健康・医療情報学ジャーナル

Background: Healthcare IT (HIT) gains more and more public attention as well as clinical relevance. A growing number of patients and physicians increasingly relies on IT services to monitor and support wellbeing and recovery both in their private as well as in professional environment. Objectives: In this study, we investigated the current status of HIT use and penetration among physicians in hospitals and private practices as well as future expectations and demands regarding HIT. Material and methods: Using clinical networks all over Germany, Austria and Switzerland, mainly in the cities of Nuremberg, Vienna and Munich, we addressed physicians to answer a standardized internet-based questionnaire consisting of 15 multiple choice and two open questions sent out via email. Parameters were evaluated in 5 categories: general use, frequency, acceptance, needs and future. An overall of 234 physicians (response rate 83.6%) have answered the online questionnaire. Results: Physicians with a median age of 45 (range 25 > 60) responded and filled out the entire questionnaire. A significant correlation between parameters gender, age and level of training (resident, specialist, consultant etc.) can be proven. Whereas male physicians tend to use HIT significantly more in their professional life than their female colleagues, it is clear that this is not the case when it comes to private use of equivalent applications. Furthermore, the use of technology varies widely across age as well as level of training. Whereas increasing age among physicians is associated with a decreasing level of application of HIT, a higher training level is notably accompanied by an increasing level when it comes to a professional application of these tools. Use of data, gained with HIT is regarded as a necessary and positive standard. Most users assume the importance of HIT to grow in the future in parallel to their current use. A clear lack of trust in terms of medical data storage is recognized on both patient and physician side. In the majority of cases, physicians tend to use their own IT over the hospitals’, showing a clear need for improvement and technological innovation within the hospitals. Conclusion: The results show a clear gap between private and professional use of IT for medical purposes. HIT growth is by the majority regarded as key development driver, the future healthcare development will head towards. We conclude that the use of IT application generally depends strongly on age, gender as well as role within the hospital and type of hospital.

Medical trend is the most important component used to indicate and file health insurance rates. Insurance companies apply trend analysis to forecast future costs and premiums. Governments use medical trend in the rate review process. In this paper we discuss four statistical methods: average ratio, linear regression, exponential regression and time series analysis, as well as their use in determining trend factors. An efficient method to detecting the outliers based on leave one out analysis is presented. A software package is developed within Microsoft Excel to calculate medical trend based on annual data or monthly data, which provides a useful tool for the insurance rate review.

The regulatory mechanisms of nuclear factor erythroid 2-related factor 2 (Nrf2) mainly include detoxification and antioxidation in the progress of isonicotinic acid hydrazide (INH)-induced liver injury. The interaction and protective effects of these two injury mechanisms have not been reported. In this study, eight Kunming mice were administered with INH via gavage at a dose of 90 mg/kg.d. The mice were then killed for 1 d, 3 d, 5 d, 7 d, 2 w, 3 w, and 4 w, and the control groups received gavage of the same volume of distilled water. The pathological changes of liver tissues and location of Nrf2 in liver cell were observed. The superoxide dismutase (SOD) and malondialdehyde (MDA), as well as the expressions of Nrf2, glutathione S-transferase (GST), and SOD mRNAs and proteins were examined. After drug administration for 1–2 weeks, the SOD (total SOD, Cu-ZnSOD, and MnSOD), GST (GSTA1 and GSTM1), and Nrf2 exhibited trough levels, whereas the MDA content reached the peak. These results suggest that Nrf2 nucleocytoplasmic transport occurred in the experimental groups on the seventh day after administration, and then the expressions of mRNAs and proteins of GSTA1, GSTM1, Cu-ZnSOD, and MnSOD were all upregulated with the activation of the Nrf2-antioxidant responsive element (ARE) pathway.

The clinical application of Functional Electrical Stimulation (FES) has evolved over the last five decades. However, the use of the Randomized Control Trial (RCT) methodology in evaluating the clinical effectiveness of new and existing applications of FES is a demanding process adding time and cost to these trials. Consequently, there has been a low level of RCTs applied to FES studies. Poor quality trials result in poor evidence of FES effectiveness with a consequence that the technique may not be adopted into clinical practice. In this paper some of the key challenges encountered in FES randomised control clinical trials are identified and a solution to address these challenges is presented in the form of a smartphone App and a Bluetooth controlled FES architecture. The design and evaluation of a smartphone application using a User Centred Design approach to provide automatic blind randomization control and facilitating the wireless temporal control of a portable Bluetooth enabled FES device is described.