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Rex, the "Talking Pill Bottle" developed in partnership by Wizzard Software and MedivoxRX, is a voice-enabled pill bottle that uses speech technology and that has now been approved by the US government for use in Veterans Administration, Indian Health, and other government-sponsored healthcare facilities.


Rex sits in a cradle attached via cable to a printer that is part of a pharmacist's computer system. The pharmacist types in the prescription instructions as given by the physician. The software used to record the instructions to Rex reduces the possibility of error by transferring additional information directly from the pharmacy's existing database. The text information is converted to a digital voice using text-to-speech technology and transmitted to a chip attached to the pill bottle. When the end user presses a button on the bottle, it plays back the patient's name, prescription type, dosage instructions, drug warnings, and other information, read aloud in a clear voice.


Rex accomplishes two important tasks: first, assisting pharmacies in complying with stringent prescription medication regulations by allowing dosage instructions and other critical information to be clearly communicated to patients by two methods of labeling, standard and "audio"; and second, the "audio label" helps ensure that a patient fully understands what the medication is, how often to take it, and when to refill the prescription or discontinue its use. According to the Journal of the American Medical Association, the inability to read and understand medication labels is a significant factor contributing to the number of medication errors and adverse drug events that kill an estimated 100,000 patients per year.


Rex helps meet the needs of an aging population as people lose their sight, cognitive functionality, and physical abilities. For example, according to the Blinded Veterans Association (BVA), there are more than 100,000 blind and visually impaired men and women veterans throughout the United States and this number is projected to reach 150,000 by the year 2010. The BVA estimates that these blind or significantly visually impaired individuals take an average of seven to 10 medications daily.


Created by a VA Pharmacist and VIST coordinator who recognized the need for an assistive device for individuals with impaired vision, the current version of Rex is inexpensive, convenient, and completely self-contained. Wizzard Software plans to make the talking bottles available in retail pharmacies throughout the world.


For more information on Rex and MedivoxRx's speech technology, and to hear an audio sample of the talking bottle, please visit





Kaspersky Labs, a developer of information security software, announced the presence of Cabir, the first network worm to propagate via mobile devices, in June 2004. Cabir is the first worm to infect cellular telephones running on the Symbian OS.


According to Kaspersky Labs, the worm was created by "Vallez," a pseudonym used by 29a, an international group of virus writers. The group specializes in creating proof-of-concept viruses for use by antivirus vendors, rather than distributing them "in the wild." Among the group's creations are Cap, the first macro virus to cause a global epidemic; Stream, the first virus for additional NTFS streams; Donut, the first virus for NET; and Rugrat, the first Win64 virus.


Preliminary analysis of the malicious code showed that Cabir is transmitted as an SIS file (a Symbian distribution file), but the file is disguised as Caribe Security Manager utility, part of the telephone security software. If the infected file is launched, the telephone screen will display the inscription "Caribe." The worm penetrates the system and is activated each time the phone is started.


Unlike most worms, the code does not exploit a system vulnerability but is based on the way telephones are designed to act. Bluetooth transceivers automatically contact each other when they come into range, and the operating system is designed in such a way that files can be exchanged over the connection. Cabir scans for the first available receiver and sends a copy of itself to that phone.


Analysis of the worm's code has so far not detected any malicious payload. Although the worm is coded to run under the Symbian OS, used in many Nokia telephones, it is possible that Cabir will function on handsets produced by other manufacturers.


A full description of Worm.Symbian.Cabir.a is available in the Kaspersky Virus Encyclopedia on the Internet at





The Society for Clinical Data Management (SCDM) has announced the availability of a validated and industry-recognized certification exam for clinical data managers. Ready for industry use since July 2004, the exam was developed to create an accepted standard of knowledge, education, and experience by which clinical data managers would be professionally recognized.


SCDM has spent the last 5 years developing the exam, which features 200 multiple-choice questions focusing on the spectrum of data management tasks, including protocol review, coding, lab management, processing of local and central lab data, and database design.


Founded in 1994, SCDM is the only organization in North America dedicated to the advancement of clinical data management as a profession.


For more information on how to apply, cost of the exam, and locations where it is offered, visit the Society's Web site at





The world's first online self-help tool for the treatment of the eating disorder bulimia has been unveiled by a European Commission-funded project. The multilanguage tool, called Salut!! (http:\\, was developed as part of the commission's Information Society Technologies research program.


To achieve this goal, the project took an integrated approach, developing diagnostic and therapeutic tools to help patients monitor, observe, and manage information about their feelings, thoughts, and behavior. Basic components of this platform include a core server module providing services for observation, planning, feedback, and responses; an administrative module providing user access management and professional monitoring; and mobile modules to facilitate access and ease of use.


The seven-step program invites patients to observe and track their eating behaviors by keeping food diaries and to complete scenario-based exercises that encourage patients to confront problems and develop strategies for dealing with them. It also tries to change patients' thought patterns, which are often characterized by self-hate and self-blame, and to raise their self-esteem.


These modules parallel the key steps in a generic cognitive-behavioral therapy treatment process. These steps include self-observation (behavioral), progressive confrontation with problems (behavioral), and changing thought patterns (cognitive schemas). Most of the program is carried out online, including weekly e-mail contact with a therapist, but patients are also required to have three face-to-face sessions.


"Patients can only access Salut!! through healthcare professionals in a hospital, clinic or psychiatric unit, for example," says Tony Lam of NetUnion (http:\\, the scientific and technological coordinator for the project. "With the Internet, people are often tempted to provide services directly to patients, but we didn't feel this was a responsible approach. The service needs to be mediated in a healthcare environment."


Clinical trials for the French version of Salut!! took place in Switzerland and showed that it could not only make treatment accessible to a greater number of bulimia sufferers but could also reduce the burden on healthcare professionals. One of the most significant findings was that Salut!! helped patients to overcome their feelings of shame about having an eating disorder, empowering them to help themselves.


Further trials are currently taking place in Sweden and Spain, and NetUnion is planning trials in Germany and Norway. The company also has plans to develop a similar self-help model for the online treatment of mental health disorders, such as stress, anxiety, and depression. The project will extend this work to develop a general platform for the delivery of mental health services within a cognitive-behavioral therapy framework.


The platform could facilitate the eventual integration of specific components such as expert systems, multilingual service modules, and natural language search facilities.


Salut!! will also implement regional research and prevention networks among the partner countries. These online networks are enabled by Web portals that are a natural extension of the project Web site. The networks aim to promote innovation by providing a meeting point for collaboration and information exchange between researchers and practitioners. A public interface is also available to facilitate dissemination of basic information about eating disorders. Any medical information provided online must respect developing guidelines and quality criteria for online dissemination of medical information. (Draft guidelines e-Europe 2002 Action Plan: Health Online workshop was held on 7 and 8 June 2001 in Brussels.)


The research and EU Community networks will also be used for the dissemination of diagnostic and therapeutic tools to a restricted and targeted user group. The project will establish formal agreement for a coherent dissemination of project results that will be respected by all partners.


Salut!! takes a holistic approach in promoting uptake and innovation during all the key steps of the prevention, diagnostic, and treatment cycle. These tools are designed to support a more collaborative relationship between doctors and their patients.


For further information about this project, please go to the Salut!! project Web site,





The Mozilla Foundation, in partnership with Adobe Systems, Apple Computer, Macromedia, Opera Software, and Sun Microsystems, today announced a series of changes to Web browser plugins that will allow Web developers to offer richer Web browsing experiences.


In response to demand by users, plugin vendors, and Web developers for Web browser support for an open and scriptable plugin model, the Mozilla partnership is working to extend the Netscape Plugin Application Program Interface (NPAPI) in a manner that allows greater interactivity with plugins such as Flash, Shockwave, QuickTime, and Java, resulting in a richer, more interactive Web browsing experience.


Plugins are small programs that Web browsers use to display multimedia content that the browsers themselves don't know how to display, such as audio and video. Scriptability of plugins is essential for building an interactive user experience on Web pages that use plugins.


The new plugin API effort taps into a long-standing, deeply rooted desire by plugin vendors to have their plugins work more seamlessly for all browsers and on all computing platforms, including Windows, Linux, and Mac OS X. The enhanced plugin API has been collaboratively developed to promote adoption by a broad set of browser and plugin vendors and will be made available under an open-source license.


Mozilla plans to release test versions of its next generation Firefox browser and of Mozilla that include the new plugin APIs, allowing plugin vendors to start creating new versions of their plugins that take full advantage of the enhanced plugin capabilities. Details on test builds with these new capabilities, plugin software developer kits, and Web page scripting examples can be found at as they become available.


Web browsers capable of supporting the new plugin enhancements, and plugins that take advantage of the new capabilities, are expected to ship in fall 2004. The plugin enhancements will be included, among others, in future versions of Mozilla Firefox, the innovative new Web browser from the Mozilla Foundation. The user base of Firefox is doubling every few months, and Firefox 0.9 was downloaded more than 1 million times in the first 2 weeks after its release.


The Mozilla Foundation was established in July 2003 with start-up support from America Online's Netscape division and exists to provide organizational, legal, and financial support for the Mozilla open-source software project. The foundation is based in Mountain View, CA, and is the heir to the great legacy and tradition of the Internet's first widely used browser, Netscape. Mozilla and the Mozilla logo are registered trademarks of the Mozilla Foundation.


For the latest Mozilla-related news and commentary, support, and discussion, please visit MozillaZine,, the largest independent Mozilla news and support site on the Web.





According to the results of an extensive review of research studies on pediatric patient safety, five key information technologies show promise in improving child safety in healthcare. The review was supported by the Agency for Healthcare Research and Quality (AHRQ grant HS11868). According to authors Kevin B. Johnson, MS, MD, of Vanderbilt University Medical Center, and Coda L. Davison, MPA, FACHE, of the Johns Hopkins University School of Medicine, some of these technologies will be widely adopted in the next 10 years. These technologies are as follows:


* Care provider order entry (CPOE), which has been studied primarily with adult patients, has dramatically decreased the incidence of medication errors such as allergic reactions and excessive drug dosages in intensive care patients.


* Guideline-based documentation was associated with increased guideline compliance in the areas of pediatric oncology, pediatric health maintenance, and emergency medicine.


* Internet-based disease management resources, from online support groups to e-mail and Web pages, can enhance decision making, improve communication, and educate adolescents and older youths about illness and prevention.


* Teleconsultation can improve access to care and has been found to be useful in pediatric surgery, evaluations of suspected abuse or neglect, psychiatry, pediatric dental screening, pediatric ophthalmology, and neonatology.


* Electronic health records (EHRs) have the potential to improve the safety of pediatric care, especially for preventive services such as exams and vaccinations.



See "Information technology: its importance to child safety," by Dr Johnson and Mr Davison, in the January/February 2004 issue of Ambulatory Pediatrics 4(1), pp. 64-72.



A recent supplement to the journal Medical Care comprises several papers from an April 2002 conference that focused on the strengths of and gaps in contributions of nursing to healthcare quality and was supported in part by the Agency for Healthcare Research and Quality (AHRQ grant HS12058).


Norma M. Lang, PhD, RN, of the University of Pennsylvania School of Nursing and her colleagues wrote in the foreword that while nurse scientists have done significant work by using large state and national data sets for quality research in various care settings, for studying hospital safety outcomes, and for examining the relationships between nurse staffing and quality of patient care, these data sets rarely include elements considered most sensitive to nursing care and interventions.


Several speakers at the 2002 conference pointed out that categories such as organizational and practice structure are absent from public data sets. While more research in key areas-including working conditions, staffing, and safety-means that these types of data are becoming available for dissemination, researchers' challenge is to capitalize on the current momentum.


For a listing of conference papers published in the supplement, visit AHRQ's Web site:



Web logs (blogs) are much talked about but still challenging to find and navigate for the average Web user. Kinja, a new blog portal service, was developed in 2003 by Nick Denton, who backed Weblog media projects such as Gawker and Gizmodo, and Meg Hourihan, a co-architect of Blogger, the first mass-market Weblog publishing system. Kinja incorporated in October 2003 and launched its beta version of the blog portal in April 2004.


Kinja is designed to bring Weblog writers to a broader audience, collecting news and commentary from some of the best sites on the Web. Visitors can browse items through topic lists that also offer excerpts, or they can create a convenient personal digest, to track their favorite writers. The favorites page can be shared with friends and colleagues. Kinja encourages users to suggest new sites and plans to eventually allow users' customized digests to be published, effectively adding users to its editorial team.


Kinja is not aimed at early adopters. Users wanting to analyze patterns of meme propagation, and other sophisticated data, should try the excellent Technorati. To experience Kinja firsthand, visit their Web site,





Quask has launched FormArtist version 3.5, which offers a unique way of collecting data not just online, but also offline with its new Offline Form Manager feature. Available in the Professional version, the Offline Form Manager allows people to complete forms and surveys without being connected to the Internet.


Forms and surveys can be distributed via e-mail, on CD, or as a file for completion offline. Recipients need to install the Offline Form Manager only once to receive any number of different forms and can fill in multiple instances of the same form. Forms can be saved and closed at any time during completion, enabling lengthy or complex forms to be completed over time and not just at one sitting.


A new Auto Forwarding capability also allows partially completed forms to be distributed from person to person, which is particularly useful when running complex "process forms" requiring input from multiple people/departments. The Offline Form Manager can be run on desktop PCs, laptops, and tablet PCs, with a PDA version to follow.


For more information and to see the product, visit





NEOS, a national business technology services and consulting firm, has announced the commercial release of its Java generation and conversion engine, Vgo. Intended to consolidate and integrate legacy applications and untangle accumulated code while maintaining core business functionality, Vgo focuses on an existing data domain to build code. It functions as a technology project enabler, allowing data conversions, migrations, and development with just a few mouse clicks.


Vgo can generate up to 75% of a Java Web application from an existing data source. Users are offered the option of generating several "flavors" of code including Struts JSP and Java Swing.


Vgo was built to generate working code quickly and efficiently to allow developers time to focus on the complexities of the business rules they need to develop to support their projects. Vgo uses no proprietary DLLs, application servers, or database schema. It is designed to run on a PC while it builds high performing, consistently coded enterprise applications.


According to NEOS, several software companies are reviewing Vgo's capabilities for possible inclusion in future productivity tool packages.


More information about NEOS and Vgo can be found online at





Quick Notes has released IDQ-Informatics Suite for Nursing, a medication-to-patient matching system for nurses, hospitals, and nursing homes. IDQ uses patented barcode technology, with focus on patient safety, and the FDA's mandate on the use of bar codes to eliminate medical and medication errors. The system is designed to link with a facility's current IT department or EMR software.


IDQ-Informatics Suite consists of IDQ-Meds, IDQ-Rounds and IDQ-Doc. IDQ-Meds uses barcode technology to identify the patient and verify the patient's medications. IDQ-Rounds uses bar coding and ThumbWare touch screen for the purpose of collecting patients' vital signs and other charting information. IDQ-Doc is used by nurses and doctors for sharing and reviewing of patients' vital signs and other data in list and graphical form.


Quick Notes seeks to establish partnerships for the purpose of promoting greater patient safety and reducing patient and medication errors in the medical community.