Maturity Assessment of Hospital Information Systems Based on Electronic Medical Record Adoption Model (EMRAM)— Private Hospital Cases in Iran

Introduction: Today, information technology is considered as an important national development principle in each country which is applied in different fields. Health care as a whole and the hospitals could be regarded as a field and organizations with most remarkable IT applications respectively. Although different benchmarks and frameworks have been developed to assess different aspects of Hospital Information Systems (HISs) by various researchers, there is not any suitable reference model yet to benchmark HIS in the world. Electronic Medical Record Adoption Model (EMRAM) has been currently presented and is globally well-known to benchmark the rate of HIS utilization in the hospitals. Notwithstanding, this model has not been introduced in Iran so far. Methods: This research was carried out based on an applied descriptive method in three private hospitals of Isfahan—one of the most important provinces of Iran—in the year 2015. The purpose of this study was to investigate IT utilization stage in three selected private hospitals. Conclusion: The findings revealed that HIS is not at the center of concern in studied hospitals and is in the first maturity stage in accordance with EMRAM. However, hospital managers are enforced and under the pressure of different beneficiaries including insurance companies to improve their HIS. Therefore, it could be concluded that these types of hospitals are still far away from desirable conditions and need to enhance their IT utilization stage significantly.

Influence of Medical Model on Therapeutic Environment

In its development history, man has always tried to be close to nature, and get physical and spiritual help from the nature. According to the development of medical model from the deity worship to modern medical science, a near-nature and ecological therapeutic and recuperative model has been more favored, thus in modern therapeutic environment, proper landscape designs can be combined with effective medical methods to achieve physical and mental immunoregulation and balance using natural and quality climatic factors. This paper introduced the development of natural science and medicinal model in different periods, and analyzed their impact on environment, concluded the benefi ts of therapeutic medicine, and demonstrated the signifi cance of therapeutic environment and landscape healing as the therapeutic factors for facilitating human rehabilitation from the perspective of therapeutic medicine. Taking "evidence-based design" as the basis of therapeutic environment design, this paper proposed landscape design methods for the therapeutic environment, in order to provide people opportunities for closing to, sharing and participating in the nature, help people to relax physically and psychologically using the positive impact of natural environment on human spirits, relieve their stress, and achieve physical and psychological peace. In addition, the development tendency of therapeutic environment in China was predicted according to the actual conditions of urban society.

Knowledge Formalization about Perforated Stomach Ulcer on the Basis of Medical Ontology

The article defines knowledge about pelforated stomach ulcer that is formalized on the basis of an ontology model of medical diagnostics domain. The paper describes a base of observations for the disease and also knowledge base which determines a clinical presentation of the disease. The dependences on courses of the disease and process localization are taken into account during knowledge formalizing. The base of knowledge for the disease has the structure that is conventional for contemporary medicine. These knowledge will be used for building a medical intellectual system of for consulting and diagnostics.

Narrative Medicine Under the Guidance of Traditional Chinese Medicine Theory

This paper is an exploration into the practice of narrative medicine in the clinical setting guided by the theory and approaches of traditional Chinese medicine(TCM).By adopting the theory of TCM,the author attempted to provide the patients with systematic treatment from the perspective of society-psychology-biology under the guidance of both the unity of Heaven and Man,and the unity of Xing(Body)and Shen(Mind/Spirit)through his clinical practice.Guided by yin-yang and Wu Xing(Five Elements)theory and focusing on the social relations of the patients for any possible relationships between patients’social,psychological and biological state,the author took the patients’emotion management as a point of departure and helped the patients recover both physically and psychologically by promoting positive transformation in patients’social,psychological,and biological state.A clinical case was provided at the end of this paper to demonstrate how the above theory was put into practice.Narrative medicine under the guidance of TCM theory can supplement modern medical humanity practices as well as extend the scope of modern medical treatment from the perspective of the unity of Heaven and Man,by enriching the content of narrative medicine,and promoting the medical model from biological medical model toward social-psychological-biological model.

Spinal fixation after laminectomy in pigs prevents postoperative spinal cord injury

Background:A safe,effective,and ethically sound animal model is essential for preclinical research to investigate spinal medical devices.We report the initial failure of a porcine spinal survival model and a potential solution by fixating the spine.Methods:Eleven female Dutch Landrace pigs underwent a spinal lumbar interlaminar decompression with durotomy and were randomized for implantation of a medical device or control group.Magnetic resonance imaging(MRI)was performed before termination.Results:Neurological deficits were observed in 6 out of the first 8 animals.Three of these animals were terminated prematurely because they reached the predefined humane endpoint.Spinal cord compression and myelopathy was observed on postoperative MRI imaging.We hypothesized postoperative spinal instability with epidural hematoma,inherent to the biology of the model,and subsequent spinal cord injury as a potential cause.In the subsequent 3 animals,we fixated the spine with Lubra plates.All these animals recovered without neurological deficits.The extent of spinal cord compression on MRI was variable across animals and did not seem to correspond well with neurological outcome.Conclusion:This study shows that in a porcine in vivo model of interlaminar decompression and durotomy,fixation of the spine after lumbar interlaminar decompression is feasible and may improve neurological outcomes.Additional research is necessary to evaluate this hypothesis.

Attitudes of Future Tourism Sector Employees Towards Organise Accessible Tourism

The aim of this paper is to show a theoretical approach to the evolution of concepts perceiving disability, taking into account the medical, social, and geographical models, as the basis for the development of principles concerning the organisation of accessible tourism for people with disabilities （PWD）. The main research objective was to identify the current attitudes of future, potential employees in the tourism （tourism and recreation students at the time of the study） towards accessible tourism. The study was based on surveys performed in May 2013 at the Adam Mickiewicz University in Poznafi （UAM, Poland） and the State University in Irkutsk （HFY, Russia）, a total sample of 216 people. The main section of the survey contained four questions regarding issues such as： optimal ways to organise tourism products for people with a disability; attitudes towards spending leisure time together with people with a disability; and specific requirements concerning the introduction of various types of improvements in tourism products aimed at people with a disability. In both cases, the results revealed that future tourism employees hold attitudes which are prevailingly open and positive towards the needs of tourists with disabilities. However, the hypothesis that the main factor influencing a reluctance to enter into contact with PwD is a lack of experience in this area, resulting in insufficient knowledge of what conditions the behaviour of PwD was also confirmed. This is a highly significant conclusion which should consider if mandatory educational programmes in the field of tourism and recreation studies are to be improved.

Influence of Tomographic Slice Thickness and Field of View Variation on the Reproduction of Thin Bone Structures for Rapid Prototyping Purposes-An in Vitro Study

This study assessed the influence of acquisition parameters of tomographic volumes on the reproduction of thin bone structures for rapid prototyping purposes. Two parameters were investigated: Field of View (FOV) and Slice Thickness (ST). The specimen was comprised of five pairs of 0.6 mm, 1.1 mm, 1.5 mm, 2.0 mm and 2.8 mm thick cortical bone plates. The plates were stuck into utility wax;the first plate of the pair was in vertical position while the second plate was oblique to the first one. Forty-five tomographic images were captured and separated into 3 groups of fifteen images. Each group had a specific FOV: 180 mm;250 mm and 430 mm, respectively. Within each of these three groups, tomographic slice thickness was varied for every five of the fifteen slices. Acquisitions were carried out with STs of 1 mm, 2.5 mm and 5 mm. The Cyclops Medical Station software was used in the voxel-to-voxel analysis of radiologic density, reaching a total of 1350 assessed images. ST and FOV variation influenced the reproduction of thin bone walls, and FOV was shown to be a very important parameter. The larger the acquisition FOV, the more reduction in the number of voxels within the range of reconstruction for cortical bone in all of the bone plates. The visual analysis of the images of very thin bone walls showed that there could be a sharp drop in the radiologic density value in several adjacent voxels, resulting in areas which might not be reproduced in the reconstruction.

Developing global image feature analysis models to predict cancer risk and prognosis

In order to develop precision or personalized medicine,identifying new quantitative imaging markers and building machine learning models to predict cancer risk and prognosis has been attracting broad research interest recently.Most of these research approaches use the similar concepts of the conventional computer-aided detection schemes of medical images,which include steps in detecting and segmenting suspicious regions or tumors,followed by training machine learning models based on the fusion of multiple image features computed from the segmented regions or tumors.However,due to the heterogeneity and boundary fuzziness of the suspicious regions or tumors,segmenting subtle regions is often difficult and unreliable.Additionally,ignoring global and/or background parenchymal tissue characteristics may also be a limitation of the conventional approaches.In our recent studies,we investigated the feasibility of developing new computer-aided schemes implemented with the machine learning models that are trained by global image features to predict cancer risk and prognosis.We trained and tested several models using images obtained from full-field digital mammography,magnetic resonance imaging,and computed tomography of breast,lung,and ovarian cancers.Study results showed that many of these new models yielded higher performance than other approaches used in current clinical practice.Furthermore,the computed global image features also contain complementary information from the features computed from the segmented regions or tumors in predicting cancer prognosis.Therefore,the global image features can be used alone to develop new case-based prediction models or can be added to current tumor-based models to increase their discriminatory power.

Initiating Hehe （和合） Medical System of Traditional Chinese Medicine and Biomedicine to Realize Health Cycle of Human Beings

This paper suggests a novel approach concerning the medical treatment of human beings, which appears to be economically and practically superior to either biomedicine or traditional medicine. A brand new medical system--Hehe （和合） medicine, has been proposed based on a preventive-biomedical-psycho-social treatment model. This is characterized by a dual approach in which life nurturing is consistently practised and medical treatment is applied when necessary in order to maintain a healthy life. Its core value would facilitate the self-restoration to health and self-adaptation to nature through health cultivation and medical means. Medical services would be firstly provided to the prevention of potential disease germinating in the human body, and clinical medical treatment would be the last resort of systematic medical practice. This paper discusses not only this new concept but also the advantages of traditional Chinese medicine and biomedicine, especially how both medical systems compare in cognitive style, on a cultural level, and on a technical level.

A Curriculum Using Simulation Models to Teach Gynecology and Obstetrics to Trainees

With the development of science and technology, great changes have taken place in medical education, making it increasingly complicated and diversified. For medical students who have just finished basic medicine courses and are preparing for their hospital internships, it is difficult to gain experience performing direct physical examinations on patients. Currently, residents＇ clinical skills are assessed very strictly; simply taking notes and reciting facts will not suffice. Because considerable attention is being paid to medical students＂ clinical skills on a national level,

Lu Xun and James Joyce： To Heal the Spirit of a Nation

Although James Joyce and Lu Xun were both writing at a time when a new nation was being created out of former empire, little has been written about the extraordinary synchronicities of their early careers or their common mission. Both understood a new nation must first be created in the hearts and minds of its people. Coming from a medical background, each regarded their countrymen as sick in spirit, paralyzed by slavish dependencies. Joyce saw such servility as fostered by Ireland＇s long colonization under the British Crown, a subservience seconded by the ＂tyranny＂ of the Roman Catholic Church. For Lu Xun, this spiritual paralysis manifested itself as a legacy of the Confucianism of the late Qing dynasty. Working from a medical model, both writers present a detailed, precise, and cold account of the speech of their characters to reveal the true nature of their disease--while allowing the reader to reach his own diagnosis. By means of this new kind of narrative, both James Joyce and Lu Xun sought to liberate the ＂soul＂ or ＂spirit＂ of their people, granting them a voice of their own which itself clarified to what extent they had been conscripted by the words of others.

Our Thoughts on Medicine and Philosophy

PHILOSOPHY ORIGINATED FROM MEDICINE, WHILE MEDICINE NESTS IN PHILOSOPHY Wherever there are humans, exploration of the inherent relationship between humans and nature is always examined. Belbre rational thinking was fully developed, ht, man beings tried to explain natural phenomena and the impact of nature on themselves using myths and primitive religions.