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WHAT IS INTERNET ? - A NETWORK OF NETWORKS BASED ON TCP/IP PROTOCOLS - A COMMUNITY OF PEOPLE WHO USE AND DEVELOP THOSE NETWORKS - A COLLECTION OF RESOURCES.

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Presentation on theme: "WHAT IS INTERNET ? - A NETWORK OF NETWORKS BASED ON TCP/IP PROTOCOLS - A COMMUNITY OF PEOPLE WHO USE AND DEVELOP THOSE NETWORKS - A COLLECTION OF RESOURCES."— Presentation transcript:

1 WHAT IS INTERNET ? - A NETWORK OF NETWORKS BASED ON TCP/IP PROTOCOLS - A COMMUNITY OF PEOPLE WHO USE AND DEVELOP THOSE NETWORKS - A COLLECTION OF RESOURCES THAT CAN BE REACHED FROM THOSE NETWORKS

2 INTERNET PHILOSOPHY WORK GLOBALLY DIAL LOCALLY

3 GRID COMPUTING GRID computing is een techniek voor het verwerken van zeer grote hoeveelheden gegevens door het wereldwijd koppelen van computers (toepassingen in b.v. hoge energiefysica, medische beeldvorming,...)

4 Benodigdheden voor Internet - Computer (PC) - Modem (analoge of breedbandmodem) - Telefoonlijn (gewone, GSM, GPRS, UMTS, ISDN, TELENET, ADSL,...) - Internettoegang (via 'service provider' cfr. Belnet, Skynet,...)

5 DEBIET (10 Mbyte file) V34+ modem Snellere modems ISDN Satellite Cable ADSL bpssec

6 BELNET - Het nieuw netwerk van Belnet anno 2008 met verhoogde capaciteit laat communicatie toe via een enorme bandbreedte  vroeger:1 treinspoor x intercitytrein  nu: 42 treinsporen x TGV 42 x 10 Gigabit = 420 Gbps -Alles verloopt via glasvezelbekabeling -Belnet levert ook SSL certificaten af - GEANT2 netwerk

7 HISTORY of the INTERNET 1960s:Department of Defense (DOD) Advanced Research Projects Agency (DARPA) Vooral electronic mail ( ), vooral gebruikt door wetenschappers en overheid Usenet Netnews (een bulletin board system, mailing lists voor discussiegroepen) 1970s:Het Transmission Control Protocol - Internetwork Protocol (TCP-IP) wordt het dominante communicatieprotocol  Internet 1980s:De National Science Foundation (NSF) zet de subsidiëring van de ontwikkelingen verder en maakt fondsen vrij voor de backbone  NSF net 1990s:National Library of Medicine and Vice President Al Gore (US) promoten de ontwikkeling van een 1gbs backbone Gebruikte netwerken, n gebruikers, traffiek - Van Wetenschappelijk  commercieel gebruik - Van Computer  naar menselijke - communicatie 2000s:Commerciële ventures supporteren de Internet expansie  ARPAnet

8 ENKELE INTERNET-DIENSTEN V-MAIL (vrije tekst via elektronische post) (ook bestanden in attachment) (ook mailinglists, discussiefora, nieuwsgroepen) vb. TELNET (terminalemulatie / user account) vb. telnet://lib.kbr.be FILE TRANSFER PROTOC. FTP (bestanden overbrengen) vb. ftp://ftp.ripe.net/ripe (paswoord = mail adres) WORLD WIDE WEB-SITES of WWW (een "site" is een verzameling van webpagina's met tekst, geluid, beeld, animatie) INTERNET RELAY CHAT of IRC ("chatten" is praten met iemand in real-time via het toetsenbord) VIDEOCONFERENCING (communiceren met spraak en beeld, incl. whiteboard)

9 ADRESSERING (1) users user“at”host.domain

10 ADRESSERING (2) ONTLEDING VAN EEN URL www UGent be.. URL http-prompt hypertext-applicatie-acroniem Subdomein[-aanduiding(en)] Hoofddomein (-aanduiding) algemeen specifiek IP-naam  IP-adres Domein(naam)

11 ADRESSERING (3) HOOFDDOMEIN-AANDUIDINGEN comCommercieel, commerciële organisaties govGovernment, overheidsinstanties en ministeries intInternational, internationale organisaties milMilitary, militaire locaties netNetwork, netwerkorganisaties orgOrganisation, overige organisaties eduEducation, onderwijsinstellingen atOostenrijkesSpanje auAustraliëfrFrankrijk beBelgiëitItalië caCanadanlNederland deDuitslandukGroot-Brittannië dkDenemarkeneuEuropa

12 COMMERCIAL or NOT ? ! URLs +.EDU +.ORG +.GOV ?.COUNTRY ABBREVIATION -.COM.INFO.BIZ

13 URL : cave !

14

15 Tim Berners-Lee (nu W3C) en Robert Cailliau “Inventors of the WWW”

16 The HyperText Transfer Protocol (HTTP) supports a universal naming scheme for information on all computers accessible through the Internet. The HyperText Markup Language (HTML) allows the display of formatted and / or multimedia documents to be independent of the device.

17 Repositories of Standard Concepts and Objects (cfr. ‘context-’ versus ‘not context-free’) The Standard Generalized Markup Language (SGML) (ISO ): A Syntax with: - procedural labels - Elements, attributes & values (rules!) - Granularity through the nesting of elements - Document Type Definitions (DTDs) - descriptive labels (semantics based structure) The Hypertext Markup Language (HTML) W3C - WG (application) Standardised DTDs for Healthcare? Extensible Markup Language (XML) (subset) - element nodes, document nodes, instruction nodes, comment nodes, pseudo-element nodes [ Extensible Style Language (XSL) presentation ]

18 WWW - BROWSERS NETSCAPE NAVIGATOR / COMMUNICATOR MOZILLA/FIREFOX MICROSOFT INTERNET EXPLORER 2008IE 7IE 6FireFoxMoz Chrome SafariOpera Sept 26.3%22.3%42.6%0.5%3.1%2.7%2.0% Source:

19 WWW - BROWSERS NETSCAPE NAVIGATOR / COMMUNICATOR MOZILLA/FIREFOX MICROSOFT INTERNET EXPLORER Major changes in popular Internet Browsers are now occurring every three months. Frequent updating becomes a must as new products really have an increased functionality!

20 HYPERMEDIA = HYPERTEXT + MULTIMEDIA HOST 1 HOST 2 HOST 3 HYPERLINK ANCHOR

21 HISTORY of the WWW BROWSERS Gopher Archie Mosaic Netscape Internet Explorer (Microsoft, cf. Windows) LANGUAGES SGML HTML XML CONTENT Text Images Sound Multimedia (incl. video) (WML)

22 INTRANET is an institutional network based on TCP/IP that uses technology developed for the Internet (such as the World Wide Web and electronic mail). Unlike access to the Internet, access to Intranets and their function is restricted to those using the institutional (eg. Hospital-) data. Most of hospital’s information is considered confidential (sensitive patient or corporate issues).

23 ICT in Healthcare: TENSIONS - A free market in information versus finite resources for healthcare “Frustration caused by unability to provide new (expensive) therapies” - Information rich versus information poor “The ‘have’s and the ‘have not’s, the information underclass …” - Changing role of and relationships between doctors and patients “Patients ‘armed’ with information from the Web …” “Doctors becoming an endangered species …” “Virtual doctors & cyberconsultations …”

24 Information Management in Healthcare : IMPLICATIONS - Need for other kinds of education “Core role of medical profession is not that of a ‘walking encyclopaedia’” “Information & Knowledge management training in Medicine” “Less memorization, more searching, thinking, choosing, deciding” - Need for new information and data policy in healthcare - Need for more communication skills: “Co-operative assessment of risks and benefits between the doctor and the patient”

25 HEALTH INFORMATION / COMMUNICATION Goals? Issues? Dimension? Research, Care, Quality Assessment, Budgetting, Education, Marketing? Prevention, Care and Cure (Diagnosis, Therapy), Follow-up, Revalidation, Palliation? Disease, Patient, Drug, Echelon, Time? “There is a need for new tools (filters)…”

26 INTERNET EVOLUTION 1. Net Wizards 2. NUA Internet Surveys

27 Communication Media and Education JOURNALs VIDEOFILMs CD-ROMs, DVDs, HD-ROMs CD-Is NARROW CASTING TV ELECTRONIC DATA INTERCHANGE (EDI) INTERNET / WORLD WIDE WEB (WWW)

28 miljard webpages Toename7 miljoen webpages per dag Hoeveelheid informatie ( info 500x > dan webpagina's) (Jaarlijks wereldwijde info = 1.5 miljoen Terabyte)

29 8 bits =1byte 2 10 bytes =Kilobyte= 1024 Bytes 2 20 bytes =Megabyte= 1024 Kilobytes 2 30 bytes =Gigabyte= 1024 Megabytes 2 40 bytes =Terabyte= 1024 Gigabytes 2 50 bytes =Petabyte= 1024 Terabytes 2 60 bytes =Exabyte= 1024 Petabytes 2 70 bytes =Zettabyte= 1024 Exabytes 2 80 bytes =Yottabyte= 1024 Zettabytes BITS en BYTES

30 REASONS for USING Internet - WWW “Instant publishing” “Instant retrieving” “More information available” (cfr. MEDLINE) “Inexpensive” (only local phone call) “Easy” (cfr. World Wide Web, WWW) “Convenient” (eg. from home) “Communication with peers” (cfr. , discussion-lists, newsgroups)  UP TO DATE (cfr. CD-ROM) Publishers switch to Internet … but competition is now ‘global’ (international) Before Internet After Internet

31 Finding Information on the WWW Altavista Google Webcrawler KartOO

32 ”HOW DO I FIND INFORMATION RELEVANT TO MY NEEDS?”  Free-text SEARCH ENGINE  Subject DIRECTORIES (directory based search engine)  Evaluated SUBJECT CATALOGUES (Hybrid SYSTEMS)

33 SEARCH ENGINES versus DIRECTORIES SEARCH ENGINES “make use of large databases of information and present selected documents based on certain search terms, phrases, etc.” SUBJECT CATALOG OR DIRECTORY “a collection of maintained links organized by content”

34 Websites ROBOT (spider, crawler) “bi-directional” Database Search engine + “indexed” “graphical interface” Queries (and) Newsgroups

35 SEARCH ENGINES: CHARACTERISTICS ? How many webpages indexed ? Search syntax (+, -, …) ? Refine features (language filters, date filters) ? Sort features ? Number of hits and/or perfect matches ? Way of ranking (relevance, irrelevance) ? User friendliness ? Fast connection speed, server-characteristics ? Intelligent content extraction (spelling, synonyms) ? Updating (rate of)

36 SYNTAX - Double quote (“ “) for phrase searching - Signs (+,-) before term - Modifiers (AND, OR, NEAR, AND NOT …) - Wild Card Search (*) for word-stemming (truncation) - Locating pages which link (LINK: URL) (1) - Locating images (IMAGE: name) (2) - Narrowing down (title:, text:, domain: ) eg. (1) LINK: (2) IMAGE: gene

37 Different Search Engines Different hits Different ranking Robots gather different SAMPLES of webpages - Some robots can successfully access more than others: image maps, frame links, applets, password protected pages “no Internet search engine is able to index the data within the MEDLINE database”

38 RANKING - Term in title section - Term in page body

39 Meta - Search - Engine Query eg. DogPile (interfaces with different Databases including: Google, Yahoo, Overture …) +  appropriate for highly specific search terms

40

41 Music & Audio Video & Audio Camera Pictures & Images People

42 BELGISCHE en/of VLAAMSE ZOEKMACHINES Ad Valvashttp://www.advalvas.be/ MediMediaNethttp://www.medimedianet.be/ Scoothttp://www.scoot.be/ Web Watchhttp://www.webwatch.be/ ( ! Nederlandstalige zoekstrings gebruiken …)

43 SUBJECT DIRECTORIES / CATALOGUES eg.: Yahoo ! - Health Section (http://dir.yahoo.com/health) + Hierarchical structure  logical “From the broader … to the narrower concept” - Human Input  less up-to-date  not always systematic

44 EVALUATED SUBJECT CATALOGUES 1. Medical Matrix (links to >5.000 quality-assessed Internet Sites) (AMIA) betalend 2. OMNI (Organising Medical Networked Information) (browsing by alphabetic classified topic, MeSH) 3. Health on the Net (HON) (the Foundation has developed a Code of Conduct)

45 EVALUATED SUBJECT CATALOGUES Strenght: evaluated  highly relevant and qualitative Weakness: compiled by individuals  incomplete * * ( ! MEDLINE has indexed over the last 5 years > 2 million documents)

46

47 The TOP TEN MEDICAL RESOURCES (alphabetical list) 1. Centers for Disease Control and Prevention (CDC) 2. Internet Mental Health 3. National Institutes of Health (NIH) 4. Oncolink 5. PubMed - MEDLINE on the Web 6. Reuters Health 7. RxList 8. TRIP - Turning Research into Practice (betalend, nu 5 gratis zoekopdrachten per week) 9. OVID 10. World Health Organisation

48 Finding what you want: CONCLUSION - High quality  evaluated subject catalogues - Broad perspective  general subject catalogues - High specificity  free text (meta-) search engines (or combination)

49 Does the resource meet a defined quality threshold? (1) 1. Accountability Authorship (author, affiliation, credentials, ) Attribution (references or sources must be stated) Disclosure (owner, sponsor, advertiser should be displayed) Currency (indication of date of creation and last update)

50 2. Badge of approval (quality label)? More based on Web design, innovation / freshness  inappropriate Exception: Health on the Net Foundation Does the resource meet a defined quality threshold? (2)

51 3. Rating Tools (checklists)(quality scores) 1. “Website Evaluation Rating Checklist” (Richard Waller) Cave: ‘this assessment is not sufficient to guarantee SAFETY’ 2. QUality Information ChecKlist Does the resource meet a defined quality threshold? (3)

52 4. Web Filtering Configure your web-browser in order to deny access to pages. PICS (Platform for Internet Content Selection) labeling scheme. Authors embed tags into a page indicating features such as (nudity, violence, …): med PICS tags. Internet Explorer: load a file with extension.rat  check page + inquiry to label bureau Does the resource meet a defined quality threshold? (4)

53 Frauds and Quackery CAVE “miracle cures” 1. Websites and Newsgroups that promote products/services to cure through a credible-looking Web-site: CANCER AIDS (aloe vera) ARTHRITIS (see cucumber) MULTIPLE SCLEROSIS BALDNESS “aimed at patients willing to try anything!”  false hope, delaying proper treatment … 2. Facts based on personal experience and anecdotes rather than on rigorous medical research and evidence

54 The Quality Issue - Cure-all remedies (“get rich quick” agenda) - Inaccurate information (good faith) - Biased information (pharmaceutical sponsorship)

55 Monitoring Health Frauds and Quackery Quackwatch National Council Against Health Fraud American Council on Science and Health

56 PubMed (Medline on the Web) Other websites also offer FREE access to Medline but PubMed is the best version: - data from the ‘PubMed in Process’ file incorporated  citations appear more quickly than in other versions eg. NEJM: within 1 week, Lancet, BMJ: within a fortnight - powerful searching (via pull down menus) !

57 Synergy between different systems to support complementary services in medicine Internet for access to Literature (education) for Extranet for Patient Related Data Exchange for access to Health Professional Services Intranet for WWW based Electronic Medical Record Systems Legacy EMR System

58 SafetySecurity - Confidentiality - Integrity - Availability - Authentication

59 NETiquette

60 SECURITY Internet Secure Extranet = Virtual Private Network Public Domain ! Confidentiality, Integrity, Availability ! Masquerade ! Interception, misrouting ! Destruction Closed Usergroup

61 Security Threats in Communications - Interception of identity - Masquerade - Replay - Manipulation: - replacement - insertion - deletion - misordening - destruction - Repudiation - Denial of service - Misrouting - Traffic analysis (Passive: Active intruder)

62 THE INTERNET-WWW IS A VERY HELPFUL COMMUNICATION CHANNEL THE INTERNET-WWW DOES NOT CREATE INFORMATION OR KNOWLEDGE

63 The Internet will influence not only the way we communicate with colleagues and patients, but the way we store clinical data, the way we pursue education, the way we publish our work. (J. Zellingher, M.D. M.D. Computing, Vol 13, no 4, 1996)

64 Medi Media Net

65 - Indications & Contra-indications - Druginteractions - Side effects, adverse drug reactions, risks Cfr : The passive Medical records of today’s medical information systems have to change into active objects that remind, suggest or even seek out advice.

66 ELECTRONISCH PATIENTEN DOSSIER (multimediaal) SPRAAKHERKENNING (Lernout & Hauspie) N.L.P. (Language & Computing) E.D.I. (MediBridge,...) B.O.S. en EXPERTSYSTEMEN (Standaarden) INTERNET - WWW (Interactieve webapplicaties) S.I.S. - KAART SMART CARDS VOORSCHRIFTEN GENEESMIDDELEN M.K.G.'s (Ziekenhuizen) INTEGRATIE en ORDERCOMMUNICATIE (Ziekenhuizen) AFSPRAKENBEHEER TARIFERING STATISTIEKEN,... DE AANTREKKELIJKHEID VAN HET ELEKTRONISCH MEDISCH DOSSIER

67 E.H.R. / Multimedia

68 ELEKTRONISCH PATIENT DOSSIER BRON-GEORIENTEERD TIJD -GEORIENTEERD PROBLEEM -GEORIENTEERD OPLOSSING -GEORIENTEERD

69 DX Plain PERFORMANCE OF FOUR COMPUTER-BASED DIAGNOSTIC SYSTEMS The New England Journal of Medicine (June 23, 1994) DXPLAIN (version 4.5) ILIAD (version 4.0) MEDITEL (version 2.0) QMR (version 2.03) PROPORTION OF CORRECT ANSWERS

70 DECISION THEORY Probabilities (Bayes) Decision Trees“Quantitative, Utilities Formal”... Heuristics “Extensible, Production rules, Frames Pragmatic” For- & Backward Reasoning EXPERTSYSTEMS In- and Output Patterns Units and Layers “Pattern Recognition, Parallel Processing Self-Learning” Connection Strenghts NEURAL NETWORKS

71 PROBABILISTIC APPROACH HEURISTIC APPROACH NEURAL NETWORKS PATTERN RECOGNITION HYBRID SYSTEMS

72 EXPERTSYSTEMEN Vooral gespecialiseerd: - elektrolieten stoornissen - schildklierlijden - diabetes - infarct - leverstoornissen -... VALIDATIE  INTERPRETATIE

73 “KNOWLEDGE-EXTRACTION is the most difficult step” Quality of Decision Support System Efforts to Formalize Information SystemsHuman Beings

74 ACCESS TO WHICH HEALTHCARE INFORMATION? FOR WHOM? WHAT: ACTORS: PURPOSE: DATAINFORMATIONKNOWLEDGE CITIZENSHEALTHCARE PROFESSIONALS (eg. patients)(eg. Medical doctors) CARERESEARCHEDUCATIONPROMOTIONSALES (*) (*) (DATA : Anonymous DataIdentifiable Patient Data Subjective DataObjective Data “Passive reception of data”“Active search for data”

75 INTEGRATION  Centralisation but  Interoperability + Communication ! - Standardisation - Confidence / Trust - Quality, safety, security, ethical & legal issues - International and global dimension

76 COMMUNICATION Co-ordination Problem: - Who will ‘organise’ communication in Healthcare? - Who will ‘benefit’ from communication? - Who has the authority, who is responsible?


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