Seal of transparency heritage in the CISMeF quality-controlled health gateway

BACKGROUND: It is an absolute necessity to continually assess the quality of health information on the Internet. Quality-controlled subject gateways are Internet services which apply a selected set of targeted measures to support systematic resource discovery. METHODS: The CISMeF health gateway became a contributor to the MedCIRCLE project to evaluate 270 health information providers. The transparency heritage consists of using the evaluation performed on providers that are referenced in the CISMeF catalogue for evaluating the documents they publish, thus passing on the transparency label from the publishers to their documents. RESULTS: Each site rated in CISMeF has a record in the CISMeF database that generates an RDF into HTML file. The search tool Doc'CISMeF displays information originating from every publisher evaluated with a specific MedCIRCLE button, which is linked to the MedCIRCLE central repository. Starting with 270 websites, this trust heritage has led to 6,480 evaluated resources in CISMeF (49.8% of the 13,012 resources included in CISMeF). CONCLUSION: With the MedCIRCLE project and transparency heritage, CISMeF became an explicit third party

Religion(s) et école(s) en Israël

Officiellement défini comme « État juif et démocratique », en situation de conflit ouvert ou latent avec ses voisins arabes depuis sa création, situé dans un espace où le sacré nourrit le conflit plus qu’il ne l’apaise, habité par des populations conscientes de leur identité culturelle et religieuse spécifique, l’État d’Israël ne pouvait exclure de l’École publique la question religieuse sans heurter de front des sensibilités et des convictions solidement enracinées. Aussi, outre l’existence de réseaux confessionnels privés subventionnés par l’État, le ministère de l’Éducation propose plusieurs secteurs publics conçus en fonction du type d’intégration du religieux dans les programmes : une École arabo-musulmane ; une école hébraïque à caractère juif religieux ; une école hébraïque à caractère juif laïque. Loin d’être réductible à une dichotomie bipolaire entre le tout-religieux et un programme minimum, on assiste aujourd’hui à un très large éventail de formes intermédiaires. Celles-ci traduisent le déclin de l’idéologie dominante à vocation intégratrice et le renoncement de l’État à favoriser une École en ce sens, fondée sur un consensus qu’élaboreraient toutes les familles spirituelles et culturelles d’Israël. Le corps social étant fragmenté en communautés et en classes, chacune d’elles invoque le droit à la différence, voire le multiculturalisme, pour revendiquer un type d’École correspondant à son image et voué à sa stricte reproduction.Officially defined as a ‘Jewish and democratic State’, in latent or open conflict with its Arab neighbours since its creation, situated in an area where the sacred nourishes the conflict more than appeasing it, inhabited by populations conscious of their specific cultural and religious identity, the State of Israel could not exclude the question of religion from the public school system without a head-on clash with solidly entrenched sensibilities and convictions. Therefore, in addition to the existence of private denominational networks subsidised by the State, the Minister of Education proposes several public sectors designed according to type of integration of the religious into the programs: an Arabo-Muslim school; a religious Jewish Hebrew school; a secular Jewish Hebrew school. Not to be seen as a simple bipolar dichotomy between the all-religious and a basic program, today there is a whole range of intermediate forms. These latter are the result of a decline of the dominant integrationist ideology and the State’s renunciation of favouring a school system in that direction, founded on a consensus elaborated by all the different Israeli spiritual and cultural families. Since the society is fragmented into communities and classes, each of them invokes the right to difference, to multiculturalism, demanding a school system corresponding to that image and devoted to reproducing it.Oficialmente definido como « Estado judío y democrático », en situación de conflicto abierto o latente con sus vecinos árabes desde su creación, situado en un espacio en donde lo sagrado nutre el conflicto más que aliviarlo, habitado por poblaciones conscientes de su identidad cultural y religiosa específica, el Estado de Israel no podía excluir de la escuela pública la cuestión religiosa sin chocar frontalmente con las sensibilidades y las convicciones sólidamente enraizadas. Por eso, además de la existencia de redes confesionales privadas subvencionadas por el Estado, el Ministerio de educación propone varios sectores públicos concebidos en función del tipo de integración de lo religioso en los programas : una Escuela árabe-musulmana ; una escuela hebraica con carácter judío religioso ; una escuela hebraica con carácter judío laico. Lejos de ser reducible a una dicotomía bipolar entre lo todo-religioso y un programa mínimo, actualmente se asiste a un vasto abanico de formas intermedias. Estas traducen la decadencia de la ideología dominante con vocación integradora y la renuncia del Estado a favorecer una Escuela en este sentido, basada sobre un consenso que elaborarían todas las familias culturales y espirituales de Israel. Como el cuerpo social se encuentra fragmentado en comunidades y clases, cada una de ellas invoca el derecho a la diferencia, incluso al multiculturalismo, para reivindicar un tipo de escuela que corresponda a su imagen y dedicada a su estricta reproducción

Clinical Knowledge Platform (CKP): a collaborative ecosystem to share interoperable clinical forms, viewers, and order sets with various EMRs

International audienceA large number of Electronic Medical Records (EMR) are currently available with a variety of features and architectures. Existing studies and frameworks presented some solutions to overcome the problem of specification and application of clinical guidelines toward the automation of their use at the point of care. However, they could not yet support thoroughly the dynamic use of medical knowledge in EMRs according to the clinical contexts and provide local application of international recommendations. This study presents the development of the Clinical Knowledge Platform (CKP): a collaborative interoperable environment to create, use, and share sets of information elements that we entitled Clinical Use Contexts (CUCs). A CUC could include medical forms, patient dashboards, and order sets that are usable in various EMRs. For this purpose, we have identified and developed three basic requirements: an interoperable, inter-mapped dictionary of concepts leaning on standard terminologies, the possibility to define relevant clinical contexts, and an interface for collaborative content production via communities of professionals. Community members work together to create and/or modify, CUCs based on different clinical contexts. These CUCs will then be uploaded to be used in clinical applications in various EMRs. With this method, each CUC is, on the one hand, specific to a clinical context and on the other hand, could be adapted to the local practice conditions and constraints. Once a CUC has been developed, it could be shared with other potential users that can consume it directly or modify it according to their needs

Laparoscopic ovarian drilling in clomiphene resistant polycystic ovarian syndrome: clinical response and outcome

Background: Laparoscopic ovarian drilling (LOD) is an alternative method for ovulation induction in clomiphene citrate (CC) resistant polycystic ovary syndrome (PCOS) patients instead of gonadotropins. Objective were to identify the changes in clinical and biochemical profiles and the ovulation and pregnancy rate following LOD in CC resistant PCOS patients.Methods: It was an interventional study infertility unit, department of obstetrics and gynecology, Bangabandhu Sheikh Mujib medical university, Dhaka, between from July 2014 to June 2015. Changes of the above-mentioned parameters were recorded during follow up of patients after LOD. The information is collected and recorded in the preset questionnaire.Results: The characteristics of study population were same before LOD and following LOD. Before LOD, infrequent menstruation was present in 83.3% patients whereas regular menstruation was found in 58.3% patients after 6 months following LOD. Endometrial thickness ≤8 was found in 100.0% in before LOD and endometrial thickness >8 was found in 70.0% after 6 month following LOD. Ovulation was found in 25.0% in after 3-month LOD and was found in 70.0% after 6 months following LOD. Pregnancy was found in 20.0% after 3 months following LOD and 50.0% in after 6 months following LOD. Ovulation and pregnancy outcome was significantly higher in after 6 months following LOD.Conclusions: LOD produces long-term improvement in menstrual regularity and reproductive performance. A sustained improvement observed in acne and BMI. Ovulation and pregnancy were found in 70% and 50.0% respectively after 6 months following LOD

Evaluation of natural language processing from emergency department computerized medical records for intra-hospital syndromic surveillance

<p>Abstract</p> <p>Background</p> <p>The identification of patients who pose an epidemic hazard when they are admitted to a health facility plays a role in preventing the risk of hospital acquired infection. An automated clinical decision support system to detect suspected cases, based on the principle of syndromic surveillance, is being developed at the University of Lyon's Hôpital de la Croix-Rousse. This tool will analyse structured data and narrative reports from computerized emergency department (ED) medical records. The first step consists of developing an application (UrgIndex) which automatically extracts and encodes information found in narrative reports. The purpose of the present article is to describe and evaluate this natural language processing system.</p> <p>Methods</p> <p>Narrative reports have to be pre-processed before utilizing the French-language medical multi-terminology indexer (ECMT) for standardized encoding. UrgIndex identifies and excludes syntagmas containing a negation and replaces non-standard terms (abbreviations, acronyms, spelling errors...). Then, the phrases are sent to the ECMT through an Internet connection. The indexer's reply, based on Extensible Markup Language, returns codes and literals corresponding to the concepts found in phrases. UrgIndex filters codes corresponding to suspected infections. Recall is defined as the number of relevant processed medical concepts divided by the number of concepts evaluated (coded manually by the medical epidemiologist). Precision is defined as the number of relevant processed concepts divided by the number of concepts proposed by UrgIndex. Recall and precision were assessed for respiratory and cutaneous syndromes.</p> <p>Results</p> <p>Evaluation of 1,674 processed medical concepts contained in 100 ED medical records (50 for respiratory syndromes and 50 for cutaneous syndromes) showed an overall recall of 85.8% (95% CI: 84.1-87.3). Recall varied from 84.5% for respiratory syndromes to 87.0% for cutaneous syndromes. The most frequent cause of lack of processing was non-recognition of the term by UrgIndex (9.7%). Overall precision was 79.1% (95% CI: 77.3-80.8). It varied from 81.4% for respiratory syndromes to 77.0% for cutaneous syndromes.</p> <p>Conclusions</p> <p>This study demonstrates the feasibility of and interest in developing an automated method for extracting and encoding medical concepts from ED narrative reports, the first step required for the detection of potentially infectious patients at epidemic risk.</p