Workflow Management for Multiple Sclerosis Patients: IT and Organization

Patients with Multiple Sclerosis (MS) visit various healthcare providers during the course of their disease. It was suggested that IT might help to\ud orchestrate their care provision. We have applied the USE IT-tool to get insight in the relevant problems, solutions and constraints of the MS-care and the MS care providers both in the organizational and the information technological area. There is hardly a chain of healthcare, but rather, a network in which informal communication plays an important role. This informal network worked reasonably effective, but inefficient and slow. The patient himself plays a keyrole in information exchange between care-providers. Many providers were unaware of the services that other healthcare providers could give in general or did provide to a specific patient. MS patients-count is only small for most care providers. None of the interviewed patients mentioned a lack of contacts between careproviders as a problem. They thought that lack of\ud experience caused their major problems: insufficient and inadequate care. To improve care, we proposed a solution that combines a “short MS-protocol”, the\ud introduction of a central coordinator of care and a Patient Relation Management (PRM) System. This is a simple web-based application that is based on agreement by the caregivers that supports routing, tracking and tracing of a MS patient and supplies the caregivers with professional guidelines, as written down in the protocol. It is likely that we would have suggested a far more complicated ICT solution if we had only analyzed the MS-care process as such, without specific consideration of the USE IT dimensions

The relevance of telehealth across the digital divided the transfer of knowledge over distance

This paper explores the concept of Relevance as an explanatory factor to the diffusion of ITuse, or, in this paper particularly, the use of Telehealth. Relevance is the net value of performance expectancy and effort expectancy and contains both micro-relevance (i.e. here-and-now) and macro-relevance (i.e. actual goals) Following the case-study approach, two Telehealth situations were studied in Rwanda and The Netherlands. In the comparison, two more existing studies in Canada and Tanzania were included. The conclusion is that Relevance is the explanatory factor, whereas particularly micro-relevance is crucial. Without the micro-relevant occasions that initiate use, there will be no use on longer term In the cases studied the micro-relevance of knowledge-transfer was crucial. Furthermore distance determined Telehealth relevance. Practical conclusions to cases were drawn

Towards a better understanding of the e-health user: comparing USE IT and Requirements study for an Electronic Patient Record.

This paper compares a traditional requirements study with 22 interviews for the design of an electronic patient record (EPR) and a USE IT analysis with 17 interviews trying to understand the end- user of an EPR. Developing, implementing and using information technology in organizations is a complex social activity. It is often characterized by ill-defined problems or vague goals, conflicts and disruptions that result from organizational change. Successfully implementing information systems in healthcare organizations appears to be a difficult task. Information Technology is regarded as an enabler of change in healthcare organizations but (information) technology adoption decisions in healthcare are complex, because of the uncertainty of benefits and the rate of change of technology. (Job) Relevance is recognized as an important determinant for IS success but still does not find its way into a systems design process

Semiclassical Propagation of Wavepackets with Complex and Real Trajectories

International audienceWe consider a semiclassical approximation, first derived by Heller and coworkers, for the time evolution of an originally Gaussian wave packet in terms of complex trajectories. We also derive additional approximations replacing the complex trajectories by real ones. These yield three different semiclassical formulae involving different real trajectories. One of these formulae is Heller's thawed Gaussian approximation. The other approximations are non-Gaussian and may involve several trajectories determined by mixed initial–final conditions. These different formulae are tested for the cases of scattering by a hard wall, scattering by an attractive Gaussian potential and bound motion in a quartic oscillator. The formula with complex trajectories gives good results in all cases. The non-Gaussian approximations with real trajectories work well in some cases, whereas the thawed Gaussian works only in very simple situations

Low temperature superlattice in monoclinic PZT

TEM has shown that the strongly piezoelectric material Pb(Zr0.52Ti0.48)O3 separates into two phases at low temperatures. The majority phase is the monoclinic phase previously found by x-ray diffraction. The minority phase, with a nanoscale coherence length, is a slightly distorted variant of the first resulting from the anti-phase rotation of the oxygen octahedra about [111]. This work clears up a recent controversy about the origin of superlattice peaks in these materials, and supports recent theoretical results predicting the coexistence of ferroelectric and rotational instabilities.Comment: REVTeX4, 4 eps figures embedded. JPG version of figs. 2&4 is also include

A Novel Connexin 26 Mutation in a Patient Diagnosed with Keratitis–Ichthyosis–Deafness Syndrome

Keratitis–ichthyosis–deafness syndrome is a rare disorder characterized by erythrokeratoderma, deafness, and keratitis. Scarring alopecia and squamous cell carcinoma can also occur. Most cases described so far were sporadic. Here we present evidence that keratitis–ichthyosis–deafness syndrome is caused by a mutation in the connexin 26 gene. This finding expands the spectrum of disorders caused by defects in connexin 26 and implies the gene in normal corneal function, hair growth, and carcinogenesis

A liquid helium target system for a measurement of parity violation in neutron spin rotation

A liquid helium target system was designed and built to perform a precision measurement of the parity-violating neutron spin rotation in helium due to the nucleon-nucleon weak interaction. The measurement employed a beam of low energy neutrons that passed through a crossed neutron polarizer--analyzer pair with the liquid helium target system located between them. Changes between the target states generated differences in the beam transmission through the polarizer--analyzer pair. The amount of parity-violating spin rotation was determined from the measured beam transmission asymmetries. The expected parity-violating spin rotation of order $10^{-6}$ rad placed severe constraints on the target design. In particular, isolation of the parity-odd component of the spin rotation from a much larger background rotation caused by magnetic fields required that a nonmagnetic cryostat and target system be supported inside the magnetic shielding, while allowing nonmagnetic motion of liquid helium between separated target chambers. This paper provides a detailed description of the design, function, and performance of the liquid helium target system.Comment: V2: 29 pages, 14 figues, submitted to Nucl. Instrum. Meth. B. Revised to address reviewer comment