Candace Gibson | University of Western Ontario (original) (raw)
Papers by Candace Gibson
CRC Press eBooks, Sep 14, 2022
Applied clinical informatics, 2015
Clearly defined boundaries are disappearing among the activities, sources, and uses of health car... more Clearly defined boundaries are disappearing among the activities, sources, and uses of health care data and information managed by health information management (HIM) and health informatics (HI) professionals. Definitions of the professional domains and scopes of practice for HIM and HI are converging with the proliferation of information and communication technologies in health care settings. Convergence is changing both the roles that HIM and HI professionals serve in their organizations as well as the competencies necessary for training future professionals. Many of these changes suggest a blurring of roles and responsibilities with increasingly overlapping curricula, job descriptions, and research agendas. Blurred lines in a highly competitive market create confusion for students and employers. In this essay, we provide some perspective on the changing landscape and suggest a course for the future. First we review the evolving definitions of HIM and HI. We next compare the curre...
CRC Press eBooks, Sep 14, 2022
Applied Clinical Informatics, 2015
Clearly defined boundaries are disappearing among the activities, sources, and uses of health car... more Clearly defined boundaries are disappearing among the activities, sources, and uses of health care data and information managed by health information management (HIM) and health informatics (HI) professionals. Definitions of the professional domains and scopes of practice for HIM and HI are converging with the proliferation of information and communication technologies in health care settings. Convergence is changing both the roles that HIM and HI professionals serve in their organizations as well as the competencies necessary for training future professionals. Many of these changes suggest a blurring of roles and responsibilities with increasingly overlapping curricula, job descriptions, and research agendas. Blurred lines in a highly competitive market create confusion for students and employers. In this essay, we provide some perspective on the changing landscape and suggest a course for the future. First we review the evolving definitions of HIM and HI. We next compare the current domains and competencies, review the characteristics as well as the education and credentialing of both disciplines, and examine areas of convergence. Given the current state, we suggest a path forward to strengthen the contributions HIM and HI professionals and educators make to the evolving health care environment.
Health care in Canada is undergoing significant transformation and change at regional, provincial... more Health care in Canada is undergoing significant transformation and change at regional, provincial, and national levels to better utilize scarce health resources to provide safe, high-quality care at lower cost. The electronic health record (EHR) is being introduced as an innovation and enabler in achieving reduced health care costs and improved patient care. As Canadian health settings move from paper to electronic health records, the role of health information management (HIM) professionals needs to correspondingly change to meet the demands of an increasingly digital workplace. This article briefly reviews findings and recommendations from various HIM projects and outlines the evolving roles and competencies of certified HIM professionals.
Throughout academia, the value of developing a strong CV is pervasive, while teaching dossiers ca... more Throughout academia, the value of developing a strong CV is pervasive, while teaching dossiers can be overlooked. Furthermore, though partaking in a teaching assistantship is often required, graduate teaching assistants (GTAs) are not always mentored in developing teaching-related skills, or in understanding their importance in future career success. Considering that the skills GTAs gain through teaching contribute significantly to their development of discipline-based expertise and presentation skills (Seldin et al., 2010), and that faculty appointments typically include a 40% teaching load, it is apparent that this problem poses a major challenge. GTAs and junior faculty are often unsure how to articulate and qualify their teaching experience, and appointment committees seeking demonstrated skill and excellence can not find adequate evidence. Finally, in an era of increased focus on research skills and productivity over teaching, it is increasingly important to find ways to promot...
Applied clinical informatics, 2018
Simple measures of electronic health record (EHR) adoption may be inadequate to evaluate EHR use... more Simple measures of electronic health record (EHR) adoption may be inadequate to evaluate EHR use; and positive outcomes associated with EHRs may be better gauged when varying degrees of EHR use are taken into account. In this article, we aim to assess the current state of the literature regarding measuring EHR use. This article conducts a scoping review of the literature to identify and classify measures of primary care EHR use with a focus on the Canadian context. We conducted a scoping review. Multiple citation databases were searched, as well as gray literature from relevant Web sites. Resulting abstracts were screened for inclusion. Included full texts were reviewed by two authors. Data from the articles were extracted; we synthesized the findings. Subsequently, we reviewed these results with seven EHR stakeholders in Canada. Thirty-seven articles were included. Eighteen measured EHR function use individually, while 19 incorporated an overall level of use. Eight frameworks f...
Catecholamines: Basic and Clinical Frontiers, 1979
ABSTRACT Transmitter release from central noradrenergic (NE) and dopaminergic (DA) neurons was as... more ABSTRACT Transmitter release from central noradrenergic (NE) and dopaminergic (DA) neurons was assessed by measuring brain concentrations of their major metabolites, 3-methoxy-4-hydroxy-phenylethyleneglycol sulfate (MOPEG-SO4) and homovanillic acid (HVA). Treatments that increased brain tyrosine also elevated the concentrations of these metabolites, especially when NE and DA neurons were activated. It is well established that the levels and syntheses of the neurotransmitters serotonin and acetylcholine are affected by brain concentrations of their respective precursors, tryptophan and choline (1). In contrast, treatments that affect brain tyrosine concentrations reportedly fail to modify NE or DA levels; hence, it has been assumed that precursor availability is not a significant factor affecting catecholamine (CA) synthesis and release. We reasoned that tyrosine hydroxylase (TOH), the rate-limiting enzyme in CA synthesis, would not be saturated with tyrosine at normal brain tyrosine levels and anticipated that brain tyrosine uptake would rise in parallel with the ratio of the tyrosine concentration in plasma to the sum of the concentrations of the neutral amino acids that compete with it for uptake (e.g., after tyrosine administration or protein consumption). Resulting changes in CA synthesis could affect CA release without clearly increasing CA levels if, as has been proposed, these transmitters exist in several metabolic compartments.
Health Information Exchange, 2016
Abstract The introduction of information and communication technologies in health care, particula... more Abstract The introduction of information and communication technologies in health care, particularly the electronic health record (EHR) and health information exchange (HIE), may be seriously hampered or delayed by the lack of available human resources with the necessary skills and competencies to implement and use them. Different types of information professionals with an appropriate mix of complementary skills are needed to deploy and maintain a country’s EHR and HIE systems as well as manage and use the health information they contain. These human resources for eHealth include health informatics and health information management professionals, which includes HIE professionals, as well as others who support ICT in health care systems. These professionals not only possess knowledge of ICT but also knowledge of the health system, data standards, and interoperability across platforms; privacy and security of health records; human factors and process engineering; project management, change management and technology adoption; and user-supporting mechanisms. This chapter will outline the human resources needed to put an HIE in place and ensure that quality data are available for meaningful use and health system improvement.
Topics in the Neurosciences, 1986
Our previous studies in an intensive care stroke unit have demonstrated an increased incidence of... more Our previous studies in an intensive care stroke unit have demonstrated an increased incidence of cardiac arrhythmias, serum cardiac enzymes and plasma catecholamines in stroke patients compared to controls. In addition, most of the patients dying from stroke had myocardial lesions similar to those seen in patients with phaeochromocytoma and in animals after systemic infusion of catecholamines. Taken together, this evidence suggests altered sympathetic activity following human stroke. To investigate this problem, two series of experiments were done in an experimental stroke model in the cat: somatosympathetic reflexes and measurement of plasma catecholamines. The first series showed that the late component of the somatosympathetic reflex elicited by stimulation of the sciatic nerve and recorded from either the T2 or T3 white ramus, or the inferior cardiac nerve was significantly increased in amplitude, after experimental stroke (Soc of Neuroscience abstract # 515 1984). The second series showed that plasma norepinepherine levels were significantly elevated in the experimental stroke animal as compared to the sham operated animal (Stroke 16: 136, 1985). In all experimental stroke animals, the extent of induced unilateral ischemia varied. However, it was observed that only the animals with involvement of the insular cortex showed alterations in sympathetic activity. These data suggest that the insula plays an important role in the changes in sympathetic activity seen after experimental stroke.
Nutrition and Health, 1984
The two most widely held biochemical models of depression—the catecholamine (CA) and indoleamine ... more The two most widely held biochemical models of depression—the catecholamine (CA) and indoleamine (IA) hypotheses—explain depression as a result of deficient transmission of the CA norepinephrine (NE) or the IA serotonin (5-hydroxytryptamine, 5-HT) respectively. Until recently, all drugs used to treat depression appeared to enhance neurotransmission in one or both of these systems, which was used to explain their antidepressant actions (Gelenberg and Klerman, 1978). In fact, it was this action of antidepressants that gave rise to the models of depression. Another way to increase brain levels of NE and 5-HT, and potentially to increase presynaptic activity, would be the systemic administration of the precursors of the neurotransmitters, an approach something like organic gardening in the brain. For this purpose, the 5-HT precursors tryptophan and 5-hydroxtryptophan (5-HTP), and the NE precursors tyrosine and dihydroxyphenylalanine (DOPA), have been administered to depressed patients. ...
2nd Annual Meeting of the Canadian College of Neuropsychopharmacology, Ontario, April, 1979: Selected Proceedings, 1981
Journal of Neuroscience Methods, 1990
A simple superperfusion apparatus for measuring endogenous dopamine (DA) release from rat retina ... more A simple superperfusion apparatus for measuring endogenous dopamine (DA) release from rat retina is described. DA release is stimulated by increasing levels of potassium (K) in the superfusion medium and this K-stimulated release is calcium dependent. Exposure of dark-adapted retinae to light also increases endogenous DA release. This system should prove useful in determining what factors may control endogenous DA release in the retina. Dopamine is considered a retinal "neurotransmitter" with an important role in regulating sensitivity to light (Dowling, 1986). DA and its synthetic enzyme, tyrosine hydroxylase, have been located histochemically in a sub-population of amacrine cells and in the interplexiform cells of the teleost retina and most mammalian retina (Ehinger, 1982; Dowling, 1986). DA modulates information flow in the retina by decreasing responsiveness of horizontal cells to light stimuli and by decreasing electrical coupling between adjacent horizontal cells (Dowling, 1986). The factors (light; presynaptic inputs) which normally regulate endogenous DA release are still unknown. Radioactively labelled DA can be taken up by these retinal cells and subsequently released by light stimulation (
Concepts, Methodologies, Tools and Applications
The introduction and use of information and communication technologies (ICT) in health care, part... more The introduction and use of information and communication technologies (ICT) in health care, particularly the electronic health record (EHR), may be seriously hampered or delayed by the lack of available human resources with the necessary skills and competencies in e-health. A number of different types of professionals are needed, and an appropriate mix of skills and workers who can complement one another in the final deployment of the EHR and in the appropriate and best use and management of the health information it contains. These include health informatics (HI) professionals or health informaticians, health information management (HIM) professionals, and others, with not only knowledge of ICT, but also knowledge of the health system, data standards, and interoperability across platforms; privacy and security of health records; human factors and process engineering; project management and technology adoption; and user-supporting mechanisms. A human resources strategy is needed to...
Amino Acids, 1990
The dietary amino acid tyrosine is the precusor of the brain and retinal catecholamine transmitte... more The dietary amino acid tyrosine is the precusor of the brain and retinal catecholamine transmitter dopamine (DA). Alterations in tissue level of this precursor may influence the rate at which the catechol is synthesized and released, particularly when the rate-limiting enzyme, tyrosine hydroxylase (TH), is activated. Physiologically, TH is activated in the retinal amacrine DA cell during exposure to light. In diabetic rats we have found that retinal tyrosine level is severely reduced and tyrosine supplementation of the diet can correct this deficiency and hence retinal DA. Retinal tyrosine level in streptozotocin-diabetic male rats was reduced to 0.24 ± 0.05 μg/mg protein from control levels of 0.71 ± 0.02 μg/mg protein. Addition of 4% tyrosine to the 24% casein basal diet increased tyrosine level threefold in both control (to 2.38 ± 0.30 μg/mg protein) and diabetic retina (to 0.62 ± 0.08 μg/mg protein). Retinal DA was also reduced in diabetic rats (controls, 2.23 ± 0.19 ng/mg protein; diabetic, 1.71 ±0.12 ng/mg protein) and this deficit was reversed by the addition of dietary tyrosine (2.12 ± 0.05 ng/mg protein).
Biological Trace Element Research, 2005
The effect of dietary zinc (Zn) supplementation on copper (Cu)-induced liver damage was investiga... more The effect of dietary zinc (Zn) supplementation on copper (Cu)-induced liver damage was investigated in Long-Evans Cinnamon rats (LEC), a model for Wilson's disease (WD). Four-week-old LEC (N=64) and control Long-Evans (LE) (N=32) female rats were divided into two groups; one group was fed with a Zn-supplemented diet (group I) and the other was given a normal rodent diet (group II). LEC rats were killed at 6, 8, 10, 12, 18, and 20 wk of age; the LE control rats were killed at 6, 12, 18, and 20 wk of age. Cu concentration in the liver was reduced in LEC rats fed the Zn-supplemented diet compared with LEC rats on the normal diet between 6 and 18 wk of age. Metallothionein (MT) concentration in the livers of LEC rats in group I increased between 12 and 20 wk of age, whereas hepatic MT concentration in LEC rats from group II decreased after 12 wk. Hepatocyte apoptosis, as determined by TUNEL, was reduced in Zn-supplemented LEC rats at all ages. Cholangiocellular carcinoma was observed only in LEC rats in group II at wk 20. These results suggest that Zn supplementation can reduce hepatic Cu concentration and delay the onset of clinical and pathological changes of Cu toxicity in LEC rats. Although the actual mechanism of protection is unknown, it could be explained by sequestration of dietary Cu by intestinal MT, induced by high dietary Zn content.
Developments, Challenges and Advancements
The introduction of information technologies and the electronic record in health care is thought ... more The introduction of information technologies and the electronic record in health care is thought to be a key means of improving efficiencies and effectiveness of the health care sy.
Neurochemical Systems, 1985
Several important CNS monoamine neurotransmitters have as their precursors simple aromatic amino ... more Several important CNS monoamine neurotransmitters have as their precursors simple aromatic amino acids present in dietary protein. For instance, serotonin (5-hydroxytryptamine; 5-HT), the indoleamine neurotransmitter, is formed from the essential amino acid tryptophan, and the catecholamines, dopamine (DA), norepinephrine (NE), and epinephrine (E), are formed from the amino acid tyrosine (Figs. 1, 2). The circulating level of these amino acids changes with meal consumption, dependent on the dietary content of protein, carbohydrate, and fat.1–4 The carrier system that transports these precursor amino acids across the blood-brain barrier is normally unsaturated, and changes in their circulating levels can raise or lower brain tryptophan and tyrosine concentration.5,6 Once in the brain, and in the particular subset of amine-containing neurons, tryptophan and tyrosine can influence the synthesis of their respective neurotransmitters, since the rate-limiting synthetic enzymes are normally unsaturated with respect to substrate or, under certain conditions, may become precursor responsive.7
CRC Press eBooks, Sep 14, 2022
Applied clinical informatics, 2015
Clearly defined boundaries are disappearing among the activities, sources, and uses of health car... more Clearly defined boundaries are disappearing among the activities, sources, and uses of health care data and information managed by health information management (HIM) and health informatics (HI) professionals. Definitions of the professional domains and scopes of practice for HIM and HI are converging with the proliferation of information and communication technologies in health care settings. Convergence is changing both the roles that HIM and HI professionals serve in their organizations as well as the competencies necessary for training future professionals. Many of these changes suggest a blurring of roles and responsibilities with increasingly overlapping curricula, job descriptions, and research agendas. Blurred lines in a highly competitive market create confusion for students and employers. In this essay, we provide some perspective on the changing landscape and suggest a course for the future. First we review the evolving definitions of HIM and HI. We next compare the curre...
CRC Press eBooks, Sep 14, 2022
Applied Clinical Informatics, 2015
Clearly defined boundaries are disappearing among the activities, sources, and uses of health car... more Clearly defined boundaries are disappearing among the activities, sources, and uses of health care data and information managed by health information management (HIM) and health informatics (HI) professionals. Definitions of the professional domains and scopes of practice for HIM and HI are converging with the proliferation of information and communication technologies in health care settings. Convergence is changing both the roles that HIM and HI professionals serve in their organizations as well as the competencies necessary for training future professionals. Many of these changes suggest a blurring of roles and responsibilities with increasingly overlapping curricula, job descriptions, and research agendas. Blurred lines in a highly competitive market create confusion for students and employers. In this essay, we provide some perspective on the changing landscape and suggest a course for the future. First we review the evolving definitions of HIM and HI. We next compare the current domains and competencies, review the characteristics as well as the education and credentialing of both disciplines, and examine areas of convergence. Given the current state, we suggest a path forward to strengthen the contributions HIM and HI professionals and educators make to the evolving health care environment.
Health care in Canada is undergoing significant transformation and change at regional, provincial... more Health care in Canada is undergoing significant transformation and change at regional, provincial, and national levels to better utilize scarce health resources to provide safe, high-quality care at lower cost. The electronic health record (EHR) is being introduced as an innovation and enabler in achieving reduced health care costs and improved patient care. As Canadian health settings move from paper to electronic health records, the role of health information management (HIM) professionals needs to correspondingly change to meet the demands of an increasingly digital workplace. This article briefly reviews findings and recommendations from various HIM projects and outlines the evolving roles and competencies of certified HIM professionals.
Throughout academia, the value of developing a strong CV is pervasive, while teaching dossiers ca... more Throughout academia, the value of developing a strong CV is pervasive, while teaching dossiers can be overlooked. Furthermore, though partaking in a teaching assistantship is often required, graduate teaching assistants (GTAs) are not always mentored in developing teaching-related skills, or in understanding their importance in future career success. Considering that the skills GTAs gain through teaching contribute significantly to their development of discipline-based expertise and presentation skills (Seldin et al., 2010), and that faculty appointments typically include a 40% teaching load, it is apparent that this problem poses a major challenge. GTAs and junior faculty are often unsure how to articulate and qualify their teaching experience, and appointment committees seeking demonstrated skill and excellence can not find adequate evidence. Finally, in an era of increased focus on research skills and productivity over teaching, it is increasingly important to find ways to promot...
Applied clinical informatics, 2018
Simple measures of electronic health record (EHR) adoption may be inadequate to evaluate EHR use... more Simple measures of electronic health record (EHR) adoption may be inadequate to evaluate EHR use; and positive outcomes associated with EHRs may be better gauged when varying degrees of EHR use are taken into account. In this article, we aim to assess the current state of the literature regarding measuring EHR use. This article conducts a scoping review of the literature to identify and classify measures of primary care EHR use with a focus on the Canadian context. We conducted a scoping review. Multiple citation databases were searched, as well as gray literature from relevant Web sites. Resulting abstracts were screened for inclusion. Included full texts were reviewed by two authors. Data from the articles were extracted; we synthesized the findings. Subsequently, we reviewed these results with seven EHR stakeholders in Canada. Thirty-seven articles were included. Eighteen measured EHR function use individually, while 19 incorporated an overall level of use. Eight frameworks f...
Catecholamines: Basic and Clinical Frontiers, 1979
ABSTRACT Transmitter release from central noradrenergic (NE) and dopaminergic (DA) neurons was as... more ABSTRACT Transmitter release from central noradrenergic (NE) and dopaminergic (DA) neurons was assessed by measuring brain concentrations of their major metabolites, 3-methoxy-4-hydroxy-phenylethyleneglycol sulfate (MOPEG-SO4) and homovanillic acid (HVA). Treatments that increased brain tyrosine also elevated the concentrations of these metabolites, especially when NE and DA neurons were activated. It is well established that the levels and syntheses of the neurotransmitters serotonin and acetylcholine are affected by brain concentrations of their respective precursors, tryptophan and choline (1). In contrast, treatments that affect brain tyrosine concentrations reportedly fail to modify NE or DA levels; hence, it has been assumed that precursor availability is not a significant factor affecting catecholamine (CA) synthesis and release. We reasoned that tyrosine hydroxylase (TOH), the rate-limiting enzyme in CA synthesis, would not be saturated with tyrosine at normal brain tyrosine levels and anticipated that brain tyrosine uptake would rise in parallel with the ratio of the tyrosine concentration in plasma to the sum of the concentrations of the neutral amino acids that compete with it for uptake (e.g., after tyrosine administration or protein consumption). Resulting changes in CA synthesis could affect CA release without clearly increasing CA levels if, as has been proposed, these transmitters exist in several metabolic compartments.
Health Information Exchange, 2016
Abstract The introduction of information and communication technologies in health care, particula... more Abstract The introduction of information and communication technologies in health care, particularly the electronic health record (EHR) and health information exchange (HIE), may be seriously hampered or delayed by the lack of available human resources with the necessary skills and competencies to implement and use them. Different types of information professionals with an appropriate mix of complementary skills are needed to deploy and maintain a country’s EHR and HIE systems as well as manage and use the health information they contain. These human resources for eHealth include health informatics and health information management professionals, which includes HIE professionals, as well as others who support ICT in health care systems. These professionals not only possess knowledge of ICT but also knowledge of the health system, data standards, and interoperability across platforms; privacy and security of health records; human factors and process engineering; project management, change management and technology adoption; and user-supporting mechanisms. This chapter will outline the human resources needed to put an HIE in place and ensure that quality data are available for meaningful use and health system improvement.
Topics in the Neurosciences, 1986
Our previous studies in an intensive care stroke unit have demonstrated an increased incidence of... more Our previous studies in an intensive care stroke unit have demonstrated an increased incidence of cardiac arrhythmias, serum cardiac enzymes and plasma catecholamines in stroke patients compared to controls. In addition, most of the patients dying from stroke had myocardial lesions similar to those seen in patients with phaeochromocytoma and in animals after systemic infusion of catecholamines. Taken together, this evidence suggests altered sympathetic activity following human stroke. To investigate this problem, two series of experiments were done in an experimental stroke model in the cat: somatosympathetic reflexes and measurement of plasma catecholamines. The first series showed that the late component of the somatosympathetic reflex elicited by stimulation of the sciatic nerve and recorded from either the T2 or T3 white ramus, or the inferior cardiac nerve was significantly increased in amplitude, after experimental stroke (Soc of Neuroscience abstract # 515 1984). The second series showed that plasma norepinepherine levels were significantly elevated in the experimental stroke animal as compared to the sham operated animal (Stroke 16: 136, 1985). In all experimental stroke animals, the extent of induced unilateral ischemia varied. However, it was observed that only the animals with involvement of the insular cortex showed alterations in sympathetic activity. These data suggest that the insula plays an important role in the changes in sympathetic activity seen after experimental stroke.
Nutrition and Health, 1984
The two most widely held biochemical models of depression—the catecholamine (CA) and indoleamine ... more The two most widely held biochemical models of depression—the catecholamine (CA) and indoleamine (IA) hypotheses—explain depression as a result of deficient transmission of the CA norepinephrine (NE) or the IA serotonin (5-hydroxytryptamine, 5-HT) respectively. Until recently, all drugs used to treat depression appeared to enhance neurotransmission in one or both of these systems, which was used to explain their antidepressant actions (Gelenberg and Klerman, 1978). In fact, it was this action of antidepressants that gave rise to the models of depression. Another way to increase brain levels of NE and 5-HT, and potentially to increase presynaptic activity, would be the systemic administration of the precursors of the neurotransmitters, an approach something like organic gardening in the brain. For this purpose, the 5-HT precursors tryptophan and 5-hydroxtryptophan (5-HTP), and the NE precursors tyrosine and dihydroxyphenylalanine (DOPA), have been administered to depressed patients. ...
2nd Annual Meeting of the Canadian College of Neuropsychopharmacology, Ontario, April, 1979: Selected Proceedings, 1981
Journal of Neuroscience Methods, 1990
A simple superperfusion apparatus for measuring endogenous dopamine (DA) release from rat retina ... more A simple superperfusion apparatus for measuring endogenous dopamine (DA) release from rat retina is described. DA release is stimulated by increasing levels of potassium (K) in the superfusion medium and this K-stimulated release is calcium dependent. Exposure of dark-adapted retinae to light also increases endogenous DA release. This system should prove useful in determining what factors may control endogenous DA release in the retina. Dopamine is considered a retinal "neurotransmitter" with an important role in regulating sensitivity to light (Dowling, 1986). DA and its synthetic enzyme, tyrosine hydroxylase, have been located histochemically in a sub-population of amacrine cells and in the interplexiform cells of the teleost retina and most mammalian retina (Ehinger, 1982; Dowling, 1986). DA modulates information flow in the retina by decreasing responsiveness of horizontal cells to light stimuli and by decreasing electrical coupling between adjacent horizontal cells (Dowling, 1986). The factors (light; presynaptic inputs) which normally regulate endogenous DA release are still unknown. Radioactively labelled DA can be taken up by these retinal cells and subsequently released by light stimulation (
Concepts, Methodologies, Tools and Applications
The introduction and use of information and communication technologies (ICT) in health care, part... more The introduction and use of information and communication technologies (ICT) in health care, particularly the electronic health record (EHR), may be seriously hampered or delayed by the lack of available human resources with the necessary skills and competencies in e-health. A number of different types of professionals are needed, and an appropriate mix of skills and workers who can complement one another in the final deployment of the EHR and in the appropriate and best use and management of the health information it contains. These include health informatics (HI) professionals or health informaticians, health information management (HIM) professionals, and others, with not only knowledge of ICT, but also knowledge of the health system, data standards, and interoperability across platforms; privacy and security of health records; human factors and process engineering; project management and technology adoption; and user-supporting mechanisms. A human resources strategy is needed to...
Amino Acids, 1990
The dietary amino acid tyrosine is the precusor of the brain and retinal catecholamine transmitte... more The dietary amino acid tyrosine is the precusor of the brain and retinal catecholamine transmitter dopamine (DA). Alterations in tissue level of this precursor may influence the rate at which the catechol is synthesized and released, particularly when the rate-limiting enzyme, tyrosine hydroxylase (TH), is activated. Physiologically, TH is activated in the retinal amacrine DA cell during exposure to light. In diabetic rats we have found that retinal tyrosine level is severely reduced and tyrosine supplementation of the diet can correct this deficiency and hence retinal DA. Retinal tyrosine level in streptozotocin-diabetic male rats was reduced to 0.24 ± 0.05 μg/mg protein from control levels of 0.71 ± 0.02 μg/mg protein. Addition of 4% tyrosine to the 24% casein basal diet increased tyrosine level threefold in both control (to 2.38 ± 0.30 μg/mg protein) and diabetic retina (to 0.62 ± 0.08 μg/mg protein). Retinal DA was also reduced in diabetic rats (controls, 2.23 ± 0.19 ng/mg protein; diabetic, 1.71 ±0.12 ng/mg protein) and this deficit was reversed by the addition of dietary tyrosine (2.12 ± 0.05 ng/mg protein).
Biological Trace Element Research, 2005
The effect of dietary zinc (Zn) supplementation on copper (Cu)-induced liver damage was investiga... more The effect of dietary zinc (Zn) supplementation on copper (Cu)-induced liver damage was investigated in Long-Evans Cinnamon rats (LEC), a model for Wilson's disease (WD). Four-week-old LEC (N=64) and control Long-Evans (LE) (N=32) female rats were divided into two groups; one group was fed with a Zn-supplemented diet (group I) and the other was given a normal rodent diet (group II). LEC rats were killed at 6, 8, 10, 12, 18, and 20 wk of age; the LE control rats were killed at 6, 12, 18, and 20 wk of age. Cu concentration in the liver was reduced in LEC rats fed the Zn-supplemented diet compared with LEC rats on the normal diet between 6 and 18 wk of age. Metallothionein (MT) concentration in the livers of LEC rats in group I increased between 12 and 20 wk of age, whereas hepatic MT concentration in LEC rats from group II decreased after 12 wk. Hepatocyte apoptosis, as determined by TUNEL, was reduced in Zn-supplemented LEC rats at all ages. Cholangiocellular carcinoma was observed only in LEC rats in group II at wk 20. These results suggest that Zn supplementation can reduce hepatic Cu concentration and delay the onset of clinical and pathological changes of Cu toxicity in LEC rats. Although the actual mechanism of protection is unknown, it could be explained by sequestration of dietary Cu by intestinal MT, induced by high dietary Zn content.
Developments, Challenges and Advancements
The introduction of information technologies and the electronic record in health care is thought ... more The introduction of information technologies and the electronic record in health care is thought to be a key means of improving efficiencies and effectiveness of the health care sy.
Neurochemical Systems, 1985
Several important CNS monoamine neurotransmitters have as their precursors simple aromatic amino ... more Several important CNS monoamine neurotransmitters have as their precursors simple aromatic amino acids present in dietary protein. For instance, serotonin (5-hydroxytryptamine; 5-HT), the indoleamine neurotransmitter, is formed from the essential amino acid tryptophan, and the catecholamines, dopamine (DA), norepinephrine (NE), and epinephrine (E), are formed from the amino acid tyrosine (Figs. 1, 2). The circulating level of these amino acids changes with meal consumption, dependent on the dietary content of protein, carbohydrate, and fat.1–4 The carrier system that transports these precursor amino acids across the blood-brain barrier is normally unsaturated, and changes in their circulating levels can raise or lower brain tryptophan and tyrosine concentration.5,6 Once in the brain, and in the particular subset of amine-containing neurons, tryptophan and tyrosine can influence the synthesis of their respective neurotransmitters, since the rate-limiting synthetic enzymes are normally unsaturated with respect to substrate or, under certain conditions, may become precursor responsive.7