Medical informatics in an undergraduate curriculum: a qualitative study

BACKGROUND: There is strong support for educating physicians in medical informatics, and the benefits of such education have been clearly identified. Despite this, North American medical schools do not routinely provide education in medical informatics. METHODS: We conducted a qualitative study to identify issues facing the introduction of medical informatics into an undergraduate medical curriculum. Nine key informants at the University of Toronto medical school were interviewed, and their responses were transcribed and analyzed to identify consistent themes. RESULTS: The field of medical informatics was not clearly understood by participants. There was, however, strong support for medical informatics education, and the benefits of such education were consistently identified. In the curriculum we examined, medical informatics education was delivered informally and inconsistently through mainly optional activities. Issues facing the introduction of medical informatics education included: an unclear understanding of the discipline; faculty and administrative detractors and, the dense nature of the existing undergraduate medical curriculum. CONCLUSIONS: The identified issues may present serious obstacles to the introduction of medical informatics education into an undergraduate medicine curriculum, and we present some possible strategies for addressing these issues

In Vivo Bioavailability and Therapeutic Assessment of Host-Guest Inclusion Phenomena for the Hydrophobic Molecule Etodolac: Pharmacodynamic and Pharmacokinetic Evaluation

The aim of present investigation was 1) to evaluate the in vivo bioavailability of an Etodolac (ETD)-β-cyclodextrin (β-CD) inclusion complex system prepared by kneading and spray drying techniques in rats, 2) to study the pharmacodynamic parameters in various animal models for analyzing the therapeutic response and, 3) to evaluate the pharmacokinetic profile of the drug administered. Inclusion complexation with β-CD enhanced the solubility of the drug, improved bioavailability and reduced ulcerogenicity of ETD in rats. Pharmacodynamic studies were carried out in normal LACA mice and pharmacokinetic evaluation was done in male Wistar rats. Pharmacokinetic parameters evaluated for the inclusion complexes revealed good correlation. The minimum dose necessary to produce analgesic or anti-arthritic activity was also decreased, indicating that the host-guest strategy that uses β-CD and ETD was very effective and could be successfully employed in the preparation of pharmaceutical formulations of anti-arthritics and analgesics

A Neuro-Expert Approach for Decision -Making in Welding Environment.

Decision making in welding is very important for achieving a good quality welded joint for the least possible cost. Of particular interest is decision making involving the selection of process, parameters, weld procedure specification, defect analysis and trouble shooting. This research has provided a means of capturing the planning knowledge in a Neuro-Expert System in a form that is capable of learning new information, correcting old information and automating the decision-making process in a welding environment. A strategy is formulated for the representation of knowledge in the form of a neural links and the translation of rules into neural link weights. After training those weights were converted back into rules to find out the inconsistent rules and capture new rules using a new approach. The various job variables affecting the process of welding are identified in detail and a Neuro-Expert system for the selection of process, parameters and weld procedure specification is developed. The neural networks are integrated with an expert system for decision making in welding environment. Apart from providing the initial parameters of welding, the expert system is used to validate the output of the neural network and served as a user-friendly interface for the neural network. Defect Analysis is performed in welding domain by mapping the welding parameters and defect patterns in a neural network. A neural network based approach for representing the knowledge in expert system is utilized for this purpose as the modification and updating of the knowledge was easier

Evaluating the impact of comprehensive epilepsy education programme for school teachers in Chandigarh city, India

AbstractPurposeSchool teachers can play a key role in the first-aid management of school children experiencing a seizure. The teachers have a pivotal role in disseminating knowledge to the children of diseases experienced by them and developing positive attitudes among the children regarding the diseases. The present study investigated the knowledge and practices used by teachers to manage epileptic seizures. The study also tested an epilepsy intervention educational package to see whether it improved the knowledge and practices of the teachers regarding epilepsy.MethodsA total of 85 teachers in schools from Chandigarh, a city of northern India, participated in the study. At the start of the study the teachers completed a pre-tested, semi-structured questionnaire on the first-aid management of epileptic seizures. They were then presented with an intervention package that included audio-visual material on basic aspects of epilepsy. The teachers were then retested after the intervention (one immediately and another after three months from the intervention). A scoring system was devised to quantify the knowledge, attitude and skills of teachers.ResultsMore than 90% of the teachers had previously either heard or read about epilepsy. Nearly half of the teachers said that books and magazines were the most common source of their information, followed by the internet. A comparison of the knowledge, attitudes and skills about the first-aid management of epilepsy based on the before and after questionnaire scores showed significant improvements in the various domains (p<0.05).ConclusionThe epilepsy intervention educational package provided a positive, short term, impact on the knowledge and skills of teachers about epilepsy. There is a need for regular workshops to improve and reinforce the knowledge and skills of the teachers about health problems like epilepsy

Alcohol and Tobacco Use Among Undergraduate and Postgraduate Medical Students in India: A Multicentric Cross-sectional Study

Background: Substance use among medical fraternity is a well-known phenomenon among both undergraduate (UG) and postgraduate (PG) medical students. Yet, there have been very few multi-centric studies to estimate the actual burden of this problem in this important population group in India. This study was conducted to estimate the prevalence of alcohol and tobacco use, assess the knowledge and attitudes towards this issue, and identify factors associated with substance use among UG and PG medical students in India.Methods: A pre-tested, self-report, anonymous questionnaire was administered to medical undergraduates and post graduate medical residents of eight medical colleges across India. This study used a convenience sample of medical colleges with random selection of study participants within each college for each group, UG and PG.Results: Prevalence of alcohol and tobacco use among UG students was 16.6%, 95% CI [14.5, 18.9] and 8.0%, 95% CI [6.4, 9.6], respectively, whereas prevalence was 31.5%, 95% CI [26.3, 37.0] and 14.5%, 95% CI [10.7, 18.9], respectively for PGs. For both substances, males had a higher prevalence of use compared to females in both groups (p &lt; 0.001). Positive family history of substance use (p &lt; 0.001 for both groups) and early age of initiation (p = 0.011 for tobacco; p &gt; 0.05 for alcohol) were associated with a greater difficulty to quit the habit. Over 90% of study participants felt that substance use adversely affected their skills and reported not using substances prior to managing their patients.Conclusions: Since substance use is a relatively common phenomenon among UG and PG medical students in India, future prospective studies and interventions are required to better understand the pattern of substance use and reduce its prevalence.

Paradoxical effect of coating on natural guar gum blended carbomer matrix systems for the neurological depressive disorders

Oral extended release products offer potential advantages in patient compliance and therapeutic outcomes like sustained blood levels with attenuation of adverse effects. In neuropsychiatric disorders like depression, most of the formulations serve a marketing objective rather than a clinical objective. The present investigation was aimed to develop a once daily sustained release formulation for delivery of an acid-labile, water soluble antidepressant, duloxetine HCl. The formulation was pragmatically designed using blend of natural and synthetic polymeric biomaterials that it releases the drug at alkaline pH in a sustained manner. The basic intention was to develop a tablet formulation with hydrophilic matrix core, using blend of release retarding natural biodegradable polymers such as guar gum, carbopol 71G-NF (a synthetic carbomer) and C-Pharm® gel. Barrier coating using HPMC-E5 was given to retard the initial release followed by enteric coating with HPMC-AS to prevent exposure of drug in acidic mileau of the stomach. The formulation exhibited desired release pattern and was described best-fit by Hixon-Crowell model. Stability analysis under stress conditions up to one month displayed good reproducibility. The matrix tablets successfully decreased the symptoms of depression (significant decrease in immobility time) in a rat forced swimming model. Pharmacokinetic data of the formulation revealed (tmax ~ 6 h, Cmax ~ 1157.58 ng/ml, mean AUCt~11145.04 ng*h/ml, and Ka~1.07h-1) good correlation in all animals.Keywords: Matrix tablets; Duloxetine HCl; Sustained release; Enteric coating; Hixon-crowell mode

Paradoxical effect of coating on natural guar gum blended carbomer matrix systems for the neurological depressive disorders

Oral extended release products offer potential advantages in patient compliance and therapeutic outcomes like sustained blood levels with attenuation of adverse effects. In neuropsychiatric disorders like depression, most of the formulations serve a marketing objective rather than a clinical objective. The present investigation was aimed to develop a once daily sustained release formulation for delivery of an acid-labile, water soluble antidepressant, duloxetine HCl. The formulation was pragmatically designed using blend of natural and synthetic polymeric biomaterials that it releases the drug at alkaline pH in a sustained manner. The basic intention was to develop a tablet formulation with hydrophilic matrix core, using blend of release retarding natural biodegradable polymers such as guar gum, carbopol 71G-NF (a synthetic carbomer) and C-Pharm® gel. Barrier coating using HPMC-E5 was given to retard the initial release followed by enteric coating with HPMC-AS to prevent exposure of drug in acidic mileau of the stomach. The formulation exhibited desired release pattern and was described best-fit by Hixon-Crowell model. Stability analysis under stress conditions up to one month displayed good reproducibility. The matrix tablets successfully decreased the symptoms of depression (significant decrease in immobility time) in a rat forced swimming model. Pharmacokinetic data of the formulation revealed (tmax ~ 6 h, Cmax ~ 1157.58 ng/ml, mean AUCt~11145.04 ng*h/ml, and Ka~1.07h-1) good correlation in all animals.Keywords: Matrix tablets; Duloxetine HCl; Sustained release; Enteric coating; Hixon-crowell mode

A unique modular implant system enhances load sharing in anterior cervical interbody fusion: a finite element study

BACKGROUND: The efficacy of dynamic anterior cervical plates is somewhat controversial. Screws in static-plate designs have a smaller diameter and can cut through bone under load. While not ideal, this unintended loosening can help mitigate stress shielding. Stand-alone interbody devices with integral fixation have large endplate contact areas that may inhibit or prevent loosening of the fixation. This study investigates the load sharing ability of a novel dynamic plate design in preventing the stress shielding of the graft material compared to the non-dynamic devices. METHODS: An experimentally validated intact C5-C6 finite element model was modified to simulate discectomy and accommodate implant-graft assembly. Four implant iterations were modeled; InterPlate titanium device with dynamic surface features (springs), InterPlate titanium non-dynamic device, InterPlate titanium design having a fully enclosed graft chamber, and the InterPlate design in unfilled PEEK having a fully enclosed graft chamber. All the models were fixed at the inferior-most surface of C6 and the axial displacement required to completely embed the dynamic surface features was applied to the model. RESULTS: InterPlate device with dynamic surface features induced higher graft stresses compared to the other design iterations resulting in uniform load sharing. The distribution of these graft stresses were more uniform for the InterPlate dynamic design. CONCLUSIONS: These results indicate that the dynamic design decreases the stress shielding by increasing and more uniformly distributing the graft stress. Fully enclosed graft chambers increase stress shielding. Lower implant material modulus of elasticity does not reduce stress shielding significantly