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My dirty stream: Pete Seeger, American folk music and environmental protest
Ethical issues of electronic patient data and informatics in clinical trial settings
The field of cancer bio-informatics unites the disciplines of scientific and clinical research withclinical practice and the treatment of individual patients. There is a need to study patients andsometimes their families, over many decades, to follow disease progress and long-term outcomes.This may require research teams to access the routinely-collected health data from generalpractice and hospital health records, prior to and after the cancer diagnosis is made. This clinicalinformation will increasingly include data provided by patients or acquired from them throughwearable devices that can monitor or deliver treatment, and data acquired from genetic relativesof the patient.All of these data, whether explicitly collected for the purpose of a clinical study, or routinelycollected as part of a patient?s life-time healthcare journey, are personal health data. There areethical and legal requirements to manage these data with care. This chapter explores the ethicalrequirements for collecting, holding, analysing and sharing personal health data, and thelegislation covering such activities
Contributions to the mixed-alkali effect in molecular dynamics simulations of alkali silicate glasses
The mixed-alkali effect on the cation dynamics in silicate glasses is
analyzed via molecular dynamics simulations. Observations suggest a description
of the dynamics in terms of stable sites mostly specific to one ionic species.
As main contributions to the mixed--alkali slowdown longer residence times and
an increased probability of correlated backjumps are identified. The slowdown
is related to the limited accessibility of foreign sites. The mismatch
experienced in a foreign site is stronger and more retarding for the larger
ions, the smaller ions can be temporarily accommodated. Also correlations
between unlike as well as like cations are demonstrated that support
cooperative behavior.Comment: 10 pages, 12 figures, 1 table, revtex4, submitted to Phys. Rev.
London SynEx Demonstrator Site: Impact Assessment Report
The key ingredients of the SynEx-UCL software components are:
1. A comprehensive and federated electronic healthcare record that can be used to
reference or to store all of the necessary healthcare information acquired from a
diverse range of clinical databases and patient-held devices.
2. A directory service component to provide a core persons demographic database to
search for and authenticate staff users of the system and to anchor patient
identification and connection to their federated healthcare record.
3. A clinical record schema management tool (Object Dictionary Client) that enables
clinicians or engineers to define and export the data sets mapping to individual
feeder systems.
4. An expansible set of clinical management algorithms that provide prompts to the
patient or clinician to assist in the management of patient care.
CHIME has built up over a decade of experience within Europe on the requirements
and information models that are needed to underpin comprehensive multiprofessional
electronic healthcare records. The resulting architecture models have
influenced new European standards in this area, and CHIME has designed and built
prototype EHCR components based on these models. The demonstrator systems
described here utilise a directory service and object-oriented engineering approach,
and support the secure, mobile and distributed access to federated healthcare
records via web-based services.
The design and implementation of these software components has been founded on
a thorough analysis of the clinical, technical and ethico-legal requirements for
comprehensive EHCR systems, published through previous project deliverables and
in future planned papers.
The clinical demonstrator site described in this report has provided the solid basis
from which to establish "proof of concept" verification of the design approach, and a
valuable opportunity to install, test and evaluate the results of the component
engineering undertaken during the EC funded project. Inevitably, a number of
practical implementation and deployment obstacles have been overcome through
this journey, each of those having contributed to the time taken to deliver the
components but also to the richness of the end products.
UCL is fortunate that the Whittington Hospital, and the department of cardiovascular
medicine in particular, is committed to a long-term vision built around this work. That
vision, outlined within this report, is shared by the Camden and Islington Health
Authority and by many other purchaser and provider organisations in the area, and
by a number of industrial parties. They are collectively determined to support the
Demonstrator Site as an ongoing project well beyond the life of the EC SynEx
Project.
This report, although a final report as far as the EC project is concerned, is really a
description of the first phase in establishing a centre of healthcare excellence. New
EC Fifth Framework project funding has already been approved to enable new and
innovative technology solutions to be added to the work already established in north
London
Information architecture for a federated health record server
This paper describes the information models that have been used to implement a federated health record server and to deploy it in a live clinical setting. The authors, working at the Centre for Health Informatics and Multiprofessional Education (University College London), have built up over a decade of experience within Europe on the requirements and information models that are needed to underpin comprehensive multi-professional electronic health records. This work has involved collaboration with a wide range of health care and informatics organisations and partners in the healthcare computing industry across Europe though the EU Health Telematics projects GEHR, Synapses, EHCR-SupA, SynEx and Medicate. The resulting architecture models have fed into recent European standardisation work in this area, such as CEN TC/251 ENV 13606. UCL has implemented a federated health record server based on these models which is now running in the Department of Cardiovascular Medicine at the Whittington Hospital in North London. The information models described in this paper reflect a refinement based on this implementation experience
Disease Management System Design Specification, System Verification and Administration [92 pages]
Design and implementation of a federated health record server
This paper describes the practical implementation of a federated health record serverbased on a generic and comprehensive public domain architecture and deployed in alive clinical setting.The authors, working at the Centre for Health Informatics and MultiprofessionalEducation (University College London), have built up over a decade of experiencewithin Europe on the requirements and information models that are needed to underpincomprehensive multi-professional electronic health records. This work has involvedcollaboration with a wide range of healthcare and informatics organisations and partnersin the healthcare computing industry across Europe though the EU Health Telematicsprojects GEHR, Synapses, EHCR-SupA, SynEx and Medicate. The resultingarchitecture models have influenced recent European standards in this area, such asCEN TC/251 ENV 13606. UCL has now designed and built a federated health recordserver based on these models which is now running in the Department ofCardiovascular Medicine at the Whittington Hospital in north London. A new EC FifthFramework project, 6WINIT, is enabling new and innovative IPv6 and wirelesstechnology solutions to be added to this work.The north London clinical demonstrator site has provided the solid basis from which toestablish "proof of concept" verification of the design approach, and a valuableopportunity to install, test and evaluate the results of the component engineeringundertaken during the EC funded projects
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