Professional Documents
Culture Documents
USE OF
COMPUTERS
IN NURSING
Submitted to
Submitted by
DRISYA.V.R.
1st Year MSc Nursing
Asst. Professor
Govt. College of nursing
Alappuzha
Alappuzha
SEMINAR ON
USE OF
COMPUTERS
IN NURSING
Submitted to
Submitted by
Mrs. JESSY.P.S.
DRISYA.V.R.
Asst. Professor
Alappuzha
Alappuzha
INDEX
Sl.no
:
CONTENT
1.
INTRODUCTION
2.
3.
4.
NURSING INFORMATICS
5.
IN HOSPITALS
a)TELECONFERENCE
b)TELEMEDICINE
6.
IN EDUCATION
a)COMPUTER ASSISTED INSTRUCTION
b)PROGRAMMED INSTRUCTION
c)COMPUTER BASED LEARNING
7.
IN RESEARCH
8.
IN NURSING PRACTICE
9.
10.
11.
DISADVANTAEGS OF COMPUTERS IN
HOSPITALS
12.
RELATED RESEARCHES
13.
CONCLUSION
14.
BIBLIOGRAPHY
Page no:
Central objective:
On completion of the class, the students acquire knowledge regarding use of
computers in nursing, appreciates its importance and use of his knowledge in the
areas of profession
Specific objective:
At the end of the class, the students are able to:
INTRODUCTION
Science has bestowed health care delivery system with
excellent technological innovations. One such innovation is the computerization of
the entire health care delivery system. Computerization has contributed
enormously towards the reduction of medical errors and the problems associated
with such errors. Computerization of health care delivery includes computerization
of the medical records popularly known as the Electronic Medical Record System
(EMR), Electronic Prescriptions, Personal Digital Assistants, Computer Automated
Cancer Detection and Computerized Theatre Management Applications. The
implementation of voice recognition technology in mobile healthcare settings is yet
another recent innovation.
Legible
Less chance of error
Standardized and customized reporting
DISADVANTAGES
A complex conceptual design process
Need for multiple external database
Need to hire database related employees
Longer running time for individual application
Computer literacy required-fear of computers
USES
Admission, discharge and transfer
Patient access record
Financial parameters
Physician order entry
Documentation
Scheduling
Pharmacy preparation
Communication
Telehealth
SCOPE OF NURSING INFORMATICS
Using the steps of nursing process and theory to support nursing practice,
management, education and research.
Establishment of personal health records.
Electronic health record system
Health informatics education
Emergency preparedness
Defense against bioterrorism
Evidence based nursing knowledge
Nursing information management system
APPLICATION OF INFORMATICS IN NURSING
i. In Nursing Practice
Computer generated nursing care plans
Clinical decision-making alerts/prompts
Electronic monitoring devices that record and trend vital signs and show
patients conditions
Patient specific discharge instructions
Information about medication administration
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ii.
In Nursing Administration
Workload measurement system
Online computer policy and procedure manuals
Staff scheduling system
Improved communication
Cost analysis
Patient tracking system
Staff attendance
iii. In Nursing Education
Online registration, attendance, test
Online grade management
Computer based tutorials
Online libraries
Online journals, publications
Presentations
Distance education technologies
iv. In Nursing Research
Computerized literature review
Collaboration with nurse researchers
Data analysis
Online publication of findings
ROLE OF INFORMATICS NURSE SPECIALIST
o Project manager
o Educator
o System analyst
o Entrepreneur
o Advocate
o Consultant
o Programmer
o Product developer
o Researcher
o Coordinator
The use of computers can be explained in the following headings: In hospitals
In nursing education
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In nursing practice
In research
In Hospitals
In hospital practice the computers are mainly used as a mean for teleconferencing,
telemedicine
TELECONFERENCE
A teleconference or teleseminar is the live exchange and mass articulation
of information among several persons and machines remote from one another but
linked by a telecommunications system. Terms such as audio conferencing,
telephone conferencing and phone conferencing are also sometimes used to refer to
teleconferencing.
The telecommunications system may support the teleconference by providing one
or more of the following: audio, video, and/or data services by one or more means,
such as telephone, computer, telegraph, teletypewriter, radio, and television.
Internet teleconferencing
Internet teleconferencing includes internet telephone conferencing, video
conferencing, web conferencing, and Augmented Reality conferencing.
Internet telephony involves conducting a teleconference over the Internet or a Wide
Area Network. One key technology in this area is Voice over Internet Protocol
(VOIP). Popular software for personal use includes Skype, Google Talk, Windows
Live Messenger and Yahoo! Messenger.
A working example of an Augmented Reality conferencing was demonstrated at
the Salone di Mobile in Milano by AR+RFID Lab is another AR teleconferencing
tool.
Software and service providers
ACT Conferencing
Adobe Acrobat Connect
AT Conference
Elluminate
Glance
InterCall
IOCOM
Life Size
Microsoft Office Live Meeting
Polycom
Premiere Global Services
Skype
TYPES OF TELECONFERENCING
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People in the meeting can see each others facial expressions and body
language, making meetings almost as effective as meeting face to face
Most set ups offer some ability for viewing online documents or video
during the meeting
Disadvantages
One of the downsides of video conferencing is the extra bandwidth
needed to send ones picture out and bring the picture of other attendees into ones
computer.
Advantages of Teleconferencing
Teleconferencing among multiple participants in two or more locations is a
strategic communication tool deployed by many companies with multiple locations
and dispersed employees. Business cyclical shifts and economic downturns tend to
see a rise in the use of teleconferencing facilities. Used judiciously and
strategically, teleconferencing can enhance organizational productivity, engage
employees at all levels and reduce travel budgets.
Reduces Travel
One of the most-apparent benefits of teleconferencing is reduced travel.
Businesses with multiple offices and federal governmental agencies with state
offices can hold discussions, share critical information and conduct other
Disadvantages of a Teleconference
Lack of Body Language
Teleconferencing doesnt let to read other participants body language,
which can give clues as to whether you need to change your direction during a
meeting. For example, if the person youre meeting with crosses his arms, it might
be a sign of defensiveness and that you are not connecting. Seeing this, you would
be able to soften your message. Someone slouching or tapping their fingers can
signal they are losing interest, letting you know to change the subject or finish your
point. In a teleconferencing situation, you do not get these cues to make changes in
your presentation.
Lack of Eye Contact
Eye contact is another key benefit you lose when teleconferencing.
Someone who looks down at the floor might be lying, giving you a clue not to take
him at his word if you are interviewing him for a job or involved in a sales call. If
someones eyes dart around the room, they might be bored. If you or your meeting
partners absolutely cant make an in-person meeting, ask about videoconferencing
capabilities. Using the video cameras on our computers and the availability of lowcost and free video services such as Skype, it might be just as easy to organize a
video meeting.
Interruptions
People who teleconference do so using landlines, cell phones and voiceover
Internet protocol, or VOIP, phones. Plan on interruptions during telephone
meetings when calls are dropped and Internet connections go dead. Many people
attend teleconferences while driving, talking on cell phones that can create static or
other noise as the user moves in and out of dead zones. Some people take
advantage of teleconferences to stay at home that day, leading to crying babies,
barking dogs or people at the door disrupting your call.
No Visual Presentation
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Aims
{
{
{
{
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Tele education
It should be understood as the development of the process of distance
education based on the use of information and telecommunication technologies
that make interactive, flexible and accessible learning possible for any potential
recipient.
Disaster management
To provide health care facilities to the victim of natural disaster such as
earthquake, tsunami, tornado etc. and manmade disasters such as war, riots etc
Telehome healthcare
It can be applied to provide home health care for elderly or underserved home
bound patient with chronic illness.
Telenursing
Telenursing refers to the use of telecommunications and information
technology in order to provide nursing service in health care whenever a large
physical distance exist between patient and nurse or between any number of
nurses.
Tele rehabilitation
It is the delivery of rehabilitation services over telecommunication network
and the internet.Telerehabilitation can deliver therapy to people who cannot travel
to a clinic because the patient has a disability. Some fields of rehabilitation practice
that have explored tele rehabilitation are neuropsychology, speech-language
pathology, audiology, occupational therapy and physical therapy.
Telecardiology
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In Education
The use of computers in education started in the 1960s. With the advent of
convenient microcomputers in the 1970s, computer use in schools has become
widespread from primary education through the university level and even in some
preschool programs. Instructional computers are basically used in one of two ways:
either they provide a straightforward presentation of data or they fill a tutorial role
in which the student is tested on comprehension
Computer based tools and applications are used to assist the teacher or school
administrator in the management of the learner and instructional process.
COMPUTER ASSISTED INSTRUCTION
A self-learning technique, usually offline/online, involving interaction of the
student with programmed instructional materials.
Computer-assisted instruction (CAI) is an interactive instructional technique
whereby a computer is used to present the instructional material and monitor the
learning that takes place.
CAI uses a combination of text, graphics, sound and video in enhancing the
learning process. The computer has many purposes in the classroom, and it can be
utilized to help a student in all areas of the curriculum.
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CAI refers to the use of the computer as a tool to facilitate and improve instruction.
CAI programs use tutorials, drill and practice, simulation, and problem solving
approaches to present topics, and they test the student's understanding.
Typical CAI provides:1. Text or multimedia content
2. Multiple-choice questions
3. Problems
4. Immediate feedback
5. Notes on incorrect responses
6. summarizes students' performance
7. Exercises for practice
8. Worksheets and tests
TYPES OF COMPUTER ASSISTED INSTRUCTION
1. Drill-and-practice: Drill and practice provide opportunities or students to
repeatedly practice the skills that have previously been presented and that further
practice is necessary for mastery.
2. Tutorial: Tutorial activity includes both the presentation of information and its
extension into different forms of work, including drill and practice, games and
simulation.
3. Games: Game software often creates a contest to achieve the highest score and
either beat others or beat the computer.
4. Simulation: Simulation software can provide an approximation of reality that
does not require the expense of real life or its risks.
5. Discovery: Discovery approach provides a large database of information
specific to a course or content area and challenges the learner to analyze, compare,
infer and evaluate based on their explorations of the data.
6. Problem Solving: This approach helps children develop specific problem
solving skills and strategies.
ADVANTAGES OF CAI
One-to-one interaction
Great motivator
Freedom to experiment with different options
Instantaneous response/immediate feedback to the answers elicited
Self-pacing - allow students to proceed at their own pace
Helps teacher can devote more time to individual students
Privacy helps the shy and slow learner to learns
Individual attention
learn more and more rapidly
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CORE ELEMENTS
Programmed instruction has the following core elements:
Contents are broken down into pieces of instructions called frames. A frame
contains statements and questions.
Learners then read the frame and immediately answer a question about the frame
There is an immediate feedback about the correctness of the frame (usually in a
different place)
Instruction is self-paced and learners are active (in the sense of reactive)
ADVANTAGES OF PROGRAMMED INSTRUCTION
The main emphasis is on individual differences and students involvements
There is not fixed time interval for learning. Students may learn at their own
pace.
Learning by doing maxims of teaching is followed to involve learners in the
learning process.
Students are exposed only to correct responses, therefore possibility to commit
errors is reduced.
Immediate confirmation of the results provides reinforcement to the learners to
proceed further. Feedback is provided to wrong answers, so that learner is able
to develop mastery over the content.
DISADVANTAGES OF PROGRAMMED INSTRUCTION
It is very difficult to develop an instructional programme.
Only cognitive objectives can be achieved.
Due to tight schedule of time table, students cannot be left to learn at their own
pace. It would be very difficult to learn the content the subject matter in a
limited period of time.
There is no chance for the students creativity, their responses are highly
structured
Development of programme is not economical in terms of cost and time.
In absence of the teacher, students may spoil the disciplinary tone of the class,
or they will be helpless when any problem arises.
It cannot be applied at primary level of education or at higher education.
SUGGESTIONS TO IMPROVE THIS STRATEGY
A programmer should have thorough knowledge of the content and technique
of content analysis.
This strategy should be used as a supplementary device for remedial teaching
in the classroom.
It should be used in distance education or continuing education programmes
where no rigid time table is applied.
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Learners with low motivation or bad study habits may fall behind
Without the routine structures of a traditional class, students may get lost or
confused about course activities and deadlines
Students may feel isolated from the instructor and classmates
Instructor may not always be available when students are studying or need help
Slow Internet connections or older computers may make accessing course
materials frustrating
Managing computer files and online learning software can sometimes seem
complex for students with beginner-level computer skills
Hands-on or lab work is difficult to simulate in a virtual classroom
IN RESEAERCH
Using a computer really helps speed up your research. Computers have
revolutionized how people gather information. The ability to store organized, neat
notes on a safe computer hard drive coupled with access to the World Wide Web
and its millions on websites makes using a computer for research.
CLINICAL DATABASE MANAGEMENT SYSTEM
A clinical data management system or CDMS is a tool used in clinical research to
manage the data of a clinical trial. The clinical trial data gathered at the
investigator site in the case are stored in the CDMS.
Classification
Paper-based systems
Electronic data capturing systems
ADVANTAGES OF USING COMPUTER IN RESEARCH
1. Internet
There is a wealth of information online about everything you could
possibly imagine. Search engines such as Google, Bing and Yahoo can direct you
to relevant information in seconds. Some websites can provide detailed statistics
and facts about your research subject, providing you with hard evidence. Other
sources on the web can provide expert opinions on subjects that can give your
piece a different critical viewpoint and form new arguments that you might not
have thought of. Take care to confirm what you are reading is accurate before
trusting it as fact.
2. Quick Communication
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In Nursing Practice
{Patient Administration
Among the first uses for general computers in the medical field was basic
patient administration, and they are of course still used for this today. Computer
systems are used at patient check-in to store patient contact information, insurance
information and pertinent medical history. In larger office and hospital settings,
they also control patient flow, keeping track of who is in which room or bed, and
which rooms and practitioners are available for routing patients.
{ Electronic Medical Records
Electronic charting makes the chart more legible. Electronic charting is the wave
of the future. There will be a computer at every bedside, and every nurse will
type her notes. Electronic charting has some distinct advantages over paper
charting, but there are some disadvantages, too. A computer makes it very easy to
keep a chart readable and accessible, but it is very easy to become accustomed to
the ease of a computer.
As security standards have been put in place for protecting confidential
patient medical data, more and more hospitals and doctors' offices are keeping
medical records in electronic form. Not only is this good for the environment,
saving millions of reams of paper every year, but electronic records provide
information instantly as a patient moves through their care process. Different
offices and specialties have instant access to critical data, and nurses can check
allergies and other important information with the touch of a button as they make
their rounds.
Five levels of Electronic Health Care Record (EHCR) keeping has been
classified.
1. The Automated Medical Record, which is a paper-based record with some
computer-generated documents.
2. The Computerized Medical Record (CMR), which makes the documents of
level 1 electronically available.
3. The Electronic Medical Record (EMR) which restructures and optimizes the
documents of the previous levels ensuring inter-operability of all documentation
systems.
4. The Electronic Patient Record (EPR) which is a patient-centered record with
information from multiple institutions
5. The Electronic Health Record (EHR) that adds general health-related
information to the EPR that is not necessarily related to a disease (Walker, 2005).
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One of the reasons medical records haven't gone digital as they have in financial
services or other fields is HIPAA. The federal Health Insurance Portability and
Accountability Act, enacted in 1996, requires hospitals, clinics and others in
health care to guard the privacy of medical records. HIPAA includes penalties of
up to $250,000 in fines and 10 years in prison for violations. Given the harsh
penalties and the number of breaches of electronic records, many in the health
care industry consider it easier to secure paper records.
Medical Record Errors
Security Breaches
Although information security technology is available to block unauthorized
access to medical records, security breaches happen all the time.
Spying on Patient Records
Privacy advocates warn that unauthorized access could lead to patient
discrimination. An insurance company could deny coverage to someone based
on what it finds in the person's medical records or an employer could decline to
hire someone because of her health history.
{ Electronic Prescriptions
Nurse Practitioners have prescriptive authority in the United States and
prescription error is a problem in current nurse practice. Communication has
been cited as the single biggest block in such prescription errors leading to
wrong reading by the pharmacist. Errors seem to be more in the dose of the
medicines prescribed. Electronic prescription systems have been designed as a
total remedy to this problem
{ Personal Digital Assistants
Personal Digital Assistants popularly known as PDA are literally handheld
computers that help patient management. Using a PDA, a nurse can access a
patient's laboratory reports and refer the latest information on relevant therapies,
tests and treatments. The PDA can also be used for billing and updating patient
visits. The PDA can also provide map and directions to the patient's homes.
Using a PDA, a nurse can instantaneously transfer prescriptions to the patient's
pharmacy, answer patient e-mail, refer to medical textbooks, drug databases,
journals and updates.
{ Computer Automated Cancer Detection
A Thin Prep Processor Model 2000 has been recently approved by the FDA for
the automatic preparation of PAP slides making it easier for screening atypical
cells in female patients suspected with Cancer of the cervix. The Thin Prep
System has been found to be especially effective for detecting low-grade
squamous intraepithelial lesions known as SILs and severe lesions. The Thin
Prep System provides for better detection of Cancer cells. PAPNET is another
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innovation that uses neural net computer technology, where, the computer
provides guidelines for identifying abnormal cells from a series of digital images
of PAP smears fed priori. Auto Pap 300 QC is another Pap test re-screening
system that uses image interpretation and pattern recognition techniques for
identifying abnormal cells
{ Computerized Theatre Management Application
Theatre Management Applications automatically record patient
information like demographic and financial data, visit history with dates,
procedures, performing and attending providers, care records with clinical
highlights and patient status, surgical data including proposed, type, actual,
severity and risks stored for reference in the event of future surgical procedures.
The most important aspect of such applications is that they facilitate the
management of patient supplies with associated refill lists. These systems help to
monitor and track the use of implant and surgical items utilized during operative
procedures. The applications allow the theatre nurses to create lists which give
full information on the necessary equipments and surgical instruments required
in the operating theatre for a surgery specific to a surgeon or specialty.
Decision support modules also provide prompts and reminders, and guides to
disease linkages between signs or symptoms, etiologies or related factors and
patient populations.
Scheduling and Personnel Management
You can self-schedule your shifts using information systems. Patient care
becomes more effective and economical using shift modules designed to handle
absences, overtime, staffing levels and cost-effective staffing. This makes for more
complete patient-care plans and more comprehensive assessments and evaluations.
Improved Drug Administration
Information systems enable electronically prescribed drugs to become more
understandable, as it is less likely that you can administer wrong drugs to patients.
By using patient-charting modules, the patient's vital signs, admission and nursing
assessments, care plan and nursing notes can be entered into the system and then
stored in a central repository that you can retrieve when needed for drug
administration.
Clinical Data Integration
Patient records have become more readable and accurate with the application of
nursing information systems, which have ensured improvement of standards of
keeping records. Time spent on patient data classification is also reduced. Retrieval
of both local and regional statistics on patients becomes easy, duplication of data
entry is avoided, and there is less manual paperwork and fewer printouts.
ADVANTAGES OF COMPUTERS IN NURSING
1. Stock of Medicines
One of the major advantages of computers in nursing is that a basic system
permits the nurses to have an updated record of the pharmaceuticals the hospital
have in stock. Therefore, when making inventories, the process is much faster and
accurate in order to always have a full stock of all the medicines needed to treat
patients. Computers also allow making a description of each medicine, including
side effects, composition and uses.
2. Clinical Records
Computers allow nurses to get the patient's clinical records in a matter of
minutes. It's not necessary for nurses to wade through stacks of papers and files
anymore. Also, if the patient has ever been treated in a specific medical institution,
the hospital interconnected network allows nurses to ask online for their patient's
clinical records and receive an immediate response. This is very important when
treating a patient since knowing their pre-existing conditions is a matter of life or
death.
3. Improving Patient Treatment and Follow-ups
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Nurses often use computers to take full notes on how a treatment is progressing.
By placing notes on the patient dosage, with reminders about giving medicines,
nurses ensure the proper treatment of a patient. Statistics show that even when
there's human error involved when treating patients, these have been reduced to a
minimum. If a medication has not been released, the computer makes a notification
so that the nurses can address this issue in a timely manner.
4. Research
Computers in nursing today contain huge medical libraries open to research and
study. Nurses, during their college years and when working in a hospital, need to
keep updated constantly. Online data bases of medical cases from all around the
world, medicine researches, and treatment comparisons are essential to their
professional growth
DISADVANTAGES OF COMPUTERS IN HOSPITALS
One of the biggest drawbacks of adding computers to hospitals is the cost.
Computers cost money, and a large hospital needs many computers to keep the
system running smoothly. Creating a network to transfer medical records or keep
track of billing is an additional initial cost. Unlike paper records, which simply
require a few more copies, electronic record keeping requires constant upkeep of
computers, computer software and other electronic elements, which can cost even
more.
Security
Paper records are kept in a doctor's office or a warehouse, but once
computers are added to a hospital, electronic record keeping typically follows.
Once electronic record keeping is begun, medical information is usually added to
a closed computer network, but as long as an Internet connection comes into the
network, the system is vulnerable to outside sources, opening the debate to
questions about patient privacy and medical record security.
Lack of Standardization
From a hospital point of view, one of the biggest disadvantages of adding
computers and electronic records to a hospital is the lack of standardization
through the medical field. Different hospitals use different shorthand abbreviations
or symbols on medical records than others. Even the codes called out during
emergencies don't always mean the same thing in every hospital. If a medical
record is transferred from another hospital or the system becomes open so hospitals
can share information, the lack of standardization in hospital notes and records
could cause problems when it comes to a medical professional's understanding of
the medical record.
RELATED RESEARCHES
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V.
Design
Mixed methods systematic review, which follows the Joanna Briggs Institute User
guide version
Data sources
Computerized searches of five databases were undertaken for the period 1995
August 2013.Review methods Critical appraisal and data extraction were
undertaken using Joanna Briggs Institute tools for experimental/observational
studies and interpretative and critical research. A narrative synthesis was used to
report results.
Results
Nineteen published papers were identified. Seventeen papers reported on online
approaches and only two papers reported on a blended approach. The synthesis of
findings focused on the following four areas: performance/clinical skill,
knowledge, self-efficacy/clinical confidence and user experience/satisfaction. The
e-learning interventions used varied throughout all the studies.
Conclusion
The available evidence suggests that online learning for teaching clinical skills is
no less effective than traditional means. Highlighted by this review is the lack of
available evidence on the implementation of a blended learning approach to
teaching clinical skills in undergraduate nurse education. Further research is
required to assess the effectiveness of this teaching methodology.
CONCLUSION
Computerization has contributed enormously towards the reduction of
medical errors and the problems associated with such errors by providing timely
access to client information and by assisting nurses with client monitoring,
decision making and bedside documentation. But, the real challenge lies in
utilization of features, functions, input and output modalities that nurse would find
most useful.
BIBLIOGRAPHY
1. Dee McGonigle, Kathleen Mastrian (2010), NURSING INFORMATICS and
foundation of knowledge, Jones and Bartlett Pvt limited; PP: - 6-28, 68-100.
2. Shabeer .P. Basheer (2013), A CONCISE TEXTBOOK OF ADVANCED
NURSING PRACTICE, EMMESS medical publishers, PP:-779-810.
3. Samta Soni (2009), textbook of advance nursing practice, jaypee publication,
PP:-533-540.
4. http://www.ehow.com/list_6815401_disadvantages-using-computerresearch_.html
5. http://www.ehow.com/info_8050652_importance-computers-research.html
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6. http://www.ehow.com/list_7184064_uses-computers-scientific-research.html
7. www.wikipedia.com
8. www.pubmed.com
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