This document discusses using eLearning to reduce costs and improve adoption of electronic medical record (EMR) systems during implementation in hospitals. Traditional classroom training for thousands of staff was very expensive and time consuming. The approach taken was to develop an enterprise training portal with online courses tailored for different roles. This allowed asynchronous learning over several weeks. Classroom time was reduced to introduce the portal. Costs were cut by 75% and training was completed in two months, achieving a critical mass of adoption, compared to over 10 months for traditional training. eLearning improved the scalability and affordability of training for successful EMR implementation.
- This randomized controlled trial studied the effect of erythropoietin treatment in 941 extremely preterm infants between 24 and 27 weeks gestation. Infants received either erythropoietin or placebo intravenously for 6 doses then subcutaneously until 32 weeks postmenstrual age.
- The primary outcome of death or severe neurodevelopmental impairment at 2 years was not significantly different between the erythropoietin and placebo groups. No meaningful differences in serious adverse events were found.
- Unlike previous studies, this larger trial found that high-dose erythropoietin treatment did not reduce the risk of death or improve neurodevelopmental outcomes in extremely preterm infants compared to placebo.
Pediatric Screen Time Review - Journal Club Fatima Farid
Journal club session - review of a study conducted on the effects of screen time on a pediatric population, includes effective paper reviewing strategies.
Comparative evaluation of 2g single dose versus conventional dose azithromycin in uncomplicated skin and skin structure infections. Indian Journal Of Pharmacology. August 2015;Vol. 47; Issue 4
This study evaluated the use of sirolimus, an mTOR inhibitor, in 4 patients with diffuse hyperinsulinemic hypoglycemia that was unresponsive to standard treatments with diazoxide and octreotide. Patients received sirolimus with dose adjustments to achieve target serum levels. Glycemic control improved in all patients after starting sirolimus. The study suggests mTOR inhibitors may provide an alternative treatment option for severe hyperinsulinemic hypoglycemia unresponsive to other therapies, but larger and longer-term studies are still needed to fully evaluate efficacy and safety.
The document summarizes a study that evaluated the effects of probiotic treatment on depression-related behaviors in rats fed either a control or high-fat diet. Key findings include:
1. Probiotic treatment significantly lowered depressive-like behavior in rats and improved performance in memory tests, regardless of diet.
2. Probiotics modulated cytokine production and expression of genes related to the hypothalamic-pituitary-adrenal axis and neuroplasticity.
3. Metabolomic analysis found probiotics significantly affected 13 plasma metabolites involved in immune function, glucose regulation, and neurotransmission.
Secondary brain injury is a frequent event in TBI patients.
These events greatly influence prognosis and are potentially preventable.
Our understanding of secondary brain injury mechanisms and physiologic responses to treatment is evolving.
- This randomized controlled trial studied the effect of erythropoietin treatment in 941 extremely preterm infants between 24 and 27 weeks gestation. Infants received either erythropoietin or placebo intravenously for 6 doses then subcutaneously until 32 weeks postmenstrual age.
- The primary outcome of death or severe neurodevelopmental impairment at 2 years was not significantly different between the erythropoietin and placebo groups. No meaningful differences in serious adverse events were found.
- Unlike previous studies, this larger trial found that high-dose erythropoietin treatment did not reduce the risk of death or improve neurodevelopmental outcomes in extremely preterm infants compared to placebo.
Pediatric Screen Time Review - Journal Club Fatima Farid
Journal club session - review of a study conducted on the effects of screen time on a pediatric population, includes effective paper reviewing strategies.
Comparative evaluation of 2g single dose versus conventional dose azithromycin in uncomplicated skin and skin structure infections. Indian Journal Of Pharmacology. August 2015;Vol. 47; Issue 4
This study evaluated the use of sirolimus, an mTOR inhibitor, in 4 patients with diffuse hyperinsulinemic hypoglycemia that was unresponsive to standard treatments with diazoxide and octreotide. Patients received sirolimus with dose adjustments to achieve target serum levels. Glycemic control improved in all patients after starting sirolimus. The study suggests mTOR inhibitors may provide an alternative treatment option for severe hyperinsulinemic hypoglycemia unresponsive to other therapies, but larger and longer-term studies are still needed to fully evaluate efficacy and safety.
The document summarizes a study that evaluated the effects of probiotic treatment on depression-related behaviors in rats fed either a control or high-fat diet. Key findings include:
1. Probiotic treatment significantly lowered depressive-like behavior in rats and improved performance in memory tests, regardless of diet.
2. Probiotics modulated cytokine production and expression of genes related to the hypothalamic-pituitary-adrenal axis and neuroplasticity.
3. Metabolomic analysis found probiotics significantly affected 13 plasma metabolites involved in immune function, glucose regulation, and neurotransmission.
Secondary brain injury is a frequent event in TBI patients.
These events greatly influence prognosis and are potentially preventable.
Our understanding of secondary brain injury mechanisms and physiologic responses to treatment is evolving.
This study aimed to compare the ability of serial cranial ultrasounds (CUS) and early MRI scans in detecting preterm brain injuries. The study found that CUS allowed for more scans due to better feasibility in the NICU, and was better at detecting grade I-II intraventricular hemorrhages and perforator strokes. MRI was superior for identifying smaller cerebellar hemorrhages and provided more quantitative data. Overall, the combination of serial CUS and MRI provided the highest sensitivity for detecting common preterm brain injuries, though MRI could not be performed in the sickest infants.
This document summarizes a journal club presentation by Asmita Gautam on an article about knowledge, attitudes, and preventative practices related to COVID-19 among university populations in Pakistan. The presentation provides details on the selected article, journal, authors, methods, results, and conclusions. It evaluates an article published in Drugs & Therapy Perspectives that studied COVID-19 knowledge, attitudes, and practices using a cross-sectional survey of 417 students and employees at two universities in Lahore, Pakistan. The presentation concludes that while knowledge and attitudes regarding COVID-19 were satisfactory, preventative practices were inadequate among the university populations studied.
The document discusses various statistical methodologies that can be applied to Ayurveda research, including experimentation, surveys, case-control studies, meta-analysis, survival studies, and time series analysis. It provides an overview of how these methods are currently used in Ayurveda research and highlights some areas that could be improved, such as employing stratification and larger sample sizes. Logistic regression and decision trees are presented as effective analytical techniques for case-control studies.
Effectiveness of Lecture Cum Demonstration Method on Knowledge and Skill Rega...Vivek Jamnik
The study aims to find the effectiveness of lecture cum demonstration method on knowledge and skill
regarding cranial nerve assessment among under graduate nursing student in selected nursing college.
This document provides a summary of an individual's qualifications and experience. It includes:
- Contact information and an objective seeking a research-oriented teaching career.
- Over 16 years of teaching experience in biostatistics in India and Saudi Arabia.
- Technical skills in statistical analysis tools like SPSS, SAS, and R.
- Academic qualifications including a Ph.D. in Statistics and M.Sc. in Statistics.
- Experience teaching biostatistics courses to students in various health science programs.
- Research publications in biostatistics and experience conducting statistical analysis.
- Participation in international and national conferences presenting research papers.
This study explored community stroke rehabilitation therapists' use of outcome measures in Scotland. A survey of 113 therapists found that the most commonly used measures were the Berg Balance Scale, Tinetti Balance and Gait scales for physical therapists, the Rivermead Behavioural Memory Test and Barthel Index for occupational therapists, and the Therapy Outcome Measure and Frenchay Aphasia Screening Test for speech and language therapists. The top reasons for selecting measures were that they are relevant to patients' goals, easy to use, and sensitive to change. However, over a third of therapists were dissatisfied with the relevance of available measures to patients. The study highlights tensions between best practice and constraints like financial barriers to using measures.
This randomized controlled trial compared the effectiveness and safety of minimal stimulation IVF (mini-IVF) to conventional IVF. 564 women were randomly assigned to either mini-IVF using oral clomiphene and gonadotropins followed by a freeze-all policy, or conventional IVF using high dose gonadotropins and fresh double embryo transfer. The primary outcome was cumulative live birth rate within 6 months, and secondary outcomes included pregnancy rates, ovarian hyperstimulation syndrome, and multiple pregnancy rates. Results showed mini-IVF resulted in comparable live birth rates but significantly lower risks of ovarian hyperstimulation syndrome and multiple pregnancies compared to conventional IVF.
Personalized Medicine: A Utilization In Pharmaceutical Field.(A Review) Makrani Shaharukh
Personalized Medicine (PM) is an emerging exercise of medicine that uses a person‟s genetic summary to monitor judgments made in favor to the diagnosis, inhibition and treatment of diseases. Personalized medicine is presence innovative through data from the Human Genome Project. It is initial to complete its aim of “the right therapy to the right patient at the right time”. Currently PM is moving us closer to more exact, predictable and powerful medication tailored for an individual patient. By the way the genomic data is the dynamic force late PM. Combined understanding of genetics is approving us to provide greater diagnoses, safer medication advising, and more effective treatment of the diseases and conditions that have affected us throughout history. This review focus on various aspects of personalized medicine.
This study compared same day sputum microscopy (two sputum samples collected one hour apart) to conventional sputum microscopy (spot sample and early morning sample collected over two days) for tuberculosis diagnosis in Chhattisgarh, India. The study found that same day microscopy missed 17% of smear-positive tuberculosis cases compared to 1% missed by conventional microscopy. Additionally, same day microscopy had a lower proportion of presumptive tuberculosis patients providing both required samples and had a lower proportion of samples with good quality. These findings suggest that same day microscopy may not be as effective as conventional microscopy for tuberculosis diagnosis in this setting.
New Perspectives on Alzheimer’s Disease and NutritionNutricia
This document summarizes a roundtable discussion on the role of nutrition in Alzheimer's disease (AD). The discussion focused on how being overweight or obese in midlife may increase the risk of developing AD decades later, though evidence is conflicting. After midlife, higher body weight and BMI are associated with lower dementia risk. Weight loss and underweight in late life are linked to higher dementia risk. The natural trajectory of BMI over the lifespan differs between those who do and do not develop dementia. Changes in BMI and weight loss may also be associated with clinical progression of AD. Further research is needed to better understand these complex relationships between nutritional status and AD risk and progression.
The Effectiveness of Energy Conservation Techniques in Reducing Fatigue in C...Crimson-Arthritis
The Effectiveness of Energy ConservationTechniques in Reducing Fatigue in Clients with Multiple Sclerosis by Sarsak HI* in Researches in Arthritis & Bone Study Crimson Publishers: Journal of Bone Disease
COMPARISON AND EVALUATION DATA MINING TECHNIQUES IN THE DIAGNOSIS OF HEART DI...ijcsa
Heart disease is one of the biggest health problems in the world because of high mortality and morbidity
caused by the disease. The use of data mining on medical data brought valuable and effective life
achievements and can enhance medical knowledge to make necessary decisions. Data mining plays an
important role in the field of medical science to solve health problems and diagnose ailments in critical
conditions and in normal conditions. For this reason, in this paper, data mining techniques are used to
diagnose heart disease from a dataset that includes 200 samples from different patients. Techniques used to
diagnose heart disease include Bagging, AdaBoostM1, Random Forest, Naive Bayes, RBF Network, IBK,
and NNge that all the techniques used to diagnose heart disease use Weka tool. Then these techniques are
compared to determine which is more accurate in the diagnosis of heart disease that according to the
results, it was found that the RBF Network with the accuracy of 88.2% is the most accurate classification in
the diagnosis of heart disease.
Efficacy of a medical food in mild Alzheimer’s disease: A randomized, control...Nutricia
1. This randomized, double-blind, controlled trial investigated the effects of a medical food supplement called Souvenaid on cognitive function in 225 patients with mild Alzheimer's disease over 12 weeks.
2. The study found a statistically significant improvement in delayed verbal recall, the primary outcome measure, in the group receiving Souvenaid compared to the control group at 12 weeks.
3. Secondary measures of cognitive function, behavior, functional abilities, and quality of life did not differ between the groups. The medical food was well-tolerated with high compliance among patients.
This document summarizes a study on drug utilization patterns in patients with burns over 15% of their total body surface area admitted to a tertiary hospital burn ward in Nashik, India. A total of 50 patients were included in the study, with an average burn percentage of 61.96%. The mortality rate was found to be 20% for burns under 40% TBSA, 33% for 40-60% TBSA, and 95% for over 60% TBSA. The most commonly prescribed drugs were Ringer's Lactate, gentamicin, ranitidine, metronidazole, cefoperazone + sulbactam, and ciprofloxacin. The drug utilization 90% included
Consensus Guidelines on Management of Childhood Convulsive Status Epilepticusmandar haval
The document provides consensus guidelines for the evaluation and management of childhood convulsive status epilepticus in India. It was developed through a multi-disciplinary consensus workshop involving experts from across India. The guidelines define status epilepticus and discuss the epidemiology in India. They emphasize the importance of early pre-hospital management to initiate treatment as soon as possible. The initial management should consist of a parenteral benzodiazepine by any feasible route. Subsequent in-hospital management is also outlined. The aim is to provide a standardized, evidence-based protocol tailored for use in India given available resources and common etiologies.
Ct and mri findings chief complaint of headacheUosum
This study evaluated CT and MRI findings in 500 patients who presented with headache as the chief complaint. Patients were divided into two groups: group A had red flag signs or clinical warning criteria, while group B did not. Of the 500 patients, 29 (5.8%) had brain abnormalities on imaging. Group A was more likely to have positive findings - 29 of 48 patients (60.4%) compared to 97 of 452 (21.5%) in group B. The most common finding was sinusitis. The study concluded that neuroimaging of headache patients without red flags has limited clinical value due to the low yield of significant positive findings.
We can aid decision making from the pre-clinical to the clinical setting, supporting line of sight to the clinic, by identifying and translating crucial biomarker approaches into the real world.
Health workers knowledge and attitude towards palliative care in an emerging tertiary center in south west Nigeria
Assessment of caregiving burden of family caregiver of advanced cancer patients and their satisfaction with the dedicated inpatient palliative care provided to their parents
This study aimed to compare the ability of serial cranial ultrasounds (CUS) and early MRI scans in detecting preterm brain injuries. The study found that CUS allowed for more scans due to better feasibility in the NICU, and was better at detecting grade I-II intraventricular hemorrhages and perforator strokes. MRI was superior for identifying smaller cerebellar hemorrhages and provided more quantitative data. Overall, the combination of serial CUS and MRI provided the highest sensitivity for detecting common preterm brain injuries, though MRI could not be performed in the sickest infants.
This document summarizes a journal club presentation by Asmita Gautam on an article about knowledge, attitudes, and preventative practices related to COVID-19 among university populations in Pakistan. The presentation provides details on the selected article, journal, authors, methods, results, and conclusions. It evaluates an article published in Drugs & Therapy Perspectives that studied COVID-19 knowledge, attitudes, and practices using a cross-sectional survey of 417 students and employees at two universities in Lahore, Pakistan. The presentation concludes that while knowledge and attitudes regarding COVID-19 were satisfactory, preventative practices were inadequate among the university populations studied.
The document discusses various statistical methodologies that can be applied to Ayurveda research, including experimentation, surveys, case-control studies, meta-analysis, survival studies, and time series analysis. It provides an overview of how these methods are currently used in Ayurveda research and highlights some areas that could be improved, such as employing stratification and larger sample sizes. Logistic regression and decision trees are presented as effective analytical techniques for case-control studies.
Effectiveness of Lecture Cum Demonstration Method on Knowledge and Skill Rega...Vivek Jamnik
The study aims to find the effectiveness of lecture cum demonstration method on knowledge and skill
regarding cranial nerve assessment among under graduate nursing student in selected nursing college.
This document provides a summary of an individual's qualifications and experience. It includes:
- Contact information and an objective seeking a research-oriented teaching career.
- Over 16 years of teaching experience in biostatistics in India and Saudi Arabia.
- Technical skills in statistical analysis tools like SPSS, SAS, and R.
- Academic qualifications including a Ph.D. in Statistics and M.Sc. in Statistics.
- Experience teaching biostatistics courses to students in various health science programs.
- Research publications in biostatistics and experience conducting statistical analysis.
- Participation in international and national conferences presenting research papers.
This study explored community stroke rehabilitation therapists' use of outcome measures in Scotland. A survey of 113 therapists found that the most commonly used measures were the Berg Balance Scale, Tinetti Balance and Gait scales for physical therapists, the Rivermead Behavioural Memory Test and Barthel Index for occupational therapists, and the Therapy Outcome Measure and Frenchay Aphasia Screening Test for speech and language therapists. The top reasons for selecting measures were that they are relevant to patients' goals, easy to use, and sensitive to change. However, over a third of therapists were dissatisfied with the relevance of available measures to patients. The study highlights tensions between best practice and constraints like financial barriers to using measures.
This randomized controlled trial compared the effectiveness and safety of minimal stimulation IVF (mini-IVF) to conventional IVF. 564 women were randomly assigned to either mini-IVF using oral clomiphene and gonadotropins followed by a freeze-all policy, or conventional IVF using high dose gonadotropins and fresh double embryo transfer. The primary outcome was cumulative live birth rate within 6 months, and secondary outcomes included pregnancy rates, ovarian hyperstimulation syndrome, and multiple pregnancy rates. Results showed mini-IVF resulted in comparable live birth rates but significantly lower risks of ovarian hyperstimulation syndrome and multiple pregnancies compared to conventional IVF.
Personalized Medicine: A Utilization In Pharmaceutical Field.(A Review) Makrani Shaharukh
Personalized Medicine (PM) is an emerging exercise of medicine that uses a person‟s genetic summary to monitor judgments made in favor to the diagnosis, inhibition and treatment of diseases. Personalized medicine is presence innovative through data from the Human Genome Project. It is initial to complete its aim of “the right therapy to the right patient at the right time”. Currently PM is moving us closer to more exact, predictable and powerful medication tailored for an individual patient. By the way the genomic data is the dynamic force late PM. Combined understanding of genetics is approving us to provide greater diagnoses, safer medication advising, and more effective treatment of the diseases and conditions that have affected us throughout history. This review focus on various aspects of personalized medicine.
This study compared same day sputum microscopy (two sputum samples collected one hour apart) to conventional sputum microscopy (spot sample and early morning sample collected over two days) for tuberculosis diagnosis in Chhattisgarh, India. The study found that same day microscopy missed 17% of smear-positive tuberculosis cases compared to 1% missed by conventional microscopy. Additionally, same day microscopy had a lower proportion of presumptive tuberculosis patients providing both required samples and had a lower proportion of samples with good quality. These findings suggest that same day microscopy may not be as effective as conventional microscopy for tuberculosis diagnosis in this setting.
New Perspectives on Alzheimer’s Disease and NutritionNutricia
This document summarizes a roundtable discussion on the role of nutrition in Alzheimer's disease (AD). The discussion focused on how being overweight or obese in midlife may increase the risk of developing AD decades later, though evidence is conflicting. After midlife, higher body weight and BMI are associated with lower dementia risk. Weight loss and underweight in late life are linked to higher dementia risk. The natural trajectory of BMI over the lifespan differs between those who do and do not develop dementia. Changes in BMI and weight loss may also be associated with clinical progression of AD. Further research is needed to better understand these complex relationships between nutritional status and AD risk and progression.
The Effectiveness of Energy Conservation Techniques in Reducing Fatigue in C...Crimson-Arthritis
The Effectiveness of Energy ConservationTechniques in Reducing Fatigue in Clients with Multiple Sclerosis by Sarsak HI* in Researches in Arthritis & Bone Study Crimson Publishers: Journal of Bone Disease
COMPARISON AND EVALUATION DATA MINING TECHNIQUES IN THE DIAGNOSIS OF HEART DI...ijcsa
Heart disease is one of the biggest health problems in the world because of high mortality and morbidity
caused by the disease. The use of data mining on medical data brought valuable and effective life
achievements and can enhance medical knowledge to make necessary decisions. Data mining plays an
important role in the field of medical science to solve health problems and diagnose ailments in critical
conditions and in normal conditions. For this reason, in this paper, data mining techniques are used to
diagnose heart disease from a dataset that includes 200 samples from different patients. Techniques used to
diagnose heart disease include Bagging, AdaBoostM1, Random Forest, Naive Bayes, RBF Network, IBK,
and NNge that all the techniques used to diagnose heart disease use Weka tool. Then these techniques are
compared to determine which is more accurate in the diagnosis of heart disease that according to the
results, it was found that the RBF Network with the accuracy of 88.2% is the most accurate classification in
the diagnosis of heart disease.
Efficacy of a medical food in mild Alzheimer’s disease: A randomized, control...Nutricia
1. This randomized, double-blind, controlled trial investigated the effects of a medical food supplement called Souvenaid on cognitive function in 225 patients with mild Alzheimer's disease over 12 weeks.
2. The study found a statistically significant improvement in delayed verbal recall, the primary outcome measure, in the group receiving Souvenaid compared to the control group at 12 weeks.
3. Secondary measures of cognitive function, behavior, functional abilities, and quality of life did not differ between the groups. The medical food was well-tolerated with high compliance among patients.
This document summarizes a study on drug utilization patterns in patients with burns over 15% of their total body surface area admitted to a tertiary hospital burn ward in Nashik, India. A total of 50 patients were included in the study, with an average burn percentage of 61.96%. The mortality rate was found to be 20% for burns under 40% TBSA, 33% for 40-60% TBSA, and 95% for over 60% TBSA. The most commonly prescribed drugs were Ringer's Lactate, gentamicin, ranitidine, metronidazole, cefoperazone + sulbactam, and ciprofloxacin. The drug utilization 90% included
Consensus Guidelines on Management of Childhood Convulsive Status Epilepticusmandar haval
The document provides consensus guidelines for the evaluation and management of childhood convulsive status epilepticus in India. It was developed through a multi-disciplinary consensus workshop involving experts from across India. The guidelines define status epilepticus and discuss the epidemiology in India. They emphasize the importance of early pre-hospital management to initiate treatment as soon as possible. The initial management should consist of a parenteral benzodiazepine by any feasible route. Subsequent in-hospital management is also outlined. The aim is to provide a standardized, evidence-based protocol tailored for use in India given available resources and common etiologies.
Ct and mri findings chief complaint of headacheUosum
This study evaluated CT and MRI findings in 500 patients who presented with headache as the chief complaint. Patients were divided into two groups: group A had red flag signs or clinical warning criteria, while group B did not. Of the 500 patients, 29 (5.8%) had brain abnormalities on imaging. Group A was more likely to have positive findings - 29 of 48 patients (60.4%) compared to 97 of 452 (21.5%) in group B. The most common finding was sinusitis. The study concluded that neuroimaging of headache patients without red flags has limited clinical value due to the low yield of significant positive findings.
We can aid decision making from the pre-clinical to the clinical setting, supporting line of sight to the clinic, by identifying and translating crucial biomarker approaches into the real world.
Health workers knowledge and attitude towards palliative care in an emerging tertiary center in south west Nigeria
Assessment of caregiving burden of family caregiver of advanced cancer patients and their satisfaction with the dedicated inpatient palliative care provided to their parents
This document describes a study that evaluated the effectiveness of a planned teaching program on knowledge of stem cell therapy among student nurses. The study used a pre-experimental design with one group of 50 student nurses who completed a pre-test, participated in the planned teaching program, and then completed a post-test. The results showed that the planned teaching program was effective at improving the students' knowledge of stem cell therapy as measured by significantly higher post-test scores. The study provides information that can help nurses gain knowledge about stem cell therapy.
The document discusses some challenges clinicians face in the information era, including information overload due to the rapid production and easy transmission of information. It notes contradictions and lack of structure in available information. The document also discusses fragmented medical literature repositories and the need for specialized search strategies. Finally, it proposes some ideas for the future, including a "Super search" that could provide contextual, comprehensive, easy and fast searches across medical literature. It also proposes the idea of using large healthcare databases and semantics to potentially replace expensive clinical trials.
Scope and Applications of Bioinformatics --Nishikant Bhojane.pptxNishikantBhojane1
Bioinformatics is the application of computer technology to get the information that's stored in certain types of biological data.
Bioinformatics provides central, globally accessible databases that enable scientists to submit, search and analyse informaton.
It offers analysis software for data studies and comparisons and provides tools for modelling, visualizing, exploring and interpreting data.
The main goal is to convert a multitude of complex data into useful information and knowledge.
Bioinformatics approaches are used to understand the function of genes, the regulation of cells, drug target selection, drug design, and disease.
Jane Blower, Deputy Chief Scientific Officer (Acting) NHS England. Jane's presentation from the Seven Day Services event in the East Midlands on 12th June 2014.
From Data to Action: Bridging Chemistry and Biology with Informatics at NCATSRajarshi Guha
This document discusses the work of the National Center for Advancing Translational Sciences (NCATS) in bridging chemistry, biology and informatics to improve the process of translational research. It describes NCATS' mission to develop new methods and technologies to enhance drug development and implementation of interventions to improve human health. Specifically, it outlines initiatives at NCATS such as the Chemical Genomics Center, which performs high-throughput screens and develops chemical probes and leads. It also discusses how translational bioinformatics uses data integration to move between molecular to clinical scales to enable decision-making in areas like drug design and target validation.
Services related to genetics ervice related to genetics for nursing student f...AkshataBansode1
service related to genetics for nursing student for their study and exam prep ration gentics is the study of the genes and it help to learn the chromes and in this down syndrome 21 trisomy ervice related to genetics for nursing student for their study and exam prep ration gentics is the study of the genes and it help to learn the chromes and in this down syndrome 21 trisomy ervice related to genetics for nursing student for their study and exam prep ration gentics is the study of the genes and it help to learn the chromes and in this down syndrome 21 trisomy ervice related to genetics for nursing student for their study and exam prep ration gentics is the study of the genes and it help to learn the chromes and in this down syndrome 21 trisomy ervice related to genetics for nursing student for their study and exam prep ration gentics is the study of the genes and it help to learn the chromes and in this down syndrome 21 trisomy xhsbnxjsh buhjn xxhijzbxui zgb 9yxihxzg gjkbxhx sjnxkshxins x
Nurse scientists serve as knowledge brokers by linking researchers and decision makers. They facilitate interaction between these groups to support evidence-based decision making in healthcare. Nurse scientists require extensive knowledge in their specialty areas and perform research by developing solutions, running experiments, and applying for grants. Their work involves producing and disseminating knowledge for government agencies, universities, and private organizations. Nurse scientists influence nursing practice by assisting with workforce planning, setting standards and processes, and designing systems to measure and improve quality of care.
1) Getting research into practice is challenging due to barriers like information overload, specialty silos, and increasing patient safety issues.
2) Tools that can help include surveys, knowledge management strategies, and establishing an information team.
3) Key success factors include dedicating resources, ensuring relevance, and fostering collaboration between stakeholders.
4) Implementing research takes time and a multifaceted approach, as changing clinical behavior is complex.
CORD Rare Drug Conference June 8-9, 2022
Global, International, and National Rare Disease Networks
Rare Disease Research Network and National Children’s Hospital - Marshall
Summar, Rare Disease Institute
This document discusses various study designs used in medical research. It describes descriptive study designs like case reports, case series, ecological studies, and cross-sectional studies which are used to describe characteristics of subjects. It also describes analytical study designs like case-control studies and cohort studies which are used to analyze associations between exposures and outcomes. Experimental study designs like randomized controlled trials are also discussed which are used to evaluate interventions. Key aspects of each study design like their strengths, weaknesses and steps are highlighted.
This document discusses the central role of pathologists in enhancing patient care in Nigeria. It notes that Nigeria has a large population but relatively few medical doctors and pathologists. Pathologists are clinically trained physicians who apply laboratory techniques and interpretation to tissues and fluids to aid in patient diagnosis and management. However, there are misconceptions about the role of pathologists. The document concludes that pathologists face challenges like lack of funding and attrition, but must address these challenges through advocacy, professional standards, and leadership to better serve patients.
Personalized medicine tools for clinical trials - kuchinkeWolfgang Kuchinke
Tools for personalised medicine in clinical trials. ---------
The implementation of clinical trials in personalized medicine is a different way of doing clinical research compared to the standard way of large clinical trials aiming for statistical significance. Personalized medicine uses a medical model that separates people into different groups with medical decisions, practices, drugs, interventions being tailored to the individual patient based on their predicted response. Basis for this approach is the progress of the study of the human genome and its variation over the last two decades. Especially advancement in automated DNA sequencing and PCR and the use of expressed sequence tags (ESTs), cDNAs, antisense molecules, small nterfering RNAs (siRNAs), full-length genes and their expression products and haplotypes.
But adoption of personalized medicine requires an active and flexible and highly integrated infrastructure, which allows joining of many different competences and technologies. We asked the question: can the tools developed for personalized medicine in the p-pedicine project be employed effectively in a clinical trials network to support personalised clinical trials. We conducted an analysis of tool integration and the evaluation tool usage requirements. Based on the survey results, the tendency for clinical trial network ECRIN is to use software as a service in the form as SaaS or ASP. ECRIN data centres will (probably) not install and employ p-medicine tools in one of their data centres. A robust business model for the provision of services and the implementation and employment of tools does not yet exist.
How can the personalized medicine infrastructure p-medicine and the clinical trials network ECRIN gain from each other to allow the conduct of personalized clinical trials?
We suggest a business model, in which personal medicine infrastructures and clinical trials networks exchange their services to gain jointly from each other. Therefore: an integration by reciprocal exchange of services may be the solution. Not only software as a service will be exchanged, but also knowledge, personnel and joint staff trainings.
Personalized medicine tools for clinical trials - KuchinkeWolfgang Kuchinke
Tools for personalised medicine in clinical trials.
The implementation of clinical trials in personalized medicine is a different way of doing clinical research, compared to the standard way of large clinical trials aiming for statistical significance. Personalized medicine uses a medical model that separates people into different groups with medical decisions, practices, drugs, interventions being tailored to the individual patient based on their predicted response. Basis for this approach is the progress of the study of the human genome and its variation over the last two decades. Especially advancements in automated DNA sequencing, PCR technologies and the use of expressed sequence tags (ESTs), cDNAs, antisense molecules, small interfering RNAs (siRNAs).
But the adoption of personalized medicine requires an active and flexible and highly integrated infrastructure, which must allow the joining of many different competences and technologies. We asked the question: can the tools developed for personalized medicine in the p-pedicine project be employed effectively in a clinical trials network to support personalised clinical trials? We conducted an analysis of tool integration and the evaluation of tool usage requirements. Based on the survey results, the tendency for the clinical trial network ECRIN is to use software as a service in the form of SaaS or ASP. ECRIN data centres will (probably) not install and employ p-medicine tools in one of their data centres. A robust business model for the provision of services and the implementation and employment of tools does not yet exist.
How can the personalized medicine infrastructure p-medicine and the clinical trials network ECRIN gain from each other to allow the conduct of personalized clinical trials? We suggest a business model, in which personalized medicine infrastructures and clinical trials networks exchange their services to gain jointly from each other. An integration of networks by reciprocal exchange of services may be the solution. Not only software as a service will be exchanged, but also knowledge, personnel and staff trainings.
Data Science Deep Roots in Healthcare IndustryDinesh V
Data Science transforms the healthcare industry with impeccable solutions that can improve patient care through EHRs, medical imaging, drug discovery, predictive medicines and genetics and genomics.
A biomarker strategy aims to answer key clinical questions to support drug development through identifying and testing biomarkers. Developing a robust biomarker strategy can mitigate risks and inform clinical study design by generating testable hypotheses to bridge pre-clinical and clinical research. Effective biomarker strategies consider assay suitability, study design, and sample availability to reliably detect biomarkers and provide statistically meaningful results. Emerging technologies allow deeper interrogation of drugs and disease through multiplexed readouts to enhance biomarker discovery and clinical development.
Human Genomics and Public Health in a Global World: Challenges for Low & Midd...Human Variome Project
This document discusses challenges for low and middle income countries regarding human genomics and public health in a global context. It notes that while genomics activity is increasing in about 50 countries, it remains fragmented without systematic monitoring or links to health policymakers. Five priorities for international genomics are identified: building an evidence base for genomic medicine, addressing health disparities, managing diverse patient populations, implications for medical education, and coordination across diseases. The document argues for greater global collaboration to improve access, establish standards, and promote equity and justice.
Here are 3 potential barriers that could have caused a delay in implementing the research findings supporting the use of saline over heparin for maintaining peripheral IV catheters:
1. Lack of awareness or accessibility of the existing research evidence among clinicians. Medical research takes time to disseminate into practice.
2. Resistance to change long-standing practices without a compelling clinical practice guideline or recommendation from a major organization. The ASHP policy from 2006 helped address this.
3. Potential economic barriers if hospitals had invested in heparin products and switching to saline-only maintenance required a change in supplies and protocols. Standardizing on the lower cost saline may have faced resistance.
Similar to “8th National Biennial Conference on Medical Informatics 2012” (20)
Unlock the Future of Search with MongoDB Atlas_ Vector Search Unleashed.pdfMalak Abu Hammad
Discover how MongoDB Atlas and vector search technology can revolutionize your application's search capabilities. This comprehensive presentation covers:
* What is Vector Search?
* Importance and benefits of vector search
* Practical use cases across various industries
* Step-by-step implementation guide
* Live demos with code snippets
* Enhancing LLM capabilities with vector search
* Best practices and optimization strategies
Perfect for developers, AI enthusiasts, and tech leaders. Learn how to leverage MongoDB Atlas to deliver highly relevant, context-aware search results, transforming your data retrieval process. Stay ahead in tech innovation and maximize the potential of your applications.
#MongoDB #VectorSearch #AI #SemanticSearch #TechInnovation #DataScience #LLM #MachineLearning #SearchTechnology
For the full video of this presentation, please visit: https://www.edge-ai-vision.com/2024/06/building-and-scaling-ai-applications-with-the-nx-ai-manager-a-presentation-from-network-optix/
Robin van Emden, Senior Director of Data Science at Network Optix, presents the “Building and Scaling AI Applications with the Nx AI Manager,” tutorial at the May 2024 Embedded Vision Summit.
In this presentation, van Emden covers the basics of scaling edge AI solutions using the Nx tool kit. He emphasizes the process of developing AI models and deploying them globally. He also showcases the conversion of AI models and the creation of effective edge AI pipelines, with a focus on pre-processing, model conversion, selecting the appropriate inference engine for the target hardware and post-processing.
van Emden shows how Nx can simplify the developer’s life and facilitate a rapid transition from concept to production-ready applications.He provides valuable insights into developing scalable and efficient edge AI solutions, with a strong focus on practical implementation.
Goodbye Windows 11: Make Way for Nitrux Linux 3.5.0!SOFTTECHHUB
As the digital landscape continually evolves, operating systems play a critical role in shaping user experiences and productivity. The launch of Nitrux Linux 3.5.0 marks a significant milestone, offering a robust alternative to traditional systems such as Windows 11. This article delves into the essence of Nitrux Linux 3.5.0, exploring its unique features, advantages, and how it stands as a compelling choice for both casual users and tech enthusiasts.
Removing Uninteresting Bytes in Software FuzzingAftab Hussain
Imagine a world where software fuzzing, the process of mutating bytes in test seeds to uncover hidden and erroneous program behaviors, becomes faster and more effective. A lot depends on the initial seeds, which can significantly dictate the trajectory of a fuzzing campaign, particularly in terms of how long it takes to uncover interesting behaviour in your code. We introduce DIAR, a technique designed to speedup fuzzing campaigns by pinpointing and eliminating those uninteresting bytes in the seeds. Picture this: instead of wasting valuable resources on meaningless mutations in large, bloated seeds, DIAR removes the unnecessary bytes, streamlining the entire process.
In this work, we equipped AFL, a popular fuzzer, with DIAR and examined two critical Linux libraries -- Libxml's xmllint, a tool for parsing xml documents, and Binutil's readelf, an essential debugging and security analysis command-line tool used to display detailed information about ELF (Executable and Linkable Format). Our preliminary results show that AFL+DIAR does not only discover new paths more quickly but also achieves higher coverage overall. This work thus showcases how starting with lean and optimized seeds can lead to faster, more comprehensive fuzzing campaigns -- and DIAR helps you find such seeds.
- These are slides of the talk given at IEEE International Conference on Software Testing Verification and Validation Workshop, ICSTW 2022.
Driving Business Innovation: Latest Generative AI Advancements & Success StorySafe Software
Are you ready to revolutionize how you handle data? Join us for a webinar where we’ll bring you up to speed with the latest advancements in Generative AI technology and discover how leveraging FME with tools from giants like Google Gemini, Amazon, and Microsoft OpenAI can supercharge your workflow efficiency.
During the hour, we’ll take you through:
Guest Speaker Segment with Hannah Barrington: Dive into the world of dynamic real estate marketing with Hannah, the Marketing Manager at Workspace Group. Hear firsthand how their team generates engaging descriptions for thousands of office units by integrating diverse data sources—from PDF floorplans to web pages—using FME transformers, like OpenAIVisionConnector and AnthropicVisionConnector. This use case will show you how GenAI can streamline content creation for marketing across the board.
Ollama Use Case: Learn how Scenario Specialist Dmitri Bagh has utilized Ollama within FME to input data, create custom models, and enhance security protocols. This segment will include demos to illustrate the full capabilities of FME in AI-driven processes.
Custom AI Models: Discover how to leverage FME to build personalized AI models using your data. Whether it’s populating a model with local data for added security or integrating public AI tools, find out how FME facilitates a versatile and secure approach to AI.
We’ll wrap up with a live Q&A session where you can engage with our experts on your specific use cases, and learn more about optimizing your data workflows with AI.
This webinar is ideal for professionals seeking to harness the power of AI within their data management systems while ensuring high levels of customization and security. Whether you're a novice or an expert, gain actionable insights and strategies to elevate your data processes. Join us to see how FME and AI can revolutionize how you work with data!
HCL Notes und Domino Lizenzkostenreduzierung in der Welt von DLAUpanagenda
Webinar Recording: https://www.panagenda.com/webinars/hcl-notes-und-domino-lizenzkostenreduzierung-in-der-welt-von-dlau/
DLAU und die Lizenzen nach dem CCB- und CCX-Modell sind für viele in der HCL-Community seit letztem Jahr ein heißes Thema. Als Notes- oder Domino-Kunde haben Sie vielleicht mit unerwartet hohen Benutzerzahlen und Lizenzgebühren zu kämpfen. Sie fragen sich vielleicht, wie diese neue Art der Lizenzierung funktioniert und welchen Nutzen sie Ihnen bringt. Vor allem wollen Sie sicherlich Ihr Budget einhalten und Kosten sparen, wo immer möglich. Das verstehen wir und wir möchten Ihnen dabei helfen!
Wir erklären Ihnen, wie Sie häufige Konfigurationsprobleme lösen können, die dazu führen können, dass mehr Benutzer gezählt werden als nötig, und wie Sie überflüssige oder ungenutzte Konten identifizieren und entfernen können, um Geld zu sparen. Es gibt auch einige Ansätze, die zu unnötigen Ausgaben führen können, z. B. wenn ein Personendokument anstelle eines Mail-Ins für geteilte Mailboxen verwendet wird. Wir zeigen Ihnen solche Fälle und deren Lösungen. Und natürlich erklären wir Ihnen das neue Lizenzmodell.
Nehmen Sie an diesem Webinar teil, bei dem HCL-Ambassador Marc Thomas und Gastredner Franz Walder Ihnen diese neue Welt näherbringen. Es vermittelt Ihnen die Tools und das Know-how, um den Überblick zu bewahren. Sie werden in der Lage sein, Ihre Kosten durch eine optimierte Domino-Konfiguration zu reduzieren und auch in Zukunft gering zu halten.
Diese Themen werden behandelt
- Reduzierung der Lizenzkosten durch Auffinden und Beheben von Fehlkonfigurationen und überflüssigen Konten
- Wie funktionieren CCB- und CCX-Lizenzen wirklich?
- Verstehen des DLAU-Tools und wie man es am besten nutzt
- Tipps für häufige Problembereiche, wie z. B. Team-Postfächer, Funktions-/Testbenutzer usw.
- Praxisbeispiele und Best Practices zum sofortigen Umsetzen
AI 101: An Introduction to the Basics and Impact of Artificial IntelligenceIndexBug
Imagine a world where machines not only perform tasks but also learn, adapt, and make decisions. This is the promise of Artificial Intelligence (AI), a technology that's not just enhancing our lives but revolutionizing entire industries.
Climate Impact of Software Testing at Nordic Testing DaysKari Kakkonen
My slides at Nordic Testing Days 6.6.2024
Climate impact / sustainability of software testing discussed on the talk. ICT and testing must carry their part of global responsibility to help with the climat warming. We can minimize the carbon footprint but we can also have a carbon handprint, a positive impact on the climate. Quality characteristics can be added with sustainability, and then measured continuously. Test environments can be used less, and in smaller scale and on demand. Test techniques can be used in optimizing or minimizing number of tests. Test automation can be used to speed up testing.
HCL Notes and Domino License Cost Reduction in the World of DLAUpanagenda
Webinar Recording: https://www.panagenda.com/webinars/hcl-notes-and-domino-license-cost-reduction-in-the-world-of-dlau/
The introduction of DLAU and the CCB & CCX licensing model caused quite a stir in the HCL community. As a Notes and Domino customer, you may have faced challenges with unexpected user counts and license costs. You probably have questions on how this new licensing approach works and how to benefit from it. Most importantly, you likely have budget constraints and want to save money where possible. Don’t worry, we can help with all of this!
We’ll show you how to fix common misconfigurations that cause higher-than-expected user counts, and how to identify accounts which you can deactivate to save money. There are also frequent patterns that can cause unnecessary cost, like using a person document instead of a mail-in for shared mailboxes. We’ll provide examples and solutions for those as well. And naturally we’ll explain the new licensing model.
Join HCL Ambassador Marc Thomas in this webinar with a special guest appearance from Franz Walder. It will give you the tools and know-how to stay on top of what is going on with Domino licensing. You will be able lower your cost through an optimized configuration and keep it low going forward.
These topics will be covered
- Reducing license cost by finding and fixing misconfigurations and superfluous accounts
- How do CCB and CCX licenses really work?
- Understanding the DLAU tool and how to best utilize it
- Tips for common problem areas, like team mailboxes, functional/test users, etc
- Practical examples and best practices to implement right away
Building Production Ready Search Pipelines with Spark and MilvusZilliz
Spark is the widely used ETL tool for processing, indexing and ingesting data to serving stack for search. Milvus is the production-ready open-source vector database. In this talk we will show how to use Spark to process unstructured data to extract vector representations, and push the vectors to Milvus vector database for search serving.
Full-RAG: A modern architecture for hyper-personalizationZilliz
Mike Del Balso, CEO & Co-Founder at Tecton, presents "Full RAG," a novel approach to AI recommendation systems, aiming to push beyond the limitations of traditional models through a deep integration of contextual insights and real-time data, leveraging the Retrieval-Augmented Generation architecture. This talk will outline Full RAG's potential to significantly enhance personalization, address engineering challenges such as data management and model training, and introduce data enrichment with reranking as a key solution. Attendees will gain crucial insights into the importance of hyperpersonalization in AI, the capabilities of Full RAG for advanced personalization, and strategies for managing complex data integrations for deploying cutting-edge AI solutions.
Pushing the limits of ePRTC: 100ns holdover for 100 daysAdtran
At WSTS 2024, Alon Stern explored the topic of parametric holdover and explained how recent research findings can be implemented in real-world PNT networks to achieve 100 nanoseconds of accuracy for up to 100 days.
In his public lecture, Christian Timmerer provides insights into the fascinating history of video streaming, starting from its humble beginnings before YouTube to the groundbreaking technologies that now dominate platforms like Netflix and ORF ON. Timmerer also presents provocative contributions of his own that have significantly influenced the industry. He concludes by looking at future challenges and invites the audience to join in a discussion.
Unlocking Productivity: Leveraging the Potential of Copilot in Microsoft 365, a presentation by Christoforos Vlachos, Senior Solutions Manager – Modern Workplace, Uni Systems
“8th National Biennial Conference on Medical Informatics 2012”
1. EVALUATION AND MONITORING OF META-
ANALYSIS IN MEDICAL RESEARCH THROUGH
INFORMATION TECHNOLOGY
Mayadhar Barik, Doctorial Candidate, Department of Nuclear Medicine
All India Institute of Medical Sciences, New Delhi-110029
Email: mayadharbarik@gmail.com
Sushil K Meher, Department of Computer Facility
All India Institute of Medical Sciences, New Delhi-110029
2. INTRODUCTION
• Monitoring and evaluation in the field of health care are
much more important and closely related
• They are undertaken to find out the result of a research
project in relation to the clinical benefits, risk factors
and its importance for society
3. OBJECTIVE
• Its efficiency, effectiveness, sustainability and
reproducibility and hence play a crucial role in
medical research and education
4. MATERIALS AND METHODS
• How a programme project research results, treatment
performances or has performed including reasons for
expects of performance, whether positive or negative
which is usually with emphasis on impact for people,
research scholars, doctors, scientists, genetists,
paramedical staff and others
5. MATERIALS AND METHODS
• Protocol development
• Estimating the treatment difference in an individual
trial
• Combining estimates of a treatment difference across
the trials
• Meta-analysis using individual patient data
• Dealing with heterogeneity
6. RESULTS
• This article includes tries to describe new innovative
methods in research methodology. Effective monitoring is
important for purposeful conclusion of a research
7. SOFTWARE FOR META-ANALYSIS
• Comprehensive meta-analysis
• Epi meta
• Statistics software for meta-analysis
• Meta-analysis easy to answer
• Easy MA
• SAS 9.2 version and multiple regression models
• Stata version 9E/11.1
8. CONCLUSION
• Here the statistical analysis should be included in the
main protocol, although it may also be useful to
produce detailed statistical analysis plan separately
• For each outcome variable analysis of population
missing data at the subject level, analysis of individual
trials, meta-analysis model, estimation and hypothesis
testing are to be performed
• To avoid too many false positive results, it is desirable
to limit the number of covariables investigated in this
way
10. CURRENT PROSPECTIVE IN GENE
THERAPY AND THE ROLE PLAYED BY
MEDICAL INFORMATICS
Mayadhar Barik, Doctorial Candidate, Department of Nuclear Medicine
All India Institute of Medical Sciences, New Delhi-110029
Email: mayadharbarik@gmail.com
Dr. Vaibhav Choudhary, Department of Medical Oncology
All India Institute of Medical Sciences, New Delhi-110029
Sushil K Meher, Department of Computer Facility
All India Institute of Medical Sciences, New Delhi-110029
11. INTRODUCTION
• Gene therapy aims to fix a disease linked with genetic
abnormality
• Gene therapy is currently receiving attention from the
scientists, clinicians and the general public in an attempt
to correct genetic defects including congenital
abnormalities and neurodevelopmental disorders.1
• However its application is beset with complications
partly because of lack of advanced knowledge and
research and partly because of vested interest by the
society.
12. OBJECTIVE
• This study is an attempt to highlight some of
the major benefits of gene therapy and to
define the role played by the medical
informatics in facilitating rational use of gene
therapy.
13. MATERIALS AND METHODS
• An attempt was made to review major studies in the
international literature to synthesize the potential risks,
benefits of gene therapy
• We also reviewed the tools and techniques in the field
of medical informatics which can be employed for
spreading awareness about gene therapy
• We developed a conceptual model of matching the key
concepts with the current protocols used in the field of
medical informatics.2
14. MATERIALS AND METHODS
• Chromosomes and Genes
• Chromosomal Disorders
• Genetic Disorders
• Inborn Errors or Metabolism (IEM)
• Prevention of Genetic Disorders (POGD)
• Common Inborn Errors of Metabolism (CIEOM)
• Gene or Gene Production
• Strategy for Gene Transfer
• Molecular Technique for Inducing the Gene
• Cell Type and Region
15. RESULTS
• Gene therapy offers a new hope for the treatment of
neurodegenerative disorders like Huntington disease. It
application in Parkinson disease has moved a step closer
to acceptance in the wake of its successful double blind
clinical trial
• The educational media, viz., fall under four categories,
audio media, the visual media, the audio-visual and the
virtual-media in vitro and vivo
• The simulation and animation capabilities of the media are
quite helpful in the conceptualization of gene therapy
• The audio-visual media are useful for counseling in matter
of genetic disorders the public.
16. DISCUSSION
• Many inherited metabolic diseases will not require
complete restoration of gene function for correcting
important aspects of the disease phenotype
• In e.g. Parkinsonism, phenylketouria and other
diseases. Pseudogene and transgenic expression is
needful.
17. DISCUSSION
• Age of the Affected Host
• Gene Therapy in Cancer
• Stem Cell and Gene Therapy in Molecular
Medicine
• Genetic Counselling
• Gene Therapy in Medical Informatics
18. CONCLUSION
• Our study suggests that an integrated and holistic use
of medical informatics can be highly beneficial for the
advanced application of gene therapy in the years to
come
• The current application of gene therapy has become
debatable and often controversial because of tendency
to use for manipulating the desirable attributes.3
• However its rational use is likely to benefit the
mankind.
19. REFERENCES
1. Osterman JV, Waddell A, Aposhian HV. DNA and gene therapy:
uncoating of polyoma pseudovirus in mouse embryo cells. Journal
Proceedings of the National Academy of Science of the United States
of America 67(1): 37-40.
2. Gennady E, Karl JH, Kevin TC, Sean S, Kelvin JAD. Regulators of
calcinurin (RCANIIL) is deficient in Huntington disease and protective
against mutant Huntington Toxicity in vitro. JBC Papers in Press.
Published on March 6, 2009 as manuscript M9006301200.
3. Samir C, Patela, Bhupendrarinh F, Chauhana KK, MM Patiala. Gene
therapy for neurodegenerative disorders: Current Status and Future
Prospects. Journal of Pharmacy Research Vol. 3, no. 5, 2010.
4. Friedmann T, Roblin R. Gene therapy for human genetic disease?
Science 1972; 175: 949.
5. Anderson WF. Prospects for human gene therapy. Science 1984; 226:
401.
20. REFERENCES
6. Verma IM. Gene Therapy, Sci Am 1990; 262: 68.
7. Gage FH, Fisher LJ, Jinnah HA, et al. Grafting genetically modified
cells to the brain: conceptual and technical issues. Prog Brain Res
1990; 82: 1.
8. Gage FH, Wolff JA, Rosenberg MB, et al. Grafting genetically
modified cells to brain: possibilities for the future. Neuroscience
1987; 23: 795.
9. Kobayashi T, Yamanaka T, Jacobs JM, et al. The twitcher mouse: an
enzymatically authentic model of human globoid cell leukodystrophy
(Krabbe disease). Brain Res 1980; 202: 479.
10. Igisu H, Suzuki K. Progressive accumulation of toxic metabolite in a
genetic leukodystrophy. Science 1984; 224: 753.
22. Reducing EMR implementation cost and
improving adoption using eLearning for
training and change management.
Dr Saurabh Bhatia, MBBS(AFMC), MS, FCR
Managing Director, TSML Solutions Pvt Ltd, Pune
S.Bhatia@TSMLS.org;
!1
23. Introduction
• Going live after a
successful
implementation of an
HIS or EMR in a big
hospital is the
beginning of the
problem for the
clinical adoption,
training and change
management team.
!2
24. This case study uses
personal experience
• Two quaternary care hospitals of
Delhi.
• One greenfield, one functional
hospital
• Bed strength was around 900
then, planned to shoot upto 1600
in 2-3 years
• Workforce was Huge
• EMR was first time introduced at
both hospitals
• Clinical adoption was suspect,
even before implementation
!3
25. The numbers
• The number of personnel to be trained in each hospital
were very similar
• 2400 nurses
• 300 in house doctors
• 600 visiting doctors (brownfield hosp)
• additional staff of about 600 employees comprising of
pharmacy, store keepers, front-office, quality department,
secretaries and clerical staff.
• The total people to be trained were estimated to be
about 4000.
!4
26. Training logistics
• After preparing the training material and
running a short pilot on a mixed group,
we came to the conclusion that about
• 8 hours of training was required by
every individual.
• The traditional method to train is to
make a set of about 20 people sit in
a computer lab, with 2 instructors
who will train them.
• Further, the training was to be done in
4 periods of 2 hours each, because
it was expected that new learners
cannot focus at a stretch for 8 hours to
learn effectively.
!5
27. Problem Statement …1/4
• Different set of employees needed different
combination of module trainings. It was thus
difficult to merely create a mathematical group of 20
trainees, but needed a group of 20 trainees with
similar needs.
• Batch making was further complicated by different
shift of duties of various personnel falling in the
same batch.
!6
28. Problem Statement …2/4
• The 2400 nurses who needed training could not be
spared during duty hours. So they would have to be
allocated before or after duty hours. This meant
abnormal timings for training.
• In greenfield hospital, nurses were being hired at a very
rapid pace and HR was unable to give us exact numbers
and training plans
• All doctors will not be able to attend as scheduled
because of emergency and OT schedules and batches
of 20 were seen impossible most of the time.
!7
29. Problem Statement …3/4
• Visiting doctors visit once or twice in a week and it
was impossible to force them to attend pre-
planned training sessions.
• Both hospitals had only one computer lab with 6-8
computers but were willing to upgrade it to 10
computers. But another 10 computer lab had to be
raised or outsourced, perhaps at a different location.
!8
30. Problem Statement …4/4
• The nurses had an attrition rate of about 25% which meant
that about 600 new nurses will have to be trained every year
subsequently, practically meaning about 2-3 new nurse
trainees will trickle in every day.
• For the remaining force, the attrition was estimated at 8% which
meant about 125 new trainees every year.
• The total training was for 200 batches at a conservative
estimate, and was expected to spill over 250 batches,
utilizing 16-20 students, of 8 hours each, totaling 2000 hrs of
class room training.
• This meant 250 working days of training which meant 10-11
months to train the entire workforce, if trainings were
conducted for 8 hrs everyday, 25 days a month.
!9
31. Problem compounding
• Time-Frame was unacceptable
• Timeframe alone could defeat the adoption programme
• Cost of training was too High
• Cost of training Nurses: INR 18,00,000 (600/day x 3000)
• Cost of training doctors: INR 18,00,000 (2000/day x 900)
• Cost of training others: INR 4,00,000 (650/day x 600)
• Cost of trainers: INR 8,00,000 (2000 hrs x 200/hr)
• Additional Infra: computers, Labs etc: 5,80,000
• Total cost: 52.8 lakhs
!10
32. What we were expected to do
• Finish training in a reasonable time frame, commensurate
with implementation plan
• Bring the cost down as a training worth ½ crore was not
affordable
• Ensure that employees, whether onboarded or old, were all
able to make/ keep hospital functional
!11
33. Our Approach
• Mixed Approach
• Synchronous+Asynchronous training
• We implemented an Enterprise Training Portal (ETP)
which behaves like a website. It was possible to access
this training material from within hospital premises, and
if permitted, from home also.
• All the training material was uploaded in ETP.
• Role based courses were created for each role e.g. Nurse,
doctor, accounts etc.
• Each user was asked to self-register and self-enroll in
courses.
• Each course had training material, practice sessions, mock
and final tests
• Each candidate was awarded a certificate of passing the
modules that their role demanded.
!12
34. Our Approach
• Synchronous:
• It was decided that classroom training would be given to each
person for not more than 2 hours.
• First 30 minutes to teach how to utilize eLearning for training.
Next 90 minutes, split over 2 sessions for doubt clearing and
advanced questions.
• The second session was a free for all doubt clearing session,
not mandatory.
• Strategically identified key people, which were more or
less one person per department, were trained for a longer
duration to become training champions
!13
35. Our Approach
• Nurses and doctors were each given a timeline
of 45 days from enrollment to complete their
training using bits and pieces of free time that they
get in the day or night duty.
• This was made a mandatory part of all new
joinees' induction training. (remember 750 new
employees?)
• The users were not allowed on the main EMR till
they had not obtained the certificate from LMS.(Part
success)
!14
36. Changes that happened
• Changes in the time taken for training
• 2 months, a critical mass was reached to call it an
adoption
• Changes in the cost of training
• The need for formal classroom training was brought down to one fourth the
number of hours with just 30% computers.+ward PCs+PCs
• The actual expenses that occurred due to this different strategy are as follows:
• Cost of nurses training: 4.5 lakhs (¼ of traditional model)
• Cost of doctors' training : 4.5 lakhs (¼ of traditional model)
• Cost of training other personnel: 1.5 lakhs (2/5th of traditional model)
• Cost of trainers: 2 lakhs ((¼ of traditional model)
• Cost of additional computers: Nil
• Additional cost of web-material building: Nothing extra was built. We used
existing Powerpoint or Word files.
• Additional expense for LMS configuration: 2 lakhs
• Total training expense: about 14.5 lakhs
!15
37. How green was my
valley?
• How succesful were we in adoption?
• Usage started across the hospital
• 65-75% employees were using the systems
• Patterns Noted:
• Nurses learnt with max enthusiasm
• Their champions also had better inputs
• Doctors’s enthusiasm curve declined with seniority
• Secretaries had to be trained instead of HsOD
• Laboratories were more critical of changed processes but
learnt the systems faster.
• Accounts and admin dept were resistant to change
• Front office had a mixed response
• Medical coding was not a part of this exercise
• External doctors were casual, at best. Most were not given
login
!16
38. Thanks for your patience.
You were listening to a
presentation by
Dr Saurabh Bhatia, MBBS(AFMC), MS, FCR
Managing Director,
TSML Solutions Pvt Ltd, Pune
S.Bhatia@TSMLS.org
About
Reducing EMR implementation cost and
improving adoption using eLearning for
training and change management.
!17