A study of general practitioners' perspectives on electronic medical records systems in NHS Scotland

<b>Background</b> Primary care doctors in NHSScotland have been using electronic medical records within their practices routinely for many years. The Scottish Health Executive eHealth strategy (2008-2011) has recently brought radical changes to the primary care computing landscape in Scotland: an information system (GPASS) which was provided free-of-charge by NHSScotland to a majority of GP practices has now been replaced by systems provided by two approved commercial providers. The transition to new electronic medical records had to be completed nationally across all health-boards by March 2012. <p></p><b> Methods</b> We carried out 25 in-depth semi-structured interviews with primary care doctors to elucidate GPs' perspectives on their practice information systems and collect more general information on management processes in the patient surgical pathway in NHSScotland. We undertook a thematic analysis of interviewees' responses, using Normalisation Process Theory as the underpinning conceptual framework. <p></p> <b>Results</b> The majority of GPs' interviewed considered that electronic medical records are an integral and essential element of their work during the consultation, playing a key role in facilitating integrated and continuity of care for patients and making clinical information more accessible. However, GPs expressed a number of reservations about various system functionalities - for example: in relation to usability, system navigation and information visualisation. <b>Conclusion </b>Our study highlights that while electronic information systems are perceived as having important benefits, there remains substantial scope to improve GPs' interaction and overall satisfaction with these systems. Iterative user-centred improvements combined with additional training in the use of technology would promote an increased understanding, familiarity and command of the range of functionalities of electronic medical records among primary care doctors

Ontology-driven, adaptive, medical questionnaires for patients with mild learning disabilities

Patients with Learning Disabilities (LD) have substantial and unmet healthcare needs, and previous studies have highlighted that they face both health inequalities and worse outcomes than the general population. Primary care practitioners are often the first port-of-call for medical consultations, and one issue faced by LD patients in this context is the very limited time available during consultations - typically less than ten minutes. In order to alleviate this issue, we propose a digital communication aid in the form of an ontology-based medical questionnaire that can adapt to a patient’s medical context as well as their accessibility needs (physical and cognitive). The application is intended to be used in advance of a consultation so that a primary care practitioner may have prior access to their LD patients’ self-reported symptoms. This work builds upon and extends previous research carried out in the development of adaptive medical questionnaires to include interactive and interface functionalities designed specifically to cater for patients with potentially complex accessibility needs. A patient’s current health status and accessibility profile (relating to their impairments) is used to dynamically adjust the structure and content of the medical questionnaire. As such, the system is able to significantly limit and focus questions to immediately relevant concerns while discarding irrelevant questions. We propose that our ontology-based design not only improves the relevance and accessibility of medical questionnaires for patients with LDs, but also provides important benefits in terms of medical knowledge-base modularity, as well as for software extension and maintenance

New compounds based on 1H-pyrrolo[2,3-b] pyridine as potent TNIK inhibitors against colorectal cancer cells. Molecular modeling studies

Cancer is a disease caused by the incorrect transformation of cells that proliferate abnormally, and it is one of the leading causes of mortality worldwide. As a result, new compounds with potential anticancer activity must be designed. In this article, three – dimensional Quantitative Structure-Activity Relationship is used to study thirty-one compounds of 1H-pyrrolo[2,3-b]pyridine derivatives as potent TNIK inhibitors against colorectal cancer cells. Their pIC50 varied from 7.37 to 9.92. The two contours, Molecular Field Analysis (CoMFA) and Comparative Molecular Similarity Indices (CoMSIA) are critical in determining the nature of the groups that enhance or reduce activity. The models CoMFA and CoMSIA indicate strong reliability with (Q2 = 0.65; R2 = 0.86; rtest2 = 0.97) and (Q2= 0.74; R2 = 0. 96; rtest2 = 0. 95), respectively. Based on the good findings produced by the contour maps generated by the approach model, we have suggested five drugs with strong activity against colorectal cancer cells. In addition, the ADMET characteristics of these newly designed compounds were examined in silico. These compounds were further evaluated by molecular docking, showing that two molecules, Y4 and Y5, exhibit favorable interactions with the targeted receptor and a high total score. Our vision is to develop new medicines with strong TNIK inhibitory activities that target Traf2 and Nck-interacting kinase TNIK as a therapeutic target

Mobile support for adults with mild learning disabilities during clinical consultations

Some of the factors that explain poor health outcomes for people with learning disabilities (LDs) include multi-morbidity and underdiagnosed health conditions. Previous studies have suggested that this population face significant communication barriers when interacting with health professionals and this is a major contributing factor to such diagnosis complications. Consequently, such health barriers are often preventable. However, there is a surprising lack of research-based technologies available that intend to promote this communication. We aim to address this gap by investigating the potential of using mobile technologies to support adults with mild LDs during clinical consultations. To achieve this, we interviewed a number of domain experts including government advisors, academics, support workers and General Practitioners. We then developed a technology probe to inform the information extracted and subsequently created a set of design guidelines for the development of Augmentative and Communicative technologies that target the clinical needs of adults with mild LDs

Localization and Absorption of Light in 2D Composite Metal-Dielectric Films at the Percolation Threshold

We study in this paper the localization of light and the dielectric properties of thin metal-dielectric composites at the percolation threshold and around a resonant frequency where the conductivities of the two components are of the same order. In particular, the effect of the loss in metallic components are examined. To this end, such systems are modelized as random $L-C$ networks, and the local field distribution as well as the effective conductivity are determined by using two different methods for comparison: an exact resolution of Kirchoff equations, and a real space renormalization group method. The latter method is found to give the general behavior of the effective conductivity but fails to determine the local field distribution. It is also found that the localization still persists for vanishing losses. This result seems to be in agreement with the anomalous absorption observed experimentally for such systems.Comment: 14 page latex, 3 ps figures. submitte

Radiative Corrections to W^+W^- \to W^+W^- in the Electroweak Standard Model

The cross-section for W^+W^- \to W^+W^- with arbitrarily polarized W bosons is calculated within the Electroweak Standard Model including the complete virtual and soft-photonic O(alpha) corrections. We show the numerical importance of the radiative corrections for the dominating polarized cross-sections and for the unpolarized cross-section. The numerical accuracy of the equivalence theorem is investigated in O(alpha) by comparing the cross-section for purely longitudinal W bosons obtained from the equivalence theorem and from the direct calculation. We point out that the instability of the W boson, which is inherent in the one-loop corrections, prevents a consistent calculation of radiative corrections to the scattering of on-real-mass-shell longitudinal W bosons beyond O(alpha).Comment: 24 pages, LaTeX, uses axodraw, epsfig. Statement clarifie