs) account for around 50% of General Practitioner (GP) appointments, 64% of outpatient appointments and 70% of hospital bed days. There needs to be a wider access to knowledge and understanding such as directories with information leaflets, documents, books on lifestyle, helpful contacts and sources to information that can support patients and the general public on the most important elements their health. This cannot be achieved just through patients accessing their health records in sole. The objective of this paper is to 1) highlight the importance of integrating General Practice (GP), Electronic Patient Records (EPR) with Library Services (LS) and 2) also explore why it would be advantageous to implement patient-centred Multidisciplinary Team (MDT) meetings in primary care for patients with Long-Term Conditions (LTCs). This article provides a UK glance and how primary care services can be improved, integrating for the better. Having access to Electronic Patient Records (EPR) alone will not help or encourage a patient to gain confidence and/ or understanding especially if patients are overwhelmed by their healthcare choices and Health Literacy (HL) complexities. Patients' whose first language is not English for example, approaching more methods to support HL is/ will be challenging. Library and Health Services partnerships should be initiated to allowing access to wider resources. In addition, patient-centred Multidisciplinary Team (MDT) meetings should be arranged at dedicated time points between a doctor and patient/ carer and these can take place in a private section within library setting involving wider participation in care plans. Given that more patients and the public will have opportunity to access their health records, a “Libraries and Health†partnership can help integrate primary healthcare better thus allowing all to access health-related literature, using books, leaflets and digital media in a comfortable environment in a setting that also has staff that can support with HL and technology. An EPR and MDT initiative should be supported with library and health partnerships; this needs to be encouraged.
长期疾病患者约占全科医生(GP)预约的50%,门诊预约的64%和住院天数的70%。需要有更广泛的获取知识和理解的途径,例如带有信息传单的目录、文件、关于生活方式的书籍、有用的联系方式和信息来源,以支持患者和公众了解其健康的最重要因素。这不能仅仅通过患者单独访问他们的健康记录来实现。本文的目的是:1)强调整合全科医生(GP)、电子病历(EPR)和图书馆服务(LS)的重要性;2)探讨为什么在长期疾病(LTCs)患者的初级保健中实施以患者为中心的多学科团队(MDT)会议是有利的。这篇文章提供了一个英国的概览,以及如何改进初级保健服务,为更好地整合。仅仅访问电子病历(EPR)并不能帮助或鼓励患者获得信心和/或理解,特别是当患者被他们的医疗保健选择和健康素养(HL)的复杂性所压倒时。例如,母语不是英语的患者,采用更多的方法来支持HL是具有挑战性的。图书馆和卫生服务部门应建立伙伴关系,以便获得更广泛的资源。此外,以患者为中心的多学科小组(MDT)会议应该安排在医生和患者/护理人员之间的专门时间点,这些会议可以在图书馆设置的私人区域举行,让更多的人参与护理计划。考虑到更多的患者和公众将有机会获得他们的健康记录,€œLibraries和health伙伴关系可以帮助更好地整合初级卫生保健,从而使所有人都能在舒适的环境中使用书籍、传单和数字媒体获取与健康有关的文献,而且工作人员也可以提供HL和技术支持。应在图书馆和卫生伙伴关系的支持下开展EPR和MDT倡议;这需要得到鼓励。
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引用次数: 3
Case Study: Resolving Diagnostic Uncertainties in the Clinical Presentation of Ocular Tuberculosis 个案研究:解决眼结核临床表现的诊断不确定性
Pub Date : 2014-07-01 DOI: 10.4018/IJUDH.2014070106
S. Gupta, D. Verma, D. P. Singh
In the developing countries, incidence of systemic tuberculosis is very high, with over 8 million new cases each year. The incidence of tuberculous uveitis is also rising correspondingly. It is difficult to diagnose ocular tuberculosis because of the lack of specific ocular findings and specific confirmatory laboratory tests. However, in a developing country like India, where the prevalence of latent tuberculosis is high, uveitis of unexplained cause not fitting into known uveitis entities, in presence of Monteux positivity, is more likely to be tubercular in origin. Hence, early diagnosis and prompt treatment with antitubercular treatment may result in dramatic drop in recurrence and improve individual patient outcomes.
在发展中国家,全身性结核病的发病率非常高,每年有800多万新病例。结核性葡萄膜炎的发病率也相应上升。由于缺乏特异性的眼部表现和特异性的实验室检查,因此很难诊断眼结核。然而,在像印度这样的发展中国家,潜伏性结核病的流行率很高,原因不明的葡萄膜炎不符合已知的葡萄膜炎实体,存在蒙特乌斯阳性,更可能是结核性的起源。因此,早期诊断和及时的抗结核治疗可以显著降低复发率并改善个体患者的预后。
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引用次数: 3
Ranitidine-Induced Hepatitis in a Young Man with Myalgia and Insomnia: Narratives in Conversational Learning Experience 雷尼替丁诱发的患有肌痛和失眠的年轻人肝炎:会话学习经验的叙述
Pub Date : 2014-07-01 DOI: 10.4018/IJUDH.2014070103
Shrutika Singh, R. Biswas
This is a conversational narrative of the learning experience of a group of medical students around an interesting case that was brought to them through the network of the user driven healthcare (UDHC) system. In addition to the traditional didactic framework of lecture-based clinical medicine, the students were exposed to patient-centered learning exercises where a patient of clinically complex issues was present as a part of the didactic experience in the classroom. As an innovative approach, which has not been trialed in the Indian medical education system, the teaching experience required following up with student narratives that reflected on the learning experience gleaned from the multidimensional clinical-didactic encounter. This paper outlines a case of ranitidine-associated hepatitis, a little known side effect of a vastly prescribed drug, and the associated discussion generated on online forums, mainly driven by the students who were involved in the clinical history of the case. There are reflective accounts of the student and preceptor involved in the teaching-learning exercise discussing the clinical encounter.
这是一组医科学生通过用户驱动医疗(UDHC)系统的网络,围绕一个有趣案例的学习经历的对话叙述。除了传统的以讲座为基础的临床医学教学框架外,学生们还接触到以患者为中心的学习练习,其中临床复杂问题的患者作为课堂教学体验的一部分。作为一种尚未在印度医学教育系统中试验过的创新方法,教学经验要求跟进学生的叙述,这些叙述反映了从多维临床教学遇到中收集到的学习经验。本文概述了一例雷尼替丁相关性肝炎,这是一种广泛处方药物的鲜为人知的副作用,以及在线论坛上产生的相关讨论,主要由参与该病例临床史的学生推动。有学生和导师参与教学练习讨论临床遇到反思的叙述。
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引用次数: 2
Medical Students Meet User Driven Health Care for Patient Centered Learning in Clinical Medicine 医学生满足以病人为中心的临床医学学习的用户驱动的医疗保健
Pub Date : 2014-07-01 DOI: 10.4018/IJUDH.2014070102
N. Arora, N. Tamrakar, A. Price, R. Biswas
Patient-centered learning and participatory research are emerging movements in the transformation of primary healthcare and research participation. In recent years this focus has extended to the utilization of User Driven Health Care (UDHC) networks for patient centered learning in medical education. Technology now makes it possible for patients, medical students, and providers to communicate through the Interneton a secure platform. Student authors experiencing this new brush with technology-supported, patient centered learning experience share how participation in a User Driven Health Care online education experience informed their learning and incited them to develop an interest in evidence based knowledge. They developed a survey tool and conducted interviews over the Internet to report on the experiences of others within the network. The findings were largely positive although some students did not feel the reality of the connection to an actual patient. Others report enjoying the experience and being enriched through the interaction, but, at the same time, expressed doubts whether this was a sustainable way to learn given the volume of information a student has to master to attain to the level of a practicing physician
以患者为中心的学习和参与性研究是初级保健和研究参与转型中的新兴运动。近年来,这一重点已扩展到利用用户驱动的卫生保健(UDHC)网络,在医学教育中以患者为中心的学习。现在的技术使病人、医学生和医疗服务提供者在一个安全的平台上通过互联网进行交流成为可能。体验这种以技术为支持、以患者为中心的学习体验的学生作者分享了参与用户驱动的医疗保健在线教育体验如何为他们的学习提供信息,并激发他们对基于证据的知识产生兴趣。他们开发了一种调查工具,并在互联网上进行了采访,以报告网络中其他人的经历。尽管一些学生并没有感受到与实际病人的联系,但研究结果在很大程度上是积极的。另一些人则表示很享受这种体验,并通过互动得到了丰富,但与此同时,考虑到学生要达到执业医师的水平必须掌握大量的信息,他们怀疑这是否是一种可持续的学习方式
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引用次数: 5
期刊
International Journal of User-Driven Healthcare
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