47 CFR 22.973 - Information exchange.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Information exchange. 22.973 Section 22.973... Cellular Radiotelephone Service § 22.973 Information exchange. (a) Prior notification. Public safety/CII... information to the public safety/CII licensee at least 10 business days before a new cell site is activated or...

47 CFR 27.70 - Information exchange.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Information exchange. 27.70 Section 27.70... COMMUNICATIONS SERVICES Technical Standards § 27.70 Information exchange. (a) Prior notification. Public safety... information to the public safety licensee at least 10 business days before a new base or fixed station is...

47 CFR 27.70 - Information exchange.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Information exchange. 27.70 Section 27.70... COMMUNICATIONS SERVICES Technical Standards § 27.70 Information exchange. (a) Prior notification. Public safety... information to the public safety licensee at least 10 business days before a new base or fixed station is...

47 CFR 22.973 - Information exchange.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Information exchange. 22.973 Section 22.973 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.973 Information exchange. (a) Prior notification. Public safety/CII...

40 CFR 22.52 - Information exchange and discovery.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Procedure Act § 22.52 Information exchange and discovery. Respondent's information exchange pursuant to § 22.19(a) shall include information on any economic benefit resulting from any activity or failure to act... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Information exchange and discovery. 22...

Informed consent comprehension in African research settings.

PubMed

Afolabi, Muhammed O; Okebe, Joseph U; McGrath, Nuala; Larson, Heidi J; Bojang, Kalifa; Chandramohan, Daniel

2014-06-01

Previous reviews on participants' comprehension of informed consent information have focused on developed countries. Experience has shown that ethical standards developed on Western values may not be appropriate for African settings where research concepts are unfamiliar. We undertook this review to describe how informed consent comprehension is defined and measured in African research settings. We conducted a comprehensive search involving five electronic databases: Medline, Embase, Global Health, EthxWeb and Bioethics Literature Database (BELIT). We also examined African Index Medicus and Google Scholar for relevant publications on informed consent comprehension in clinical studies conducted in sub-Saharan Africa. 29 studies satisfied the inclusion criteria; meta-analysis was possible in 21 studies. We further conducted a direct comparison of participants' comprehension on domains of informed consent in all eligible studies. Comprehension of key concepts of informed consent varies considerably from country to country and depends on the nature and complexity of the study. Meta-analysis showed that 47% of a total of 1633 participants across four studies demonstrated comprehension about randomisation (95% CI 13.9-80.9%). Similarly, 48% of 3946 participants in six studies had understanding about placebo (95% CI 19.0-77.5%), while only 30% of 753 participants in five studies understood the concept of therapeutic misconception (95% CI 4.6-66.7%). Measurement tools for informed consent comprehension were developed with little or no validation. Assessment of comprehension was carried out at variable times after disclosure of study information. No uniform definition of informed consent comprehension exists to form the basis for development of an appropriate tool to measure comprehension in African participants. Comprehension of key concepts of informed consent is poor among study participants across Africa. There is a vital need to develop a uniform definition for

Health Information Exchange: What do patients want?

PubMed

Medford-Davis, Laura N; Chang, Lawrence; Rhodes, Karin V

2017-12-01

To determine whether emergency department patients want to share their medical records across health systems through Health Information Exchange and if so, whether they prefer to sign consent or share their records automatically, 982 adult patients presenting to an emergency department participated in a questionnaire-based interview. The majority (N = 906; 92.3%) were willing to share their data in a Health Information Exchange. Half (N = 490; 49.9%) reported routinely getting healthcare outside the system and 78.6 percent reported having records in other systems. Of those who were willing to share their data in a Health Information Exchange, 54.3 percent wanted to sign consent but 90 percent of those would waive consent in the case of an emergency. Privacy and security were primary concerns of patients not willing to participate in Health Information Exchange and preferring to sign consent. Improved privacy and security protections could increase participation, and findings support consideration of "break-the-glass" provider access to Health Information Exchange records in an emergent situation.

48 CFR 5.405 - Exchange of acquisition information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Exchange of acquisition... ACQUISITION PLANNING PUBLICIZING CONTRACT ACTIONS Release of Information 5.405 Exchange of acquisition... than one contracting activity within an agency, the exchange and coordination of pertinent information...

Health Care Information in African-American Churches

PubMed Central

Harmon, Brook E.; Kim, Sei-Hill; Blake, Christine E.; Hébert, James R.

2014-01-01

Churches are a trusted resource in African American communities; however, little is known about their presentation of health care information. This study characterized health care information disseminated by 11 African American churches. Content analysis conducted on print media systematically collected over one year used a coding scheme with .77 intercoder reliability. Health care information was identified in 243 items and represented three topics (screening, medical services, health insurance). Screening was the most common topic (n=156), flyers/handouts most often used (n=90), and the church the most common source (n=71). Using chi-square tests, information was assessed over time with health insurance information showing a statistically significant increase (χ2=6.08, p <.05). Study churches provided health care information at varying levels of detail with most coming from church and community publications. Future research should examine additional characteristics of health care information, its presence in other churches and community settings, and how exposure influences behaviors. PMID:24509024

29 CFR 1640.3 - Exchange of information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 4 2012-07-01 2012-07-01 false Exchange of information. 1640.3 Section 1640.3 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COORDINATING... Exchange of information. The EEOC, section 504 agencies, and designated agencies shall share any...

29 CFR 1640.3 - Exchange of information.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 4 2013-07-01 2013-07-01 false Exchange of information. 1640.3 Section 1640.3 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COORDINATING... Exchange of information. The EEOC, section 504 agencies, and designated agencies shall share any...

29 CFR 1640.3 - Exchange of information.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 4 2011-07-01 2011-07-01 false Exchange of information. 1640.3 Section 1640.3 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COORDINATING... Exchange of information. The EEOC, section 504 agencies, and designated agencies shall share any...

29 CFR 1640.3 - Exchange of information.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 4 2014-07-01 2014-07-01 false Exchange of information. 1640.3 Section 1640.3 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COORDINATING... Exchange of information. The EEOC, section 504 agencies, and designated agencies shall share any...

29 CFR 1640.3 - Exchange of information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 4 2010-07-01 2010-07-01 false Exchange of information. 1640.3 Section 1640.3 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COORDINATING... Exchange of information. The EEOC, section 504 agencies, and designated agencies shall share any...

Health information exchange policy and evaluation.

PubMed

Marchibroda, Janet M

2007-12-01

Concerns about the quality, safety, and cost of healthcare have driven the nation to increase its focus on this issue. A number of states are moving forward-in parallel with federal efforts-to develop and adopt policies for improving health and healthcare through health information technology and electronic health information exchange. Based on the eHealth Initiative's experience providing technical assistance to more than 20 states, and its work related to its coalition of more than 250 state, regional and community-based health information exchange initiatives and organizations, the most difficult challenges facing these initiatives and organizations today is that related to assessing the value of services that emerge from the health information exchange to various stakeholders groups such as providers, payers, and employers, and converting those value assessments to business plans that promote and assure sustainability for these initiatives. The combination of increased federal and state focus and funding and the pace at which regional and community-based health information networks are developing, along with the identification of value and sustainability as some of the most difficult challenges experienced by these efforts, all point to the significant need for evaluation. The most critical evaluation questions focus on the impact of health information technology and health information exchange on quality, safety, efficiency, the value of such efforts for various stakeholders, and assessment of how grant programs can be designed to support positive impact, value, and a sustainable business model, so that efforts continue when the grant funds are fully expended.

Health information exchange reduces repeated diagnostic imaging for back pain.

PubMed

Bailey, James E; Pope, Rebecca A; Elliott, Elizabeth C; Wan, Jim Y; Waters, Teresa M; Frisse, Mark E

2013-07-01

This study seeks to determine whether health information exchange reduces repeated diagnostic imaging and related costs in emergency back pain evaluation. This was a longitudinal data analysis of health information exchange patient-visit data. All repeated emergency department (ED) patient visits for back pain with previous ED diagnostic imaging to a Memphis metropolitan area ED between August 1, 2007, and July 31, 2009, were included. Use of a regional health information exchange by ED personnel to access the patient's record during the emergency visit was the primary independent variable. Main outcomes included repeated lumbar or thoracic diagnostic imaging (radiograph, computed tomography [CT], or magnetic resonance imaging [MRI]) and total patient-visit estimated cost. One hundred seventy-nine (22.4%) of the 800 qualifying repeated back pain visits resulted in repeated diagnostic imaging (radiograph 84.9%, CT 6.1%, and MRI 9.5%). Health information exchange use in the study population was low, at 12.5%, and health care providers as opposed to administrative/nursing staff accounted for 80% of the total health information exchange use. Health information exchange use by any ED personnel was associated with reduced repeated diagnostic imaging (odds ratio 0.36; 95% confidence interval 0.18 to 0.71), as was physician or nurse practitioner health information exchange use (odds ratio 0.47; 95% confidence interval 0.23 to 0.96). No cost savings were associated with health information exchange use because of increased CT imaging when health care providers used health information exchange. Health information exchange use is associated with 64% lower odds of repeated diagnostic imaging in the emergency evaluation of back pain. Health information exchange effect on estimated costs was negligible. More studies are needed to evaluate specific strategies to increase health information exchange use and further decrease potentially unnecessary diagnostic imaging and associated

Is Cancer Information Exchanged on Social Media Scientifically Accurate?

PubMed

Gage-Bouchard, Elizabeth A; LaValley, Susan; Warunek, Molli; Beaupin, Lynda Kwon; Mollica, Michelle

2017-07-19

Cancer patients and their caregivers are increasingly using social media as a platform to share cancer experiences, connect with support, and exchange cancer-related information. Yet, little is known about the nature and scientific accuracy of cancer-related information exchanged on social media. We conducted a content analysis of 12 months of data from 18 publically available Facebook Pages hosted by parents of children with acute lymphoblastic leukemia (N = 15,852 posts) and extracted all exchanges of medically-oriented cancer information. We systematically coded for themes in the nature of cancer-related information exchanged on personal Facebook Pages and two oncology experts independently evaluated the scientific accuracy of each post. Of the 15,852 total posts, 171 posts contained medically-oriented cancer information. The most frequent type of cancer information exchanged was information related to treatment protocols and health services use (35%) followed by information related to side effects and late effects (26%), medication (16%), medical caregiving strategies (13%), alternative and complementary therapies (8%), and other (2%). Overall, 67% of all cancer information exchanged was deemed medically/scientifically accurate, 19% was not medically/scientifically accurate, and 14% described unproven treatment modalities. These findings highlight the potential utility of social media as a cancer-related resource, but also indicate that providers should focus on recommending reliable, evidence-based sources to patients and caregivers.

Differing Strategies to Meet Information‐Sharing Needs: Publicly Supported Community Health Information Exchanges Versus Health Systems’ Enterprise Health Information Exchanges

PubMed Central

KASH, BITA A.

2016-01-01

Policy Points: Community health information exchanges have the characteristics of a public good, and they support population health initiatives at the state and national levels. However, current policy equally incentivizes health systems to create their own information exchanges covering more narrowly defined populations.Noninteroperable electronic health records and vendors’ expensive custom interfaces are hindering health information exchanges. Moreover, vendors are imposing the costs of interoperability on health systems and community health information exchanges.Health systems are creating networks of targeted physicians and facilities by funding connections to their own enterprise health information exchanges. These private networks may change referral patterns and foster more integration with outpatient providers. Context The United States has invested billions of dollars to encourage the adoption of and implement the information technologies necessary for health information exchange (HIE), enabling providers to efficiently and effectively share patient information with other providers. Health care providers now have multiple options for obtaining and sharing patient information. Community HIEs facilitate information sharing for a broad group of providers within a region. Enterprise HIEs are operated by health systems and share information among affiliated hospitals and providers. We sought to identify why hospitals and health systems choose either to participate in community HIEs or to establish enterprise HIEs. Methods We conducted semistructured interviews with 40 policymakers, community and enterprise HIE leaders, and health care executives from 19 different organizations. Our qualitative analysis used a general inductive and comparative approach to identify factors influencing participation in, and the success of, each approach to HIE. Findings Enterprise HIEs support health systems' strategic goals through the control of an information technology

Health information exchange: national and international approaches.

PubMed

Vest, Joshua R

2012-01-01

Health information exchange (HIE), the process of electronically moving patient-level information between different organizations, is viewed as a solution to the fragmentation of data in health care. This review provides a description of the current state of HIE in seven nations, as well was three international HIE efforts, with a particular focus on the relation of exchange efforts to national health care systems, common challenges, and the implications of cross-border information sharing. National and international efforts highlighted in English language informatics journals, professional associations, and government reports are described. Fully functioning HIE is not yet a common phenomenon worldwide. However, multiple nations see the potential benefits of HIE and that has led to national and international efforts of varying scope, scale, and purview. National efforts continue to work to overcome the challenges of interoperability, record linking, insufficient infrastructures, governance, and interorganizational relationships, but have created architectural strategies, oversight agencies, and incentives to foster exchange. The three international HIE efforts reviewed represent very different approaches to the same problem of ensuring the availability of health information across borders. The potential of HIE to address many cost and quality issues will ensure HIE remains on many national agendas. In many instances, health care executives and leaders have opportunities to work within national programs to help shape local exchange governance and decide technology partners. Furthermore, HIE raises policy questions concerning the role of centralized planning, national identifiers, standards, and types of information exchanged, each of which are vital issues to individual health organizations and worthy of their attention.

e-Government for Development Information Exchange (DIE): Zambia

NASA Astrophysics Data System (ADS)

Joseph, Bwalya Kelvin

In most parts of the world, political systems which utilize authoritative rule and mostly employ top-down decision-making processes are slowly transcending towards democratic norms. Information Technology Systems have been identified and adopted as one of the most efficient vehicles for appropriate, transparent and inclusive / participatory decision making. Zambia has shown a higher propensity to indigenous knowledge systems which are full of inefficiencies, a lot of red tape in public service delivery, and prone to corrupt practices. Despite that being the case, it is slowly trying to implement e-government. The adoption of e-government promises a sharp paradigm shift where public institutions will be more responsive and transparent, promote efficient PPP (Public Private Partnerships), and empower citizens by making knowledge and other resources more directly accessible. This paper examines three cases from Zambia where ICT in support of e-government has been implemented for Development Information Exchange (DIE) - knowledge-based decision making. The paper also assesses the challenges, opportunities, and issues together with e-government adoption criteria regarding successful encapsulation of e-government into the Zambian contextual environment. I propose a conceptual model which offers balanced e-government adoption criteria involving a combination of electronic and participatory services. This conceptual e-government adoption model can later be replicated to be used at the Southern African Development Community (SADC) level given the similarity in the contextual environment.

41 CFR 60-742.2 - Exchange of information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Exchange of information. 60-742.2 Section 60-742.2 Public Contracts and Property Management Other Provisions Relating to... AGAINST EMPLOYERS HOLDING GOVERNMENT CONTRACTS OR SUBCONTRACTS § 60-742.2 Exchange of information. (a...

Applications of health information exchange information to public health practice.

PubMed

Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

2014-01-01

Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US' investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health.

Applications of Health Information Exchange Information to Public Health Practice

PubMed Central

Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

2014-01-01

Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US’ investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health. PMID:25954386

The African Connection

ERIC Educational Resources Information Center

Oguntoyinbo, Lekan

2012-01-01

From student and faculty exchanges to joint research projects, U.S. universities maintain a broad spectrum of collaborative relationships with African universities. It's unclear how many U.S. colleges and universities have partnerships with African universities. The African Studies Association, an organization of scholars, doesn't keep that kind…

Physician capability to electronically exchange clinical information, 2011.

PubMed

Patel, Vaishali; Swain, Matthew J; King, Jennifer; Furukawa, Michael F

2013-10-01

To provide national estimates of physician capability to electronically share clinical information with other providers and to describe variation in exchange capability across states and electronic health record (EHR) vendors using the 2011 National Ambulatory Medical Care Survey Electronic Medical Record Supplement. Survey of a nationally representative sample of nonfederal office-based physicians who provide direct patient care. The survey was administered by mail with telephone follow-up and had a 61% weighted response rate. The overall sample consisted of 4326 respondents. We calculated estimates of electronic exchange capability at the national and state levels, and applied multivariate analyses to examine the association between the capability to exchange different types of clinical information and physician and practice characteristics. In 2011, 55% of physicians had computerized capability to send prescriptions electronically; 67% had the capability to view lab results electronically; 42% were able to incorporate lab results into their EHR; 35% were able to send lab orders electronically; and, 31% exchanged patient clinical summaries with other providers. The strongest predictor of exchange capability is adoption of an EHR. However, substantial variation exists across geography and EHR vendors in exchange capability, especially electronic exchange of clinical summaries. In 2011, a majority of office-based physicians could exchange lab and medication data, and approximately one-third could exchange clinical summaries with patients or other providers. EHRs serve as a key mechanism by which physicians can exchange clinical data, though physicians' capability to exchange varies by vendor and by state.

29 CFR 1691.2 - Exchange of information.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 4 2013-07-01 2013-07-01 false Exchange of information. 1691.2 Section 1691.2 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS OF EMPLOYMENT DISCRIMINATION FILED AGAINST RECIPIENTS OF FEDERAL FINANCIAL ASSISTANCE § 1691.2 Exchange of...

Health information exchange policies of 11 diverse health systems and the associated impact on volume of exchange.

PubMed

Downing, N Lance; Adler-Milstein, Julia; Palma, Jonathan P; Lane, Steven; Eisenberg, Matthew; Sharp, Christopher; Longhurst, Christopher A

2017-01-01

Provider organizations increasingly have the ability to exchange patient health information electronically. Organizational health information exchange (HIE) policy decisions can impact the extent to which external information is readily available to providers, but this relationship has not been well studied. Our objective was to examine the relationship between electronic exchange of patient health information across organizations and organizational HIE policy decisions. We focused on 2 key decisions: whether to automatically search for information from other organizations and whether to require HIE-specific patient consent. We conducted a retrospective time series analysis of the effect of automatic querying and the patient consent requirement on the monthly volume of clinical summaries exchanged. We could not assess degree of use or usefulness of summaries, organizational decision-making processes, or generalizability to other vendors. Between 2013 and 2015, clinical summary exchange volume increased by 1349% across 11 organizations. Nine of the 11 systems were set up to enable auto-querying, and auto-querying was associated with a significant increase in the monthly rate of exchange (P = .006 for change in trend). Seven of the 11 organizations did not require patient consent specifically for HIE, and these organizations experienced a greater increase in volume of exchange over time compared to organizations that required consent. Automatic querying and limited consent requirements are organizational HIE policy decisions that impact the volume of exchange, and ultimately the information available to providers to support optimal care. Future efforts to ensure effective HIE may need to explicitly address these factors. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.

29 CFR 1691.2 - Exchange of information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 4 2012-07-01 2012-07-01 false Exchange of information. 1691.2 Section 1691.2 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS OF... information. EEOC and agencies shall share any information relating to the employment policies and practices...

29 CFR 1691.2 - Exchange of information.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 4 2014-07-01 2014-07-01 false Exchange of information. 1691.2 Section 1691.2 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS OF... information. EEOC and agencies shall share any information relating to the employment policies and practices...

29 CFR 1691.2 - Exchange of information.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 4 2011-07-01 2011-07-01 false Exchange of information. 1691.2 Section 1691.2 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS OF... information. EEOC and agencies shall share any information relating to the employment policies and practices...

29 CFR 1691.2 - Exchange of information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 4 2010-07-01 2010-07-01 false Exchange of information. 1691.2 Section 1691.2 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS OF... information. EEOC and agencies shall share any information relating to the employment policies and practices...

African-German Cooperation in Educational Research and Planning.

ERIC Educational Resources Information Center

Sachsenmeier, Peter

The report presents background information and proceedings from a conference held in Bonn, Germany, in September 1977 to encourage exchange of ideas between African and German educators and government officials. Specifically, the conference served to document the increasing interest of German educators to interact with educators from the third…

Implementation of Medical Information Exchange System Based on EHR Standard

PubMed Central

Han, Soon Hwa; Kim, Sang Guk; Jeong, Jun Yong; Lee, Bi Na; Choi, Myeong Seon; Kim, Il Kon; Park, Woo Sung; Ha, Kyooseob; Cho, Eunyoung; Kim, Yoon; Bae, Jae Bong

2010-01-01

Objectives To develop effective ways of sharing patients' medical information, we developed a new medical information exchange system (MIES) based on a registry server, which enabled us to exchange different types of data generated by various systems. Methods To assure that patient's medical information can be effectively exchanged under different system environments, we adopted the standardized data transfer methods and terminologies suggested by the Center for Interoperable Electronic Healthcare Record (CIEHR) of Korea in order to guarantee interoperability. Regarding information security, MIES followed the security guidelines suggested by the CIEHR of Korea. This study aimed to develop essential security systems for the implementation of online services, such as encryption of communication, server security, database security, protection against hacking, contents, and network security. Results The registry server managed information exchange as well as the registration information of the clinical document architecture (CDA) documents, and the CDA Transfer Server was used to locate and transmit the proper CDA document from the relevant repository. The CDA viewer showed the CDA documents via connection with the information systems of related hospitals. Conclusions This research chooses transfer items and defines document standards that follow CDA standards, such that exchange of CDA documents between different systems became possible through ebXML. The proposed MIES was designed as an independent central registry server model in order to guarantee the essential security of patients' medical information. PMID:21818447

Implementation of Medical Information Exchange System Based on EHR Standard.

PubMed

Han, Soon Hwa; Lee, Min Ho; Kim, Sang Guk; Jeong, Jun Yong; Lee, Bi Na; Choi, Myeong Seon; Kim, Il Kon; Park, Woo Sung; Ha, Kyooseob; Cho, Eunyoung; Kim, Yoon; Bae, Jae Bong

2010-12-01

To develop effective ways of sharing patients' medical information, we developed a new medical information exchange system (MIES) based on a registry server, which enabled us to exchange different types of data generated by various systems. To assure that patient's medical information can be effectively exchanged under different system environments, we adopted the standardized data transfer methods and terminologies suggested by the Center for Interoperable Electronic Healthcare Record (CIEHR) of Korea in order to guarantee interoperability. Regarding information security, MIES followed the security guidelines suggested by the CIEHR of Korea. This study aimed to develop essential security systems for the implementation of online services, such as encryption of communication, server security, database security, protection against hacking, contents, and network security. The registry server managed information exchange as well as the registration information of the clinical document architecture (CDA) documents, and the CDA Transfer Server was used to locate and transmit the proper CDA document from the relevant repository. The CDA viewer showed the CDA documents via connection with the information systems of related hospitals. This research chooses transfer items and defines document standards that follow CDA standards, such that exchange of CDA documents between different systems became possible through ebXML. The proposed MIES was designed as an independent central registry server model in order to guarantee the essential security of patients' medical information.

The ARAC-RODOS-WSPEEDI Information Exchange Project

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sullivan, T J

1999-09-01

Under the auspices of a US DOE-JAPAN Memorandum of Understanding JAERI and LLNL agreed to develop and evaluate a prototype information exchange protocol for nuclear accident emergency situations. This project received some interest from the US DOS and FEMA as it fits nicely under the umbrella of the G-7's GEMINI (Global Emergency Management Information Network Initiative) project. Because of LLNL/ARAC and JAERV WSPEEDI interest in nuclear accident consequence assessment and hazard prediction on all scales, to include global, we were happy to participate. Subsequent to the Spring 1997 RODOS-ARAC Workshop a Memorandum of Agreement was developed to enhance mutual collaborationmore » on matters of emergency systems development. In the summer of 1998 the project leaders of RODOS, WSPEEDI and ARAC met at FZK and agreed to join in a triangular collaboration on the development and demonstration of an emergency information exchange protocol. JAERI and FZK are engaged in developing a formal cooperation agreement. The purpose of this project is to evaluate the prototype information protocol application for technical feasibility and mutual benefit through simulated (real) event; quick exchange of atmospheric modeling products and environmental data during emergencies, distribution of predicted results to other countries having no prediction capabilities, and utilization of the link for collaborative studies.« less

43 CFR 2203.2 - Submission of information concerning proposed exchange.

Code of Federal Regulations, 2014 CFR

2014-10-01

...: GENERAL PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.2 Submission of information concerning proposed exchange. (a) Any person submitting a proposal for a fee exchange of Federal coal... proposed exchange. 2203.2 Section 2203.2 Public Lands: Interior Regulations Relating to Public Lands...

43 CFR 2203.2 - Submission of information concerning proposed exchange.

Code of Federal Regulations, 2013 CFR

2013-10-01

...: GENERAL PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.2 Submission of information concerning proposed exchange. (a) Any person submitting a proposal for a fee exchange of Federal coal... proposed exchange. 2203.2 Section 2203.2 Public Lands: Interior Regulations Relating to Public Lands...

43 CFR 2203.2 - Submission of information concerning proposed exchange.

Code of Federal Regulations, 2012 CFR

2012-10-01

...: GENERAL PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.2 Submission of information concerning proposed exchange. (a) Any person submitting a proposal for a fee exchange of Federal coal... proposed exchange. 2203.2 Section 2203.2 Public Lands: Interior Regulations Relating to Public Lands...

43 CFR 2203.2 - Submission of information concerning proposed exchange.

Code of Federal Regulations, 2011 CFR

2011-10-01

...: GENERAL PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.2 Submission of information concerning proposed exchange. (a) Any person submitting a proposal for a fee exchange of Federal coal... proposed exchange. 2203.2 Section 2203.2 Public Lands: Interior Regulations Relating to Public Lands...

U.S.-U.S.S.R. Rail Inspection Information Exchange

DOT National Transportation Integrated Search

1977-06-01

This trip report describes the results and conclusions of the U.S. delegation resulting from the U.S.-U.S.S.R. Rail Inspection Information exchange tour of the Soviet Union, August 24 through September 1, 1975. This information exchange was conducted...

Speeding decisions. Social security's information exchange program.

PubMed

Winter, Kitt; Hastings, Bob

2011-05-01

The Social Security Administration has plenty of reasons to streamline its records request process-more than 15 million reasons each year, in fact. That's why it has been pioneering information exchange projects with the private sector, including use of the Nationwide Health Information Network.

"Take an opportunity whenever you get it": Information Sharing among African-American Women with Hypertension.

PubMed

Jones, Lenette M; Wright, Kathy D; Wallace, McKenzie K; Veinot, Tiffany

2018-01-01

Nearly half of African-American women have hypertension, which increases their risk for cardiovascular disease and stroke. A plethora of consumer health information products and services exist to inform people with hypertension and to promote self-management among them. Promotion of information sharing by African-American women represents a promising, culturally-applicable strategy for consumer health information services focused on hypertension self-management. Yet, how African-American women share hypertension information with others is unclear. The purpose of this qualitative, descriptive study was to examine practices of information sharing in African-American women with hypertension. Thirteen women (mean age = 73, SD = 9.87) participated in one of two focus groups held at an urban community health center. Thematic analysis revealed that the women shared information about how they self-managed their blood pressure 1) with female family members and friends, 2) about ways in which they adapted self-management strategies to work for them, 3) mostly in group settings, and 4) because they wanted to prevent others from suffering and reinforce their own knowledge about hypertension self-management. New findings emerged regarding assessing "readiness" for information. Study findings will be used to inform the design of an information sharing intervention to support self-management of hypertension in African-American women.

CALINX (California Information Exchange): a multi-stakeholder statewide initiative to improve healthcare information flows.

PubMed

Hopkins, D S; Oswald, N; McCaffrey, K; Bressler, S; Davidson, N; Vela, L

2000-01-01

Given the diffusion of responsibilities for gathering and reporting healthcare information in a managed care environment, California stakeholders are taking concrete steps to break the deadlock on data and information flows that has characterized the industry for some time. The California Information Exchange (CALINX) was established to facilitate the implementation of the Health Insurance Portability and Accountability Act (HIPAA) standards in California and to create trust for data exchange between trading partners, without which data exchange still will not occur. Strategic directions are set by the chief executives of key associations and organizations representing purchasers, plans, providers, and consumers. Multi-stakeholder workgroups have produced detailed data guidelines for the HIPAA standards along with rules for exchange of key data sets between trading partners. These rules address frequency, timeliness, and accuracy of data submission. Both the data guidelines and the rules have been tested in live demonstration projects, and the results of these projects have been reported to substantiate the business case for implementation. Further incentives are being built into contracts between purchasers and plans, and between plans and providers. CALINX is currently promoting widespread adoption of the data guidelines and rules for exchange with all members of the industry.

47 CFR 22.880 - Information exchange.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.880 Information exchange. (a) Prior notification. Public safety/CII licensees may notify a commercial aviation air-ground system...

29 CFR 1641.2 - Exchange of information.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS... CONTRACTS OR SUBCONTRACTS § 1641.2 Exchange of information. (a) EEOC and OFCCP shall share any information... not applicable to requests for data in EEOC files made by any State or local agency designated as a...

29 CFR 1641.2 - Exchange of information.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS... CONTRACTS OR SUBCONTRACTS § 1641.2 Exchange of information. (a) EEOC and OFCCP shall share any information... not applicable to requests for data in EEOC files made by any State or local agency designated as a...

29 CFR 1641.2 - Exchange of information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS... CONTRACTS OR SUBCONTRACTS § 1641.2 Exchange of information. (a) EEOC and OFCCP shall share any information... not applicable to requests for data in EEOC files made by any State or local agency designated as a...

29 CFR 1641.2 - Exchange of information.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS... CONTRACTS OR SUBCONTRACTS § 1641.2 Exchange of information. (a) EEOC and OFCCP shall share any information... not applicable to requests for data in EEOC files made by any State or local agency designated as a...

29 CFR 1641.2 - Exchange of information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS... CONTRACTS OR SUBCONTRACTS § 1641.2 Exchange of information. (a) EEOC and OFCCP shall share any information... not applicable to requests for data in EEOC files made by any State or local agency designated as a...

The perspectives and experiences of African American students in an informal science program

NASA Astrophysics Data System (ADS)

Bulls, Domonique L.

Science, technology, engineering, and mathematics (STEM) fields are the fastest growing sectors of the economy, nationally and globally. In order for the United States (U.S.) to maintain its competitiveness, it is important to address STEM experiences at the precollege level. In early years, science education serves as a foundation and pipeline for students to pursue STEM in college and beyond. Alternative approaches to instruction in formal classrooms have been introduced to engage more students in science. One alternative is informal science education. Informal science education is an avenue used to promote science education literacy. Because it is less regulated than science teaching in formal classroom settings, it allows for the incorporation of culture into science instruction. Culturally relevant science teaching is one way to relate science to African American students, a population that continually underperforms in K-12 science education. This study explores the science perspectives and experiences of African American middle school students participating in an informal science program. The research is framed by the tenets of culturally relevant pedagogy and shaped by the following questions: (1) What specific aspects of the Carver Program make it unique to African American students? (2) How is culturally relevant pedagogy incorporated into the informal science program? (3) How does the incorporation of culturally relevant pedagogy into the informal science program influence African American students' perceptions about science? The findings to the previously stated questions add to the limited research on African American students in informal science learning environments and contribute to the growing research on culturally relevant science. This study is unique in that it explores the cultural components of an informal science program.

Quantum secret information equal exchange protocol based on dense coding

NASA Astrophysics Data System (ADS)

Jiang, Ying-Hua; Zhang, Shi-Bin; Dai, Jin-Qiao; Shi, Zhi-Ping

2018-04-01

In this paper, we design a novel quantum secret information equal exchange protocol, which implements the equal exchange of secret information between the two parties with the help of semi-trusted third party (TP). In the protocol, EPR pairs prepared by the TP are, respectively, distributed to both the communication parties. Then, the two parties perform Pauli operation on each particle and return the new particles to TP, respectively. TP measures each new pair with Bell basis and announces the measurement results. Both parties deduce the secret information of each other according to the result of announcement by TP. Finally, the security analysis shows that this protocol solves the problem about equal exchange of secret information between two parties and verifies the security of semi-trusted TPs. It proves that the protocol can effectively resist glitch attacks, intercept retransmission attacks and entanglement attack.

Model Development for EHR Interdisciplinary Information Exchange of ICU Common Goals

PubMed Central

Collins, Sarah A.; Bakken, Suzanne; Vawdrey, David K.; Coiera, Enrico; Currie, Leanne

2010-01-01

Purpose Effective interdisciplinary exchange of patient information is an essential component of safe, efficient, and patient–centered care in the intensive care unit (ICU). Frequent handoffs of patient care, high acuity of patient illness, and the increasing amount of available data complicate information exchange. Verbal communication can be affected by interruptions and time limitations. To supplement verbal communication, many ICUs rely on documentation in electronic health records (EHRs) to reduce errors of omission and information loss. The purpose of this study was to develop a model of EHR interdisciplinary information exchange of ICU common goals. Methods The theoretical frameworks of distributed cognition and the clinical communication space were integrated and a previously published categorization of verbal information exchange was used. 59.5 hours of interdisciplinary rounds in a Neurovascular ICU were observed and five interviews and one focus group with ICU nurses and physicians were conducted. Results Current documentation tools in the ICU were not sufficient to capture the nurses' and physicians' collaborative decision-making and verbal communication of goal-directed actions and interactions. Clinicians perceived the EHR to be inefficient for information retrieval, leading to a further reliance on verbal information exchange. Conclusion The model suggests that EHRs should support: 1) Information tools for the explicit documentation of goals, interventions, and assessments with synthesized and summarized information outputs of events and updates; and 2) Messaging tools that support collaborative decision-making and patient safety double checks that currently occur between nurses and physicians in the absence of EHR support. PMID:20974549

Keeping up appearances: Strategic information exchange by disidentified group members

PubMed Central

Matschke, Christina

2017-01-01

Information exchange is a crucial process in groups, but to date, no one has systematically examined how a group member’s relationship with a group can undermine this process. The current research examined whether disidentified group members (i.e., members who have a negative relationship with their group) strategically undermine the group outcome in information exchange. Disidentification has been found to predict negative group-directed behaviour, but at the same time disidentified members run the risk of being punished or excluded from the group when displaying destructive behaviour. In three studies we expected and found that disidentified group members subtly act against the interest of the group by withholding important private information, while at the same time they keep up appearances by sharing important information that is already known by the other group members. These findings stress the importance of taking a group member’s relationship with a group into account when considering the process of information exchange. PMID:28384322

Explaining and improving breast cancer information acquisition among African American women in the Deep South.

PubMed

Anderson-Lewis, Charkarra; Ross, Levi; Johnson, Jarrett; Hastrup, Janice L; Green, B Lee; Kohler, Connie L

2012-06-01

A major challenge facing contemporary cancer educators is how to optimize the dissemination of breast cancer prevention and control information to African American women in the Deep South who are believed to be cancer free. The purpose of this research was to provide insight into the breast cancer information-acquisition experiences of African American women in Alabama and Mississippi and to make recommendations on ways to better reach members of this high-risk, underserved population. Focus group methodology was used in a repeated, cross-sectional research design with 64 African American women, 35 years old or older who lived in one of four urban or rural counties in Alabama and Mississippi. Axial-coded themes emerged around sources of cancer information, patterns of information acquisition, characteristics of preferred sources, and characteristics of least-preferred sources. It is important to invest in lay health educators to optimize the dissemination of breast cancer information to African American women who are believed to be cancer free in the Deep South.

Adequacy of pharmacological information provided in pharmaceutical drug advertisements in African medical journals

PubMed Central

Oshikoya, Kazeem A.; Senbanjo, Idowu O.; Soipe, Ayo

2008-01-01

Pharmaceutical advertisement of drugs is a means of advocating drug use and their selling but not a substitute for drug formulary to guide physicians in safe prescribing. Objectives: To evaluate drug advertisements in Nigerian and other African medical journals for their adequacy of pharmacological information. Methods: Twenty four issues from each of West African Journal of Medicine (WAJM), East African Medical Journal (EAMJ), South African Medical Journal (SAMJ), Nigerian Medical Practitioner (NMP), Nigerian Quarterly Journal of Hospital Medicine (NQJHM) and Nigerian Postgraduate Medical Journal (NPMJ) were reviewed. While EAMJ, SAMJ and NMP are published monthly, the WAJM, NQJHM and NPMJ are published quarterly. The monthly journals were reviewed between January 2005 and December 2006, and the quarterly journals between January 2001 and December 2006. The drug information with regards to brand/non-proprietary name, pharmacological data, clinical information, pharmaceutical information and legal aspects was evaluated as per World Health Organisation (WHO) criteria. Counts in all categories were collated for each advertiser. Results: Forty one pharmaceutical companies made 192 advertisements. 112 (58.3%) of these advertisements were made in the African medical journals. Pfizer (20.3%) and Swipha (12.5%) topped the list of the advertising companies. Four (2.1%) adverts mentioned generic names only, 157 (81.8%) mentioned clinical indications. Adults and children dosage (39.6%), use in special situations such as pregnancy and renal or liver problems (36.5%), adverse effects (30.2%), average duration of treatment (26.0%), and potential for interaction with other drugs (18.7%) were less discussed. Pharmaceutical information such as available dosage forms and product and package information {summary of the generic and proprietary names, the formulation strength, active ingredient, route of administration, batch number, manufactured and expiry dates, and the manufacturer

40 CFR 22.19 - Prehearing information exchange; prehearing conference; other discovery.

Code of Federal Regulations, 2010 CFR

2010-07-01

... method of discovery sought, provide the proposed discovery instruments, and describe in detail the nature... finding that: (i) The information sought cannot reasonably be obtained by alternative methods of discovery... promptly supplement or correct the exchange when the party learns that the information exchanged or...

47 CFR 90.675 - Information exchange.

Code of Federal Regulations, 2010 CFR

2010-10-01

... business days before a new cell site is activated or an existing cell site is modified: (1) Location; (2... believes a proposed cell will generate unacceptable interference; (2) Permit ESMR or part 22 Cellular... cell is activated. (c) Public safety information exchange. (1) Upon request by an ESMR or part 22...

Facilitators on networks reveal optimal interplay between information exchange and reciprocity.

PubMed

Szolnoki, Attila; Perc, Matjaž; Mobilia, Mauro

2014-04-01

Reciprocity is firmly established as an important mechanism that promotes cooperation. An efficient information exchange is likewise important, especially on structured populations, where interactions between players are limited. Motivated by these two facts, we explore the role of facilitators in social dilemmas on networks. Facilitators are here mirrors to their neighbors-they cooperate with cooperators and defect with defectors-but they do not participate in the exchange of strategies. As such, in addition to introducing direct reciprocity, they also obstruct information exchange. In well-mixed populations, facilitators favor the replacement and invasion of defection by cooperation as long as their number exceeds a critical value. In structured populations, on the other hand, there exists a delicate balance between the benefits of reciprocity and the deterioration of information exchange. Extensive Monte Carlo simulations of social dilemmas on various interaction networks reveal that there exists an optimal interplay between reciprocity and information exchange, which sets in only when a small number of facilitators occupy the main hubs of the scale-free network. The drawbacks of missing cooperative hubs are more than compensated for by reciprocity and, at the same time, the compromised information exchange is routed via the auxiliary hubs with only marginal losses in effectivity. These results indicate that it is not always optimal for the main hubs to become leaders of the masses, but rather to exploit their highly connected state to promote tit-for-tat-like behavior.

Facilitators on networks reveal optimal interplay between information exchange and reciprocity

NASA Astrophysics Data System (ADS)

Szolnoki, Attila; Perc, Matjaž; Mobilia, Mauro

2014-04-01

Reciprocity is firmly established as an important mechanism that promotes cooperation. An efficient information exchange is likewise important, especially on structured populations, where interactions between players are limited. Motivated by these two facts, we explore the role of facilitators in social dilemmas on networks. Facilitators are here mirrors to their neighbors—they cooperate with cooperators and defect with defectors—but they do not participate in the exchange of strategies. As such, in addition to introducing direct reciprocity, they also obstruct information exchange. In well-mixed populations, facilitators favor the replacement and invasion of defection by cooperation as long as their number exceeds a critical value. In structured populations, on the other hand, there exists a delicate balance between the benefits of reciprocity and the deterioration of information exchange. Extensive Monte Carlo simulations of social dilemmas on various interaction networks reveal that there exists an optimal interplay between reciprocity and information exchange, which sets in only when a small number of facilitators occupy the main hubs of the scale-free network. The drawbacks of missing cooperative hubs are more than compensated for by reciprocity and, at the same time, the compromised information exchange is routed via the auxiliary hubs with only marginal losses in effectivity. These results indicate that it is not always optimal for the main hubs to become leaders of the masses, but rather to exploit their highly connected state to promote tit-for-tat-like behavior.

An exchange format for use-cases of hospital information systems.

PubMed

Masuda, G; Sakamoto, N; Sakai, R; Yamamoto, R

2001-01-01

Object-oriented software development is a powerful methodology for development of large hospital information systems. We think use-case driven approach is particularly useful for the development. In the use-cases driven approach, use-cases are documented at the first stage in the software development process and they are used through the whole steps in a variety of ways. Therefore, it is important to exchange and share the use-cases and make effective use of them through the overall lifecycle of a development process. In this paper, we propose a method of sharing and exchanging use-case models between applications, developers, and projects. We design an XML based exchange format for use-cases. We then discuss an application of the exchange format to support several software development activities. We preliminarily implemented a support system for object-oriented analysis based on the exchange format. The result shows that using the structural and semantic information in the exchange format enables the support system to assist the object-oriented analysis successfully.

Willingness to Exchange Health Information via Mobile Devices: Findings From a Population-Based Survey.

PubMed

Serrano, Katrina J; Yu, Mandi; Riley, William T; Patel, Vaishali; Hughes, Penelope; Marchesini, Kathryn; Atienza, Audie A

2016-01-01

The rapid proliferation of mobile devices offers unprecedented opportunities for patients and health care professionals to exchange health information electronically, but little is known about patients' willingness to exchange various types of health information using these devices. We examined willingness to exchange different types of health information via mobile devices, and assessed whether sociodemographic characteristics and trust in clinicians were associated with willingness in a nationally representative sample. We analyzed data for 3,165 patients captured in the 2013 Health Information National Trends Survey. Multinomial logistic regression analysis was conducted to test differences in willingness. Ordinal logistic regression analysis assessed correlates of willingness to exchange 9 types of information separately. Participants were very willing to exchange appointment reminders (odds ratio [OR] = 6.66; 95% CI, 5.68-7.81), general health tips (OR = 2.03; 95% CI, 1.74-2.38), medication reminders (OR = 2.73; 95% CI, 2.35-3.19), laboratory/test results (OR = 1.76; 95% CI, 1.62-1.92), vital signs (OR = 1.63; 95% CI, 1.48-1.80), lifestyle behaviors (OR = 1.40; 95% CI, 1.24-1.58), and symptoms (OR = 1.62; 95% CI, 1.46-1.79) as compared with diagnostic information. Older adults had lower odds of being more willing to exchange any type of information. Education, income, and trust in health care professional information correlated with willingness to exchange certain types of information. Respondents were less willing to exchange via mobile devices information that may be considered sensitive or complex. Age, socioeconomic factors, and trust in professional information were associated with willingness to engage in mobile health information exchange. Both information type and demographic group should be considered when developing and tailoring mobile technologies for patient-clinician communication. © 2016 Annals of Family Medicine, Inc.

Willingness to Exchange Health Information via Mobile Devices: Findings From a Population-Based Survey

PubMed Central

Serrano, Katrina J.; Yu, Mandi; Riley, William T.; Patel, Vaishali; Hughes, Penelope; Marchesini, Kathryn; Atienza, Audie A.

2016-01-01

PURPOSE The rapid proliferation of mobile devices offers unprecedented opportunities for patients and health care professionals to exchange health information electronically, but little is known about patients’ willingness to exchange various types of health information using these devices. We examined willingness to exchange different types of health information via mobile devices, and assessed whether sociodemographic characteristics and trust in clinicians were associated with willingness in a nationally representative sample. METHODS We analyzed data for 3,165 patients captured in the 2013 Health Information National Trends Survey. Multinomial logistic regression analysis was conducted to test differences in willingness. Ordinal logistic regression analysis assessed correlates of willingness to exchange 9 types of information separately. RESULTS Participants were very willing to exchange appointment reminders (odds ratio [OR] = 6.66; 95% CI, 5.68–7.81), general health tips (OR = 2.03; 95% CI, 1.74–2.38), medication reminders (OR = 2.73; 95% CI, 2.35–3.19), laboratory/test results (OR = 1.76; 95% CI, 1.62–1.92), vital signs (OR = 1.63; 95% CI, 1.48–1.80), lifestyle behaviors (OR = 1.40; 95% CI, 1.24–1.58), and symptoms (OR = 1.62; 95% CI, 1.46–1.79) as compared with diagnostic information. Older adults had lower odds of being more willing to exchange any type of information. Education, income, and trust in health care professional information correlated with willingness to exchange certain types of information. CONCLUSIONS Respondents were less willing to exchange via mobile devices information that may be considered sensitive or complex. Age, socioeconomic factors, and trust in professional information were associated with willingness to engage in mobile health information exchange. Both information type and demographic group should be considered when developing and tailoring mobile technologies for patient-clinician communication. PMID:26755781

Physicians' opinions of a health information exchange

PubMed Central

Warholak, Terri L; Murcko, Anita C; Slack, Marion; Malone, Daniel C

2010-01-01

Background Arizona Medicaid developed a Health Information Exchange (HIE) system called the Arizona Medical Information Exchange (AMIE). Objective To evaluate physicians' perceptions regarding AMIE's impact on health outcomes and healthcare costs. Measurements A focus-group guide was developed and included five domains: perceived impact of AMIE on (1) quality of care; (2) workflow and efficiency; (3) healthcare costs; (4) system usability; and (5) AMIE data content. Qualitative data were analyzed using analytical coding. Results A total of 29 clinicians participated in the study. The attendance rate was 66% (N=19) for the first and last month of focus-group meetings and 52% (N=15) for the focus group meetings conducted during the second month. The benefits most frequently mentioned during the focus groups included: (1) identification of “doctor shopping”; (2) averting duplicative testing; and (3) increased efficiency of clinical information gathering. The most frequent disadvantage mentioned was the limited availability of data in the AMIE system. Conclusion Respondents reported that AMIE had the potential to improve care, but they felt that AMIE impact was limited due to the data available. PMID:21106994

Physicians' opinions of a health information exchange.

PubMed

Hincapie, Ana Lucia; Warholak, Terri L; Murcko, Anita C; Slack, Marion; Malone, Daniel C

2011-01-01

Arizona Medicaid developed a Health Information Exchange (HIE) system called the Arizona Medical Information Exchange (AMIE). To evaluate physicians' perceptions regarding AMIE's impact on health outcomes and healthcare costs. A focus-group guide was developed and included five domains: perceived impact of AMIE on (1) quality of care; (2) workflow and efficiency; (3) healthcare costs; (4) system usability; and (5) AMIE data content. Qualitative data were analyzed using analytical coding. A total of 29 clinicians participated in the study. The attendance rate was 66% (N=19) for the first and last month of focus-group meetings and 52% (N=15) for the focus group meetings conducted during the second month. The benefits most frequently mentioned during the focus groups included: (1) identification of "doctor shopping"; (2) averting duplicative testing; and (3) increased efficiency of clinical information gathering. The most frequent disadvantage mentioned was the limited availability of data in the AMIE system. Respondents reported that AMIE had the potential to improve care, but they felt that AMIE impact was limited due to the data available.

Explaining and Improving Breast Cancer Information Acquisition among African American Women in the Deep South

PubMed Central

Anderson-Lewis, Charkarra; Ross, Levi; Johnson, Jarrett; Hastrup, Janice L.; Green, B. Lee; Kohler, Connie L.

2012-01-01

Objectives A major challenge facing contemporary cancer educators is how to optimize the dissemination of breast cancer prevention and control information to African American women in the Deep South who are believed to be cancer free. The purpose of this research was to provide insight into the breast cancer information-acquisition experiences of African American women in Alabama and Mississippi and to make recommendations on ways to better reach members of this high-risk, underserved population. Methods Focus group methodology was used in a repeated, cross-sectional research design with 64 African American women, 35 years old or older who lived in one of four urban or rural counties in Alabama and Mississippi. Results Axial-coded themes emerged around sources of cancer information, patterns of information acquisition, characteristics of preferred sources, and characteristics of least-preferred sources. Conclusions It is important to invest in lay health educators to optimize the dissemination of breast cancer information to African American women who are believed to be cancer free in the Deep South. PMID:22665151

28 CFR 42.602 - Exchange of information.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Exchange of information. 42.602 Section 42.602 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND PROCEDURES Procedures for Complaints of Employment Discrimination Filed Against Recipients of...

Ontological modeling of electronic health information exchange.

PubMed

McMurray, J; Zhu, L; McKillop, I; Chen, H

2015-08-01

Investments of resources to purposively improve the movement of information between health system providers are currently made with imperfect information. No inventories of system-level electronic health information flows currently exist, nor do measures of inter-organizational electronic information exchange. Using Protégé 4, an open-source OWL Web ontology language editor and knowledge-based framework, we formalized a model that decomposes inter-organizational electronic health information flow into derivative concepts such as diversity, breadth, volume, structure, standardization and connectivity. The ontology was populated with data from a regional health system and the flows were measured. Individual instance's properties were inferred from their class associations as determined by their data and object property rules. It was also possible to visualize interoperability activity for regional analysis and planning purposes. A property called Impact was created from the total number of patients or clients that a health entity in the region served in a year, and the total number of health service providers or organizations with whom it exchanged information in support of clinical decision-making, diagnosis or treatment. Identifying providers with a high Impact but low Interoperability score could assist planners and policy-makers to optimize technology investments intended to electronically share patient information across the continuum of care. Finally, we demonstrated how linked ontologies were used to identify logical inconsistencies in self-reported data for the study. Copyright © 2015 Elsevier Inc. All rights reserved.

Extension of analog network coding in wireless information exchange

NASA Astrophysics Data System (ADS)

Chen, Cheng; Huang, Jiaqing

2012-01-01

Ever since the concept of analog network coding(ANC) was put forward by S.Katti, much attention has been focused on how to utilize analog network coding to take advantage of wireless interference, which used to be considered generally harmful, to improve throughput performance. Previously, only the case of two nodes that need to exchange information has been fully discussed while the issue of extending analog network coding to more than three nodes remains undeveloped. In this paper, we propose a practical transmission scheme to extend analog network coding to more than two nodes that need to exchange information among themselves. We start with the case of three nodes that need to exchange information and demonstrate that through utilizing our algorithm, the throughput can achieve 33% and 20% increase compared with that of traditional transmission scheduling and digital network coding, respectively. Then, we generalize the algorithm so that it can fit for occasions with any number of nodes. We also discuss some technical issues and throughput analysis as well as the bit error rate.

National Information Exchange Model (NIEM): DoD Adoption and Implications for C2 (Briefing Charts)

DTIC Science & Technology

2014-06-18

Application Data Consumers Information Exchange Package ( IEP ) the data exchanged at runtime Data Producers IES defines Information Exchange...Specification (IES) build-time description of the data to be exchanged Developers System / Application System / Application IEP | 9 | Data...Exchange Package ( IEP ) the data exchanged at runtime Data Producers System / Application System / Application IEP Consumer’s Understanding

A Study of Interlibrary Loan Transactions in the Texas Information Exchange.

ERIC Educational Resources Information Center

Texas Information Exchange, Austin.

A questionnaire was designed and circulated to all member libraries of the Texas Information Exchange to gather data associated with the costs and volume of interlibrary loan activity from September 1, 1975 to February 28, 1976. Forty of the forty-five members of the Exchange participated in the study. In the area of costs, information was…

Enabling Health Reform through Regional Health Information Exchange: A Model Study from China

PubMed Central

Wen, Dong; Meng, Qun

2017-01-01

Objective. To investigate and share the major challenges and experiences of building a regional health information exchange system in China in the context of health reform. Methods. This study used interviews, focus groups, a field study, and a literature review to collect insights and analyze data. The study examined Xinjin's approach to developing and implementing a health information exchange project, using exchange usage data for analysis. Results. Within three years and after spending approximately $2.4 million (15 million RMB), Xinjin County was able to build a complete, unified, and shared information system and many electronic health record components to integrate and manage health resources for 198 health institutions in its jurisdiction, thus becoming a model of regional health information exchange for facilitating health reform. Discussion. Costs, benefits, experiences, and lessons were discussed, and the unique characteristics of the Xinjin case and a comparison with US cases were analyzed. Conclusion. The Xinjin regional health information exchange system is different from most of the others due to its government-led, government-financed approach. Centralized and coordinated efforts played an important role in its operation. Regional health information exchange systems have been proven critical for meeting the global challenges of health reform. PMID:29065565

Database & information tools for transportation research management : Connecticut transportation research peer exchange report of a thematic peer exchange.

DOT National Transportation Integrated Search

2006-05-01

Specific objectives of the Peer Exchange were: : Discuss and exchange information about databases and other software : used to support the program-cycles managed by state transportation : research offices. Elements of the program cycle include: :...

Information Exchange Between Resilient and High-Threat Networks: Techniques for Threat Mitigation

DTIC Science & Technology

2004-11-01

Information Exchange between Resilient and High-Threat Networks : Techniques for Threat Mitigation Tim Dean and Graham Wyatt QinetiQ...SUMMARY High resilience military networks frequently have requirements for exchange of information with networks of low assurance, including networks of...assured, two-way, information flow between high resilience networks and other networks of unknown threat. The techniques include conventional and

Barriers and facilitators to exchanging health information: a systematic review.

PubMed

Eden, Karen B; Totten, Annette M; Kassakian, Steven Z; Gorman, Paul N; McDonagh, Marian S; Devine, Beth; Pappas, Miranda; Daeges, Monica; Woods, Susan; Hersh, William R

2016-04-01

We conducted a systematic review of studies assessing facilitators and barriers to use of health information exchange (HIE). We searched MEDLINE, PsycINFO, CINAHL, and the Cochrane Library databases between January 1990 and February 2015 using terms related to HIE. English-language studies that identified barriers and facilitators of actual HIE were included. Data on study design, risk of bias, setting, geographic location, characteristics of the HIE, perceived barriers and facilitators to use were extracted and confirmed. Ten cross-sectional, seven multiple-site case studies, and two before-after studies that included data from several sources (surveys, interviews, focus groups, and observations of users) evaluated perceived barriers and facilitators to HIE use. The most commonly cited barriers to HIE use were incomplete information, inefficient workflow, and reports that the exchanged information that did not meet the needs of users. The review identified several facilitators to use. Incomplete patient information was consistently mentioned in the studies conducted in the US but not mentioned in the few studies conducted outside of the US that take a collective approach toward healthcare. Individual patients and practices in the US may exercise the right to participate (or not) in HIE which effects the completeness of patient information available to be exchanged. Workflow structure and user roles are key but understudied. We identified several facilitators in the studies that showed promise in promoting electronic health data exchange: obtaining more complete patient information; thoughtful workflow that folds in HIE; and inclusion of users early in implementation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Health information exchange and healthcare utilization.

PubMed

Vest, Joshua R

2009-06-01

Health information exchange (HIE) makes previously inaccessible data available to clinicians, resulting in more complete information. This study tested the hypotheses that HIE information access reduced emergency room visits and inpatient hospitalizations for ambulatory care sensitive conditions among medically indigent adults. HIE access was quantified by how frequently system users' accessed patients' data. Encounter counts were modeled using zero inflated binomial regression. HIE was not accessed for 43% of individuals. Patient factors associated with accessed data included: prior utilization, chronic conditions, and age. Higher levels of information access were significantly associated with increased counts of all encounter types. Results indicate system users were more likely to access HIE for patients for whom the information might be considered most beneficial. Ultimately, these results imply that HIE information access did not transform care in the ways many would expect. Expectations in utilization reductions, however logical, may have to be reevaluated or postponed.

Why relevant chemical information cannot be exchanged without disclosing structures

NASA Astrophysics Data System (ADS)

Filimonov, Dmitry; Poroikov, Vladimir

2005-09-01

Both society and industry are interested in increasing the safety of pharmaceuticals. Potentially dangerous compounds could be filtered out at early stages of R&D by computer prediction of biological activity and ADMET characteristics. Accuracy of such predictions strongly depends on the quality & quantity of information contained in a training set. Suggestion that some relevant chemical information can be added to such training sets without disclosing chemical structures was generated at the recent ACS Symposium. We presented arguments that such safety exchange of relevant chemical information is impossible. Any relevant information about chemical structures can be used for search of either a particular compound itself or its close analogues. Risk of identifying such structures is enough to prevent pharma industry from relevant chemical information exchange.

Information Exchange of the Atomic Energy Society of Japan with Nuclear Societies Worldwide

DOE Office of Scientific and Technical Information (OSTI.GOV)

Masao Hori; Yasushi Tomita

2000-06-04

This paper describes committees of the Atomic Energy Society of Japan (AESJ) related to information exchange, AESJ publications, AESJ Internet applications, and means for future information exchange between nuclear societies.

An Early Model for Value and Sustainability in Health Information Exchanges: Qualitative Study

PubMed Central

2018-01-01

Background The primary value relative to health information exchange has been seen in terms of cost savings relative to laboratory and radiology testing, emergency department expenditures, and admissions. However, models are needed to statistically quantify value and sustainability and better understand the dependent and mediating factors that contribute to value and sustainability. Objective The purpose of this study was to provide a basis for early model development for health information exchange value and sustainability. Methods A qualitative study was conducted with 21 interviews of eHealth Exchange participants across 10 organizations. Using a grounded theory approach and 3.0 as a relative frequency threshold, 5 main categories and 16 subcategories emerged. Results This study identifies 3 core current perceived value factors and 5 potential perceived value factors—how interviewees predict health information exchanges may evolve as there are more participants. These value factors were used as the foundation for early model development for sustainability of health information exchange. Conclusions Using the value factors from the interviews, the study provides the basis for early model development for health information exchange value and sustainability. This basis includes factors from the research: fostering consumer engagement; establishing a provider directory; quantifying use, cost, and clinical outcomes; ensuring data integrity through patient matching; and increasing awareness, usefulness, interoperability, and sustainability of eHealth Exchange. PMID:29712623

An Early Model for Value and Sustainability in Health Information Exchanges: Qualitative Study.

PubMed

Feldman, Sue S

2018-04-30

The primary value relative to health information exchange has been seen in terms of cost savings relative to laboratory and radiology testing, emergency department expenditures, and admissions. However, models are needed to statistically quantify value and sustainability and better understand the dependent and mediating factors that contribute to value and sustainability. The purpose of this study was to provide a basis for early model development for health information exchange value and sustainability. A qualitative study was conducted with 21 interviews of eHealth Exchange participants across 10 organizations. Using a grounded theory approach and 3.0 as a relative frequency threshold, 5 main categories and 16 subcategories emerged. This study identifies 3 core current perceived value factors and 5 potential perceived value factors-how interviewees predict health information exchanges may evolve as there are more participants. These value factors were used as the foundation for early model development for sustainability of health information exchange. Using the value factors from the interviews, the study provides the basis for early model development for health information exchange value and sustainability. This basis includes factors from the research: fostering consumer engagement; establishing a provider directory; quantifying use, cost, and clinical outcomes; ensuring data integrity through patient matching; and increasing awareness, usefulness, interoperability, and sustainability of eHealth Exchange. ©Sue S Feldman. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 30.04.2018.

StarBright Learning Exchange

ERIC Educational Resources Information Center

Kalinowski, Michael

2007-01-01

This article features StarBright Learning Exchange, a program that provides a cross-cultural exchange between Australian and South African early childhood educators. The program was originated when its president, Carol Allen, and her colleague, Karen Williams, decided that they could no longer sit by and watch the unfolding social catastrophe that…

28 CFR 42.602 - Exchange of information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Exchange of information. 42.602 Section 42.602 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND PROCEDURES Procedures for Complaints of Employment Discrimination Filed Against Recipients of Federal Financial Assistance § 42.602...

Electronic Tools for Health Information Exchange

PubMed Central

2013-01-01

Background As patients experience transitions in care, there is a need to share information between care providers in an accurate and timely manner. With the push towards electronic medical records and other electronic tools (eTools) (and away from paper-based health records) for health information exchange, there remains uncertainty around the impact of eTools as a form of communication. Objective To examine the impact of eTools for health information exchange in the context of care coordination for individuals with chronic disease in the community. Data Sources A literature search was performed on April 26, 2012, using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published until April 26, 2012 (no start date limit was applied). Review Methods A systematic literature search was conducted, and meta-analysis conducted where appropriate. Outcomes of interest fell into 4 categories: health services utilization, disease-specific clinical outcomes, process-of-care indicators, and measures of efficiency. The quality of the evidence was assessed individually for each outcome. Expert panels were assembled for stakeholder engagement and contextualization. Results Eleven articles were identified (4 randomized controlled trials and 7 observational studies). There was moderate quality evidence of a reduction in hospitalizations, hospital length of stay, and emergency department visits following the implementation of an electronically generated laboratory report with recommendations based on clinical guidelines. The evidence showed no difference in disease-specific outcomes; there was no evidence of a positive impact on process-of-care indicators or measures of efficiency. Limitations A limited body of research specifically examined eTools for health information exchange in

DEVELOPMENT OF A SYSTEM FOR AN EDUCATIONAL PRODUCTS INFORMATION EXCHANGE. FINAL REPORT.

ERIC Educational Resources Information Center

KOMOSKI, P. KENNETH

THIS STUDY WAS UNDERTAKEN TO DESIGN AN EASILY ACCESSIBLE NATIONWIDE SYSTEM FOR EXCHANGING DESCRIPTIVE, EVALUATIVE PRODUCT INFORMATION AMONG ALL SECTORS OF THE EDUCATIONAL COMMUNITY ON A COOPERATIVE COST-SHARING BASIS. THE FEASIBILITY OF SUCH A COLLECTION AND EXCHANGE OF DESCRIPTIVE AND EVALUATIVE INFORMATION ABOUT INSTRUCTIONAL MATERIALS SYSTEMS…

Creating sustainable local health information exchanges: can barriers to stakeholder participation be overcome?

PubMed

Grossman, Joy M; Kushner, Kathryn L; November, Elizabeth A

2008-02-01

Local health information exchanges (HIEs) hold the promise of collecting patient clinical data across sites of care to provide more complete and timely information for treatment, as well as supporting quality improvement and reporting, public health activities, and clinical research. Findings from a study of stakeholder perspectives on participation in four HIEs by the Center for Studying Health System Change (HSC) and the National Institute for Health Care Management (NIHCM) Foundation suggest, however, that barriers to achieving data exchange remain high. Concerns about loss of competitive advantage and data misuse impede provider and health plan willingness to contribute patient data. Additionally, uncertainty about who benefits from HIEs is affecting stakeholder willingness to fund the exchanges. The more mature exchanges--Cincinnati-based HealthBridge and the Indiana Health Information Exchange (IHIE)--have achieved some viability by meeting a specific business need--more efficient delivery of hospital test results to physicians. The newer exchanges--CareSpark, serving northeast Tennessee and southwest Virginia, and the Tampa Bay Regional Health Information Organization (RHIO)--have struggled to identify and finance initial services without a similar critical mass of hospital participation. While narrow data exchange efforts that improve transaction efficiency may be a pragmatic first step to overcome barriers to stakeholder participation, expanding HIEs to achieve the broad-based data exchange necessary for quality reporting and pay-for-performance (P4P) activities raises more challenges.

Associations between perceived crisis mode work climate and poor information exchange within hospitals.

PubMed

Patterson, Mark E; Bogart, Miller S; Starr, Kathleen R

2015-03-01

Because hospital units operating in crisis mode could create unsafe transitions of care due to miscommunication, our objective was to estimate associations between perceived crisis mode work climate and patient information exchange problems within hospitals. Self-reported data from 247,140 hospital staff members across 884 hospitals were obtained from the 2010 Hospital Survey on Patient Safety Culture. Presence of a crisis mode work climate was defined as respondents agreeing that the hospital unit in which they work tries to do too much too quickly. Presence of patient information exchange problems was defined as respondents agreeing that problems often occur in exchanging patient information across hospital units. Multivariable ordinal regressions estimated the likelihood of perceived problems in exchanging patient information across hospital units, controlling for perceived levels of crisis mode work climate, skill levels, work climate, and hospital infrastructure. Compared to those disagreeing, hospital staff members agreeing that the hospital unit in which they work tries to do too much too quickly were 1.6 times more likely to perceive problems in exchanging patient information across hospital units (odds ratio: 1.6, 95% confidence interval: 1.58-1.65). Hospital staff members perceiving crisis mode work climates within their hospital unit are more likely to perceive problems in exchanging patient information across units, underscoring the need to improve communication during transitions of care. © 2014 Society of Hospital Medicine.

2017 Fire Protection Informational Exchange Meeting

DTIC Science & Technology

documents the results of an information exchange meeting held May 1011, 2017 at the US Army Research Laboratory, which brought together interested...parties across the armed services to outline, as a community, the current state of the art in fire protection research and engineering and determine...where future efforts would be most advantageous. The forum provided the opportunity to strengthen old collaborations, begin new partnerships, and serve

21 CFR 26.71 - Exchange of information.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Exchange of information. 26.71 Section 26.71 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL MUTUAL RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS...

Cosmonauts Solovyev and Dezhurov exchange information on Mir

NASA Image and Video Library

1995-07-10

STS071-118-007 (27 June - 7 July 1995) --- Onboard the Russia?s Mir Space Station Mir Base Block, cosmonauts Anatoly Y. Solovyev (left) and Vladimir N. Dezhurov, Mir 19 and 18 commanders, respectively, exchange information about their research tasks. The two represent a change of guard aboard Mir, as Dezhurov prepares to come back to Earth with the STS-71 crew aboard Space Shuttle Atlantis. Nikolai M. Budarin and Gennadiy M. Strekalov - cosmonaut/flight engineers making the same exchange -- are out of frame.

Simulation Suggests that medical group mergers won't undermine the potential utility of health information exchanges.

PubMed

Rudin, Robert S; Schneider, Eric C; Volk, Lynn A; Szolovits, Peter; Salzberg, Claudia A; Simon, Steven R; Bates, David W

2012-03-01

Federal and state agencies are investing substantial resources in the creation of community health information exchanges, which are consortia that enable independent health care organizations to exchange clinical data. However, under pressure to form accountable care organizations, medical groups may merge and support private health information exchanges. Such activity could reduce the potential utility of community exchanges-that is, the exchanges' capacity to share patient data across hospitals and physician practices that are independent. Simulations of care transitions based on data from ten Massachusetts communities suggest that there would have to be many such mergers to undermine the potential utility of health information exchanges. At the same time, because hospitals and the largest medical groups account for only 10-20 percent of care transitions in a community, information exchanges will still need to recruit a large proportion of the medical groups in a given community for the exchanges to maintain their usefulness in fostering information exchange across independent providers.

Impact of Health Disclosure Laws on Health Information Exchanges

PubMed Central

Adjerid, Idris; Padman, Rema

2011-01-01

Health information exchanges (HIEs) are expected to facilitate data sharing between healthcare entities, thereby improving the efficiency and quality of care. Privacy concerns have been consistently cited as one of the primary challenges to HIE formation and success. Currently, it is unclear how privacy laws – in particular, legislation restricting the disclosure of health records – have shaped the development of HIEs. This preliminary study explores the landscape of state-level health privacy legislation and examines the impact of variations in such privacy and confidentiality laws on the progress of HIEs. We found that states with stronger privacy laws, limiting the disclosure of health information, had significantly more HIEs exchanging data and had fewer failed HIEs. We suggest that this counterintuitive finding may be explained by the more subtle benefits of such laws, such as increased confidence and trust of participants in an exchange. Other key contributors to this work are Alessandro Acquisti, Rahul Telang, and Julia Adler-Milstein PMID:22195054

Estimated financial savings associated with health information exchange and ambulatory care referral.

PubMed

Frisse, Mark E; Holmes, Rodney L

2007-12-01

Data and financial models based on an operational health information exchange suggest that health care delivery costs can be reduced by making clinical data available at the time of care in urban emergency departments. Reductions are the result of decreases in laboratory and radiographic tests, fewer admissions for observation, and lower overall emergency department costs. The likelihood of reducing these costs depends on the extent to which clinicians alter their workflow and take into account information available through the exchange from other institutions prior to initiating a treatment plan. Far greater savings can be realized in theory by identifying individuals presenting to emergency departments whose acute and long-term care needs are more suitably addressed at lower costs in ambulatory settings or medical homes. These alternative ambulatory settings can more effectively address the chronic care needs of those who receive most of their care in emergency departments. To support a shift from emergency room care to clinic care, health care information available through the health information exchange must be made available in both emergency department and ambulatory care settings. If practice workflow and patient behavior can be changed, a more effective and efficient care delivery system will be made possible through the secure exchange of clinical information across regional settings. These projections support the case for the financial viability of regional health information exchanges and motivate participation of hospitals and ambulatory care organizations-particularly in urban settings.

Exchanging Medical Information with Eastern Europe through the Internet.

ERIC Educational Resources Information Center

Daniels, Julie K.; Cronje, Ruth J.; Sokolowski, Beth C.

1998-01-01

Interviews foreign Information Coordinators who facilitate exchange of medical information over the Internet between healthcare providers in America and eastern Europe to learn how Internet technologies are being introduced, disseminated, and adopted in their institutions. Applies diffusion of innovations theory for interpretation. Shows technical…

Tweeting the Friendly Skies: Investigating Information Exchange among Twitter Users about Airlines

ERIC Educational Resources Information Center

Sreenivasan, Nirupama Dharmavaram; Lee, Chei Sian; Goh, Dion Hoe-Lian

2012-01-01

Purpose: The purpose of this study is to investigate airline users' microblog postings pertaining to their travel-related information exchange so as to assess their wants, preferences and feedback about airline products and services. Examining such real-time information exchange is important as users rely on this for various purposes such as…

The Influence of Organizational Systems on Information Exchange in Long-Term Care Facilities: An Institutional Ethnography.

PubMed

Caspar, Sienna; Ratner, Pamela A; Phinney, Alison; MacKinnon, Karen

2016-06-01

Person-centered care is heavily dependent on effective information exchange among health care team members. We explored the organizational systems that influence resident care attendants' (RCAs) access to care information in long-term care (LTC) settings. We conducted an institutional ethnography in three LTC facilities. Investigative methods included naturalistic observations, in-depth interviews, and textual analysis. Practical access to texts containing individualized care-related information (e.g., care plans) was dependent on job classification. Regulated health care professionals accessed these texts daily. RCAs lacked practical access to these texts and primarily received and shared information orally. Microsystems of care, based on information exchange formats, emerged. Organizational systems mandated written exchange of information and did not formally support an oral exchange. Thus, oral information exchanges were largely dependent on the quality of workplace relationships. Formal systems are needed to support structured oral information exchange within and between the microsystems of care found in LTC. © The Author(s) 2016.

MIX. The McGraw-Hill Information Exchange.

ERIC Educational Resources Information Center

Laliberte, Stephen M.

1986-01-01

"MIX" is an online publishing service and information exchange from the Educational Management Services Division of McGraw-Hill. Through computer conferencing and electronic mail, MIX provides access to a network of people across the country who are seeking ways to put computers to use to improve the quality of education. MIX is an…

Market efficiency in foreign exchange markets

NASA Astrophysics Data System (ADS)

Oh, Gabjin; Kim, Seunghwan; Eom, Cheoljun

2007-08-01

We investigate the relative market efficiency in financial market data, using the approximate entropy(ApEn) method for a quantification of randomness in time series. We used the global foreign exchange market indices for 17 countries during two periods from 1984 to 1998 and from 1999 to 2004 in order to study the efficiency of various foreign exchange markets around the market crisis. We found that on average, the ApEn values for European and North American foreign exchange markets are larger than those for African and Asian ones except Japan. We also found that the ApEn for Asian markets increased significantly after the Asian currency crisis. Our results suggest that the markets with a larger liquidity such as European and North American foreign exchange markets have a higher market efficiency than those with a smaller liquidity such as the African and Asian markets except Japan.

Satisfying patient-consumer principles for health information exchange: evidence from California case studies.

PubMed

Miller, Robert H

2012-03-01

In June 2010 sixteen organizations representing California patients and consumers adopted nine principles for electronically exchanging health information among and within provider organizations. The principles were formulated with the goal of improving patient and population health care by increasing the availability and use of patient data while protecting patients' privacy. This study assesses to what extent five health care organizations-all in different stages of increasing their capacity for health information exchange-conformed to the principles in early 2011. Although an increasing amount of electronic data has been exchanged among organizations and with patients, progress has been modest, and patients still have little control over their data. For organizations to comply with all nine patient and consumer principles, clear "rules of the road" for information sharing must be defined, and patient education in health information exchange and control over personal data must be increased.

Needs and Preferences for Receiving Mental Health Information in an African American Focus Group Sample

PubMed Central

Mishra, Shiraz I.; Lucksted, Alicia; Gioia, Deborah; Barnet, Beth; Baquet, Claudia R.

2013-01-01

The purpose of this study is to better understand the mental health/illness information and service delivery preferences among African American residents of Baltimore. We conducted four focus groups (n=42) among African American adults currently unconnected with the mental health system. Participants expressed fear of stigma and perceptions of racism as major barriers to seeking information and/or services and discussed some normalizing strategies to address these barriers. African Americans harbor cultural and traditional beliefs regarding mental illness which could also act as barriers. Findings have implications for imparting acceptable and culturally-sensitive mental health education and service delivery programs in community settings. PMID:18633704

Information exchange networks for chronic illness care in primary care practices: an observational study

PubMed Central

2010-01-01

Background Information exchange networks for chronic illness care may influence the uptake of innovations in patient care. Valid and feasible methods are needed to document and analyse information exchange networks in healthcare settings. This observational study aimed to examine the usefulness of methods to study information exchange networks in primary care practices, related to chronic heart failure, diabetes and chronic obstructive pulmonary disease. Methods The study was linked to a quality improvement project in the Netherlands. All health professionals in the practices were asked to complete a short questionnaire that documented their information exchange relations. Feasibility was determined in terms of response rates and reliability in terms of reciprocity of reports of receiving and providing information. For each practice, a number of network characteristics were derived for each of the chronic conditions. Results Ten of the 21 practices in the quality improvement project agreed to participate in this network study. The response rates were high in all but one of the participating practices. For the analysis, we used data from 67 health professionals from eight practices. The agreement between receiving and providing information was, on average, 65.6%. The values for density, centralization, hierarchy, and overlap of the information exchange networks showed substantial variation between the practices as well as between the chronic conditions. The most central individual in the information exchange network could be a nurse or a physician. Conclusions Further research is needed to refine the measure of information networks and to test the impact of network characteristics on the uptake of innovations. PMID:20205758

Health information-seeking behavior and older African American women.

PubMed Central

Gollop, C J

1997-01-01

This study explored the ways in which urban, older, African American women obtain health information and some of the factors that influence such activity. Among the possible determinants examined were self-perceived literacy, access to health information, and mobility. The findings suggest that respondents receive health information from their physicians, the mass media, and members of their social networks. The results of this research also indicated that members of this population have a highly positive perception of the public library, although only a small segment use the library regularly, and that it may be in the interest of the library to investigate the role it could play in providing health information to older adults. PMID:9160150

Health information-seeking behavior and older African American women.

PubMed

Gollop, C J

1997-04-01

This study explored the ways in which urban, older, African American women obtain health information and some of the factors that influence such activity. Among the possible determinants examined were self-perceived literacy, access to health information, and mobility. The findings suggest that respondents receive health information from their physicians, the mass media, and members of their social networks. The results of this research also indicated that members of this population have a highly positive perception of the public library, although only a small segment use the library regularly, and that it may be in the interest of the library to investigate the role it could play in providing health information to older adults.

Environmental Attitudes and Information Sources among African American College Students

ERIC Educational Resources Information Center

Lee, E. Bun

2008-01-01

The author examined the environmental attitudes of African American college students by using the 15-item New Ecological Paradigm (NEP) Scale. The author also attempted to determine their everyday environmental behaviors such as recycling and conservation and investigated major information sources for local, national, and international…

Information retrieval pathways for health information exchange in multiple care settings.

PubMed

Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

2014-11-01

To determine which health information exchange (HIE) technologies and information retrieval pathways healthcare professionals relied on to meet their information needs in the context of laboratory test results, radiological images and reports, and medication histories. Primary data was collected over a 2-month period across 3 emergency departments, 7 primary care practices, and 2 public health clinics in New York state. Qualitative research methods were used to collect and analyze data from semi-structured interviews and participant observation. The study reveals that healthcare professionals used a complex combination of information retrieval pathways for HIE to obtain clinical information from external organizations. The choice for each approach was setting- and information-specific, but was also highly dynamic across users and their information needs. Our findings about the complex nature of information sharing in healthcare provide insights for informatics professionals about the usage of information; indicate the need for managerial support within each organization; and suggest approaches to improve systems for organizations and agencies working to expand HIE adoption.

From the Office of the National Coordinator: the strategy for advancing the exchange of health information.

PubMed

Williams, Claudia; Mostashari, Farzad; Mertz, Kory; Hogin, Emily; Atwal, Parmeeth

2012-03-01

Electronic health information exchange addresses a critical need in the US health care system to have information follow patients to support patient care. Today little information is shared electronically, leaving doctors without the information they need to provide the best care. With payment reforms providing a strong business driver, the demand for health information exchange is poised to grow. The Office of the National Coordinator for Health Information Technology, Department of Health and Human Services, has led the process of establishing the essential building blocks that will support health information exchange. Over the coming year, this office will develop additional policies and standards that will make information exchange easier and cheaper and facilitate its use on a broader scale.

Exploring Predictors of Information Use to Self-Manage Blood Pressure in Midwestern African American Women with Hypertension.

PubMed

Jones, Lenette M; Veinot, Tiffany; Pressler, Susan J; Coleman-Burns, Patricia; McCall, Alecia

2018-06-01

Self-management of hypertension requires patients to find, understand, and use information to lower their blood pressure. Little is known about information use among African American women with hypertension, therefore the purpose of this study was to examine predictors of self-reported information use to self-manage blood pressure. Ninety-four Midwestern African American women (mean age = 59) completed questionnaires about information behaviors (seeking, sharing, use) and personal beliefs (attitude, social norms) related to self-management of blood pressure. Linear regression was used to identify significant predictors of information use. The total variance explained by the model was 36%, F(7, 79) = 6.29, p < .001. Information sharing was the only significant predictor (beta = .46, p < .001). These results provide evidence that information sharing is a potential health behavior to support intervention strategies for African American women with hypertension.

Health information exchange: persistent challenges and new strategies

PubMed Central

Gamm, Larry D

2010-01-01

Recent federal policies and actions support the adoption of health information exchange (HIE) in order to improve healthcare by addressing fragmented personal health information. However, concerted efforts at facilitating HIE have existed for over two decades in this country. The lessons of these experiences include a recurrence of barriers and challenges beyond those associated with technology. Without new strategies, the current support and methods of facilitating HIE may not address these barriers. PMID:20442146

Models of information exchange between radio interfaces of Wi-Fi group of standards

NASA Astrophysics Data System (ADS)

Litvinskaya, O. S.

2018-05-01

This paper offers models of information exchange between radio interfaces of the Wi-Fi group of standards by the example of a real facility management system for the oil and gas industry. Interaction between the MU-MIMO and MIMO technologies is analyzed. An optimal variant of information exchange is proposed.

Information Exchange and Information Disclosure in Social Networking Web Sites: Mediating Role of Trust

ERIC Educational Resources Information Center

Mital, Monika; Israel, D.; Agarwal, Shailja

2010-01-01

Purpose: The purpose of this paper is to examine the mediating effect of trust on the relationship between the type of information exchange (IE) and information disclosure (ID) on social networking web sites (SNWs). Design/methodology/approach: Constructs were developed for type of IE and trust. To understand the mediating role of trust a…

Overcoming obstacles to the exchange of information between risk tools

NASA Technical Reports Server (NTRS)

Feather, Martin S.; Cornford, Steven L.; Meshkat, Leila; Voss, Luke

2005-01-01

Our work to date in connecting risk tools hs had successes, but also has revealed there to be significant impediments to information exchange between them. These impediments stem from the well-known phenomenon of 'semantic dissonance' - mismatch between conceptual assumptions made by the separately developed tools. This issue represents a fundamental challenge that arises regardless of the mechanism of information exchange. This paper explains the issue and illustrates it with reference to our experiences to date connecting several risk tools. We motivate this work, present and discuss the solutions we have adopted to surmount these impediments, and the implications this work has for future efforts to integrate risk tools.

Information Exchange Procedures. Outcomes Study Procedures. Technical Report No. 66.

ERIC Educational Resources Information Center

Byers, Maureen

The Information Exchange Procedures (IEP) developed by the National Center for Higher Education Management Systems (NCHEMS) are a set of standard definitions and procedures for collecting information about disciplines and student degree programs, outcomes of instructional programs, and general institutional characteristics. A fundamental purpose…

An Introduction to the Federal Information Exchange System.

ERIC Educational Resources Information Center

De Santi, Vincent; Scheele, D. Sam

This publication offers a basic introduction to the Federal Information Exchange System (FIXS), a set of procedures for periodically collecting, processing, and publishing data on federal and state expenditures for each program listed in the "Catalog of Federal Assistance Programs." FIXS is designed for use in conjunction with the…

Geography of community health information organization activity in the United States: Implications for the effectiveness of health information exchange.

PubMed

Vest, Joshua R

The United States has invested nearly a billion dollars in creating community health information organizations (HIOs) to foster health information exchange. Community HIOs provide exchange services to health care organizations within a distinct geographic area. While geography is a key organizing principle for community HIOs, it is unclear if geography is an effective method for organization or what challenges are created by a geography-based approach to health information exchange. This study describes the extent of reported community HIO coverage in the United States and explores the practical and policy implications of overlaps and gaps in HIO service areas. Furthermore, because self-reported service areas may not accurately reflect the true extent of HIOs activities, this study maps the actual markets for health services included in each HIO. An inventory of operational community HIOs that included self-reported geographic markets and participating organizations was face-validated using a crowd-sourcing approach. Aggregation of the participating hospitals' individual health care markets provided the total geographic market served by each community HIO. Mapping and overlay analyses using geographic information system methods described the extent of community HIO activity in the United States. Evidence suggests that community HIOs may be inefficiently distributed. Parts of the United States have multiple, overlapping HIOs, while others do not have any providing health information exchange services. In markets served by multiple community HIOs, 45% of hospitals were participants of only one HIO. The current geography of community HIO activity does not provide comprehensive patient information to providers, nor community-wide information for public health agencies. The discord between the self-reported and market geography of community HIOs raises concerns about the potential effectiveness of health information exchange, illustrates the limitations of geography as

Informal and Incidental Learning Experiences of African American Women That Shaped and Influenced Their Leadership Development and Style

ERIC Educational Resources Information Center

Clark, Marilyn Ann

2013-01-01

The primary purpose of this study was to examine how African American women in corporations develop leadership and construct their leadership style through informal and incidental learning experiences. This study explored relationships between informal adult learning and career mapping processes of leadership for African American women. A…

78 FR 76187 - 30-Day Notice of Proposed Information Collection: Exchange Programs Alumni Web Site Registration

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

...: Exchange Programs Alumni Web Site Registration ACTION: Notice of request for public comment and submission... Information Collection: Exchange Programs Alumni Web site Registration. OMB Control Number: 1405-0192. Type of... proposed collection: The International Exchange Alumni Web site requires information to process users...

Stable target opinion through power-law bias in information exchange

NASA Astrophysics Data System (ADS)

Datta, Amitava

2018-04-01

We study a model of binary decision making when a certain population of agents is initially seeded with two different opinions, "+" and "-," with fractions p1 and p2, respectively, p1+p2=1 . Individuals can reverse their initial opinion only once based on this information exchange. We study this model on a completely connected network, where any pair of agents can exchange information, and a two-dimensional square lattice with periodic boundary conditions, where information exchange is possible only between the nearest neighbors. We propose a model in which each agent maintains two counters of opposite opinions and accepts opinions of other agents with a power-law bias until a threshold is reached, when they fix their final opinion. Our model is inspired by the study of negativity bias and positive-negative asymmetry, which has been known in the psychology literature for a long time. Our model can achieve a stable intermediate mix of positive and negative opinions in a population. In particular, we show that it is possible to achieve close to any fraction p3, 0 ≤p3≤1 , of "-" opinion starting from an initial fraction p1 of "-" opinion by applying a bias through adjusting the power-law exponent of p3.

Stable target opinion through power-law bias in information exchange.

PubMed

Datta, Amitava

2018-04-01

We study a model of binary decision making when a certain population of agents is initially seeded with two different opinions, "+" and "-," with fractions p_{1} and p_{2}, respectively, p_{1}+p_{2}=1. Individuals can reverse their initial opinion only once based on this information exchange. We study this model on a completely connected network, where any pair of agents can exchange information, and a two-dimensional square lattice with periodic boundary conditions, where information exchange is possible only between the nearest neighbors. We propose a model in which each agent maintains two counters of opposite opinions and accepts opinions of other agents with a power-law bias until a threshold is reached, when they fix their final opinion. Our model is inspired by the study of negativity bias and positive-negative asymmetry, which has been known in the psychology literature for a long time. Our model can achieve a stable intermediate mix of positive and negative opinions in a population. In particular, we show that it is possible to achieve close to any fraction p_{3}, 0≤p_{3}≤1, of "-" opinion starting from an initial fraction p_{1} of "-" opinion by applying a bias through adjusting the power-law exponent of p_{3}.

Finnish physicians' experiences with computer-supported patient information exchange and communication in clinical work.

PubMed

Viitanen, Johanna; Nieminen, Marko; Hypponen, Hannele; Laaveri, Tinja

2011-01-01

Several researchers share the concern of healthcare information systems failing to support communication and collaboration in clinical practices. The objective of this paper is to investigate the current state of computer-supported patient information exchange and associated communication between clinicians. We report findings from a national survey on Finnish physicians? experiences with their currently used clinical information systems with regard to patient information documentation, retrieval, management and exchange-related tasks. The questionnaire study with 3929 physicians indicated the main concern being cross-organisational patient information delivery. In addition, physicians argued computer usage increasingly steals time and attention from caring activities and even disturbs physician?nurse collaboration. Problems in information management were particularly emphasised among those physicians working in hospitals and wards. The survey findings indicated that collaborative applications and mobile or wireless solutions have not been widely adapted in Finnish healthcare and suggested an urgent need for adopting appropriate information and communication technology applications to support information exchange and communication between physicians, and physicians and nurses.

The Cultural Contours of Democracy: Indigenous Epistemologies Informing South African Citizenship

ERIC Educational Resources Information Center

Kubow, Patricia K.; Min, Mina

2016-01-01

Drawing upon the African concept of "ubuntu," this article examines the epistemic orientations toward individual-society relations that inform democratic citizenship and identity in South Africa. Findings from focus group interviews conducted with 50 Xhosa teachers from all seven primary and intermediate schools in a township outside…

Facilitating the Information Exchange Using a Modular Electronic Discharge Summary.

PubMed

Denecke, Kerstin; Dittli, Pascal A; Kanagarasa, Niveadha; Nüssli, Stephan

2018-01-01

Discharge summaries are a standard communication tool delivering important clinical information from inpatient to ambulatory care. To ensure a high quality, correctness and completeness, the generation process is time consuming. It requires also contributions of multiple persons. This is problematic since the primary care provider needs the information from the discharge summary for continuing the intended treatment. To address this challenge, we developed a concept for exchanging a modular electronic discharge summary. Through a literature review and interviews with multiple stakeholders, we analysed existing processes and derived requirements for an improved communication of the discharge summary. In this paper, we suggest a concept of a modular electronic discharge summary that is exchanged through the electronic patient dossier in CDA CH level 2 documents. Until 2020, all Swiss hospitals are obliged to connect to the electronic patient dossier. Our concept allows to access already completed modules of the discharge summary from the primary care side, before the entire report is entirely finalised. The data is automatically merged with the local patient record on the physician side and prepared for data integration into the practice information system. Our concept offers the opportunity not only to improve the information exchange between hospital and primary care, but it also provides a potential use case and demonstrates a benefit of the electronic patient dossier for primary care providers who are so far not obliged to connect to the patient dossier in Switzerland.

Factors motivating and affecting health information exchange usage

PubMed Central

Zhao, Hongwei; Jaspserson, 'Jon; Gamm, Larry D; Ohsfeldt, Robert L

2011-01-01

Objective Health information exchange (HIE) is the process of electronically sharing patient-level information between providers. However, where implemented, reports indicate HIE system usage is low. The aim of this study was to determine the factors associated with different types of HIE usage. Design Cross-sectional analysis of clinical data from emergency room encounters included in an operational HIE effort linked to system user logs using crossed random-intercept logistic regression. Measurements Independent variables included factors indicative of information needs. System usage was measured as none, basic usage, or a novel pattern of usage. Results The system was accessed for 2.3% of all encounters (6142 out of 271 305). Novel usage patterns were more likely for more complex patients. The odds of HIE usage were lower in the face of time constraints. In contrast to expectations, system usage was lower when the patient was unfamiliar to the facility. Limitations Because of differences between HIE efforts and the fact that not all types of HIE usage (ie, public health) could be included in the analysis, results are limited in terms of generalizablity. Conclusions This study of actual HIE system usage identifies patients and circumstances in which HIE is more likely to be used and factors that are likely to discourage usage. The paper explores the implications of the findings for system redesign, information integration across exchange partners, and for meaningful usage criteria emerging from provisions of the Health Information Technology for Economic & Clinical Health Act. PMID:21262919

Smart health community: the hidden value of health information exchange.

PubMed

Ciriello, James N; Kulatilaka, Nalin

2010-12-01

Investments in health information technology are accelerating the digitization of medicine. The value from these investments, however, can grow beyond efficiencies by filling the information gaps between the various stakeholders. New work processes, governance structures, and relationships are needed for the coevolution of healthcare markets and business models. But coevolution is slow, hindered by the scarcity of incentives for legacy delivery systems and constrained by the prevailing patient-healthcare paradigm. The greater opportunity lies in wellness for individuals, families, communities, and society at large: a consumer-community paradigm. Capturing new value from this opportunity can start with investment in health information exchange and the creation of Smart Health Communities. By shifting the focus of exchange from public servant to value-added service provider, these communities can serve as a platform for a wider array of wellness services from consumer care, traditional healthcare, and research.

Impediments to the adoption of alternative sewerage in South African urban informal settlements.

PubMed

Ashipala, N; Armitage, N P

2011-01-01

In recent decades South Africa has witnessed a substantial growth in its urban population. This growth has been accompanied by the mushrooming of informal settlements (shantytowns) flanking more formal development. The lack of adequate urban drainage in many of these informal settlements has resulted in extremely polluted environments which add to the disease burden of the poor people who live there. In many instances, informal settlements in South Africa are established on marginal land that is inherently difficult to service using conventional gravity sewerage. International experience has shown that various alternative wastewater collection systems may present more appropriate ways of providing water-borne sewerage in areas that are difficult to service by conventional means. Alternative sewerage schemes have however had a poor record of success in South African informal settlements - primarily stemming from the implementing agencies' failure to adequately address various social and institutional factors. In this paper, a review of South African experiences with simplified sewerage, settled sewerage and vacuum sewerage in urban informal settlements is used to highlight the key constraints that currently impede the application of these technologies.

Benefits and problems of electronic information exchange as perceived by health care professionals: an interview study

PubMed Central

2011-01-01

Background Various countries are currently implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs, their overall adoption remains low and meets resistance from health care providers. This study aims to increase our understanding of health care providers' attitude towards the n-EPR, by investigating their perceptions of the benefits and problems of electronic information exchange in health care and the n-EPR in particular. Methods The study was conducted in three Dutch health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, interviews were conducted with 17 stakeholders working in these organisations. Relevant themes were deduced by means of thematic qualitative analysis. Results Health care providers perceived electronic information exchange to promote the efficiency and quality of care. The problems they perceived in electronic information exchange mainly concerned the confidentiality and safety of information exchange and the reliability and quality of patient data. Many problems perceived by health care providers did not specifically apply to the n-EPR, but to electronic information exchange in general. Conclusions The implementation of the Dutch n-EPR has mainly followed a top-down approach, thereby neglecting the fact that the perceptions and preferences of its users (health care providers) need to be addressed in order to achieve successful implementation. The results of this study provide valuable suggestions about how to promote health care providers' willingness to adopt electronic information exchange, which can be useful for other countries currently implementing an n-EPR. Apart from providing information about the benefits and usefulness of electronic information exchange, efforts should be focused on minimising the problems as perceived by health care providers. The safety and

Benefits and problems of electronic information exchange as perceived by health care professionals: an interview study.

PubMed

Zwaanswijk, Marieke; Verheij, Robert A; Wiesman, Floris J; Friele, Roland D

2011-10-07

Various countries are currently implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs, their overall adoption remains low and meets resistance from health care providers. This study aims to increase our understanding of health care providers' attitude towards the n-EPR, by investigating their perceptions of the benefits and problems of electronic information exchange in health care and the n-EPR in particular. The study was conducted in three Dutch health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, interviews were conducted with 17 stakeholders working in these organisations. Relevant themes were deduced by means of thematic qualitative analysis. Health care providers perceived electronic information exchange to promote the efficiency and quality of care. The problems they perceived in electronic information exchange mainly concerned the confidentiality and safety of information exchange and the reliability and quality of patient data. Many problems perceived by health care providers did not specifically apply to the n-EPR, but to electronic information exchange in general. The implementation of the Dutch n-EPR has mainly followed a top-down approach, thereby neglecting the fact that the perceptions and preferences of its users (health care providers) need to be addressed in order to achieve successful implementation. The results of this study provide valuable suggestions about how to promote health care providers' willingness to adopt electronic information exchange, which can be useful for other countries currently implementing an n-EPR. Apart from providing information about the benefits and usefulness of electronic information exchange, efforts should be focused on minimising the problems as perceived by health care providers. The safety and confidentiality of electronic information exchange

The African American Male Librarian: Motivational Factors in Choosing a Career in Library and Information Science

ERIC Educational Resources Information Center

Davis-Kendrick, Kaetrena D.

2009-01-01

A recent American Library Association (ALA) report has shown that less than 1% of credentialed librarians are African American males. This article discusses possible reasons for this dearth; and, in an effort to inform future LIS recruiting and marketing campaigns, the included study attempted to discover which factors lead African American males…

Understanding information exchange during disaster response: Methodological insights from infocentric analysis

Treesearch

Toddi A. Steelman; Branda Nowell; Deena Bayoumi; Sarah McCaffrey

2014-01-01

We leverage economic theory, network theory, and social network analytical techniques to bring greater conceptual and methodological rigor to understand how information is exchanged during disasters. We ask, "How can information relationships be evaluated more systematically during a disaster response?" "Infocentric analysis"—a term and...

Meaningful use: a roadmap for the advancement of health information exchange

PubMed Central

2013-01-01

Frankel and colleagues have compared Israel and the U.S.’s experiences with health information exchange (HIE). They highlight the importance of institutional factors in fostering HIE development, notably the influence of local structures, experience and incentives. Historically, information infrastructure in the U.S. has been limited due to lack of standards, fragmented institutions and competition. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 authorized billions of dollars for the adoption and “Meaningful Use” of electronic health records. HITECH programs and Meaningful Use incentives target the advancement of HIE through 1) building blocks, 2) local support and 3) payment incentives. Meaningful Use requirements create a roadmap to broader electronic exchange of health information among providers and with patients. Ultimately, successful HIE in the U.S. will depend on whether Meaningful Use can address institutional needs within local markets. This is a commentary on http://www.ijhpr.org/content/2/1/722 PMID:23880399

African and Non-African Admixture Components in African Americans and An African Caribbean Population

PubMed Central

Murray, Tanda; Beaty, Terri H.; Mathias, Rasika A.; Rafaels, Nicholas; Grant, Audrey Virginia; Faruque, Mezbah U.; Watson, Harold R.; Ruczinski, Ingo; Dunston, Georgia M.; Barnes, Kathleen C.

2013-01-01

Admixture is a potential source of confounding in genetic association studies, so it becomes important to detect and estimate admixture in a sample of unrelated individuals. Populations of African descent in the US and the Caribbean share similar historical backgrounds but the distributions of African admixture may differ. We selected 416 ancestry informative markers (AIMs) to estimate and compare admixture proportions using STRUCTURE in 906 unrelated African Americans (AAs) and 294 Barbadians (ACs) from a study of asthma. This analysis showed AAs on average were 72.5% African, 19.6% European and 8% Asian, while ACs were 77.4% African, 15.9% European, and 6.7% Asian which were significantly different. A principal components analysis based on these AIMs yielded one primary eigenvector that explained 54.04% of the variation and captured a gradient from West African to European admixture. This principal component was highly correlated with African vs. European ancestry as estimated by STRUCTURE (r2 = 0.992, r2 = 0.912, respectively). To investigate other African contributions to African American and Barbadian admixture, we performed PCA on ~14,000 (14k) genome-wide SNPs in AAs, ACs, Yorubans, Luhya and Maasai African groups, and estimated genetic distances (FST). We found AAs and ACs were closest genetically (FST = 0.008), and both were closer to the Yorubans than the other East African populations. In our sample of individuals of African descent, ~400 well-defined AIMs were just as good for detecting substructure as ~14,000 random SNPs drawn from a genome-wide panel of markers. PMID:20717976

HTML5 microdata as a semantic container for medical information exchange.

PubMed

Kimura, Eizen; Kobayashi, Shinji; Ishihara, Ken

2014-01-01

Achieving interoperability between clinical electronic medical records (EMR) systems and cloud computing systems is challenging because of the lack of a universal reference method as a standard for information exchange with a secure connection. Here we describe an information exchange scheme using HTML5 microdata, where the standard semantic container is an HTML document. We embed HL7 messages describing laboratory test results in the microdata. We also annotate items in the clinical research report with the microdata. We mapped the laboratory test result data into the clinical research report using an HL7 selector specified in the microdata. This scheme can provide secure cooperation between the cloud-based service and the EMR system.

78 FR 15800 - 30-Day Notice of Proposed Information Collection: Exchange Student Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-12

... Collection. Originating Office: Educational and Cultural Affairs (ECA/ PE/C/PY). Form Number: SV2012-0007... automated collection techniques or other forms of information technology. Please note that comments... provisions of the Mutual Educational and Cultural Exchange Act, as amended, and the Exchange Visitor Program...

Information content and acoustic structure of male African elephant social rumbles

PubMed Central

Stoeger, Angela S.; Baotic, Anton

2016-01-01

Until recently, the prevailing theory about male African elephants (Loxodonta africana) was that, once adult and sexually mature, males are solitary and targeted only at finding estrous females. While this is true during the state of ‘musth’ (a condition characterized by aggressive behavior and elevated androgen levels), ‘non-musth’ males exhibit a social system seemingly based on companionship, dominance and established hierarchies. Research on elephant vocal communication has so far focused on females, and very little is known about the acoustic structure and the information content of male vocalizations. Using the source and filter theory approach, we analyzed social rumbles of 10 male African elephants. Our results reveal that male rumbles encode information about individuality and maturity (age and size), with formant frequencies and absolute fundamental frequency values having the most informative power. This first comprehensive study on male elephant vocalizations gives important indications on their potential functional relevance for male-male and male-female communication. Our results suggest that, similar to the highly social females, future research on male elephant vocal behavior will reveal a complex communication system in which social knowledge, companionship, hierarchy, reproductive competition and the need to communicate over long distances play key roles. PMID:27273586

Factors Influencing Electronic Clinical Information Exchange in Small Medical Group Practices

ERIC Educational Resources Information Center

Kralewski, John E.; Zink, Therese; Boyle, Raymond

2012-01-01

Purpose: The purpose of this study was to identify the organizational factors that influence electronic health information exchange (HIE) by medical group practices in rural areas. Methods: A purposive sample of 8 small medical group practices in 3 experimental HIE regions were interviewed to determine the extent of clinical information exchange…

Addressing Low Colorectal Cancer Screening in African Americans: Using Focus Groups to Inform the Development of Effective Interventions.

PubMed

May, Folasade P; Whitman, Cynthia B; Varlyguina, Ksenia; Bromley, Erica G; Spiegel, Brennan M R

2016-09-01

African Americans have the highest burden of colorectal cancer (CRC) in the United States of America (USA) yet lower CRC screening rates than whites. Although poor screening has prompted efforts to increase screening uptake, there is a persistent need to develop public health interventions in partnership with the African American community. The aim of this study was to conduct focus groups with African Americans to determine preferences for the content and mode of dissemination of culturally tailored CRC screening interventions. In June 2013, 45-75-year-old African Americans were recruited through online advertisements and from an urban Veterans Affairs system to create four focus groups. A semi-structured interview script employing open-ended elicitation was used, and transcripts were analyzed using ATLAS.ti software to code and group data into a concept network. A total of 38 participants (mean age = 54) were enrolled, and 59 ATLAS.ti codes were generated. Commonly reported barriers to screening included perceived invasiveness of colonoscopy, fear of pain, and financial concerns. Facilitators included poor diet/health and desire to prevent CRC. Common sources of health information included media and medical providers. CRC screening information was commonly obtained from medical personnel or media. Participants suggested dissemination of CRC screening education through commercials, billboards, influential African American public figures, Internet, and radio. Participants suggested future interventions include culturally specific information, including details about increased risk, accessing care, and dispelling of myths. Public health interventions to improve CRC screening among African Americans should employ media outlets, emphasize increased risk among African Americans, and address race-specific barriers. Specific recommendations are presented for developing future interventions.

Comprehensive Molecular Profiling of African-American Prostate Cancer to Inform on Prognosis and Disease Biology

DTIC Science & Technology

2017-10-01

development and patterning, and to become more knowledgeable in molecular genetics and the pathology of human prostatic diseases. Specific Aims: 1...AWARD NUMBER: W81XWH-15-1-0661 TITLE: Comprehensive Molecular Profiling of African-American Prostate Cancer to Inform on Prognosis and...COVERED 30 Sept 2016 – 29 Sept 2017 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Comprehensive Molecular Profiling of African-American Prostate Cancer to

Consumer-mediated health information exchanges: the 2012 ACMI debate.

PubMed

Cimino, James J; Frisse, Mark E; Halamka, John; Sweeney, Latanya; Yasnoff, William

2014-04-01

The American College of Medical Informatics (ACMI) sponsors periodic debates during the American Medical Informatics Fall Symposium to highlight important informatics issues of broad interest. In 2012, a panel debated the following topic: "Resolved: Health Information Exchange Organizations Should Shift Their Principal Focus to Consumer-Mediated Exchange in Order to Facilitate the Rapid Development of Effective, Scalable, and Sustainable Health Information Infrastructure." Those supporting the proposition emphasized the need for consumer-controlled community repositories of electronic health records (health record banks) to address privacy, stakeholder cooperation, scalability, and sustainability. Those opposing the proposition emphasized that the current healthcare environment is so complex that development of consumer control will take time and that even then, consumers may not be able to mediate their information effectively. While privately each discussant recognizes that there are many sides to this complex issue, each followed the debater's tradition of taking an extreme position in order emphasize some of the polarizing aspects in the short time allotted them. In preparing this summary, we sought to convey the substance and spirit of the debate in printed form. Transcripts of the actual debate were edited for clarity, and appropriate supporting citations were added for the further edification of the reader. Published by Elsevier Inc.

Consumer-Mediated Health Information Exchanges: The 2012 ACMI Debate

PubMed Central

Cimino, James J.; Frisse, Mark; Halamka, John; Sweeney, Latanya; Yasnoff, William

2017-01-01

The American College of Medical Informatics (ACMI) sponsors periodic debates during the American Medical Informatics Fall Symposium to highlight important informatics issues of broad interest. In 2012, a panel debated the following topic: “Resolved: Health Information Exchange Organizations Should Shift Their Principal Focus to Consumer-Mediated Exchange in Order to Facilitate the Rapid Development of Effective, Scalable, and Sustainable Health Information Infrastructure.” Those supporting the proposition emphasized the need for consumer-controlled community repositories of electronic health records (health record banks) to address privacy, stakeholder cooperation, scalability, and sustainability. Those opposing the proposition emphasized that the current healthcare environment is so complex that development of consumer control will take time and that even then, consumers may not be able to mediate their information effectively. While privately, each discussant recognizes that there are many sides to this complex issue, each followed the debater’s tradition of taking an extreme position in order emphasize some of the polarizing aspects in the short time allotted them. In preparing this summary, we sought to convey the substance and spirit of the debate in printed form. Transcripts of the actual debate were edited for clarity, and appropriate supporting citations were added for the further edification of the reader. PMID:24561078

Management of laboratory data and information exchange in the electronic health record.

PubMed

Wilkerson, Myra L; Henricks, Walter H; Castellani, William J; Whitsitt, Mark S; Sinard, John H

2015-03-01

In the era of the electronic health record, the success of laboratories and pathologists will depend on effective presentation and management of laboratory information, including test orders and results, and effective exchange of data between the laboratory information system and the electronic health record. In this third paper of a series that explores empowerment of pathology in the era of the electronic health record, we review key elements of managing laboratory information within the electronic health record and examine functional issues pertinent to pathologists and laboratories in the exchange of laboratory information between electronic health records and both anatomic and clinical pathology laboratory information systems. Issues with electronic order-entry and results-reporting interfaces are described, and considerations for setting up these interfaces are detailed in tables. The role of the laboratory medical director as mandated by the Clinical Laboratory Improvement Amendments of 1988 and the impacts of discordance between laboratory results and their display in the electronic health record are also discussed.

Neighbourhood Book Exchanges: Localising Information Practices

ERIC Educational Resources Information Center

Webster, Tenny; Gollner, Kathleen; Nathan, Lisa

2015-01-01

Introduction: Through this paper we report on an exploratory study into the design and use of neighbourhood book exchanges in North America. We identify dominant media framings of these book exchanges in North America, along with claims made concerning the influence of the exchanges. We compare the media claims with insights from interviews with…

Greater Patient Health Information Control to Improve the Sustainability of Health Information Exchanges.

PubMed

Abdelhamid, Mohamed

2018-06-09

Health information exchanges (HIEs) are multisided platforms that facilitate the sharing of patient health information (PHI) between providers and payers across organizations within a region, community or hospital system. The benefits of HIEs to payers and providers include lower cost, faster services, and better health outcome. However, most HIEs have configured the patient healthcare consent process to give all providers who sign up with the exchange access to PHI for all consenting patients, leaving no control to patients in customized what information to share and with who. This research investigates the impact of granting greater control to patients in sharing their personal health information on consent rates and making them active participants in the HIEs system. This research utilizes a randomized experimental survey design study. The study uses responses from 388 participants and structural equation modeling (SEM) to test the conceptual model. The main findings of this research include that patients consent rate increases significantly when greater control in sharing PHI is offered to the patient. In addition, greater control reduces the negative impact of privacy concern on the intention to consent. Similarly, trust in healthcare professionals leads to higher consent when greater control is offered to the patient. Thus, greater control empowers the role of trust in engaging patients and sustaining HIEs. The paper makes a theoretical contribution to research by extending the unified theory of acceptance and use of technology (UTAUT) model. The findings impact practice by providing insights that will help sustain HIEs. Copyright © 2018. Published by Elsevier Inc.

From reproduction to reinvention. Women's roles in African cities.

PubMed

Simone, A

1995-01-01

African governments are expressing a new awareness that interventions focused on women's health, education, political participation, and human rights are essential to the control of population growth. Lacking, however, are formal models of innovative techniques for mobilizing endogenous resource bases and maximizing popular participation. Marginalized from social and economic development, African urban women have been able to elaborate new forms of social economies and reciprocal interaction that merit attention. In the shift from the household production and reproduction characteristic of parochial rural economies to the cross-circuitry of urban trade, women have facilitated the formation of interhousehold alliances and the sharing of opportunities and resources essential to urban survival. Because women tend to operate in informal contexts outside the realm of bureaucratic control, they have been able to improvise new forms of solidarity, information exchange, and income generation. Moreover, through their ability to link disparate households, compounds, and neighborhoods, women are evolving new processes of institutional reform that cut across territory, class position, and other forms of stratification.

Medication errors in residential aged care facilities: a distributed cognition analysis of the information exchange process.

PubMed

Tariq, Amina; Georgiou, Andrew; Westbrook, Johanna

2013-05-01

Medication safety is a pressing concern for residential aged care facilities (RACFs). Retrospective studies in RACF settings identify inadequate communication between RACFs, doctors, hospitals and community pharmacies as the major cause of medication errors. Existing literature offers limited insight about the gaps in the existing information exchange process that may lead to medication errors. The aim of this research was to explicate the cognitive distribution that underlies RACF medication ordering and delivery to identify gaps in medication-related information exchange which lead to medication errors in RACFs. The study was undertaken in three RACFs in Sydney, Australia. Data were generated through ethnographic field work over a period of five months (May-September 2011). Triangulated analysis of data primarily focused on examining the transformation and exchange of information between different media across the process. The findings of this study highlight the extensive scope and intense nature of information exchange in RACF medication ordering and delivery. Rather than attributing error to individual care providers, the explication of distributed cognition processes enabled the identification of gaps in three information exchange dimensions which potentially contribute to the occurrence of medication errors namely: (1) design of medication charts which complicates order processing and record keeping (2) lack of coordination mechanisms between participants which results in misalignment of local practices (3) reliance on restricted communication bandwidth channels mainly telephone and fax which complicates the information processing requirements. The study demonstrates how the identification of these gaps enhances understanding of medication errors in RACFs. Application of the theoretical lens of distributed cognition can assist in enhancing our understanding of medication errors in RACFs through identification of gaps in information exchange. Understanding

75 FR 66413 - 30-Day Notice of Proposed Information Collection: Exchange Programs Alumni Web Site Registration...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-28

...: Exchange Programs Alumni Web Site Registration, DS-7006 ACTION: Notice of request for public comment and... Collection The Exchange Programs Alumni Web site requires information to process users' voluntary requests for participation in the Web site. Other than contact information, which is required for website...

Differences in Professional and Informal Help Seeking among Older African Americans, Black Caribbeans and Non-Hispanic Whites

PubMed Central

Woodward, Amanda T.; Chatters, Linda M.; Taylor, Robert Joseph; Neighbors, Harold W.; Jackson, James S.

2011-01-01

This study uses a national probability sample of older adults to examine racial and ethnic differences in the use of professional services and informal support for a stressful personal problem. Using data from the National Survey of American Life, this study focuses on African Americans, Black Caribbean immigrants, and Whites aged 55 years and older who experienced a personal problem that caused them significant distress (n=862). Multinomial logistic regression is used to estimate the association of race with the use of professional services only, informal support only, both professional services and informal support, or no help at all, while controlling for demographic and socioeconomic variables, characteristics of the informal support network, the type of problem experienced, and experiences of racial discrimination. Examining the use of professional services and informal support provides a more complete picture of racial and ethnic differences of help-seeking behaviors among older adults, and the factors associated with the sources from which these adults request help. Most respondents use informal support alone or in combination with professional services. Black Caribbeans are more likely than African Americans to rely on informal support only, whereas African Americans are more likely than Whites to not receive help. However, these findings are accounted for by differences in social support and experiences of discrimination. PMID:21666782

African American perspectives: A qualitative study of an informal science enrichment program

NASA Astrophysics Data System (ADS)

Simpson, Jamila Rashida

The purposes of this study were to determine what program characteristics African American parents consider when they enroll their children into an informal science education enrichment program, the parents' evaluation of a program called Jordan Academy in which they enrolled their children, and the alignment of the parents' perspectives with Black Cultural Ethos (BCE). BCE refers to nine dimensions posited by Wade Boykin, a psychologist, as comprising African American culture. Participants were parents of students that attended Jordan Academy, an informal science enrichment program designed for third through sixth grade students from underserved populations. Qualitative methodologies were utilized to perform a thorough assessment of parents' perspectives. Data sources included classroom observations, student surveys, academy curriculum, photos and video-taped class sessions. Data included teachers and parents' responses to semi-structured, audio recorded interviews and students' written responses to open-ended items on the program's evaluation instrument. The data were analyzed for themes and the findings compared to Black Cultural Ethos. Findings revealed that the participants believed that informal science education offered their children opportunities not realized in the formal school setting - a means of impacting their children holistically. The parents expressed the academic, cultural, and personal development of their children in their characterizations of the ideal informal science education experience and in their evaluations of Jordan Academy. Overall, the parents' views emphasized the BCE values of harmony, affect, verve, movement, orality and communalism. The study has important implications for practices within and research on informal science education.

78 FR 42103 - Agency Information Collection Activities: African Growth and Opportunity Act Certificate of Origin

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-15

... Activities: African Growth and Opportunity Act Certificate of Origin AGENCY: U.S. Customs and Border... submitting the following information collection request to the Office of Management and Budget (OMB) for... Certificate of Origin (AGOA). This is a proposed extension of an information collection that was previously...

Cell Phone Information Seeking Explains Blood Pressure in African American Women.

PubMed

Jones, Lenette M; Veinot, Tiffany C; Pressler, Susan J

2018-05-01

Although cell phone use and Internet access via cell phone is not marked by racial disparities, little is known about how cell phone use relates to blood pressure and health information seeking behaviors. The purposes of this study were to (a) describe Internet activities, cell phone use, and information seeking; (b) determine differences in blood pressure and information seeking between cell phone information seekers and nonseekers; and (c) examine cell phone information seeking as a predictor of blood pressure in African American women. Participants ( N = 147) completed a survey and had their blood pressure measured. Independent-sample t tests showed a significant difference in systolic blood pressure in cell phone information seekers and nonseekers. Linear regression revealed cell phone information seeking as an independent predictor of systolic blood pressure, despite confounders. It is possible that cell phone information seekers were using health information to make decisions about self-management of blood pressure.

A strategic gaming model for health information exchange markets.

PubMed

Martinez, Diego A; Feijoo, Felipe; Zayas-Castro, Jose L; Levin, Scott; Das, Tapas K

2018-03-01

Current market conditions create incentives for some providers to exercise control over patient data in ways that unreasonably limit its availability and use. Here we develop a game theoretic model for estimating the willingness of healthcare organizations to join a health information exchange (HIE) network and demonstrate its use in HIE policy design. We formulated the model as a bi-level integer program. A quasi-Newton method is proposed to obtain a strategy Nash equilibrium. We applied our modeling and solution technique to 1,093,177 encounters for exchanging information over a 7.5-year period in 9 hospitals located within a three-county region in Florida. Under a set of assumptions, we found that a proposed federal penalty of up to $2,000,000 has a higher impact on increasing HIE adoption than current federal monetary incentives. Medium-sized hospitals were more reticent to adopt HIE than large-sized hospitals. In the presence of collusion among multiple hospitals to not adopt HIE, neither federal incentives nor proposed penalties increase hospitals' willingness to adopt. Hospitals' apathy toward HIE adoption may threaten the value of inter-connectivity even with federal incentives in place. Competition among hospitals, coupled with volume-based payment systems, creates no incentives for smaller hospitals to exchange data with competitors. Medium-sized hospitals need targeted actions (e.g., outside technological assistance, group purchasing arrangements) to mitigate market incentives to not adopt HIE. Strategic game theoretic models help to clarify HIE adoption decisions under market conditions at play in an extremely complex technology environment.

Impact of Health Information Exchange on Emergency Medicine Clinical Decision Making.

PubMed

Gordon, Bradley D; Bernard, Kyle; Salzman, Josh; Whitebird, Robin R

2015-12-01

The objective of the study was to understand the immediate utility of health information exchange (HIE) on emergency department (ED) providers by interviewing them shortly after the information was retrieved. Prior studies of physician perceptions regarding HIE have only been performed outside of the care environment. Trained research assistants interviewed resident physicians, physician assistants and attending physicians using a semi-structured questionnaire within two hours of making a HIE request. The responses were recorded, then transcribed for qualitative analysis. The transcribed interviews were analyzed for emerging qualitative themes. We analyzed 40 interviews obtained from 29 providers. Primary qualitative themes discovered included the following: drivers for requests for outside information; the importance of unexpected information; historical lab values as reference points; providing context when determining whether to admit or discharge a patient; the importance of information in refining disposition; improved confidence of provider; and changes in decisions for diagnostic imaging. ED providers are driven to use HIE when they're missing a known piece of information. This study finds two additional impacts not previously reported. First, providers sometimes find additional unanticipated useful information, supporting a workflow that lowers the threshold to request external information. Second, providers sometimes report utility when no changes to their existing plan are made as their confidence is increased based on external records. Our findings are concordant with previous studies in finding exchanged information is useful to provide context for interpreting lab results, making admission decisions, and prevents repeat diagnostic imaging.

[Information exchange via internet--possibilities, limits, future].

PubMed

Schmiedl, S; Geishauser, M; Klöppel, M; Biemer, E

1998-01-01

Today, the exchange of information in the Internet is dominated by the WWW and e-mail. Discussion groups like mailing lists and newsgroups also permit communication in groups. Information retrieval becomes a crucial challenge in using the Internet. In the field of medicine, three more aspects are of special importance: privacy, legal requirements, and the necessity of transferring large amounts of data. For these problems, today's Internet doesn't provide a sufficient solution yet. Future developments will not only improve the existing services, but also lead to fundamental changes in the transfer technologies: Safer data transfer is to be ensured by new encrypting software together with the planned transfer protocol IPv6. Introducing the new transfer mode ATM will lead to better and resource saving transmission. Computer, telephone and TV networks will grow together, resulting in convergence of media.

An Anesthesia Preinduction Checklist to Improve Information Exchange, Knowledge of Critical Information, Perception of Safety, and Possibly Perception of Teamwork in Anesthesia Teams.

PubMed

Tscholl, David W; Weiss, Mona; Kolbe, Michaela; Staender, Sven; Seifert, Burkhardt; Landert, Daniel; Grande, Bastian; Spahn, Donat R; Noethiger, Christoph B

2015-10-01

An anesthesia preinduction checklist (APIC) to be performed before anesthesia induction was introduced and evaluated with respect to 5 team-level outcomes, each being a surrogate end point for patient safety: information exchange (the percentage of checklist items exchanged by a team, out of 12 total items); knowledge of critical information (the percentage of critical information items out of 5 total items such as allergies, reported as known by the members of a team); team members' perceptions of safety (the median scores given by the members of a team on a continuous rating scale); their perception of teamwork (the median scores given by the members of a team on a continuous rating scale); and clinical performance (the percentage of completed items out of 14 required tasks, e.g., suction device checked). A prospective interventional study comparing anesthesia teams using the APIC with a control group not using the APIC was performed using a multimethod design. Trained observers rated information exchange and clinical performance during on-site observations of anesthesia inductions. After the observations, each team member indicated the critical information items they knew and their perceptions of safety and teamwork. One hundred five teams using the APIC were compared with 100 teams not doing so. The medians of the team-level outcome scores in the APIC group versus the control group were as follows: information exchange: 100% vs 33% (P < 0.001), knowledge of critical information: 100% vs 90% (P < 0.001), perception of safety: 91% vs 84% (P < 0.001), perception of teamwork: 90% vs 86% (P = 0.028), and clinical performance: 93% vs 93% (P = 0.60). This study provides empirical evidence that the use of a preinduction checklist significantly improves information exchange, knowledge of critical information, and perception of safety in anesthesia teams-all parameters contributing to patient safety. There was a trend indicating improved perception of teamwork.

Agents Based e-Commerce and Securing Exchanged Information

NASA Astrophysics Data System (ADS)

Al-Jaljouli, Raja; Abawajy, Jemal

Mobile agents have been implemented in e-Commerce to search and filter information of interest from electronic markets. When the information is very sensitive and critical, it is important to develop a novel security protocol that can efficiently protect the information from malicious tampering as well as unauthorized disclosure or at least detect any malicious act of intruders. In this chapter, we describe robust security techniques that ensure a sound security of information gathered throughout agent’s itinerary against various security attacks, as well as truncation attacks. A sound security protocol is described, which implements the various security techniques that would jointly prevent or at least detect any malicious act of intruders. We reason about the soundness of the protocol usingSymbolic Trace Analyzer (STA), a formal verification tool that is based on symbolic techniques. We analyze the protocol in key configurations and show that it is free of flaws. We also show that the protocol fulfils the various security requirements of exchanged information in MAS, including data-integrity, data-confidentiality, data-authenticity, origin confidentiality and data non-repudiability.

The Development of Community-Based Health Information Exchanges: A Comparative Assessment of Organizational Models

ERIC Educational Resources Information Center

Champagne, Tiffany

2013-01-01

The purpose of this dissertation research was to critically examine the development of community-based health information exchanges (HIEs) and to comparatively analyze the various models of exchanges in operation today nationally. Specifically this research sought to better understand several aspects of HIE: policy influences, organizational…

Informal Learning in Science, Math, and Engineering Majors for African American Female Undergraduates

ERIC Educational Resources Information Center

McPherson, Ezella

2014-01-01

This research investigates how eight undergraduate African American women in science, math, and engineering (SME) majors accessed cultural capital and informal science learning opportunities from preschool to college. It uses the multiple case study methodological approach and cultural capital as frameworks to better understand the participants'…

Health Information Exchange: The Determinants of Usage and the Impact on Utilization

ERIC Educational Resources Information Center

Vest, Joshua Ryan

2010-01-01

Health information exchange (HIE) is the process of electronically sharing patient-level information among different organizations with the objectives of quality and cost improvements. The adoption of HIE in the United States is not widespread, but numerous efforts at facilitating HIE exist and the incentives for electronic health record system…

Leader-member exchange relationships in health information management.

PubMed

Hunt, T J

2014-01-01

This article seeks to raise awareness of the leader-member exchange (LMX) theory of leadership and its potential benefit to the health information management (HIM) profession. A literature review that was conducted identified a leadership challenge for HIM practitioners. The review also provides examples of leadership definitions, and potential benefits of LMX to HIM professionals in leading people and influencing leaders in their organizations. The LMX concept may be an avenue to investigate in preparing future and current HIM professionals for leadership.

WaterML, an Information Standard for the Exchange of in-situ hydrological observations

NASA Astrophysics Data System (ADS)

Valentine, D.; Taylor, P.; Zaslavsky, I.

2012-04-01

The WaterML 2.0 Standards Working Group (SWG), working within the Open Geospatial Consortium (OGC) and in cooperation with the joint OGC-World Meteorological Organization (WMO) Hydrology Domain Working Group (HDWG), has developed an open standard for the exchange of water observation data; WaterML 2.0. The focus of the standard is time-series data, commonly generated from in-situ style monitoring. This is high value data for hydrological applications such as flood forecasting, environmental reporting and supporting hydrological infrastructure (e.g. dams, supply systems), which is commonly exchanged, but a lack of standards inhibits efficient reuse and automation. The process of developing WaterML required doing a harmonization analysis of existing standards to identify overlapping concepts and come to agreement on a harmonized definition. Generally the formats captured similar requirements, all with subtle differences, such as how time-series point metadata was handled. The in-progress standard WaterML 2.0 incorporates the semantics of the hydrologic information: location, procedure, and observations, and is implemented as an application schema of the Geography Markup Language version 3.2.1, making use of the OGC Observations & Measurements standards. WaterML2.0 is designed as an extensible schema to allow encoding of data to be used in a variety of exchange scenarios. Example areas of usage are: exchange of data for operational hydrological monitoring programs; supporting operation of infrastructure (e.g. dams, supply systems); cross-border exchange of observational data; release of data for public dissemination; enhancing disaster management through data exchange; and exchange in support of national reporting The first phase of WaterML2.0 focused on structural definitions allowing for the transfer of time-series, with less work on harmonization of vocabulary items such as quality codes. Vocabularies from various organizations tend to be specific and take time to

76 FR 8804 - 30-Day Notice of Proposed Information Collection: Form DS-3097, Exchange Visitor Program Annual...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-15

... DS-3097, Exchange Visitor Program Annual Report, OMB Control Number 1405-0151 ACTION: Notice of... Department of State has submitted the following information collection request to the Office of Management... Information Collection: Exchange Visitor Program Annual Report. OMB Control Number: 1405-0151. Type of Request...

Comparing narrative and informational videos to increase mammography in low-income African American women.

PubMed

Kreuter, Matthew W; Holmes, Kathleen; Alcaraz, Kassandra; Kalesan, Bindu; Rath, Suchitra; Richert, Melissa; McQueen, Amy; Caito, Nikki; Robinson, Lou; Clark, Eddie M

2010-12-01

Compare effects of narrative and informational videos on use of mammography, cancer-related beliefs, recall of core content and a range of reactions to the videos. African American women (n=489) ages 40 and older were recruited from low-income neighborhoods in St. Louis, MO and randomly assigned to watch a narrative video comprised of stories from African American breast cancer survivors (Living Proof) or a content-equivalent informational video using a more expository and didactic approach (Facts for Life). Effects were measured immediately post-exposure and at 3- and 6-month follow-up. The narrative video was better liked, enhanced recall, reduced counterarguing, increased breast cancer discussions with family members and was perceived as more novel. Women who watched the narrative video also reported fewer barriers to mammography, more confidence that mammograms work, and were more likely to perceive cancer as an important problem affecting African Americans. Use of mammography at 6-month follow-up did not differ for the narrative vs. informational groups overall (49% vs. 40%, p=.20), but did among women with less than a high school education (65% vs. 32%, p<.01), and trended in the same direction for those who had no close friends or family with breast cancer (49% vs. 31%, p=.06) and those who were less trusting of traditional cancer information sources (48% vs. 30%, p=.06). Narrative forms of communication may increase the effectiveness of interventions to reduce cancer health disparities. Narratives appear to have particular value in certain population sub-groups; identifying these groups and matching them to specific communication approaches may increase effectiveness. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Comparing narrative and informational videos to increase mammography in low-income African American women

PubMed Central

Kreuter, Matthew W.; Holmes, Kathleen; Alcaraz, Kassandra; Kalesan, Bindu; Rath, Suchitra; Richert, Melissa; McQueen, Amy; Caito, Nikki; Robinson, Lou; Clark, Eddie M.

2011-01-01

OBJECTIVE Compare effects of narrative and informational videos on use of mammography, cancer-related beliefs, recall of core content and a range of reactions to the videos. METHOD African American women (n=489) ages 40 and older were recruited from low-income neighborhoods in St. Louis, MO and randomly assigned to watch a narrative video comprised of stories from African American breast cancer survivors (Living Proof) or a content-equivalent informational video using a more expository and didactic approach (Facts for Life). Effects were measured immediately post-exposure and at 3- and 6-month follow-up. RESULTS The narrative video was better liked, enhanced recall, reduced counterarguing, increased breast cancer discussions with family members and was perceived as more novel. Women who watched the narrative video also reported fewer barriers to mammography, more confidence that mammograms work, and were more likely to perceive cancer as an important problem affecting African Americans. Use of mammography at 6-month follow-up did not differ for the narrative vs. informational groups overall (49% vs. 40%, p=.20), but did among women with less than a high school education (65% vs. 32%, p<.01), and trended in the same direction for those who had no close friends or family with breast cancer (49% vs. 31%, p=.06) and those who were less trusting of traditional cancer information sources (48% vs. 30%, p=.06). CONCLUSIONS Narrative forms of communication may increase the effectiveness of interventions to reduce cancer health disparities. PRACTICE IMPLICATIONS Narratives appear to have particular value in certain population sub-groups; identifying these groups and matching them to specific communication approaches may increase effectiveness. PMID:21071167

Improving newborn screening laboratory test ordering and result reporting using health information exchange

PubMed Central

van Dyck, Peter C; Rinaldo, Piero; McDonald, Clement; Howell, R Rodrey; Zuckerman, Alan; Downing, Gregory

2010-01-01

Capture, coding and communication of newborn screening (NBS) information represent a challenge for public health laboratories, health departments, hospitals, and ambulatory care practices. An increasing number of conditions targeted for screening and the complexity of interpretation contribute to a growing need for integrated information-management strategies. This makes NBS an important test of tools and architecture for electronic health information exchange (HIE) in this convergence of individual patient care and population health activities. For this reason, the American Health Information Community undertook three tasks described in this paper. First, a newborn screening use case was established to facilitate standards harmonization for common terminology and interoperability specifications guiding HIE. Second, newborn screening coding and terminology were developed for integration into electronic HIE activities. Finally, clarification of privacy, security, and clinical laboratory regulatory requirements governing information exchange was provided, serving as a framework to establish pathways for improving screening program timeliness, effectiveness, and efficiency of quality patient care services. PMID:20064796

"Practice Story Exchanges" and Their Creative Invitation to Informal Learning

ERIC Educational Resources Information Center

Willis, Peter

2013-01-01

This is a study of how members of a collaborative group interested in promoting convivial civilisation in human society took up exchanging practice stories--stories of doing something or seeing something done as examples of convivial backyard civilisation--in order tacitly to create an informal learning environment where practices of such a…

47 CFR 36.612 - Updating information submitted to the National Exchange Carrier Association.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., may update the information submitted to the National Exchange Carrier Association (NECA) on July 31st... must update the information submitted to NECA on July 31st pursuant to § 36.611(h) according to the schedule. Every non-rural telephone company must update the information submitted to NECA on July 31st...

47 CFR 36.612 - Updating information submitted to the National Exchange Carrier Association.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., may update the information submitted to the National Exchange Carrier Association (NECA) on July 31st... must update the information submitted to NECA on July 31st pursuant to § 36.611(h) according to the schedule. Every non-rural telephone company must update the information submitted to NECA on July 31st...

Effects of a Culturally Informed Intervention on Abused, Suicidal African American Women

PubMed Central

Taha, Farah; Zhang, Huaiyu; Snead, Kara; Jones, Ashley D.; Blackmon, Brittane; Bryant, Rachel J.; Siegelman, Asher E.; Kaslow, Nadine J.

2014-01-01

Background This study examined 1) the relative efficacy of a culturally-sensitive empowerment group intervention (Nia) aimed at increasing three protective factors—self-esteem, hopefulness, and effectiveness of obtaining resources—versus treatment as usual (TAU) for low-income, abused African American women who recently had attempted suicide and 2) the impact of participants’ readiness to change with regard to their abusive relationship and suicidal behavior on their levels of each protective factor in the two conditions. Methods The sample included 89 African American women who reported intimate partner violence (IPV) exposure and a recent suicide attempt. Results Multivariate general linear modeling revealed that those in Nia showed greater improvements in self-esteem, but not in hopefulness or effectiveness of obtaining resources. However, significant interactions emerged in which participants that were “less ready to change” (i.e., earlier in the stages of change process) their IPV situation and suicidal behavior endorsed greater levels of hopefulness and perceived effectiveness of obtaining resources, respectively, following Nia. Conclusion Findings suggest that abused, suicidal African American women who are more reluctant initially to changing their abusive situation and suicidal behavior may benefit from even a brief, culturally-informed intervention. PMID:25403027

Effects of a culturally informed intervention on abused, suicidal African American women.

PubMed

Taha, Farah; Zhang, Huaiyu; Snead, Kara; Jones, Ashley D; Blackmon, Brittane; Bryant, Rachel J; Siegelman, Asher E; Kaslow, Nadine J

2015-10-01

This study examined (a) the relative efficacy of a culturally sensitive empowerment group intervention (Nia) aimed at increasing 3 protective factors-self-esteem, hopefulness, and effectiveness of obtaining resources-versus treatment as usual (TAU) for low-income, abused African American women who recently had attempted suicide and (b) the impact of participants' readiness to change with regard to their abusive relationship and suicidal behavior on their levels of each protective factor in the 2 conditions. The sample included 89 African American women who reported intimate partner violence (IPV) exposure and a recent suicide attempt. Multivariate general linear modeling revealed that those in Nia showed greater improvements in self-esteem, but not in hopefulness or effectiveness of obtaining resources. However, significant interactions emerged in which participants who were "less ready to change" (i.e., earlier in the stages of change process) their IPV situation and suicidal behavior endorsed greater levels of hopefulness and perceived effectiveness of obtaining resources, respectively, following Nia. Findings suggest that abused, suicidal African American women who are more reluctant initially to changing their abusive situation and suicidal behavior may benefit from even a brief, culturally informed intervention. (c) 2015 APA, all rights reserved).

Leader-Member Exchange Relationships in Health Information Management

PubMed Central

Hunt, T.J.

2014-01-01

This article seeks to raise awareness of the leader-member exchange (LMX) theory of leadership and its potential benefit to the health information management (HIM) profession. A literature review that was conducted identified a leadership challenge for HIM practitioners. The review also provides examples of leadership definitions, and potential benefits of LMX to HIM professionals in leading people and influencing leaders in their organizations. The LMX concept may be an avenue to investigate in preparing future and current HIM professionals for leadership. PMID:24808805

A Global Information Exchange (GIE) Project in a Graduate Course

ERIC Educational Resources Information Center

Thirunarayanan, M. O.; Coccaro-Pons, Jennifer

2016-01-01

Graduate students who were enrolled in an introductory educational technology course that met face-to-face completed a Global Information Exchange (GIE) project. The goal of the project was to promote global awareness among the graduate students who were also classroom teachers, and by extension their K-12 students. The graduate students, who also…

77 FR 28543 - Nationwide Health Information Network: Conditions for Trusted Exchange

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-15

... expansion, electronic exchange has been governed by a patchwork of contractual relationships, procurement.... Consequently, this ad-hoc governance approach has led to asymmetries in the policies and technical standards... This request for information (RFI) reflects ONC's current thinking regarding the approach ONC should...

78 FR 13141 - 30-Day Notice of Proposed Information Collection: Exchange Visitor Program Participant Survey...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-26

...: Exchange Visitor Program Participant Survey--Summer Work Travel ACTION: Notice of request for public... of Information Collection: Exchange Visitor Program Participant Survey--Summer Work Travel Program... participants in the Summer Work Travel category. Estimated Number of Respondents: 109,000. Estimated Number of...

Health Information Exchange as a Complex and Adaptive Construct: Scoping Review.

PubMed

Akhlaq, Ather; Sheikh, Aziz; Pagliari, Claudia

2017-01-25

To understand how the concept of Health Information Exchange (HIE) has evolved over time.  Supplementary analysis of data from a systematic scoping review of definitions of HIE from 1900 to 2014, involving temporal analysis of underpinning themes. The search identified 268 unique definitions of HIE dating from 1957 onwards; 103 in scientific databases and 165 in Google. These contained consistent themes, representing the core concept of exchanging health information electronically, as well as fluid themes, reflecting the evolving policy, business, organisational and technological context of HIE (including the emergence of HIE as an organisational 'entity'). These are summarised graphically to show how the concept has evolved around the world with the passage of time.  The term HIE emerged in 1957 with the establishment of Occupational HIE, evolving through the 1990s with concepts such as electronic data interchange and mobile computing technology; then from 2006-10 largely aligning with the US Government's health information technology strategy and the creation of HIEs as organisational entities, alongside the broader interoperability imperative, and continuing to evolve today as part of a broader international agenda for sustainable, information-driven health systems. The concept of HIE is an evolving and adaptive one, reflecting the ongoing quest for integrated and interoperable information to improve the efficiency and effectiveness of health systems, in a changing technological and policy environment.

Identity and science learning in African American students in informal science education contexts

NASA Astrophysics Data System (ADS)

James, Sylvia M.

2007-12-01

Science education researchers are recognizing the need to consider identity and other sociocultural factors when examining causes of the science achievement gap for African American students. Non-school settings may hold greater promise than formal schooling to promote identities that are conductive to science learning in African Americans. This mixed-methods study explored the relationship between participation in out-of-school-time (OST) science enrichment programs and African American middle and high school students' racial and ethnic identity (RED, social identity as science learners, and achievement. Pre-post questionnaires used a previously validated model of REI combined with an original subscale that was developed to measure social identity as science learners. Case studies of two programs allowed for an analysis of the informal learning setting. The treatment group (N = 36) consisted of African American middle and high school students in five OST science programs, while the control group (N = 54) students were enrolled in science classes in public schools in the mid-Atlantic region. Results of a t-test of independent means indicated that there was no significant difference between the treatment and control group on measures of REI or science identity. However, the treatment group earned significantly higher science grades compared to the control group, and an ANOVA revealed a significant relationship between science identity and the intention to pursue post-secondary science studies. Although not significant, MANOVA results indicated that students who participated in OST programs exhibited gradual increases in RD and science identity over time according to grade level and gender. Follow-up analysis revealed significant relationships between awareness of racism, gender, and length of time in OST programs. The case studies illustrated that a unique community of practice exists within the OST programs. Access to authentic science learning experiences, youth

Kidney transplant and the digital divide: is information and communication technology a barrier or a bridge to transplant for African Americans?

PubMed

Lockwood, Mark B; Saunders, Milda R; Lee, Christopher S; Becker, Yolanda T; Josephson, Michelle A; Chon, W James

2013-12-01

Barriers to kidney transplant for African Americans are well documented in the literature. Little information on ownership of information and communication technology and use of such technology in transplant populations has been published. To characterize racial differences related to ownership and use of information and communication technology in kidney transplant patients. A single-center, cross-sectional survey study. An urban Midwestern transplant center. 78 pretransplant patients and 177 transplant recipients. The survey consisted of 6 demographic questions, 3 disease-related questions, and 9 technology-related questions. Dichotomous (yes/no) and Likert-scale items were the basis for the survey. Cell phone use was high and comparable between groups (94% in African Americans, 90% in whites, P= .22). A vast majority (75% of African Americans and 74% of whites) reported being "comfortable" sending and receiving text messages. Computer ownership (94.3% vs 79.3%) and Internet access (97.7% vs 80.7%) were greater among whites than African Americans (both P< .01). Fewer African Americans were frequent users of the Internet (27.1% vs 56.3%) and e-mail (61.6% vs 79.3%) than whites (both P<.01). More African Americans than whites preferred education in a classroom setting (77% vs 60%; P< .005) and educational DVDs (66% vs 46%; P< .002). The use of cell phone technology and text messaging was ubiquitous and comparable between groups, but computer and Internet access and frequency of use were not. Reaching out to the African American community may best be accomplished by using cell phone/text messaging as opposed to Internet-based platforms.

Best management practices to exchange information between the TOC and district offices.

DOT National Transportation Integrated Search

2009-06-01

The objective of this study was to develop best management practices for exchange information between the Transportation Operation Center (TOC) and the district offices and regional traffic management centers. Data collected for this study included: ...

Characteristics of soils in selected maize growing sites along altitudinal gradients in East African highlands

PubMed Central

Njuguna, Elijah; Gathara, Mary; Nadir, Stanley; Mwalusepo, Sizah; Williamson, David; Mathé, Pierre-Etienne; Kimani, Jackson; Landmann, Tobias; Juma, Gerald; Ong’amo, George; Gatebe, Erastus; Ru, Bruno Le; Calatayud, Paul-andré

2015-01-01

Maize is the main staple crop in the East African Mountains. Understanding how the edaphic characteristics change along altitudinal gradients is important for maximizing maize production in East African Highlands, which are the key maize production areas in the region. This study evaluated and compared the levels of some macro and micro-elements (Al, Ca, Fe, K, Mg, Mn, Na and P) and other soil parameters (pH, organic carbon content, soil texture [i.e. % Sand, % Clay and % Silt], cation exchange capacity [CEC], electric conductivity [EC], and water holding capacity [HC]). Soil samples were taken from maize plots along three altitudinal gradients in East African highlands (namely Machakos Hills, Taita Hills and Mount Kilimanjaro) characterized by graded changes in climatic conditions. For all transects, pH, Ca, K and Mg decreased with the increase in altitude. In contrast, % Silt, organic carbon content, Al and water holding capacity (HC) increased with increasing altitude. The research provides information on the status of the physical–chemical characteristics of soils along three altitudinal ranges of East African Highlands and includes data available for further research. PMID:26509187

NASA's experience in the international exchange of scientific and technical information in the aerospace field

NASA Technical Reports Server (NTRS)

Thibideau, Philip A.

1989-01-01

The early NASA international scientific and technical information (STI) exchange arrangements were usually detailed in correspondence with the librarians of the institutions involved. While this type of exchange, which involved only hardcopy (paper) products, grew to include some 220 organization in 43 countries, NASA's main focus shifted substantially to the STI relationship with the European Space Agency (ESA) which began in 1964. The NASA/ESA Tripartite Exchange Program, which now has more than 500 participants, provides more than 4,000 highly-relevant technical reports, fully processed, for the NASA produced 'Aerospace Database'. In turn, NASA provides an updated copy of this Database, known in Europe as the 'NASA File', for access, through ESA's Information Retrieval Service, by participating European organizations. Our experience in the evolving cooperation with ESA has established the 'model' for our more recent exchange agreements with Israel, Australia, Canada, and one under negotiation with Japan. The results of these agreements are made available to participating European organizations through the NASA File.

Managing Information for Development in the 21st Century: Prospects for African Libraries, Challenges to the World.

ERIC Educational Resources Information Center

Nwalo, Kenneth Ivo Ngozi

This paper discusses the role information can play in the development of African countries in the 21st century. It stresses that development information can only be guaranteed when libraries in Africa computerize their systems, form networks for resource sharing, and take advantage of the benefits of information technology (IT), especially CD-ROM…

Interactional Features of Repair Negotiation in NS-NNS Interaction on Two Task Types: Information Gap and Personal Information Exchange

ERIC Educational Resources Information Center

Kitajima, Ryu

2013-01-01

The studies in task-based approaches in second language acquisition claim that controlled and goal convergent tasks such as information gap tasks surpass open-ended conversations such as personal information exchange tasks for the development of the learner's interlanguage, in that the formers promote more repair negotiation. And yet, few studies…

Discovering Africa through Internet-Based Geographic Information Systems: A Pan-African Summit Simulation

ERIC Educational Resources Information Center

Milson, Andrew J.; Gilbert, Kathleen M.; Earle, Brian D.

2007-01-01

In the United States, people get very little news about Africa, and what news they do get is about war or famine, with little historical information or context. In this article, the authors describe how they developed and implemented a Pan-African Summit simulation project in order to give their approximately 100, 9th-grade students (in five World…

Developing the foundation for syndromic surveillance and health information exchange for yolo county, california.

PubMed

Chaudhary, Osama

2012-01-01

This report delineates Yolo County Health Department's process to ascertain its optimal methods of participation in syndromic surveillance and health information exchange. As a health department serving a county of just 200,000 residents, Yolo County Health Department needed to operate within strict financial constraints. Meaningful Use legislation enabled it to pursue both syndromic surveillance and health information exchange participation whilst complying with its budgetary restrictions. The Health Information Technology for Economic and Clinical Health (HITECH), a segment of the American Recovery and Reinvestment Act of 2009, has incentivized the 'Meaningful Use' of electronic health records (EHRs) by providing incentive reimbursements and non-compliance penalties. The Meaningful Use of EHRs is to take place over 3 Stages: Stage 1 has begun, Stage 2 is imminent, and Stage 3 is currently being discussed. Having been solicited by both health information exchange and syndromic surveillance options which were cost-prohibitive, Yolo County Health Department focused attention on BioSense 2.0, a Meaningul Use-ready and virtually free syndromic surveillance program developed by the Federal Centers for Disease Control and Prevention. In collaboration with Sacramento County Department of Health and Human Services, and with support from several other area counties, Yolo County Health Department submitted a Funding Opportunity application for BioSense 2.0 regional implementation. Through this collaboration, Yolo County Health Department has begun participating in the formative stages of the Sacramento Area Center for Advanced Biosurveillance (SAC-B). Via SAC-B, Yolo County Health Department will be able to participate in syndromic surveillance in the BioSense 2.0 program, and simultaneously expand its electronic health data sharing towards a more comprehensive health information exchange. LASTLY, OVER THE COURSE OF THESE PROJECTS, THREE OTHER METHODS OF PARTICIPATING IN

47 CFR 36.612 - Updating information submitted to the National Exchange Carrier Association.

Code of Federal Regulations, 2013 CFR

2013-10-01

... update the information submitted to the National Exchange Carrier Association (NECA) on July 31st... non-rural telephone company must update the information submitted to NECA on July 31st pursuant to § 36.611 (h) according to the schedule. (1) Submit data covering the last nine months of the previous...

47 CFR 36.612 - Updating information submitted to the National Exchange Carrier Association.

Code of Federal Regulations, 2012 CFR

2012-10-01

... update the information submitted to the National Exchange Carrier Association (NECA) on July 31st... non-rural telephone company must update the information submitted to NECA on July 31st pursuant to § 36.611 (h) according to the schedule. (1) Submit data covering the last nine months of the previous...

Retrospective: lessons learned from the Santa Barbara project and their implications for health information exchange.

PubMed

Frohlich, Jonah; Karp, Sam; Smith, Mark D; Sujansky, Walter

2007-01-01

Despite its closure in December 2006, the Santa Barbara County Care Data Exchange helped focus national attention on the value of health information exchange (HIE). This in turn led to the federal government's plan to establish regional health information organizations (RHIOs). During its existence, the project pioneered innovative approaches, including certification of health information technology vendors, a community-wide governance model, and deployment of a peer-to-peer technical model now in wider use. RHIO efforts will benefit from the project's lessons about the need for an incremental development approach, rigorous implementation processes, early attention to privacy and liability concerns, and planning for a sustainable business model.

African Americans and participation in clinical trials: differences in beliefs and attitudes by gender.

PubMed

BeLue, R; Taylor-Richardson, K D; Lin, J; Rivera, A T; Grandison, D

2006-12-01

To explore gender differences in perceptions of 1) barriers and motivators to participation in clinical trials and perceived need of clinical trials and 2) perceptions of risks and benefits of participation in clinical trials in African American men and women. Focus groups were conducted among African American participants by gender. A total of 67 African American participated in the focus groups. All focus groups were audio-taped and transcribed verbatim. Data analysis was performed by combining the key elements of grounded theory and content analysis with the assistance of the qualitative software ATLAS.ti 5.0. Different themes emerged for men versus women. The business and economic of research were important to male participants. The researcher-participant relationship emerged as one of the strongest themes related to potential female participation in research. Focus group results indicate that African American men and women present different preferences, beliefs and barriers to participation. Men expressed the desire to know information on funding issues, financial benefit and impact of the research. Women expressed the desire to be treated respectfully and as an individual as opposed to just a study subject. Integrating gender preferences into researcher-participant interactions, advertisement, informed consent delivery and advertisement of research studies may lead to increased participation rates. Discussing and presenting relevant information on clinical research funding mechanisms, and the business of clinical research with potential participants may be helpful in building trust with the researcher and the research team. Creating a process for information exchange and methods to minimize the power imbalance between the researcher and participant may also build trust and help participants feel more comfortable to participate in research.

GIRAF 2009 - Taking action on geoscience information across Africa

NASA Astrophysics Data System (ADS)

Asch, Kristine

2010-05-01

A workshop in Windhoek Between 16 and 20 March 2009 97 participants from 26 African nations, plus four European countries, and representatives from UNESCO, ICSU and IUGS-CGI, held a workshop at the Namibian Geological Survey in Windhoek. The workshop - GIRAF 2009 - Geoscience InfoRmation In Africa - was organised by the Federal Institute for Geosciences and Natural Resources (BGR) and the Geological Survey of Namibia (GSN) at the Namibian Ministry for Mines and Energy and was mainly financed by the German Federal Ministry for Economic Cooperation and Development (BMZ), supported by the IUGS Commission for the Management and Application of Geoscience Information (CGI). The participants came to Namibia to discuss one of the most topical issues in the geological domain - geoscience information and informatics. A prime objective was to set up a pan-African network for exchanging knowledge about geoscience information. GIRAF 2009 builds on the results of a preparatory workshop organised by the CGI and funded by the IUGS, which was held in June 2006 in Maputo at the 21st Colloquium on African Geology - CAG21. This preparatory workshop concentrated on identifying general problems and needs of African geological institutions in discussion with representatives of African geological surveys, universities, private companies and non-governmental organisations. The GIRAF 2009 workshop used the results of this discussion to plan and design its programme Aims In detail the five aims of the GIRAF2009 workshop were: to bring together relevant African authorities, national experts and stakeholders in geoscience information; to initiate the building of a pan-African geoscience information knowledge network to exchange and share geoscience information knowledge and best practice; to integrate the authorities, national experts and experts across Africa into global geoinformation initiatives; to develop a strategic plan for Africa's future in geoscience information; to make Africa a

Open for business: private networks create a marketplace for health information exchange.

PubMed

Dimick, Chris

2012-05-01

Large health systems and their IT vendors are creating private information exchange networks at a time when federally funded state operations are gearing up for launch, Is there room for private and public offerings in the new HIE marketplace?

Toward improved interpretation and theory building of African American male sexualities.

PubMed

Lewis, Linwood J; Kertzner, Robert M

2003-11-01

This paper examined five challenges to clear understanding of African American male sexualities: incorrect assumptions of African American homogeneity; an underemphasis on developmental change, the contexts and the meanings of sexual behaviors; and a lack of compelling theoretical grounding for African American sexualities. Critical elements for effective theorizing and research about African American sexualities (i.e. multiple levels of analysis, examination of phenomenological meaning of sexuality, measurement of dynamic/developmental change) were outlined and candidate theories within sexual science (social exchange theories, symbolic interactionism, sexual scripting theory) were analyzed in light of these elements. It is suggested that a re-orientation of sex research about African American men using these elements will result in improved understanding of African American sexualities in multiple contexts.

Health information exchange usage in emergency departments and clinics: the who, what, and why.

PubMed

Johnson, Kevin B; Unertl, Kim M; Chen, Qingxia; Lorenzi, Nancy M; Nian, Hui; Bailey, James; Frisse, Mark

2011-01-01

Health information exchange (HIE) systems are being developed across the nation. Understanding approaches taken by existing successful exchanges can help new exchange efforts determine goals and plan implementations. The goal of this study was to explore characteristics of use and users of a successful regional HIE. We used a mixed-method analysis, consisting of cross-sectional audit log data, semi-structured interviews, and direct observation in a sample of emergency departments and ambulatory safety net clinics actively using HIE. For each site, we measured overall usage trends, user logon statistics, and data types accessed by users. We also assessed reasons for use and outcomes of use. Overall, users accessed HIE for 6.8% of all encounters, with higher rates of access for repeat visits, for patients with comorbidities, for patients known to have data in the exchange, and at sites providing HIE access to both nurses and physicians. Discharge summaries and test reports were the most frequently accessed data in the exchange. Providers consistently noted retrieving additional history, preventing repeat tests, comparing new results to retrieved results, and avoiding hospitalizations as a consequence of HIE access. HIE use in emergency departments and ambulatory clinics was focused on patients where missing information was believed to be present in the exchange and was related to factors including the roles of people with access, the setting, and other site-specific issues that impacted the overall breadth of routine system use. These data should form an important foundation as other sites embark upon HIE implementation.

Text Exchange System

NASA Technical Reports Server (NTRS)

Snyder, W. V.; Hanson, R. J.

1986-01-01

Text Exchange System (TES) exchanges and maintains organized textual information including source code, documentation, data, and listings. System consists of two computer programs and definition of format for information storage. Comprehensive program used to create, read, and maintain TES files. TES developed to meet three goals: First, easy and efficient exchange of programs and other textual data between similar and dissimilar computer systems via magnetic tape. Second, provide transportable management system for textual information. Third, provide common user interface, over wide variety of computing systems, for all activities associated with text exchange.

Use of Computer-Based Reference Services in Texas Information Exchange Libraries.

ERIC Educational Resources Information Center

Menges, Gary L.

The Texas Information Exchange (TIE) is a state-wide library network organized in 1967 for the purpose of sharing resources among Texas libraries. Its membership includes 37 college and university libraries, the Texas State Library, and ten public libraries that serve as Major Resource Centers in the Texas State Library Communications Network. In…

NASA's experience in the international exchange of scientific and technical information in the aerospace field

NASA Technical Reports Server (NTRS)

Thibideau, Philip A.

1990-01-01

The early NASA international scientific and technical information exchange arrangements were usually detailed in correspondence with the librarians of the institutions involved. While this type of exchange grew to include some 200 organizations in 43 countries, NASA's main focus shifted to the relationship with the European Space Agency (ESA), which began in 1964. The NASA/ESA Tripartite Exchange Program provides more than 4000 technical reports from the NASA-produced Aerospace Database. The experience in the evolving cooperation between NASA and ESA has established the model for more recent exchange agreements with Israel, Australia, and Canada. The results of these agreements are made available to participating European organizations through the NASA File.

Validation analysis of informant's ratings of cognitive function in African Americans and Nigerians

PubMed Central

Shen, Jianzhao; Gao, Sujuan; Unverzagt, Frederick W.; Ogunniyi, Adesola; Baiyewu, Olusegun; Gureje, Oye; Hendrie, Hugh C.; Hall, Kathleen S.

2011-01-01

SUMMARY Objectives To examine informant validity using the Community Screening Interview for Dementia (CSI ‘D’) both cross-sectionally and longitudinally in two very different cultures and to explore the effects of informants and study participants’ characteristics on the validity of informants’ reports. Methods Elderly African Americans age 65 years and older residing in Indianapolis, USA and elderly Yoruba Nigerians age 65 years and older residing in Ibadan, Nigeria were assessed on cognitive functioning using the CSI ‘D’ at baseline (1992–1993) and five-year follow-up (1997–1998). At baseline, the informant validity in both samples was evaluated against participants’ cognitive tests using Pearson correlation and regular regression models. At follow-up, informants ratings on cognitive decline were assessed against participants’ cognitive decline scores from baseline to follow-up using biserial correlation and logistic regressions. Results At baseline, informants’ reports on cognitive functioning significantly correlated with cognitive scores in both samples (Indianapolis:r = –0.43, p < 0.001; Ibadan:r = –0.47, p < 0.001). The participant–informant relationships significantly affected the informants’ reports in the two samples with different patterns (p = 0.005 for Indianapolis and p < 0.001 for Ibadan) at a given level of cognitive functioning. African Americans spouses reported more cognitive problems, while siblings reported more problems for the Yoruba Nigerians. At follow-up, informants’ ratings on cognitive decline significantly correlated with the cognitive decline scores (Indianapolis r = 0.38, p < 0.001; Ibadan r = 0.32, p < 0.001). The characteristics of study participants and informants had little impact on the informants’ ratings on cognitive decline. Conclusions Informant reports are valid in assessing the cognitive functioning of study participants both cross-sectionally and longitudinally in two very different

eHealth Networking Information Systems - The New Quality of Information Exchange.

PubMed

Messer-Misak, Karin; Reiter, Christoph

2017-01-01

The development and introduction of platforms that enable interdisciplinary exchange on current developments and projects in the area of eHealth have been stimulated by different authorities. The aim of this project was to develop a repository of eHealth projects that will make the wealth of eHealth projects visible and enable mutual learning through the sharing of experiences and good practice. The content of the database and search criteria as well as their categories were determined in close co-ordination and cooperation with stakeholders from the specialist areas. Technically, we used Java Server Faces (JSF) for the implementation of the frontend of the web application. Access to structured information on projects can support stakeholders to combining skills and knowledge residing in different places to create new solutions and approaches within a network of evolving competencies and opportunities. A regional database is the beginning of a structured collection and presentation of projects, which can then be incorporated into a broader context. The next step will be to unify this information transparently.

75 FR 25025 - 60-Day Notice of Proposed Information Collection: Exchange Programs Alumni Web Site Registration...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-06

...: Exchange Programs Alumni Web Site Registration, DS-7006 ACTION: Notice of request for public comments... the Paperwork Reduction Act of 1995. Title of Information Collection: Exchange Programs Alumni Web... techniques or other forms of technology. Abstract of proposed collection: The State Alumni Web site requires...

Investigation of the Impact of Extracting and Exchanging Health Information by Using Internet and Social Networks.

PubMed

Pistolis, John; Zimeras, Stelios; Chardalias, Kostas; Roupa, Zoe; Fildisis, George; Diomidous, Marianna

2016-06-01

Social networks (1) have been embedded in our daily life for a long time. They constitute a powerful tool used nowadays for both searching and exchanging information on different issues by using Internet searching engines (Google, Bing, etc.) and Social Networks (Facebook, Twitter etc.). In this paper, are presented the results of a research based on the frequency and the type of the usage of the Internet and the Social Networks by the general public and the health professionals. The objectives of the research were focused on the investigation of the frequency of seeking and meticulously searching for health information in the social media by both individuals and health practitioners. The exchanging of information is a procedure that involves the issues of reliability and quality of information. In this research, by using advanced statistical techniques an effort is made to investigate the participant's profile in using social networks for searching and exchanging information on health issues. Based on the answers 93 % of the people, use the Internet to find information on health-subjects. Considering principal component analysis, the most important health subjects were nutrition (0.719 %), respiratory issues (0.79 %), cardiological issues (0.777%), psychological issues (0.667%) and total (73.8%). The research results, based on different statistical techniques revealed that the 61.2% of the males and 56.4% of the females intended to use the social networks for searching medical information. Based on the principal components analysis, the most important sources that the participants mentioned, were the use of the Internet and social networks for exchanging information on health issues. These sources proved to be of paramount importance to the participants of the study. The same holds for nursing, medical and administrative staff in hospitals.

77 FR 70786 - Request for Information Regarding Health Care Quality for Exchanges

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-27

...] Request for Information Regarding Health Care Quality for Exchanges AGENCY: Centers for Medicare... Quality Improvement in Health Care (National Quality Strategy) to create national aims and priorities that would guide local, state, and national efforts to improve the quality of health care in the United...

Learn about the Environmental Information Exchange Network

EPA Pesticide Factsheets

States, territories, and tribes can partner with EPA to exchange standardized data to improve its quality, increase its availability, and integrate it better across different sources using connecting nodes, xml schema, and a data exchange template.

The Role of an African American Principal in an Urban Information Technology High School

ERIC Educational Resources Information Center

Gooden, Mark A.

2005-01-01

The research reported here is the result of an exploration of the challenges and triumphs of an African American secondary principal who used a culture-specific leadership style in his quest to raise the standards at an information technology high school. This case study of the principal explores his combining of the elements of traditional…

Cryptographic Securities Exchanges

NASA Astrophysics Data System (ADS)

Thorpe, Christopher; Parkes, David C.

While transparency in financial markets should enhance liquidity, its exploitation by unethical and parasitic traders discourages others from fully embracing disclosure of their own information. Traders exploit both the private information in upstairs markets used to trade large orders outside traditional exchanges and the public information present in exchanges' quoted limit order books. Using homomorphic cryptographic protocols, market designers can create "partially transparent" markets in which every matched trade is provably correct and only beneficial information is revealed. In a cryptographic securities exchange, market operators can hide information to prevent its exploitation, and still prove facts about the hidden information such as bid/ask spread or market depth.

Health information exchange implementation: lessons learned and critical success factors from a case study.

PubMed

Feldman, Sue S; Schooley, Benjamin L; Bhavsar, Grishma P

2014-08-15

Much attention has been given to the proposition that the exchange of health information as an act, and health information exchange (HIE), as an entity, are critical components of a framework for health care change, yet little has been studied to understand the value proposition of implementing HIE with a statewide HIE. Such an organization facilitates the exchange of health information across disparate systems, thus following patients as they move across different care settings and encounters, whether or not they share an organizational affiliation. A sociotechnical systems approach and an interorganizational systems framework were used to examine implementation of a health system electronic medical record (EMR) system onto a statewide HIE, under a cooperative agreement with the Office of the National Coordinator for Health Information Technology, and its collaborating organizations. The objective of the study was to focus on the implementation of a health system onto a statewide HIE; provide insight into the technical, organizational, and governance aspects of a large private health system and the Virginia statewide HIE (organizations with the shared goal of exchanging health information); and to understand the organizational motivations and value propositions apparent during HIE implementation. We used a formative evaluation methodology to investigate the first implementation of a health system onto the statewide HIE. Qualitative methods (direct observation, 36 hours), informal information gathering, semistructured interviews (N=12), and document analysis were used to gather data between August 12, 2012 and June 24, 2013. Derived from sociotechnical concepts, a Blended Value Collaboration Enactment Framework guided the data gathering and analysis to understand organizational stakeholders' perspectives across technical, organizational, and governance dimensions. Several challenges, successes, and lessons learned during the implementation of a health system to the

Health Information Exchange Implementation: Lessons Learned and Critical Success Factors From a Case Study

PubMed Central

2014-01-01

Background Much attention has been given to the proposition that the exchange of health information as an act, and health information exchange (HIE), as an entity, are critical components of a framework for health care change, yet little has been studied to understand the value proposition of implementing HIE with a statewide HIE. Such an organization facilitates the exchange of health information across disparate systems, thus following patients as they move across different care settings and encounters, whether or not they share an organizational affiliation. A sociotechnical systems approach and an interorganizational systems framework were used to examine implementation of a health system electronic medical record (EMR) system onto a statewide HIE, under a cooperative agreement with the Office of the National Coordinator for Health Information Technology, and its collaborating organizations. Objective The objective of the study was to focus on the implementation of a health system onto a statewide HIE; provide insight into the technical, organizational, and governance aspects of a large private health system and the Virginia statewide HIE (organizations with the shared goal of exchanging health information); and to understand the organizational motivations and value propositions apparent during HIE implementation. Methods We used a formative evaluation methodology to investigate the first implementation of a health system onto the statewide HIE. Qualitative methods (direct observation, 36 hours), informal information gathering, semistructured interviews (N=12), and document analysis were used to gather data between August 12, 2012 and June 24, 2013. Derived from sociotechnical concepts, a Blended Value Collaboration Enactment Framework guided the data gathering and analysis to understand organizational stakeholders’ perspectives across technical, organizational, and governance dimensions. Results Several challenges, successes, and lessons learned during the

Legal Barriers to the Growth of Health Information Exchange-Boulders or Pebbles?

PubMed

Mello, Michelle M; Adler-Milstein, Julia; Ding, Karen L; Savage, Lucia

2018-03-01

Policy Points: Historically, in addition to economic and technical hurdles, state and federal health information privacy laws have been cited as a significant obstacle to expanding electronic health information exchange (HIE) in the United States. Our review finds that over the past decade, several helpful developments have ameliorated the legal barriers to HIE, although variation in states' patient consent requirements remains a challenge. Today, health care providers' complaints about legal obstacles to HIE may be better understood as reflecting concerns about the economic and competitive risks of information sharing. Although the clinical benefits of exchanging patients' health information electronically across providers have long been recognized, participation in health information exchange (HIE) has lagged behind adoption of electronic health records. Barriers erected by federal and state health information privacy law have been cited as a leading reason for the slow progress. A comprehensive assessment of these issues has not been undertaken for nearly a decade, despite a number of salient legal developments. Analysis of federal and state health information privacy statutes and regulations and secondary materials. Although some legal barriers to HIE persist, many have been ameliorated-in some cases, simply through improved understanding of what the law actually requires. It is now clear that the Health Insurance Portability and Accountability Act presents no obstacles to electronically sharing protected health information for treatment purposes and does not hold providers who properly disclose information liable for privacy breaches by recipients. The failure of federal efforts to establish a unique patient identifier number does slow HIE by inhibiting optimal matching of patient records, but other action to facilitate matching will be taken under the 21st Century Cures Act. The Cures Act also creates the legal architecture to begin to combat "information

A Comparison Between Caucasians and African Americans in Willingness to Participate in Cancer Clinical Trials: The Roles of Knowledge, Distrust, Information Sources, and Religiosity.

PubMed

Meng, Jingbo; McLaughlin, Margaret; Pariera, Katrina; Murphy, Sheila

2016-06-01

This study aims to (a) examine the roles of knowledge, distrust in medical professionals, information sources, and 2 dimensions of religiosity (i.e., religious activity and religious belief) in influencing willingness to participate (WTP) in cancer clinical trials and to (b) compare the results for Caucasians and African Americans in order to inform future recruitment. An online survey was fielded via a Knowledge Networks panel with a nationally representative sample including 478 Caucasians and 173 African Americans. The results showed that distrust in medical professionals was a strong barrier to WTP for both ethnic groups, whereas factual knowledge about trial procedures was not associated with WTP for either ethnic group. Seeking trial information from doctors was positively associated with WTP for Caucasians; seeking trial information from hospitals was positively associated with WTP for African Americans. More interestingly, levels of religious activity negatively predicted WTP for Caucasians but positively predicted WTP for African Americans. Self-reported religious belief was not associated with WTP for either ethnic group. In sum, although distrust is a common barrier to WTP, the influence of preferred information sources and religious activity on WTP varies as a function of ethnicity.

Strategies to prevent and reduce diabetes and obesity in Sacramento, California: the African American Leadership Coalition and University of California, Davis.

PubMed

Ziegahn, Linda; Styne, Dennis; Askia, Joyce; Roberts, Tina; Lewis, Edward T; Edwards, Whitney

2013-11-14

Diabetes is one of the leading causes of illness and death for African Americans and people of African descent throughout the United States and in the city and county of Sacramento, California. The involvement of families and communities in developing prevention strategies can increase the likelihood that behavioral changes will be sustained. Three member organizations of the African American Leadership Coalition (AALC) entered into a partnership with the University of California, Davis (UC Davis) to engage families in developing a process to identify barriers to diabetes and obesity prevention and reduction, exchange strategies, and create action plans for prevention. The intervention comprised 3 phases: 1) coalition formation and training; 2) data collection, analysis, and dissemination of results; and 3) development of family and community action plans. Academic and community partners planned and implemented all project phases together. Sources of information about diabetes and obesity were primarily doctors and the Internet; barriers were related to lack of time needed to prepare healthy meals, high food costs, transportation to fresh markets, motivation around healthy habits, and unsafe environments. Action plans addressed behavioral change and family cohesion. The group discussion format encouraged mutual support and suggestions for better eating and physical exercise habits. This collaborative partnership model can strengthen existing group relationships or promote new affiliations that form the basis for future action coalitions. Participants worked both within and across groups to exchange information, stories of success and challenges, and specific health improvement strategies.

Multiple health risk perception and information processing among African Americans and whites living in poverty.

PubMed

Hovick, Shelly R; Freimuth, Vicki S; Johnson-Turbes, Ashani; Chervin, Doryn D

2011-11-01

We investigated the risk-information-processing behaviors of people living at or near the poverty line. Because significant gaps in health and communication exist among high- and low-income groups, increasing the information seeking and knowledge of poor individuals may help them better understand risks to their health and increase their engagement in health-protective behaviors. Most earlier studies assessed only a single health risk selected by the researcher, whereas we listed 10 health risks and allowed the respondents to identify the one that they worried about most but took little action to prevent. Using this risk, we tested one pathway inspired by the risk information seeking and processing model to examine predictors of information insufficiency and of systematic processing and extended this pathway to include health-protective action. A phone survey was conducted of African Americans and whites living in the southern United States with an annual income of ≤$35,000 (N= 431). The results supported the model pathway: worry partially mediated the relationship between perceived risk and information insufficiency, which, in turn, increased systematic processing. In addition, systematic processing increased health-protective action. Compared with whites and better educated respondents, African Americans and respondents with little education had significantly higher levels of information insufficiency but higher levels of systematic processing and health-protective action. That systematic processing and knowledge influenced health behavior suggests a potential strategy for reducing health disparities. © 2011 Society for Risk Analysis.

How can knowledge exchange portals assist in knowledge management for evidence-informed decision making in public health?

PubMed Central

2014-01-01

Background Knowledge exchange portals are emerging as web tools that can help facilitate knowledge management in public health. We conducted a review to better understand the nature of these portals and their contribution to knowledge management in public health, with the aim of informing future development of portals in this field. Methods A systematic literature search was conducted of the peer-reviewed and grey literature to identify articles that described the design, development or evaluation of Knowledge Exchange Portals KEPs in the public health field. The content of the articles was analysed, interpreted and synthesised in light of the objectives of the review. Results The systematic search yielded 2223 articles, of which fifteen were deemed eligible for review, including eight case studies, six evaluation studies and one commentary article. Knowledge exchange portals mainly included design features to support knowledge access and creation, but formative evaluation studies examining user needs suggested collaborative features supporting knowledge exchange would also be useful. Overall web usage statistics revealed increasing use of some of these portals over time; however difficulties remain in retaining users. There is some evidence to suggest that the use of a knowledge exchange portal in combination with tailored and targeted messaging can increase the use of evidence in policy and program decision making at the organisational level. Conclusions Knowledge exchange portals can be a platform for providing integrated access to relevant content and resources in one location, for sharing and distributing information and for bringing people together for knowledge exchange. However more performance evaluation studies are needed to determine how they can best support evidence-informed decision making in public health. PMID:24884530

How can knowledge exchange portals assist in knowledge management for evidence-informed decision making in public health?

PubMed

Quinn, Emma; Huckel-Schneider, Carmen; Campbell, Danielle; Seale, Holly; Milat, Andrew J

2014-05-12

Knowledge exchange portals are emerging as web tools that can help facilitate knowledge management in public health. We conducted a review to better understand the nature of these portals and their contribution to knowledge management in public health, with the aim of informing future development of portals in this field. A systematic literature search was conducted of the peer-reviewed and grey literature to identify articles that described the design, development or evaluation of Knowledge Exchange Portals KEPs in the public health field. The content of the articles was analysed, interpreted and synthesised in light of the objectives of the review. The systematic search yielded 2223 articles, of which fifteen were deemed eligible for review, including eight case studies, six evaluation studies and one commentary article. Knowledge exchange portals mainly included design features to support knowledge access and creation, but formative evaluation studies examining user needs suggested collaborative features supporting knowledge exchange would also be useful. Overall web usage statistics revealed increasing use of some of these portals over time; however difficulties remain in retaining users. There is some evidence to suggest that the use of a knowledge exchange portal in combination with tailored and targeted messaging can increase the use of evidence in policy and program decision making at the organisational level. Knowledge exchange portals can be a platform for providing integrated access to relevant content and resources in one location, for sharing and distributing information and for bringing people together for knowledge exchange. However more performance evaluation studies are needed to determine how they can best support evidence-informed decision making in public health.

76 FR 24956 - 30-Day Notice of Proposed Information Collection: Certificate of Eligibility for Exchange Visitor...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-03

...: Certificate of Eligibility for Exchange Visitor (J-1) Status; Form DS-2019, OMB No. 1405-0119. ACTION: Notice... Management and Budget (OMB) for approval in accordance with the Paperwork Reduction Act of 1995. Title of Information Collection: Certificate of Eligibility for Exchange Visitor (J-1) Status OMB Control Number: 1405...

Investing in International Information Exchange Activities to Improve the Safety, Cost Effectiveness and Schedule of Cleanup - 13281

DOE Office of Scientific and Technical Information (OSTI.GOV)

Seed, Ian; James, Paula; Mathieson, John

2013-07-01

With decreasing budgets and increasing pressure on completing cleanup missions as quickly, safely and cost-effectively as possible, there is significant benefit to be gained from collaboration and joint efforts between organizations facing similar issues. With this in mind, the US Department of Energy (DOE) and the UK Nuclear Decommissioning Authority (NDA) have formally agreed to share information on lessons learned on the development and application of new technologies and approaches to improve the safety, cost effectiveness and schedule of the cleanup legacy wastes. To facilitate information exchange a range of tools and methodologies were established. These included tacit knowledge exchangemore » through facilitated meetings, conference calls and Site visits as well as explicit knowledge exchange through document sharing and newsletters. A DOE web-based portal has been established to capture these exchanges and add to them via discussion boards. The information exchange is operating at the Government-to-Government strategic level as well as at the Site Contractor level to address both technical and managerial topic areas. This effort has resulted in opening a dialogue and building working relationships. In some areas joint programs of work have been initiated thus saving resource and enabling the parties to leverage off one another activities. The potential benefits of high quality information exchange are significant, ranging from cost avoidance through identification of an approach to a problem that has been proven elsewhere to cost sharing and joint development of a new technology to address a common problem. The benefits in outcomes significantly outweigh the costs of the process. The applicability of the tools and methods along with the lessons learned regarding some key issues is of use to any organization that wants to improve value for money. In the waste management marketplace, there are a multitude of challenges being addressed by multiple

The strategic use of standardized information exchange technology in a university health system.

PubMed

Cheng, Po-Hsun; Chen, Heng-Shuen; Lai, Feipei; Lai, Jin-Shin

2010-04-01

This article illustrates a Web-based health information system that is comprised of specific information exchange standards related to health information for healthcare services in National Taiwan University Health System. Through multidisciplinary teamwork, medical and informatics experts collaborated and studied on system scope definition, standard selection challenges, system implementation barriers, system management outcomes, and further expandability of other systems. After user requirement analysis and prototyping, from 2005 to 2008, an online clinical decision support system with multiple functions of reminding and information push was implemented. It was to replace its original legacy systems and serve among the main hospital and three branches of 180-200 clinics and 7,500-8,000 patient visits per day. To evaluate the effectiveness of this system, user surveys were performed, which revealed that the average score of user satisfaction increased from 2.80 to 3.18 on a 4-point scale. Among the items, especially e-learning for training service, courtesy communications for system requests, and courtesy communications for system operations showed statistically significant improvement. From this study, the authors concluded that standardized information exchange technologies can be used to create a brand new enterprise value and steadily obtain more competitive advantages for a prestige healthcare system.

The next step in health data exchanges: trust and privacy in exchange networks.

PubMed

Gravely, Steve D; Whaley, Erin S

2009-01-01

The rapid development of health information exchanges (HIE), regional health information organizations (RHIO), the Nationwide Health Information Network (NHIN) and other data exchange platforms for health records creates complex and multifaceted challenges for protecting the privacy and security of health information. Often these issues are addressed in a contractual agreement between two parties seeking to exchange data. Until recently, this point-to-point approach has been acceptable because there were few operational HIEs or RHIOs that were ready, willing and able to actually exchange data. With the proliferation of HIEs and RHIOs that are either operational or on the cusp of being operational, the utility of point-to-point is diminishing. It is no longer efficient for a RHIO to negotiate a separate data exchange agreement with every one of its exchange partners. The evolving model for data exchange agreements is a multi-party trust agreement. This article will examine the crucial components of a multi-party trust agreement.

Exploring Business Strategy in Health Information Exchange Organizations.

PubMed

Langabeer, James R; Champagne, Tiffany

2016-01-01

Unlike consumer goods industries, healthcare has been slow to implement technolo gies that support exchange of data in patients' health records. This results in avoid able medication errors, avoidable hospital readmissions, unnecessary duplicate testing, and other inefficient or wasteful practices. Community-based regional health information exchange (HIE) organizations have evolved in response to federal aims to encourage interoperability, yet little is known about their strategic approach. We use the lens of institutional and strategic management theories to empirically explore the differences in business strategies deployed in HIEs that are, to date, financially sustainable versus those that are not. We developed a 20-question survey targeted to CEOs to assess HIE business strategies. Our sample consisted of 60 community-based exchanges distributed throughout the United States, and we achieved a 58% response rate. Questions centered on competitive strategy and financial sustainability. We relied on logistic regression methods to explore relationships between variables. Our regression identified characteristics common to sustainable organizations. We defined sustainability as revenues exceeding operational costs. Seventeen of the 35 organizations (49%) defined themselves as currently sustainable. Focus and cost leadership strategies were significantly associated with sustainability. Growth strate gies, which were much more common than other strategies, were not associated with sustainability. We saw little evidence of a differentiation strategy (i.e., the basis of competition whereby the attributes of a product or service are unmatched by rivals). Most CEOs had a relatively optimistic outlook, with 60% stating they were confident of surviving over the next 5 years; however, nearly 9% of the organizations were in some phase of divestiture or exit from the market. HIEs are evolving differently based on local leadership decisions, yet their strategic approach is

The Jackson Heart KIDS Pilot Study: Theory-Informed Recruitment in an African American Population.

PubMed

Beech, Bettina M; Bruce, Marino A; Crump, Mary E; Hamilton, Gina E

2017-04-01

Recruitment for large cohort studies is typically challenging, particularly when the pool of potential participants is limited to the descendants of individuals enrolled in a larger, longitudinal "parent" study. The increasing complexity of family structures and dynamics can present challenges for recruitment in offspring. Few best practices exist to guide effective and efficient empirical approaches to participant recruitment. Social and behavioral theories can provide insight into social and cultural contexts influencing individual decision-making and facilitate the development strategies for effective diffusion and marketing of an offspring cohort study. The purpose of this study was to describe the theory-informed recruitment approaches employed by the Jackson Heart KIDS Pilot Study (JHKS), a prospective offspring feasibility study of 200 African American children and grandchildren of the Jackson Heart Study (JHS)-the largest prospective cohort study examining cardiovascular disease among African American adults. Participant recruitment in the JHKS was founded on concepts from three theoretical perspectives-the Diffusion of Innovation Theory, Strength of Weak Ties, and Marketing Theory. Tailored recruitment strategies grounded in participatory strategies allowed us to exceed enrollment goals for JHKS Pilot Study and develop a framework for a statewide study of African American adolescents.

The Jackson Heart KIDS Pilot Study: Theory-Informed Recruitment in an African American Population

PubMed Central

Beech, Bettina M.; Bruce, Marino A.; Crump, Mary E.; Hamilton, Gina E.

2016-01-01

Recruitment for large cohort studies is typically challenging, particularly when the pool of potential participants is limited to the descendants of individuals enrolled in a larger, longitudinal “parent” study. The increasing complexity of family structures and dynamics can present challenges for recruitment in offspring. Few best practices exist to guide effective and efficient empirical approaches to participant recruitment. Social and behavioral theories can provide insight into social and cultural contexts influencing individual decision-making and facilitate the development strategies for effective diffusion and marketing of an offspring cohort study. The purpose of this study was to describe the theory-informed recruitment approaches employed by the Jackson Heart KIDS Pilot Study (JHKS), a prospective offspring feasibility study of 200 African American children and grandchildren of the Jackson Heart Study (JHS)—the largest prospective cohort study examining cardiovascular disease among African American adults. Participant recruitment in the JHKS was founded on concepts from three theoretical perspectives—the Diffusion of Innovation Theory, Strength of Weak Ties, and Marketing Theory. Tailored recruitment strategies grounded in participatory strategies allowed us to exceed enrollment goals for JHKS Pilot Study and develop a framework for a statewide study of African American adolescents. PMID:27129858

Information exchange of the Atomic Energy Society of Japan with nuclear societies worldwide

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hori, Masao; Tomita, Yasushi

2000-07-01

The Atomic Energy Society of Japan (AESJ) exchanges information with nuclear societies worldwide by intersocietal communication through international councils of nuclear societies and through bilateral agreements between foreign societies and by such media as international meetings, publications, and Internet applications.

47 CFR 14.48 - Confidentiality of information produced or exchanged by the parties.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Confidentiality of information produced or exchanged by the parties. 14.48 Section 14.48 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping...

47 CFR 14.48 - Confidentiality of information produced or exchanged by the parties.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false Confidentiality of information produced or exchanged by the parties. 14.48 Section 14.48 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping...

47 CFR 14.48 - Confidentiality of information produced or exchanged by the parties.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Confidentiality of information produced or exchanged by the parties. 14.48 Section 14.48 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping...

Sharing Service Resource Information for Application Integration in a Virtual Enterprise - Modeling the Communication Protocol for Exchanging Service Resource Information

NASA Astrophysics Data System (ADS)

Yamada, Hiroshi; Kawaguchi, Akira

Grid computing and web service technologies enable us to use networked resources in a coordinated manner. An integrated service is made of individual services running on coordinated resources. In order to achieve such coordinated services autonomously, the initiator of a coordinated service needs to know detailed service resource information. This information ranges from static attributes like the IP address of the application server to highly dynamic ones like the CPU load. The most famous wide-area service discovery mechanism based on names is DNS. Its hierarchical tree organization and caching methods take advantage of the static information managed. However, in order to integrate business applications in a virtual enterprise, we need a discovery mechanism to search for the optimal resources based on the given a set of criteria (search keys). In this paper, we propose a communication protocol for exchanging service resource information among wide-area systems. We introduce the concept of the service domain that consists of service providers managed under the same management policy. This concept of the service domain is similar to that for autonomous systems (ASs). In each service domain, the service information provider manages the service resource information of service providers that exist in this service domain. The service resource information provider exchanges this information with other service resource information providers that belong to the different service domains. We also verified the protocol's behavior and effectiveness using a simulation model developed for proposed protocol.

Obtaining providers' 'buy-in' and establishing effective means of information exchange will be critical to HITECH's success.

PubMed

Gold, Marsha R; McLaughlin, Catherine G; Devers, Kelly J; Berenson, Robert A; Bovbjerg, Randall R

2012-03-01

In enacting the Health Information Technology for Economic and Clinical Health (HITECH) provisions of the American Recovery and Reinvestment Act, Congress set ambitious goals for the nation to integrate information technology into health care delivery. The provisions called for the electronic exchange of health information and the adoption and meaningful use of health information technology in health care practices and hospitals. We examined the marketplace and regulatory forces that influence HITECH's success and identify outstanding challenges, some beyond the provisions' control. To reach HITECH's goals, providers and patients must be persuaded of the value of health information exchange and support its implementation. Privacy concerns and remaining technical challenges must also be overcome. Achieving HITECH's goals will require well-aligned incentives, both visionary and practical pursuit of exchange infrastructure, and realistic assumptions about how quickly such wholesale change can be accomplished. The use of metrics to show adoption proceeding at a reasonable pace, increased flow of data across parties, and evidence that care is improving, at least in areas with robust systems, will be essential to persuade stakeholders that the initiative is progressing well and warrants continued investment.

Why Do Information Gaps Persist in African Smallholder Agriculture? Perspectives from Farmers Lacking Exposure to Conservation Agriculture

ERIC Educational Resources Information Center

Brown, Brendan; Llewellyn, Rick; Nuberg, Ian

2018-01-01

Purpose: To explore why substantial agricultural information gaps persist in African smallholder farming communities and how to reduce them. Design/methodology/approach: Using conservation agriculture (CA) as a case study, we deeply explore with 29 smallholder farmers why they are yet to obtain sufficient information to enable practice evaluation.…

Improving Information Exchange in the Chicken Processing Sector Using Standardised Data Lists

NASA Astrophysics Data System (ADS)

Donnelly, Kathryn Anne-Marie; van der Roest, Joop; Höskuldsson, Stefán Torfi; Olsen, Petter; Karlsen, Kine Mari

Research has shown that to improve electronic communication between companies, universal standardised data lists are necessary. In food supply chains in particular there is an increased need to exchange data in the wake of food safety incidents. Food supply chain companies already record numerous measurements, properties and parameters. These records are necessary for legal reasons, labelling, traceability, profiling desirable characteristics, showing compliance and for meeting customer requirements. Universal standards for name and content of each of these data elements would improve information exchange between buyers, sellers, authorities, consumers and other interested parties. A case study, carried out for the chicken sector, attempted to identify the most relevant parameters including which of these were already communicated to external bodies.

The Earth Information Exchange: A Portal for Earth Science From the ESIP Federation

NASA Astrophysics Data System (ADS)

Wertz, R.; Hutchinson, C.; Hardin, D.

2006-12-01

The Federation of Earth Science Information Partners is a unique consortium of more than 90 organizations that collect, interpret and develop applications for remotely sensed Earth Observation Information. Included in the ESIP network are NASA, NOAA and USGS data centers, research universities, government research laboratories, supercomputer facilities, education resource providers, information technology innovators, nonprofit organizations and commercial enterprises. The consortium's work is dedicated to providing the most up-to-date, science-based information to researchers and decision-makers who are working to understand and address the environmental, economic and social challenges facing our planet. By increasing the use and usability of Earth observation data and linking it with decision-making tools, the Federation partners leverage the value of these important data resources for the betterment of society and our planet. To further the dissemination of Earth Science data, the Federation is developing the Earth Information Exchange (EIE). The EIE is a portal that will provide access to the vast information holdings of the members' organizations in one web-based location and will provides a robust marketplace in which the products and services needed to use and understand this information can be readily acquired. Since the Federation membership includes the federal government's Earth observing data centers, we believe that the impact of the EIE on Earth science research and education and environmental policy making will be profound. In the EIE, Earth observation data, products and services, are organized by the societal benefits categories defined by the international working group developing the Global Earth Observation System of Systems (GEOSS). The quality of the information is ensured in each of the Exchange's issue areas by maintaining working groups of issue area researchers and practitioners who serve as stewards for their respective communities. The

Uncovering Hospitalists' Information Needs from Outside Healthcare Facilities in the Context of Health Information Exchange Using Association Rule Learning.

PubMed

Martinez, D A; Mora, E; Gemmani, M; Zayas-Castro, J

2015-01-01

Important barriers to health information exchange (HIE) adoption are clinical workflow disruptions and troubles with the system interface. Prior research suggests that HIE interfaces providing faster access to useful information may stimulate use and reduce barriers for adoption; however, little is known about informational needs of hospitalists. To study the association between patient health problems and the type of information requested from outside healthcare providers by hospitalists of a tertiary care hospital. We searched operational data associated with fax-based exchange of patient information (previous HIE implementation) between hospitalists of an internal medicine department in a large urban tertiary care hospital in Florida, and any other affiliated and unaffiliated healthcare provider. All hospitalizations from October 2011 to March 2014 were included in the search. Strong association rules between health problems and types of information requested during each hospitalization were discovered using Apriori algorithm, which were then validated by a team of hospitalists of the same department. Only 13.7% (2 089 out of 15 230) of the hospitalizations generated at least one request of patient information to other providers. The transactional data showed 20 strong association rules between specific health problems and types of information exist. Among the 20 rules, for example, abdominal pain, chest pain, and anaemia patients are highly likely to have medical records and outside imaging results requested. Other health conditions, prone to have records requested, were lower urinary tract infection and back pain patients. The presented list of strong co-occurrence of health problems and types of information requested by hospitalists from outside healthcare providers not only informs the implementation and design of HIE, but also helps to target future research on the impact of having access to outside information for specific patient cohorts. Our data

Managing Resource Dependence Difficulties in African Higher Education: The Case of Multiple Exchange Relationships

ERIC Educational Resources Information Center

Wangenge-Ouma, Gerald

2011-01-01

The paper has a twofold structure and focus. The first part is an examination of the funding challenges facing African universities resulting mainly from public finance difficulties, and the second part is a case study of how some Kenyan and South African public universities have attempted to mitigate resource dependence difficulties through…

Joint Atomic Information Exchange Group information management project. Briefing outlining functions and specifications of JAIEG automated information management system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smith, M.G.

1983-07-20

The Joint Atomic Information Exchange Group (JAIEG) was formed in 1959. JAIEG's charter was to be the agent to determine the transmissibility of atomic information to foreign governments or regional defense organizations. JAIEG, operating from the joint policy direction of the Deputy Assistant Secretary for Military Application under the Department of Energy and of the Assistant to the Secretary of Defense for Atomic Energy under the Department of Defense, determines in a uniform and consistent manner the transmissibility of Restricted Data (RD) and Formerly Restricted Data (FRD). JAIEG also maintains records of all transmittal of such data, and maintains recordmore » copies of all information reviewed. This information exists only on paper and must be processed manually. JAIEG's work load has grown continuously with the size of its filing system. This has prompted an investigation of the potential benefits of automating JAIEG activities. Science Applications, Inc. (SAI) has studied JAIEG procedures and has identified several areas where JAIEG information processing activities can be automated to achieve greater system efficiency.« less

A distributed framework for health information exchange using smartphone technologies.

PubMed

Abdulnabi, Mohamed; Al-Haiqi, Ahmed; Kiah, M L M; Zaidan, A A; Zaidan, B B; Hussain, Muzammil

2017-05-01

Nationwide health information exchange (NHIE) continues to be a persistent concern for government agencies, despite the many efforts and the conceived benefits of sharing patient data among healthcare providers. Difficulties in ensuring global connectivity, interoperability, and concerns on security have always hampered the government from successfully deploying NHIE. By looking at NHIE from a fresh perspective and bearing in mind the pervasiveness and power of modern mobile platforms, this paper proposes a new approach to NHIE that builds on the notion of consumer-mediated HIE, albeit without the focus on central health record banks. With the growing acceptance of smartphones as reliable, indispensable, and most personal devices, we suggest to leverage the concept of mobile personal health records (PHRs installed on smartphones) to the next level. We envision mPHRs that take the form of distributed storage units for health information, under the full control and direct possession of patients, who can have ready access to their personal data whenever needed. However, for the actual exchange of data with health information systems managed by healthcare providers, the latter have to be interoperable with patient-carried mPHRs. Computer industry has long ago solved a similar problem of interoperability between peripheral devices and operating systems. We borrow from that solution the idea of providing special interfaces between mPHRs and provider systems. This interface enables the two entities to communicate with no change to either end. The design and operation of the proposed approach is explained. Additional pointers on potential implementations are provided, and issues that pertain to any solution to implement NHIE are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

Peer led HIV/AIDS prevention for women in South African informal settlements.

PubMed

O'Hara Murdock, Peggy; Garbharran, Hari; Edwards, Mary Jo; Smith, Maria A; Lutchmiah, Johnny; Mkhize, Makhosi

2003-07-01

South African women who live in informal settlement communities are at high risk of HIV/AIDS infection due to their poor economic and social status. Prevention programs must include methods for improving their social conditions as well as their sexual risk behaviors. Members of Partners trained 24 women from informal settlements to lead HIV/AIDS education workshops for 480 residents. When these participants reached out to their neighbors, this participatory community-based approach resulted in providing HIV/AIDS prevention messages to more than 1,440 residents. Program leaders from three settlements said in focus group discussions that results from this social influences peer led approach demonstrated that women residents are a valuable resource in providing effective HIV/AIDS prevention programs to South Africa's most vulnerable residents.

Sun Exposure, Sun-Related Symptoms, and Sun Protection Practices in an African Informal Traditional Medicines Market.

PubMed

Wright, Caradee Y; Reddy, Tarylee; Mathee, Angela; Street, Renée A

2017-09-28

Informal workers in African market trade have little formal protection against sun exposure. We aimed to examine sun exposure, sun-related symptoms, and sun protection practices in an informal occupational setting. Trained fieldworkers asked 236 workers in the Warwick Junction market about their workplace, skin and eye sensitivity and skin colour, symptoms faced at work during the summer due to heat, and preventive measures. Data were analyzed using univariate logistic regression to assess the effect of gender and the risk of experiencing symptoms to sun exposure in relation to pre-existing diseases and perception of sun exposure as a hazard. Of the 236 participants, 234 were Black African and 141 (59.7%) were female. Portable shade was the most commonly used form of sun protection (69.9%). Glare from the sun (59.7%) and excessive sweating (57.6%) were commonly reported sun-related health symptoms. The use of protective clothing was more prevalent among those who perceived sun exposure as a hazard ( p = 0.003). In an informal occupational setting, sun exposure was high. Protective clothing and portable shade to eliminate heat and bright light were self-implemented. Action by local authorities to protect informal workers should consider sun exposure to support workers in their efforts to cope in hot weather.

Real Time Alert System: A Disease Management System Leveraging Health Information Exchange

PubMed Central

Anand, Vibha; Sheley, Meena E.; Xu, Shawn; Downs, Stephen M.

2012-01-01

Background Rates of preventive and disease management services can be improved by providing automated alerts and reminders to primary care providers (PCPs) using of health information technology (HIT) tools. Methods: Using Adaptive Turnaround Documents (ATAD), an existing Health Information Exchange (HIE) infrastructure and office fax machines, we developed a Real Time Alert (RTA) system. RTA is a computerized decision support system (CDSS) that is able to deliver alerts to PCPs statewide for recommended services around the time of the patient visit. RTA is also able to capture structured clinical data from providers using existing fax technology. In this study, we evaluate RTA’s performance for alerting PCPs when their patients with asthma have an emergency room visit anywhere in the state. Results: Our results show that RTA was successfully able to deliver “just in time” patient-relevant alerts to PCPs across the state. Furthermore, of those ATADs faxed back and automatically interpreted by the RTA system, 35% reported finding the provided information helpful. The PCPs who reported finding information helpful also reported making a phone call, sending a letter or seeing the patient for follow up care. Conclusions: We have successfully demonstrated the feasibility of electronically exchanging important patient related information with the PCPs statewide. This is despite a lack of a link with their electronic health records. We have shown that using our ATAD technology, a PCP can be notified quickly of an important event such as a patient’s asthma related emergency room admission so further follow up can happen in near real time. PMID:23569648

Real time alert system: a disease management system leveraging health information exchange.

PubMed

Anand, Vibha; Sheley, Meena E; Xu, Shawn; Downs, Stephen M

2012-01-01

Rates of preventive and disease management services can be improved by providing automated alerts and reminders to primary care providers (PCPs) using of health information technology (HIT) tools. Using Adaptive Turnaround Documents (ATAD), an existing Health Information Exchange (HIE) infrastructure and office fax machines, we developed a Real Time Alert (RTA) system. RTA is a computerized decision support system (CDSS) that is able to deliver alerts to PCPs statewide for recommended services around the time of the patient visit. RTA is also able to capture structured clinical data from providers using existing fax technology. In this study, we evaluate RTA's performance for alerting PCPs when their patients with asthma have an emergency room visit anywhere in the state. Our results show that RTA was successfully able to deliver "just in time" patient-relevant alerts to PCPs across the state. Furthermore, of those ATADs faxed back and automatically interpreted by the RTA system, 35% reported finding the provided information helpful. The PCPs who reported finding information helpful also reported making a phone call, sending a letter or seeing the patient for follow up care. We have successfully demonstrated the feasibility of electronically exchanging important patient related information with the PCPs statewide. This is despite a lack of a link with their electronic health records. We have shown that using our ATAD technology, a PCP can be notified quickly of an important event such as a patient's asthma related emergency room admission so further follow up can happen in near real time.

African Ancestry Is Associated with Asthma Risk in African Americans

PubMed Central

Pino-Yanes, María; Wade, Michael S.; Pérez-Méndez, Lina; Kittles, Rick A.; Wang, Deli; Papaiahgari, Srinivas; Ford, Jean G.; Kumar, Rajesh; Garcia, Joe G. N.

2012-01-01

Background Asthma is a common complex condition with clear racial and ethnic differences in both prevalence and severity. Asthma consultation rates, mortality, and severe symptoms are greatly increased in African descent populations of developed countries. African ancestry has been associated with asthma, total serum IgE and lower pulmonary function in African-admixed populations. To replicate previous findings, here we aimed to examine whether African ancestry was associated with asthma susceptibility in African Americans. In addition, we examined for the first time whether African ancestry was associated with asthma exacerbations. Methodology/Principal Findings After filtering for self-reported ancestry and genotype data quality, samples from 1,117 self-reported African-American individuals from New York and Baltimore (394 cases, 481 controls), and Chicago (321 cases followed for asthma exacerbations) were analyzed. Genetic ancestry was estimated based on ancestry informative markers (AIMs) selected for being highly divergent among European and West African populations (95 AIMs for New York and Baltimore, and 66 independent AIMs for Chicago). Among case-control samples, the mean African ancestry was significantly higher in asthmatics than in non-asthmatics (82.0±14.0% vs. 77.8±18.1%, mean difference 4.2% [95% confidence interval (CI):2.0–6.4], p<0.0001). This association remained significant after adjusting for potential confounders (odds ratio: 4.55, 95% CI: 1.69–12.29, p = 0.003). African ancestry failed to show an association with asthma exacerbations (p = 0.965) using a model based on longitudinal data of the number of exacerbations followed over 1.5 years. Conclusions/Significance These data replicate previous findings indicating that African ancestry constitutes a risk factor for asthma and suggest that elevated asthma rates in African Americans can be partially attributed to African genetic ancestry. PMID:22235241

[Problems encountered by hospital pharmacists with information systems: Analysis of exchanges within social networks].

PubMed

Charpiat, B; Mille, F; Fombeur, P; Machon, J; Zawadzki, E; Bobay-Madic, A

2018-05-21

The development of information systems in French hospitals is mandatory. The aim of this work was to analyze the content of exchanges carried out within social networks, dealing with problems encountered with hospital pharmacies information systems. Messages exchanged via the mailing list of the Association pour le Digital et l'Information en Pharmacie and abstracts of communications presented at hospital pharmacists trade union congresses were analyzed. Those referring to information systems used in hospital pharmacies were selected. From March 2015 to June 2016, 122 e-mails sent by 80 pharmacists concerned information systems. From 2002 to 2016, 45 abstracts dealt with this topic. Problems most often addressed in these 167 documents were "parameterization and/or functionalities" (n=116), interfaces and complexity of the hospital information systems (n=52), relationship with health information technologies vendors and poor reactivity (n=32), additional workload (n=32), ergonomics (n=30), insufficient user training (n=22). These problems are interdependent, lead to errors and in order to mitigate their consequences, they compel pharmacy professionals to divert a significant amount of working hours to the detriment of pharmaceutical care and dispensing and preparing drugs. Hospital pharmacists are faced with many problems of insecurity and inefficiency generated by information systems. Researches are warranted to determine their cost, specify their deleterious effects on care and identify the safest information systems. Copyright © 2018 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

A Panel of Ancestry Informative Markers for the Complex Five-Way Admixed South African Coloured Population

PubMed Central

Daya, Michelle; van der Merwe, Lize; Galal, Ushma; Möller, Marlo; Salie, Muneeb; Chimusa, Emile R.; Galanter, Joshua M.; van Helden, Paul D.; Henn, Brenna M.; Gignoux, Chris R.; Hoal, Eileen

2013-01-01

Admixture is a well known confounder in genetic association studies. If genome-wide data is not available, as would be the case for candidate gene studies, ancestry informative markers (AIMs) are required in order to adjust for admixture. The predominant population group in the Western Cape, South Africa, is the admixed group known as the South African Coloured (SAC). A small set of AIMs that is optimized to distinguish between the five source populations of this population (African San, African non-San, European, South Asian, and East Asian) will enable researchers to cost-effectively reduce false-positive findings resulting from ignoring admixture in genetic association studies of the population. Using genome-wide data to find SNPs with large allele frequency differences between the source populations of the SAC, as quantified by Rosenberg et. al's -statistic, we developed a panel of AIMs by experimenting with various selection strategies. Subsets of different sizes were evaluated by measuring the correlation between ancestry proportions estimated by each AIM subset with ancestry proportions estimated using genome-wide data. We show that a panel of 96 AIMs can be used to assess ancestry proportions and to adjust for the confounding effect of the complex five-way admixture that occurred in the South African Coloured population. PMID:24376522

International Crisis Information Network

DTIC Science & Technology

2006-12-01

AU African Union CA Civil Affairs (Specifically United States Army) CDHAM Center for Disaster and Humanitarian Assistance Medicine CEMAC Economic...Department of Defense DODD Department of Defense Directive ECOWAS Economic Community of West African States EU European Union FR First Responder HA...passion, such as rugby fans on Rugby365.com, or music lovers on MP3.com. These people exchange ideas and thoughts about the given passion.”83 The

Health Information Seeking Among Rural African Americans, Caucasians, and Hispanics: It Is Built, Did They Come?

PubMed

Powe, Barbara D

2015-09-01

This cross-sectional study examines health information-seeking behaviors and access to and use of technology among rural African Americans, Caucasians, and Hispanics. There was a low level of health information seeking across the sample. Few used smartphones or tablets and did not endorse receiving health information from their health care provider by e-mail. Printed materials remained a source of health information as did friends and family. Information should be shared using multiple platforms including more passive methods such as television and radio. More research is needed to ensure the health literacy, numeracy, and ability to navigate the online environment. Copyright © 2015 Elsevier Inc. All rights reserved.

Strategies to Prevent and Reduce Diabetes and Obesity in Sacramento, California: The African American Leadership Coalition and University of California, Davis

PubMed Central

Styne, Dennis; Askia, Joyce; Roberts, Tina; Lewis, Edward T.; Edwards, Whitney

2013-01-01

Background Diabetes is one of the leading causes of illness and death for African Americans and people of African descent throughout the United States and in the city and county of Sacramento, California. The involvement of families and communities in developing prevention strategies can increase the likelihood that behavioral changes will be sustained. Context Three member organizations of the African American Leadership Coalition (AALC) entered into a partnership with the University of California, Davis (UC Davis) to engage families in developing a process to identify barriers to diabetes and obesity prevention and reduction, exchange strategies, and create action plans for prevention. Methods The intervention comprised 3 phases: 1) coalition formation and training; 2) data collection, analysis, and dissemination of results; and 3) development of family and community action plans. Academic and community partners planned and implemented all project phases together. Outcomes Sources of information about diabetes and obesity were primarily doctors and the Internet; barriers were related to lack of time needed to prepare healthy meals, high food costs, transportation to fresh markets, motivation around healthy habits, and unsafe environments. Action plans addressed behavioral change and family cohesion. The group discussion format encouraged mutual support and suggestions for better eating and physical exercise habits. Interpretation This collaborative partnership model can strengthen existing group relationships or promote new affiliations that form the basis for future action coalitions. Participants worked both within and across groups to exchange information, stories of success and challenges, and specific health improvement strategies. PMID:24229570

Sexual health information seeking on the Internet: comparisons between White and African American college students.

PubMed

Fogel, Joshua; Fajiram, Sandra; Morgan, Phyllis D

2010-01-01

College students are often interested in information about sexual health topics. A study of 149 college students and their use of the Internet for sexual health information was conducted. The study findings indicated that African American college students, as compared to White college students, and women, as compared to men, had greater odds for searching on the Internet for birth control information. Among male college students, a higher internal locus of control was associated with lower odds for looking at birth control information on the Internet. Nurses and healthcare providers working in college settings can use these findings to develop strategies for identifying those who are more likely to reference the Internet to obtain birth control and sexual health information.

Bridging Organizational Divides in Health Care: An Ecological View of Health Information Exchange

PubMed Central

Johnson, Kevin B; Gadd, Cynthia S; Lorenzi, Nancy M

2013-01-01

Background The fragmented nature of health care delivery in the United States leads to fragmented health information and impedes patient care continuity and safety. Technologies to support interorganizational health information exchange (HIE) are becoming more available. Understanding how HIE technology changes health care delivery and affects people and organizations is crucial to long-term successful implementation. Objective Our study investigated the impacts of HIE technology on organizations, health care providers, and patients through a new, context-aware perspective, the Regional Health Information Ecology. Methods We conducted more than 180 hours of direct observation, informal interviews during observation, and 9 formal semi-structured interviews. Data collection focused on workflow and information flow among health care team members and patients and on health care provider use of HIE technology. Results We structured the data analysis around five primary information ecology components: system, locality, diversity, keystone species, and coevolution. Our study identified three main roles, or keystone species, involved in HIE: information consumers, information exchange facilitators, and information repositories. The HIE technology impacted patient care by allowing providers direct access to health information, reducing time to obtain health information, and increasing provider awareness of patient interactions with the health care system. Developing the infrastructure needed to support HIE technology also improved connections among information technology support groups at different health care organizations. Despite the potential of this type of technology to improve continuity of patient care, HIE technology adoption by health care providers was limited. Conclusions To successfully build a HIE network, organizations had to shift perspectives from an ownership view of health data to a continuity of care perspective. To successfully integrate external health

Guidelines to encourage the adoption and meaningful use of health information technologies in the South African healthcare landscape.

PubMed

Mostert-Phipps, Nicky; Pottas, Dalenca; Korpela, Mikko

2013-01-01

There are various benefits associated with the adoption and meaningful use of health information technologies (HITs) in the healthcare sector. Despite these benefits, the South African healthcare sector has been slow to adopt HITs such as electronic record systems. The purpose of this research project was to formulate guidelines to encourage the adoption and meaningful use of HITs in the South African healthcare landscape. A three-round Delphi study was conducted to identify factors that should be addressed to encourage the adoption and meaningful use of HITs in the South African healthcare landscape. The Delphi panel included 21 participants that were considered to be suitably knowledgeable regarding the area under consideration. Consensus was reached on 42 factors that were rated as having a direct to significant impact on the adoption and meaningful use of HITs in the South African context. These factors were further analysed to formulate 20 guidelines that indicate that there are a wide range of factors that would have to be addressed involving a multitude of stakeholders.

The value of health care information exchange and interoperability.

PubMed

Walker, Jan; Pan, Eric; Johnston, Douglas; Adler-Milstein, Julia; Bates, David W; Middleton, Blackford

2005-01-01

In this paper we assess the value of electronic health care information exchange and interoperability (HIEI) between providers (hospitals and medical group practices) and independent laboratories, radiology centers, pharmacies, payers, public health departments, and other providers. We have created an HIEI taxonomy and combined published evidence with expert opinion in a cost-benefit model. Fully standardized HIEI could yield a net value of dollar 77.8 billion per year once fully implemented. Nonstandardized HIEI offers smaller positive financial returns. The clinical impact of HIEI for which quantitative estimates cannot yet be made would likely add further value. A compelling business case exists for national implementation of fully standardized HIEI.

What should we measure? Conceptualizing usage in health information exchange

PubMed Central

Jasperson, Jon

2010-01-01

Under the provisions of the Health Information Technology for Economic & Clinical Health act providers need to demonstrate their ‘meaningful use’ of electronic health record systems' health information exchange (HIE) capability. HIE usage is not a simple construct, but the choice of its measurement must attend to the users, context, and objectives of the system being examined. This review examined how usage is reported in the existing literature and also what conceptualizations of usage might best reflect the nature and objectives of HIE. While existing literature on HIE usage included a diverse set of measures, most were theoretically weak, did not attend to the interplay of measure, level of analysis and architectural strategy, and did not reflect how HIE usage affected the actual process of care. Attention to these issues will provide greater insight into the effects of previously inaccessible information on medical decision-making and the process of care. PMID:20442148

A case report in health information exchange for inter-organizational patient transfers.

PubMed

Richardson, J E; Malhotra, S; Kaushal, R

2014-01-01

To provide a case report of barriers and promoters to implementing a health information exchange (HIE) tool that supports patient transfers between hospitals and skilled nursing facilities. A multi-disciplinary team conducted semi-structured telephone and in-person interviews in a purposive sample of HIE organizational informants and providers in New York City who implemented HIE to share patient transfer information. The researchers conducted grounded theory analysis to identify themes of barriers and promoters and took steps to improve the trustworthiness of the results including vetting from a knowledgeable study participant. Between May and October 2011, researchers recruited 18 participants: informaticians, healthcare administrators, software engineers, and providers from a skilled nursing facility. Subjects perceived the HIE tool's development a success in that it brought together stakeholders who had traditionally not partnered for informatics work, and that they could successfully share patient transfer information between a hospital and a skilled nursing facility. Perceived barriers included lack of hospital stakeholder buy-in and misalignment with clinical workflows that inhibited use of HIE-based patient transfer data. Participants described barriers and promoters in themes related to organizational, technical, and user-oriented issues. The investigation revealed that stakeholders could develop and implement health information technology that technically enables clinicians in both hospitals and skilled nursing facilities to exchange real-time information in support of patient transfers. User level barriers, particularly in the emergency department, should give pause to developers and implementers who plan to use HIE in support of patient transfers. Participants' experiences demonstrate how stakeholders may succeed in developing and piloting an electronic transfer form that relies on HIE to aggregate, communicate, and display relevant patient transfer

An Assessment of Information Exchange Practices, Challenges, and Opportunities to Support US Disease Surveillance in 3 States.

PubMed

Garcia, Macarena C; Garrett, Nedra Y; Singletary, Vivian; Brown, Sheereen; Hennessy-Burt, Tamara; Haney, Gillian; Link, Kimberly; Tripp, Jennifer; Mac Kenzie, William R; Yoon, Paula

2017-12-07

State and local public health agencies collect and use surveillance data to identify outbreaks, track cases, investigate causes, and implement measures to protect the public-s health through various surveillance systems and data exchange practices. The purpose of this assessment was to better understand current practices at state and local public health agencies for collecting, managing, processing, reporting, and exchanging notifiable disease surveillance information. Over an 18-month period (January 2014-June 2015), we evaluated the process of data exchange between surveillance systems, reporting burdens, and challenges within 3 states (California, Idaho, and Massachusetts) that were using 3 different reporting systems. All 3 states use a combination of paper-based and electronic information systems for managing and exchanging data on reportable conditions within the state. The flow of data from local jurisdictions to the state health departments varies considerably. When state and local information systems are not interoperable, manual duplicative data entry and other work-arounds are often required. The results of the assessment show the complexity of disease reporting at the state and local levels and the multiple systems, processes, and resources engaged in preparing, processing, and transmitting data that limit interoperability and decrease efficiency. Through this structured assessment, the Centers for Disease Control and Prevention (CDC) has a better understanding of the complexities for surveillance of using commercial off-the-shelf data systems (California and Massachusetts), and CDC-developed National Electronic Disease Surveillance System Base System. More efficient data exchange and use of data will help facilitate interoperability between National Notifiable Diseases Surveillance Systems.

Observability and Estimation of Distributed Space Systems via Local Information-Exchange Networks

NASA Technical Reports Server (NTRS)

Rahmani, Amirreza; Mesbahi, Mehran; Fathpour, Nanaz; Hadaegh, Fred Y.

2008-01-01

In this work, we develop an approach to formation estimation by explicitly characterizing formation's system-theoretic attributes in terms of the underlying inter-spacecraft information-exchange network. In particular, we approach the formation observer/estimator design by relaxing the accessibility to the global state information by a centralized observer/estimator- and in turn- providing an analysis and synthesis framework for formation observers/estimators that rely on local measurements. The noveltyof our approach hinges upon the explicit examination of the underlying distributed spacecraft network in the realm of guidance, navigation, and control algorithmic analysis and design. The overarching goal of our general research program, some of whose results are reported in this paper, is the development of distributed spacecraft estimation algorithms that are scalable, modular, and robust to variations inthe topology and link characteristics of the formation information exchange network. In this work, we consider the observability of a spacecraft formation from a single observation node and utilize the agreement protocol as a mechanism for observing formation states from local measurements. Specifically, we show how the symmetry structure of the network, characterized in terms of its automorphism group, directly relates to the observability of the corresponding multi-agent system The ramification of this notion of observability over networks is then explored in the context of distributed formation estimation.

The essential role of reconfiguration capabilities in the implementation of HIV-related health information exchanges.

PubMed

Steward, Wayne T; Koester, Kimberly A; Collins, Shane P; Maiorana, Andre; Myers, Janet J

2012-10-01

To understand the dynamic capabilities that enabled the six demonstration projects of the Information Technology Networks of Care Initiative to implement health information exchanges (HIEs) tailored to their local HIV epidemics and regional care systems. We conducted 111 semi-structured interviews with project staff and information technology (IT) specialists associated with the demonstration projects, staff from community-based organizations and public health agencies collaborating in the design and implementation of the HIEs, and providers who used each HIE. The dynamic capability framework guided analyses. In the context of a HIE, the framework's components include information systems (the actual technological exchange systems and capacity to update them), absorptive capacity (the ability to implement an operating HIE), reconfiguration capacity (the ability to adapt workflows and clinical practices in response to a HIE), and organizational size and human resources (characteristics likely to affect a clinic's ability to respond). Across the projects, we found evidence for the importance of three dynamic capabilities: information systems, reconfiguration capacity, and organizational size and human resources. However, of these three, reconfiguration capacity was the most salient. Implementation outcomes at all six of the projects were shaped substantially by the degree of attention dedicated to reworking procedures and practices so that HIE usage became routine. Electronic information exchange offers the promise of improved coordination of care. However, implementation of HIEs goes beyond programing and hardware installation challenges, and requires close attention to the needs of the HIEs end-users. Providers need to discern value from a HIE because their active participation is essential to ensuring that clinic and agency practices and procedures are reconfigured to incorporate new systems into daily work processes. Copyright © 2012 Elsevier Ireland Ltd. All

47 CFR 1.731 - Confidentiality of information produced or exchanged by the parties.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the party believes in good faith that the materials fall within an exemption to disclosure contained... Complaints § 1.731 Confidentiality of information produced or exchanged by the parties. (a) Any materials... confidentiality for such materials shall so indicate by clearly marking each page, or portion thereof, for which a...

Using a "Socio-Cultural" Approach in Teaching Information Technology to African American Students with Academic Difficulties

ERIC Educational Resources Information Center

Seay, Cameron

2004-01-01

There continues to be a severe under-representation of African Americans in the fields of information technology (IT) and computer science. The author contends that this is attributable, at least in part, to inappropriate assumptions about the nature of thinking, knowing, teaching and learning. He contends that attention given to these assumptions…

Use of Computers in Information Handling. Report of the DSE/PADIS Training Workshop (Nairobi, Kenya, April 21-May 2, 1986).

ERIC Educational Resources Information Center

Huttemann, Lutz, Ed.; Inganji, Francis K., Ed.

This workshop attended by 21 participants from 13 countries was designed to promote the use of computerized information and documentation services in the eastern and southern African subregion, and increase the exchange of experiences of the personnel involved in the field. The full text is provided for the following papers presented at the…

Changing Fatherhood: An Exploratory Qualitative Study with African and African Caribbean Men in England

ERIC Educational Resources Information Center

Williams, Robert; Hewison, Alistair; Wildman, Stuart; Roskell, Carolyn

2013-01-01

This paper presents findings from a qualitative study undertaken with 46 African and African Caribbean men exploring their experiences of fatherhood. Data analysis was informed by Connell's theoretical work on changing gender relations. Findings indicate that fathers' lives were mediated by masculinities, racism, gender, migration and generational…

An Introduction to West African Literature.

ERIC Educational Resources Information Center

Taiwo, Oladele

Intended to provide help for those interested in studying West African literature, this book is divided into three parts. Part One provides background information: the various African oral traditions are discussed, related to the way of life of the people, and examined for the extent to which they form the basis of present West African literary…

The ichthyoplankton assemblage of the Canaries-African Coastal Transition Zone: A review

NASA Astrophysics Data System (ADS)

Rodriguez, J. M.; Moyano, M.; Hernandez-Leon, S.

2009-12-01

In this paper we review information on the ichthyoplankton assemblage of the Canaries-African Coastal Transition Zone (C-ACTZ). This CTZ shows the singularity that the Canary Archipelago interrupts the main flow of the Canary Current and Trade Winds, introducing large mesoscale variability, in the form of island warm wakes and cyclonic and anticyclonic eddies downstream of the islands. Besides, upwelling filaments stretch towards the archipelago from the African coastal upwelling, transporting phytoplankton, zooplankton and fish larvae. They also interact with eddies shed from the islands to exchange water properties and biogenic material. All these mesoscale features influence the composition, structure, abundance and distribution of the larval fish community (LFC) of the region. The Canary Current (CC) and eddies shed from the islands drag larvae of island neritic fish species into the oceanic region and contribute, along warm wakes, to the horizontal distribution of fish larvae. Upwelling and upwelling filaments transport larvae of African neritic species into the oceanic region. These larvae dominate the LFC and account for the relatively high average larval fish abundance found in the C-ACTZ during the summer upwelling season. Filaments originated in the region of Cape Juby-Cape Bojador are entrained around a quasi-permanent cyclonic eddy, trapped between Gran Canaria Island and the African coast, forming a system through which most of the African neritic larvae may return to the African shelf. However, some larvae reach the eastern islands of the Canary archipelago and they may be spread all over the neritic region of the archipelago by eddies shed from the islands. Also in summer, the distribution of the LFC of the C-ACTZ is vertically stratified and fish larvae seem to carry out little or not diel vertical migration. Overall, this study highlights the strong relationship between mesoscale oceanographic processes and the LFC in the C-ACTZ.

Repeated Diagnostic Imaging Studies in Ontario and the Impact of Health Information Exchange Systems.

PubMed

Welk, Blayne; Liu, Kuan; Al-Jaishi, Ahmed; McArthur, Eric; Jain, Arsh K; Ordon, Michael

2016-01-01

Health information exchange systems can link the results of diagnostic imaging tests across hospitals and geographic areas. One of the potential benefits of these systems is a reduction in imaging studies ordered by physicians who do not know about or have access to the previous imaging results. We used administrative data from Ontario, Canada (from the year 2013), to measure how frequently the same cross-sectional imaging study is repeated in a patient. Overall, 12.8% of the specified imaging tests were repeated within 90 days. An area of Southwestern Ontario with a health information exchange system for diagnostic imaging tests had a 13% lower rate of repeat cross-sectional imaging compared with the rest of the province (11.2 vs 12.8%, p < 0.01). The use of linked radiology systems may be able to reduce the number of repeated imaging tests and improve patient safety and hospital efficiency.

African Americans’ and Hispanics’ Information Needs About Cancer Care

PubMed Central

Muñoz-Antonia, Teresita; Ung, Danielle; Montiel-Ishino, F. Alejandro; Nelson, Alison; Canales, Jorge; Quinn, Gwendolyn P.

2015-01-01

Few studies have reported on African American and Hispanic (AA and H) populations’ informational needs when seeking cancer care at an institution that offers clinical trials. Moffitt Cancer Center (MCC) sought to identify and examine the decision making process, the perceptions, and the preferred channels of communication about cancer care services for AA and H communities in order to develop a list of marketing recommendations. Five focus groups (N=45) consisting of two AA and three H were conducted in four counties of the MCC catchment area in Tampa, FL. Participants were asked about their perceptions, knowledge, attitudes, and beliefs about cancer care and MCC. Focus groups were audio-recorded and verbatim transcripts were analyzed using content analysis. Similarities in responses were found between AA and H participants. Participants received general health and cancer information from media sources and word of mouth and preferred to hear patient testimonials. There were concerns about costs, insurance coverage, and the actual geographic location of the cancer center. In general, H participants were not opposed to participating in cancer clinical trials/research, whereas, AA participants were more hesitant. A majority of participants highly favored an institution that offered standard care and clinical trials. AA and H participants shared similar concerns and preferences in communication channels, but each group had specific informational needs. The perceptions and preferences of AA and H must be explored in order to successfully and efficiently increase cancer clinical trial participation. PMID:25189798

African Americans' and Hispanics' information needs about cancer care.

PubMed

Muñoz-Antonia, Teresita; Ung, Danielle; Montiel-Ishino, F Alejandro; Nelson, Alison; Canales, Jorge; Quinn, Gwendolyn P

2015-06-01

Few studies have reported on African American and Hispanic (AA and H) populations' informational needs when seeking cancer care at an institution that offers clinical trials. Moffitt Cancer Center (MCC) sought to identify and examine the decision making process, the perceptions, and the preferred channels of communication about cancer care services for AA and H communities in order to develop a list of marketing recommendations. Five focus groups (N = 45) consisting of two AA and three H were conducted in four counties of the MCC catchment area in Tampa, FL. Participants were asked about their perceptions, knowledge, attitudes, and beliefs about cancer care and MCC. Focus groups were audio-recorded and verbatim transcripts were analyzed using content analysis. Similarities in responses were found between AA and H participants. Participants received general health and cancer information from media sources and word of mouth and preferred to hear patient testimonials. There were concerns about costs, insurance coverage, and the actual geographic location of the cancer center. In general, H participants were not opposed to participating in cancer clinical trials/research, whereas, AA participants were more hesitant. A majority of participants highly favored an institution that offered standard care and clinical trials. AA and H participants shared similar concerns and preferences in communication channels, but each group had specific informational needs. The perceptions and preferences of AA and H must be explored in order to successfully and efficiently increase cancer clinical trial participation.

Role of Department Heads in Academic Development: A Leader-Member Exchange and Organizational Resource Perspective

ERIC Educational Resources Information Center

Horne, Andre Leonard; du Plessis, Yvonne; Nkomo, Stella

2016-01-01

This article examines the role of leadership in the development of academic talent in higher education from a social exchange and organizational support perspective. Drawing from a sample of academic staff at a large South African university, the study investigates the extent to which a quality leader-member exchange relationship versus a formal…

Information Exchange Procedures for Major Research Universities; Technical Diary of the Major Research Universities' Pilot Test.

ERIC Educational Resources Information Center

Topping, Jim

The applicability and validity of NCHEMS' Information Exchange Procedures (IEP) to major research universities are examined. IEP enables peer institutions to compare information about their resources. Evaluation of the IEP costing methods are examined in this document, which is intended as an appendix to "Evaluation of the IEP Costing…

47 CFR 54.1306 - Updating Information Submitted to the National Exchange Carrier Association.

Code of Federal Regulations, 2014 CFR

2014-10-01

... incumbent local exchange carrier subject to § 54.1301(a) may update the information submitted to the... on a rolling year basis according to the schedule. (1) Submit data covering the last nine months of... September 30th of the existing year; (2) Submit data covering the last six months of the previous calendar...

Proceedings of the Southern Regional Information Exchange Group Biennial Symposium on Forest Genetics

Treesearch

G. Sam Foster; Alex M. Diner; [Editors

1994-01-01

This volume is the proceedings of the 1992 Southern Regional Information Exchange Group (SRIEG) Biennial Symposium on Forest Genetics. The meeting was held in Huntsville, Alabama, USA on July 8-10, 1992 and was entitled, "Applications of Vegetative Propagation in Forestry." The nine papers were divided into three sets under the headings: "Tissue Culture...

HIV/AIDS information by African companies: an empirical analysis.

PubMed

Barako, Dulacha G; Taplin, Ross H; Brown, Alistair M

2010-01-01

This article investigates the extent of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Disclosures (HIV/AIDSD) in online annual reports by 200 listed companies from 10 African countries for the year ending 2006. Descriptive statistics reveal a very low level of overall HIV/AIDSD practices with a mean of 6 per cent disclosure, with half (100 out of 200) of the African companies making no disclosures at all. Logistic regression analysis reveals that company size and country are highly significant predictors of any disclosure of HIV/AIDS in annual reports. Profitability is also statistically significantly associated with the extent of disclosure.

Practices, technologies, and usage of incident management and traveler information exchange and sharing in Texas

DOT National Transportation Integrated Search

2001-12-01

In this report, researchers present a review of the practices and technologies being used in Texas for incident management and traveler information exchange and sharing. Through interviews and site visits, researchers assimilated data from the Dallas...

Establishing and Enriching School-Community Ties in Small Schools. Small Schools Network Information Exchange Number 6.

ERIC Educational Resources Information Center

Regional Laboratory for Educational Improvement of the Northeast & Islands, Andover, MA.

This information packet contains 14 articles reprinted from various books and journals. Establishing and enriching school-community ties in small schools is the theme for this "Information Exchange Packet," the sixth in a series developed for Small Schools Network members. The articles and their authors are: "Skills in Building Support for…

African American Pastors' Beliefs and Actions Regarding Childhood Incest in the African American Community

ERIC Educational Resources Information Center

Wells, Tesia Denis

2012-01-01

This quantitative study sought to explore African American pastors' beliefs and actions regarding childhood incest in the African American community and their decisions to inform the proper authorities. This exploratory study was developed in order to draw both public and academic attention to the understudied phenomenon of childhood incest within…

Building the Next Generation of Scientists with US-Africa Exchange Programs

NASA Astrophysics Data System (ADS)

Sheth, Kartik

2014-01-01

In the past couple of decades and in the upcoming decade an explosion of cutting edge multi-wavelength facilities have begun or are expected to be operating across the African continent (SALT, HESS, MITRA, AVN, PAPER, MeerKAT, African VLBI and the SKA). At the same time countries across the continent are developing human capacity in science and technology using astronomy as a gateway science. Building on previous collaborations between the National Radio Astronomy Observatory and South Africa, we are embarking on an effort to build a new international (and national) partnership to exchange students and faculty between the US and the African continent. I will describe the status and future development plans for this program.

Geographical distribution of patients visiting a health information exchange in New York City

PubMed Central

Onyile, Arit; Vaidya, Sandip R; Kuperman, Gilad; Shapiro, Jason S

2013-01-01

Objective For a health information exchange (HIE) organization to succeed in any given region, it is important to understand the optimal catchment area for the patient population it is serving. The objective of this analysis was to understand the geographical distribution of the patients being served by one HIE organization in New York City (NYC). Materials and Methods Patient demographic data were obtained from the New York Clinical Information Exchange (NYCLIX), a regional health information organization (RHIO) representing most of the major medical centers in the borough of Manhattan in NYC. Patients’ home address zip codes were used to create a research dataset with aggregate counts of patients by US county and international standards organization country. Times Square was designated as the geographical center point of the RHIO for distance calculations. Results Most patients (87.7%) live within a 30 mile radius from Times Square and there was a precipitous drop off of patients visiting RHIO-affiliated facilities at distances greater than 100 miles. 43.6% of patients visiting NYCLIX facilities were from the other NYC boroughs rather than from Manhattan itself (31.9%). Discussion Most patients who seek care at members of NYCLIX live within a well-defined area and a clear decrease in patients visiting NYCLIX sites with distance was identified. Understanding the geographical distribution of patients visiting the large medical centers in the RHIO can inform the RHIO's planning as it looks to add new participant organizations in the surrounding geographical area. PMID:23104049

Feasibility of 30-day hospital readmission prediction modeling based on health information exchange data.

PubMed

Swain, Matthew J; Kharrazi, Hadi

2015-12-01

Unplanned 30-day hospital readmission account for roughly $17 billion in annual Medicare spending. Many factors contribute to unplanned hospital readmissions and multiple models have been developed over the years to predict them. Most researchers have used insurance claims or administrative data to train and operationalize their Readmission Risk Prediction Models (RRPMs). Some RRPM developers have also used electronic health records data; however, using health informatics exchange data has been uncommon among such predictive models and can be beneficial in its ability to provide real-time alerts to providers at the point of care. We conducted a semi-systematic review of readmission predictive factors published prior to March 2013. Then, we extracted and merged all significant variables listed in those articles for RRPMs. Finally, we matched these variables with common HL7 messages transmitted by a sample of health information exchange organizations (HIO). The semi-systematic review resulted in identification of 32 articles and 297 predictive variables. The mapping of these variables with common HL7 segments resulted in an 89.2% total coverage, with the DG1 (diagnosis) segment having the highest coverage of 39.4%. The PID (patient identification) and OBX (observation results) segments cover 13.9% and 9.1% of the variables. Evaluating the same coverage in three sample HIOs showed data incompleteness. HIOs can utilize HL7 messages to develop unique RRPMs for their stakeholders; however, data completeness of exchanged messages should meet certain thresholds. If data quality standards are met by stakeholders, HIOs would be able to provide real-time RRPMs that not only predict intra-hospital readmissions but also inter-hospital cases. A RRPM derived using HIO data exchanged through may prove to be a useful method to prevent unplanned hospital readmissions. In order for the RRPM derived from HIO data to be effective, hospitals must actively exchange clinical information

Reciprocal Family, Friendship and Church Support Networks of African Americans: Findings from the National Survey of American Life.

PubMed

Taylor, Robert Joseph; Mouzon, Dawne M; Nguyen, Ann W; Chatters, Linda M

2016-12-01

This study examined reciprocal support networks involving extended family, friends and church members among African Americans. Our analysis examined specific patterns of reciprocal support (i.e., received only, gave only, both gave and received, neither gave or received), as well as network characteristics (i.e., contact and subjective closeness) as correlates of reciprocal support. The analysis is based on the African American sub-sample of the National Survey of American Life (NSAL). Overall, our findings indicate that African Americans are very involved in reciprocal support networks with their extended family, friends and church members. Respondents were most extensively involved in reciprocal supports with extended family members, followed closely by friends and church networks. Network characteristics (i.e., contact and subjective closeness) were significantly and consistently associated with involvement with reciprocal support exchanges for all three networks. These and other findings are discussed in detail. This study complements previous work on the complementary roles of family, friend and congregational support networks, as well as studies of racial differences in informal support networks.

Emergency Physicians’ Perceptions of Health Information Exchange

PubMed Central

Shapiro, Jason S.; Kannry, Joseph; Kushniruk, Andre W.; Kuperman, Gilad

2007-01-01

Background Health information exchange (HIE) is a potentially powerful technology that can improve the quality of care delivered in emergency departments, but little is known about emergency physicians’ current perceptions of HIE. Objectives This study sought to assess emergency physicians’ perceived needs and knowledge of HIE. Methods A questionnaire was developed based on heuristics from the literature and implemented in a Web-based tool. The survey was sent as a hyperlink via e-mail to 371 attending emergency physicians at 12 hospitals in New York City. Results The response rate was 58% (n = 216). Although 63% said more than one quarter of their patients would benefit from external health information, the barriers to obtain it without HIE are too high—85% said it was difficult or very difficult to obtain external data, taking an average of 66 minutes, 72% said that their attempts fail half of the time, and 56% currently attempt to obtain external data less than 10% of the time. When asked to create a rank-order list, electrocardiograms (ECGs) were ranked the highest, followed by discharge summaries. Respondents also chose images over written reports for ECGs and X-rays, but preferred written reports for advanced imaging and cardiac studies. Conclusion There is a strong perceived need for HIE, most respondents were not aware of HIE prior to this study, and there are certain types of data and presentations of data that are preferred by emergency physicians in the New York City region. PMID:17712079

Emergency physicians' perceptions of health information exchange.

PubMed

Shapiro, Jason S; Kannry, Joseph; Kushniruk, Andre W; Kuperman, Gilad

2007-01-01

Health information exchange (HIE) is a potentially powerful technology that can improve the quality of care delivered in emergency departments, but little is known about emergency physicians' current perceptions of HIE. This study sought to assess emergency physicians' perceived needs and knowledge of HIE. A questionnaire was developed based on heuristics from the literature and implemented in a Web-based tool. The survey was sent as a hyperlink via e-mail to 371 attending emergency physicians at 12 hospitals in New York City. The response rate was 58% (n = 216). Although 63% said more than one quarter of their patients would benefit from external health information, the barriers to obtain it without HIE are too high--85% said it was difficult or very difficult to obtain external data, taking an average of 66 minutes, 72% said that their attempts fail half of the time, and 56% currently attempt to obtain external data less than 10% of the time. When asked to create a rank-order list, electrocardiograms (ECGs) were ranked the highest, followed by discharge summaries. Respondents also chose images over written reports for ECGs and X-rays, but preferred written reports for advanced imaging and cardiac studies. There is a strong perceived need for HIE, most respondents were not aware of HIE prior to this study, and there are certain types of data and presentations of data that are preferred by emergency physicians in the New York City region.

Verifier-based three-party authentication schemes using extended chaotic maps for data exchange in telecare medicine information systems.

PubMed

Lee, Tian-Fu

2014-12-01

Telecare medicine information systems provide a communicating platform for accessing remote medical resources through public networks, and help health care workers and medical personnel to rapidly making correct clinical decisions and treatments. An authentication scheme for data exchange in telecare medicine information systems enables legal users in hospitals and medical institutes to establish a secure channel and exchange electronic medical records or electronic health records securely and efficiently. This investigation develops an efficient and secure verified-based three-party authentication scheme by using extended chaotic maps for data exchange in telecare medicine information systems. The proposed scheme does not require server's public keys and avoids time-consuming modular exponential computations and scalar multiplications on elliptic curve used in previous related approaches. Additionally, the proposed scheme is proven secure in the random oracle model, and realizes the lower bounds of messages and rounds in communications. Compared to related verified-based approaches, the proposed scheme not only possesses higher security, but also has lower computational cost and fewer transmissions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Complex lives: resiliency of African American Women with HIV/AIDS serving as informal kinship care providers.

PubMed

Stokes, Charu

2014-01-01

Using the resiliency model as a framework, this qualitative description study was designed to elicit the experiences of African American women living with HIV/AIDS serving as informal kinship care providers. Themes emerging from the interviews included (a) strengths of informal social supports, (b) benefits of living with HIV as opposed to women who are not HIV positive, and (c) negative experiences of child welfare services. Findings suggest a plethora of resources women accessed through community-based agencies because of their HIV/AIDS status, as opposed to child welfare agencies.

Observability and Estimation of Distributed Space Systems via Local Information-Exchange Networks

NASA Technical Reports Server (NTRS)

Fathpour, Nanaz; Hadaegh, Fred Y.; Mesbahi, Mehran; Rahmani, Amirreza

2011-01-01

Spacecraft formation flying involves the coordination of states among multiple spacecraft through relative sensing, inter-spacecraft communication, and control. Most existing formation-flying estimation algorithms can only be supported via highly centralized, all-to-all, static relative sensing. New algorithms are proposed that are scalable, modular, and robust to variations in the topology and link characteristics of the formation exchange network. These distributed algorithms rely on a local information exchange network, relaxing the assumptions on existing algorithms. Distributed space systems rely on a signal transmission network among multiple spacecraft for their operation. Control and coordination among multiple spacecraft in a formation is facilitated via a network of relative sensing and interspacecraft communications. Guidance, navigation, and control rely on the sensing network. This network becomes more complex the more spacecraft are added, or as mission requirements become more complex. The observability of a formation state was observed by a set of local observations from a particular node in the formation. Formation observability can be parameterized in terms of the matrices appearing in the formation dynamics and observation matrices. An agreement protocol was used as a mechanism for observing formation states from local measurements. An agreement protocol is essentially an unforced dynamic system whose trajectory is governed by the interconnection geometry and initial condition of each node, with a goal of reaching a common value of interest. The observability of the interconnected system depends on the geometry of the network, as well as the position of the observer relative to the topology. For the first time, critical GN&C (guidance, navigation, and control estimation) subsystems are synthesized by bringing the contribution of the spacecraft information-exchange network to the forefront of algorithmic analysis and design. The result is a

Sociotechnical challenges to developing technologies for patient access to health information exchange data

PubMed Central

Ancker, Jessica S; Miller, Melissa C; Patel, Vaishali; Kaushal, Rainu

2014-01-01

Background Providing patients with access to their medical data is widely expected to help educate and empower them to manage their own health. Health information exchange (HIE) infrastructures could potentially help patients access records across multiple healthcare providers. We studied three HIE organizations as they developed portals to give consumers access to HIE data previously exchanged only among healthcare organizations. Objective To follow the development of new consumer portal technologies, and to identify barriers and facilitators to patient access to HIE data. Methods Semistructured interviews of 15 key informants over a 2-year period spanning the development and early implementation of three new projects, coded according to a sociotechnical framework. Results As the organizations tried to develop functionality that fully served the needs of both providers and patients, plans were altered by technical barriers (primarily related to data standardization) and cultural and legal issues surrounding data access. Organizational changes also played an important role in altering project plans. In all three cases, patient access to data was significantly scaled back from initial plans. Conclusions This prospective study revealed how sociotechnical factors previously identified as important in health information technology success and failure helped to shape the evolution of three novel consumer informatics projects. Barriers to providing patients with seamless access to their HIE data were multifactorial. Remedies will have to address technical, organizational, cultural, and other factors. PMID:24064443

Towards an optimal flow: Density-of-states-informed replica-exchange simulations

DOE PAGES

Vogel, Thomas; Perez, Danny

2015-11-05

Here we learn that replica exchange (RE) is one of the most popular enhanced-sampling simulations technique in use today. Despite widespread successes, RE simulations can sometimes fail to converge in practical amounts of time, e.g., when sampling around phase transitions, or when a few hard-to-find configurations dominate the statistical averages. We introduce a generalized RE scheme, density-of-states-informed RE, that addresses some of these challenges. The key feature of our approach is to inform the simulation with readily available, but commonly unused, information on the density of states of the system as the RE simulation proceeds. This enables two improvements, namely,more » the introduction of resampling moves that actively move the system towards equilibrium and the continual adaptation of the optimal temperature set. As a consequence of these two innovations, we show that the configuration flow in temperature space is optimized and that the overall convergence of RE simulations can be dramatically accelerated.« less

Health Information-Seeking Practices of African American Young Men Who Have Sex with Men: A Qualitative Study

ERIC Educational Resources Information Center

Rose, India D.; Friedman, Daniela B.; Spencer, S. Melinda; Annang, Lucy; Lindley, Lisa L.

2016-01-01

The current study used a qualitative, phenomenological approach to investigate the health information-seeking practices of African American young men who have sex with men (AAYMSM). Forty-two self-identified AAYMSM, aged 18 to 21, residing in a Southeastern U.S. city participated in a qualitative focus group or face-to-face interview to examine…

[No exchange of information without technology : modern infrastructure in radiology].

PubMed

Hupperts, H; Hermann, K-G A

2014-01-01

Modern radiology cannot accomplish the daily numbers of examinations without supportive technology. Even though technology seems to be becoming increasingly more indispensable, business continuity should be ensured at any time and if necessary even with a limited technical infrastructure by business continuity management. An efficient information security management system forms the basis. The early radiology information systems were islands of information processing. A modern radiology department must be able to be modularly integrated into an informational network of a bigger organization. The secondary use of stored data for clinical decision-making support poses new challenges for the integrity of the data or systems because medical knowledge is displayed and provided in a context of treatment. In terms of imaging the creation and distribution radiology services work in a fully digital manner which is often different for radiology reports. Legally secure electronic diagnostic reports require a complex technical infrastructure; therefore, diagnostic findings still need to be filed as a paper document. The internal exchange and an improved dose management can be simplified by systems which continuously and automatically record the doses and thus provide the possibility of permanent analysis and reporting. Communication between patient and radiologist will gain ongoing importance. Intelligent use of technology will convey this to the radiologist and it will facilitate the understanding of the information by the patient.

The Role of Cooperation and Information Exchange in Transnational River Basins: the Zambezi River case

NASA Astrophysics Data System (ADS)

Castelletti, A.; Giuliani, M.; Soncini-Sessa, R.

2012-12-01

The presence of multiple, institutionally independent but physically interconnected decision-makers is a distinctive features of many water resources systems, especially of transnational river basins. The adoption of a centralized approach to study the optimal operation of these systems, as mostly done in the water resources literature, is conceptually interesting to quantify the best achievable performance, but of little practical impact given the real political and institutional setting. Centralized management indeed assumes a cooperative attitude and full information exchange by the involved parties. However, when decision-makers belong to different countries or institutions, it is very likely that they act considering only their local objectives, producing global externalities that negatively impact on other objectives. In this work we adopt a Multi-Agent Systems framework, which naturally allows to represent a set of self-interested agents (decision-makers and/or stakeholders) acting in a distributed decision-making process. According to this agent-based approach, each agent represents a decision-maker, whose decisions are defined by an explicit optimization problem considering only the agent's local interests. In particular, this work assesses the role of information exchange and increasing level of cooperation among originally non-cooperative agents. The Zambezi River basin is used to illustrate the methodology: the four largest reservoirs in the basin (Ithezhithezhi, Kafue-Gorge, Kariba and Cahora Bassa) are mainly operated for maximizing the economic revenue from hydropower energy production with considerably negative effects on the aquatic ecosystem in the Zambezi delta due to the alteration of the natural flow regime. We comparatively analyse the ideal centralized solution and the current situation where all the decision-makers act independently and non-cooperatively. Indeed, although a new basin-level institution called Zambezi Watercourse Commission

The Integration of Geographical Information System and Remotely Sensed Data to Track and Predict the Migration Path of the Africanized Honey Bee

NASA Technical Reports Server (NTRS)

Ward, Charles; Bravo, Jessica; De Luna, Rosalia; Lopez, Gerardo; Pichardo, Itza; Trejo, Danny; Vargas, Gabriel

1997-01-01

One of the research groups at the Pan American Center for Earth and Environmental Studies (PACES) is researching the northward migration path of Africanized Honey Bees or often referred to in the popular press as killer bees. The goal of the Killer Bee Research Group (KBRG) is to set up a database in the form of a geographical information system, which will be used to track and predict the bees future migration path. Included in this paper is background information on geographical information systems, the SPANS Explorer software package which was used to implement the database, and Advanced Very High Resolution Radiometer data and how each of these is being incorporated in the research. With an accurate means of predicting future migration paths, the negative effects of the Africanized honey bees maybe reduced.

Exchange Network

EPA Pesticide Factsheets

The Environmental Information Exchange Network (EN) is an Internet-based system used by state, tribal and territorial partners to securely share environmental and health information with one another and EPA.

Research peer exchange.

DOT National Transportation Integrated Search

2005-10-01

The Montana Department of Transportation hosted a research management peer exchange October 3-7, 2005. The : objectives of the peer exchange were to: identify strengths, challenges, and opportunities for the information services : component of MDT...

77 FR 50757 - 60-Day Notice of Proposed Information Collection: Exchange Visitor Program Participant Survey...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-22

.... Type of Request: New Collection. Originating Office: Bureau of Educational and Cultural Affairs, ECA/EC... of technology. Abstract of proposed collection: This collection of information is under the provisions of the Mutual Educational and Cultural Exchange Act, as amended, and its implementing regulations...

The role of conflict minerals, artisanal mining, and informal trading networks in African intrastate and regional conflicts

USGS Publications Warehouse

Chirico, Peter G.; Malpeli, Katherine C.

2014-01-01

The relationship between natural resources and armed conflict gained public and political attention in the 1990s, when it became evident that the mining and trading of diamonds were connected with brutal rebellions in several African nations. Easily extracted resources such as alluvial diamonds and gold have been and continue to be exploited by rebel groups to fund their activities. Artisanal and small-scale miners operating under a quasi-legal status often mine these mineral deposits. While many African countries have legalized artisanal mining and established flow chains through which production is intended to travel, informal trading networks frequently emerge in which miners seek to evade taxes and fees by selling to unauthorized buyers. These networks have the potential to become international in scope, with actors operating in multiple countries. The lack of government control over the artisanal mining sector and the prominence of informal trade networks can have severe social, political, and economic consequences. In the past, mineral extraction fuelled violent civil wars in Sierra Leone, Liberia, and Angola, and it continues to do so today in several other countries. The significant influence of the informal network that surrounds artisanal mining is therefore an important security concern that can extend across borders and have far-reaching impacts.

Is public communication about end-of-life care helping to inform all? Cancer news coverage in African American versus mainstream media.

PubMed

Fishman, Jessica M; Ten Have, Thomas; Casarett, David

2012-04-15

Because cancers are a leading cause of death, these diseases receive a great deal of news attention. However, because news media frequently target specific racial or ethnic audiences, some populations may receive different information, and it is unknown whether reporting equally informs all audiences about the options for care at the end of life. This study of news reporting compared "mainstream" (general market) media with African American media, which serves the largest minority group. The specific goal of this study was to determine whether these news media communicate differently about cure-directed cancer treatment and end-of-life alternatives. This content analysis included 660 cancer news stories from online and print media that targeted either African American or mainstream audiences. The main outcome measures included whether reporting discussed adverse events of cancer treatment, cancer treatment failure, cancer death/dying, and end-of-life palliative or hospice care. Unadjusted and adjusted analyses indicated that the news stories in the African American media are less likely than those in mainstream media to discuss each of the topics studied. Comparing the proportions of news stories in mainstream versus African American media, 31.6% versus 13.6% discussed adverse events (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.51-5.66; P = .001); 14.1% versus 4.2% mentioned treatment failure (OR, 3.79; 95% CI, 1.45-9.88; P = .006); and 11.9% versus 3.8% focused on death/dying (OR, 3.42; 95% CI, 1.39-8.38; P = .007). Finally, although very few news stories discussed end-of-life hospice or palliative care, all were found in mainstream media (7/396 vs 0/264). The African American news media sampled are less likely than mainstream news media to portray negative cancer outcomes and end-of-life care. Given media's segmented audiences, these findings raise concerns that not all audiences are being informed equally well. Because media content is modifiable

Is Public Communication about End-of-Life Care Helping to Inform All?: Cancer News Coverage in African American vs. Mainstream Media

PubMed Central

Fishman, Jess M.; Ten Have, Thomas; Casarett, David

2014-01-01

Background Because cancers are a leading cause of death, these diseases receive a great deal of news attention. However, because news media frequently target specific racial or ethnic audiences, some populations may receive different information, and it is unknown whether reporting equally informs all about options for care at the end of life. This study of US news reporting compares “mainstream” (general market) media to African American media, which serves the largest minority group. The specific goal of this study was to determine whether these news media communicate differently about cure-directed cancer treatment and end-of-life alternatives. Methods This content analysis includes 660 cancer news stories from online and print media that target either African American or mainstream audiences. The main outcome measures include whether reporting discussed: adverse events of cancer treatment; cancer treatment failure; cancer death/dying; and end-of-life palliative or hospice care. Results Unadjusted and adjusted analyses indicate that the news stories in the African American media are less likely than those in mainstream media to discuss each of the topics studied. Comparing the proportions of news stories in mainstream vs. African American media , 31.6% vs. 13.6% discussed adverse events (OR 2.92; 95% CI 1.51-5.66; P=0.001); 14.1% vs. 4.2% mentioned treatment failure (OR, 3.79; 95% CI 1.45-9.88; P=0.006); and 11.9% vs. 3.8% focused on death/dying (OR, 3.42; 95% CI 1.39-8.38; P=.007). Lastly, although very few news stories discussed end-of-life hospice or palliative care, all were found in mainstream media (7/396 vs. 0/264). Conclusion The African American news media sampled are less likely than mainstream news media to portray negative cancer outcomes and end-of-life care. Given media's segmented audiences, these findings raise concerns that not all audiences are being informed equally well. Because media content is modifiable, there may be opportunities to

Using computer technology for HIV prevention among African-Americans: development of a tailored information program for safer sex (TIPSS)

PubMed Central

Noar, Seth M.; Webb, Elizabeth M.; Van Stee, Stephanie K.; Redding, Colleen A.; Feist-Price, Sonja; Crosby, Richard; Troutman, Adewale

2011-01-01

New prevention options are urgently needed for African-Americans in the United States given the disproportionate impact of HIV/AIDS on this group. This combined with recent evidence supporting the efficacy of computer technology-based interventions in HIV prevention led our research group to pursue the development of a computer-delivered individually tailored intervention for heterosexually active African-Americans—the tailored information program for safer sex (TIPSS). In the current article, we discuss the development of the TIPSS program, including (i) the targeted population and behavior, (ii) theoretical basis for the intervention, (iii) design of the intervention, (iv) formative research, (v) technical development and testing and (vi) intervention delivery and ongoing randomized controlled trial. Given the many advantages of computer-based interventions, including low-cost delivery once developed, they offer much promise for the future of HIV prevention among African-Americans and other at-risk groups. PMID:21257676

77 FR 20687 - 30-Day Notice of Proposed Information Collection: Form DS-3097, Exchange Visitor Program Annual...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-05

... the proposed information collection and supporting documents from Robin J. Lerner, Deputy Assistant.... Robin J. Lerner, Deputy Assistant Secretary for Private Sector Exchange, Bureau of Educational and...

Aeronautical Satellite-Assisted Process for Information Exchange Through Network Technologies (Aero-SAPIENT) Conducted

NASA Technical Reports Server (NTRS)

Zernic, Michael J.

2002-01-01

Broadband satellite communications for aeronautics marries communication and network technologies to address NASA's goals in information technology base research and development, thereby serving the safety and capacity needs of the National Airspace System. This marriage of technology increases the interactivity between airborne vehicles and ground systems. It improves decision-making and efficiency, reduces operation costs, and improves the safety and capacity of the National Airspace System. To this end, a collaborative project called the Aeronautical Satellite Assisted Process for Information Exchange through Network Technologies, or Aero-SAPIENT, was conducted out of Tinker AFB, Oklahoma, during November and December 2000.

Privacy as an enabler, not an impediment: building trust into health information exchange.

PubMed

McGraw, Deven; Dempsey, James X; Harris, Leslie; Goldman, Janlori

2009-01-01

Building privacy and security protections into health information technology systems will bolster trust in such systems and promote their adoption. The privacy issue, too long seen as a barrier to electronic health information exchange, can be resolved through a comprehensive framework that implements core privacy principles, adopts trusted network design characteristics, and establishes oversight and accountability mechanisms. The public policy challenges of implementing this framework in a complex and evolving environment will require improvements to existing law, new rules for entities outside the traditional health care sector, a more nuanced approach to the role of consent, and stronger enforcement mechanisms.

A security framework for nationwide health information exchange based on telehealth strategy.

PubMed

Zaidan, B B; Haiqi, Ahmed; Zaidan, A A; Abdulnabi, Mohamed; Kiah, M L Mat; Muzamel, Hussaen

2015-05-01

This study focuses on the situation of health information exchange (HIE) in the context of a nationwide network. It aims to create a security framework that can be implemented to ensure the safe transmission of health information across the boundaries of care providers in Malaysia and other countries. First, a critique of the major elements of nationwide health information networks is presented from the perspective of security, along with such topics as the importance of HIE, issues, and main approaches. Second, a systematic evaluation is conducted on the security solutions that can be utilized in the proposed nationwide network. Finally, a secure framework for health information transmission is proposed within a central cloud-based model, which is compatible with the Malaysian telehealth strategy. The outcome of this analysis indicates that a complete security framework for a global structure of HIE is yet to be defined and implemented. Our proposed framework represents such an endeavor and suggests specific techniques to achieve this goal.

Gaps, disconnections, and discontinuities--the role of information exchange in the delivery of quality long-term care.

PubMed

Georgiou, Andrew; Marks, Anne; Braithwaite, Jeffrey; Westbrook, Johanna Irene

2013-10-01

The smart use of information and communication technologies (ICT) is widely seen as a means of enhancing the quality of aged care services. One of the barriers to ICT diffusion in aged care is the failure to cater for the complex and interdisciplinary requirements of the aged care environment. The aim of this qualitative study was to identify the layers of information exchange and communication and produce a conceptual model that can help to inform decisions related to the design, implementation, and sustainability of ICT. A qualitative study conducted in 2010 within seven Australian residential aged care facilities. It included 11 focus groups involving 47 staff and 54 individual interviews and observation sessions. The analysis of work processes identified key information exchange components related to the type of information (residential, clinical, and administrative) that is collected, stored, and communicated. This information relies on a diverse number of internal and external communication channels that are important for the organization of care. The findings highlight potential areas of communication dysfunction as a consequence of structural holes, fragmentation, or disconnections that can adversely affect the continuity and coordination of care, its safety, and quality.

AMCP Partnership Forum: Enabling the Exchange of Clinical and Economic Information Pre-FDA Approval.

PubMed

2017-01-01

Current federal laws and FDA regulations have significantly restricted the sharing of clinical and health economic information on biopharmaceuticals that have yet to receive FDA approval. Over the past several years, organizations that make health care coverage decisions, including those that set copayments, premiums, and formulary placement, have expressed a need for receiving this information before approval, as long as appropriate safeguards exist to prevent this information from reaching unintended entities. Population health decision makers have indicated that waiting until FDA approval is often too late for the critical planning, budgeting, and forecasting associated with health benefit design, especially given the recent influx of high-cost medications and scrutiny for better evaluation and preparation. Recognizing that securities laws restrict the disclosure of nonpublic information and may need to be amended, permissible early dissemination would allow population health decision makers to incorporate clinical and economic information for pipeline drugs or expanded indications into financial forecasting for the following year's plan. Access to this information is needed 12-18 months before FDA approval when organizations are deciding on terms of coverage and budgetary assumptions for state health insurance rate filings, Medicare and Medicaid bids, contracts with health care purchasers, and other financial arrangements. The need for exchange of clinical economic information before FDA approval was first introduced at a previous Academy of Managed Care (AMCP) forum in March 2016, which addressed section 114 of the Food and Drug Administration Modernization Act and the communication of such information after FDA approval. To address preapproval information specifically, AMCP convened a Partnership Forum on September 13-14, 2016. This forum included a diverse group of stakeholders representing managed care, the biopharmaceutical industry, providers, patients

Information infrastructure for consumer health: a health information exchange stakeholder study.

PubMed

Thornewill, Judah; Dowling, Alan F; Cox, Barbara A; Esterhay, Robert J

2011-05-01

An enabling infrastructure for population-wide health information capture and transfer is beginning to emerge in the U.S. However, the essential infrastructure component that is still missing is effective health information exchange (HIE). Health record banks (HRBs) are one of several possible approaches to achieving HIE. Is the approach viable? If so, what requirements must be satisfied in order for it to succeed? The research, conducted in 2007-2008, explored HRB-related interests, concerns, benefits, payment preferences, design requirements, value propositions, and challenges for 12 healthcare stakeholder groups and the consumers they serve in a U.S. metropolitan area of 1.3 million people. A mixed-methods design was developed in a community action research context. Data were gathered and analyzed through 23 focus groups, 13 web surveys, a consumer phone survey (nonstratified random sample) and follow-up meetings. Recruiting goals for leaders representing targeted groups were achieved using a multi-channel communications strategy. Key themes were identified through data triangulation. Then, requirements, value propositions and challenges were developed through iterative processes of interaction with community members. Results include key themes, design requirements, value propositions, and challenges for 12 stakeholder groups and consumers. The research provides a framework for developing a consumer permission-driven, financially sustainable, community HRB model. However, for such a model to flourish, it will need to be part of a nationwide network of HIEs with compatible HRB approaches able to overcome a number of challenges. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Are there differences in health information exchange by health system type?

PubMed

Opoku-Agyeman, William; Menachemi, Nir

2016-01-01

Despite the potential of health information exchange (HIE) to improve safety and reduce cost, hospitals have been slow to adopt HIE with only 30% of U.S. hospitals doing so in 2012. The aim of this study was to explore the relationship between different health system types and how they engage in HIE. Data on health system types and engagement in HIE activity were combined with secondary hospital characteristics. Ordinal logistic regression analyses were used to examine the relationship between a scale measuring the level of HIE engagement and health system type controlling for hospital and market characteristics. Data from 1552 hospitals were available for analyses. Overall, hospital in a health system of any kind exchanged more patient data elements (e.g., patient demographics, clinical summaries, laboratory results, medication history, and radiology report) compared with stand-alone hospitals (3.82 vs. 1.80, p < .001). Overall, 62.2% of hospitals were part of a health system, and among system hospitals, 125 (8.0%) were in centralized health systems, 75 (4.8%) were in centralized physician/insurance health system, 284 (18.3%) were in moderately centralized health system, 391 (25.2%) were in decentralized health system, and 91 (5.9%) were in independent health system. In regression analyses, hospitals belonging to a health system were more likely to exchange patient health data with other hospitals in the same system (OR = 3.94, p < .001) but not with hospitals outside their system (OR = 1.89, p = .445). Across health system types, there was no significant difference in the exchange of patient health data. Hospital engagement in HIE is associated with health system membership. These findings will assist hospital leaders and managers to better understand how the structure and nature of their system may influence what their individual hospital can and cannot do in their decision to engage in HIE and other decisions that support the overall system objectives.

Fish as a proxy for African paleogeography: results from both extant and fossil taxa and prospects to constrain faunal exchange pathway through time

NASA Astrophysics Data System (ADS)

Otero, Olga; Joordens, Josephine; Dettai, Agnès; Christ, Leemans; Pinton, Aurélie

2016-04-01

reveal ancient distributions. The further we are going back in time the more they will constitute most of or the whole relevant sample. Our results also suggest that information on the (paleo)ecology of the fish provides useful data notably to qualify the aquatic systems that have prevailed at the time of connection between basins. So, changes in basin geomorphology constrain fish evolution, and thus we are able to reconstruct and date these changes thanks to fish evolution studies. Since it is widely agreed that the identification of corridors and barriers is critical to understand faunal exchange, we are convinced that for each case study, we can identify the fish (either fossil or extant) that will provide a relevant "geomorphological model". To validate this approach, our current project aims to identify the exchange corridor that may have intermittently existed between the Chad and Turkana basins during the last 3 million years [6]. These corridors may have constituted possible pathways for interbasinal exchange of large mammals at a key time period of Australopithecine evolution. We will end our presentation with preliminary results concerning phylogeography of the extant catfish Synodontis schall, one of our three model species. [1] Pinton A., Otero O. in progress - How much do fish distribution depend on drainage system history? the case study of continental Africa. [2] Pinton A., Agnèse J.F., Paugy D., Otero O. 2013 - A large-scale phylogeny of Synodontis (Mochokidae, Siluriformes) reveals the influence of geological events on continental diversity during the Cenozoic. Molecular Phylogenetics and Evolution, 66 (2013): 1027-1040. [3] Otero O. 2011 - Current knowledge and new assumptions on the evolutionary history of the African lungfish, Protopterus, based on a review of its fossil record. Fish & Fisheries, 2011(12): 235-255. [4] Otero O., Pinton A., Mackaye H.T., Likius A., Vignaud P., Brunet M. 2009 - Fishes and palaeogeography of the African drainage basins

Testing for purchasing power parity in 21 African countries using several unit root tests

NASA Astrophysics Data System (ADS)

Choji, Niri Martha; Sek, Siok Kun

2017-04-01

Purchasing power parity is used as a basis for international income and expenditure comparison through the exchange rate theory. However, empirical studies show disagreement on the validity of PPP. In this paper, we conduct the testing on the validity of PPP using panel data approach. We apply seven different panel unit root tests to test the validity of the purchasing power parity (PPP) hypothesis based on the quarterly data on real effective exchange rate for 21 African countries from the period 1971: Q1-2012: Q4. All the results of the seven tests rejected the hypothesis of stationarity meaning that absolute PPP does not hold in those African Countries. This result confirmed the claim from previous studies that standard panel unit tests fail to support the PPP hypothesis.

Newly available technologies present expanding opportunities for scientific and technical information exchange

NASA Technical Reports Server (NTRS)

Tolzman, Jean M.

1993-01-01

The potential for expanded communication among researchers, scholars, and students is supported by growth in the capabilities for electronic communication as well as expanding access to various forms of electronic interchange and computing capabilities. Increased possibilities for information exchange, collegial dialogue, collaboration, and access to remote resources exist as high-speed networks, increasingly powerful workstations, and large, multi-user computational facilities are more frequently linked and more commonly available. Numerous writers speak of the telecommunications revolution and its impact on the development and dissemination of knowledge and learning. One author offers the phrase 'Scholarly skywriting' to represent a new form of scientific communication that he envisions using electronic networks. In the United States (U.S.), researchers associated with the National Science Foundation (NSF) are exploring 'nationwide collaboratories' and 'digital collaboration.' Research supported by the U.S. National Aeronautics and Space Administration (NASA) points to a future where workstations with built-in audio, video monitors, and screen sharing protocols are used to support collaborations with colleagues located throughout the world. Instruments and sensors located worldwide will produce data streams that will be brought together, analyzed, and distributed as new findings. Researchers will have access to machines that can supply domain-specific information in addition to locator and directory assistance. New forms of electronic journals will emerge and provide opportunities for researchers and scientists to exchange information electronically and interactively in a range of structures and formats. Ultimately, the wide-scale use of these technologies in the dissemination of research results and the stimulation of collegial dialogue will change the way we represent and express our knowledge of the world. A new paradigm will evolve--perhaps a truly worldwide

Hospital to Post-Acute Care Facility Transfers: Identifying Targets for Information Exchange Quality Improvement.

PubMed

Jones, Christine D; Cumbler, Ethan; Honigman, Benjamin; Burke, Robert E; Boxer, Rebecca S; Levy, Cari; Coleman, Eric A; Wald, Heidi L

2017-01-01

Information exchange is critical to high-quality care transitions from hospitals to post-acute care (PAC) facilities. We conducted a survey to evaluate the completeness and timeliness of information transfer and communication between a tertiary-care academic hospital and its related PAC facilities. This was a cross-sectional Web-based 36-question survey of 110 PAC clinicians and staff representing 31 PAC facilities conducted between October and December 2013. We received responses from 71 of 110 individuals representing 29 of 31 facilities (65% and 94% response rates). We collapsed 4-point Likert responses into dichotomous variables to reflect completeness (sufficient vs insufficient) and timeliness (timely vs not timely) for information transfer and communication. Among respondents, 32% reported insufficient information about discharge medical conditions and management plan, and 83% reported at least occasionally encountering problems directly related to inadequate information from the hospital. Hospital clinician contact information was the most common insufficient domain. With respect to timeliness, 86% of respondents desired receipt of a discharge summary on or before the day of discharge, but only 58% reported receiving the summary within this time frame. Through free-text responses, several participants expressed the need for paper prescriptions for controlled pain medications to be sent with patients at the time of transfer. Staff and clinicians at PAC facilities perceive substantial deficits in content and timeliness of information exchange between the hospital and facilities. Such deficits are particularly relevant in the context of the increasing prevalence of bundled payments for care across settings as well as forthcoming readmissions penalties for PAC facilities. Targets identified for quality improvement include structuring discharge summary information to include information identified as deficient by respondents, completion of discharge summaries

On-Line Learning Technologies: Networking in the Classroom. Rural, Small Schools Network Information Exchange No. 16, Summer 1994.

ERIC Educational Resources Information Center

Regional Laboratory for Educational Improvement of the Northeast & Islands, Andover, MA.

This packet includes reprints of articles and other information concerning the use of computer networks in small, rural schools. Computer networks can minimize isolation; develop stronger links to the community; access reference information from remote sources; and create professional and academic exchanges for teachers, administrators, and…

Learning from Health Information Exchange Technical Architecture and Implementation in Seven Beacon Communities

PubMed Central

McCarthy, Douglas B.; Propp, Karen; Cohen, Alexander; Sabharwal, Raj; Schachter, Abigail A.; Rein, Alison L.

2014-01-01

As health care providers adopt and make “meaningful use” of health information technology (health IT), communities and delivery systems must set up the infrastructure to facilitate health information exchange (HIE) between providers and numerous other stakeholders who have a role in supporting health and care. By facilitating better communication and coordination between providers, HIE has the potential to improve clinical decision-making and continuity of care, while reducing unnecessary use of services. When implemented as part of a broader strategy for health care delivery system and payment reform, HIE capability also can enable the use of analytic tools needed for population health management, patient engagement in care, and continuous learning and improvement. The diverse experiences of seven communities that participated in the three-year federal Beacon Community Program offer practical insight into factors influencing the technical architecture of exchange infrastructure and its role in supporting improved care, reduced cost, and a healthier population. The case studies also document challenges faced by the communities, such as significant time and resources required to harmonize variations in the interpretation of data standards. Findings indicate that their progress developing community-based HIE strategies, while driven by local needs and objectives, is also influenced by broader legal, policy, and market conditions. PMID:25848591

Learning from health information exchange technical architecture and implementation in seven beacon communities.

PubMed

McCarthy, Douglas B; Propp, Karen; Cohen, Alexander; Sabharwal, Raj; Schachter, Abigail A; Rein, Alison L

2014-01-01

As health care providers adopt and make "meaningful use" of health information technology (health IT), communities and delivery systems must set up the infrastructure to facilitate health information exchange (HIE) between providers and numerous other stakeholders who have a role in supporting health and care. By facilitating better communication and coordination between providers, HIE has the potential to improve clinical decision-making and continuity of care, while reducing unnecessary use of services. When implemented as part of a broader strategy for health care delivery system and payment reform, HIE capability also can enable the use of analytic tools needed for population health management, patient engagement in care, and continuous learning and improvement. The diverse experiences of seven communities that participated in the three-year federal Beacon Community Program offer practical insight into factors influencing the technical architecture of exchange infrastructure and its role in supporting improved care, reduced cost, and a healthier population. The case studies also document challenges faced by the communities, such as significant time and resources required to harmonize variations in the interpretation of data standards. Findings indicate that their progress developing community-based HIE strategies, while driven by local needs and objectives, is also influenced by broader legal, policy, and market conditions.

An observational study of the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities.

PubMed

Elysee, Gerald; Herrin, Jeph; Horwitz, Leora I

2017-10-01

Stagnation in hospitals' adoption of data integration functionalities coupled with reduction in the number of operational health information exchanges could become a significant impediment to hospitals' adoption of 3 critical capabilities: electronic health information exchange, interoperability, and medication reconciliation, in which electronic systems are used to assist with resolving medication discrepancies and improving patient safety. Against this backdrop, we assessed the relationships between the 3 capabilities.We conducted an observational study applying partial least squares-structural equation modeling technique to 27 variables obtained from the 2013 American Hospital Association annual survey Information Technology (IT) supplement, which describes health IT capabilities.We included 1330 hospitals. In confirmatory factor analysis, out of the 27 variables, 15 achieved loading values greater than 0.548 at P < .001, as such were validated as the building blocks of the 3 capabilities. Subsequent path analysis showed a significant, positive, and cyclic relationship between the capabilities, in that decreases in the hospitals' adoption of one would lead to decreases in the adoption of the others.These results show that capability for high quality medication reconciliation may be impeded by lagging adoption of interoperability and health information exchange capabilities. Policies focused on improving one or more of these capabilities may have ancillary benefits.

Development of an Exchange Format for the European Environmental Chemical Data and Information Network (ECDIN).

ERIC Educational Resources Information Center

And Others; Proctor, David, J.

1978-01-01

Uses collection and storage of data in an environmental chemicals data bank to develop an exchange format of hierarchical tree structure between network partners. Rules identify and process the nodes in the tree in such a way that information is neither lost nor degraded upon transfer between network partners. (CWM)

Selecting SNPs informative for African, American Indian and European Ancestry: application to the Family Investigation of Nephropathy and Diabetes (FIND).

PubMed

Williams, Robert C; Elston, Robert C; Kumar, Pankaj; Knowler, William C; Abboud, Hanna E; Adler, Sharon; Bowden, Donald W; Divers, Jasmin; Freedman, Barry I; Igo, Robert P; Ipp, Eli; Iyengar, Sudha K; Kimmel, Paul L; Klag, Michael J; Kohn, Orly; Langefeld, Carl D; Leehey, David J; Nelson, Robert G; Nicholas, Susanne B; Pahl, Madeleine V; Parekh, Rulan S; Rotter, Jerome I; Schelling, Jeffrey R; Sedor, John R; Shah, Vallabh O; Smith, Michael W; Taylor, Kent D; Thameem, Farook; Thornley-Brown, Denyse; Winkler, Cheryl A; Guo, Xiuqing; Zager, Phillip; Hanson, Robert L

2016-05-04

The presence of population structure in a sample may confound the search for important genetic loci associated with disease. Our four samples in the Family Investigation of Nephropathy and Diabetes (FIND), European Americans, Mexican Americans, African Americans, and American Indians are part of a genome- wide association study in which population structure might be particularly important. We therefore decided to study in detail one component of this, individual genetic ancestry (IGA). From SNPs present on the Affymetrix 6.0 Human SNP array, we identified 3 sets of ancestry informative markers (AIMs), each maximized for the information in one the three contrasts among ancestral populations: Europeans (HAPMAP, CEU), Africans (HAPMAP, YRI and LWK), and Native Americans (full heritage Pima Indians). We estimate IGA and present an algorithm for their standard errors, compare IGA to principal components, emphasize the importance of balancing information in the ancestry informative markers (AIMs), and test the association of IGA with diabetic nephropathy in the combined sample. A fixed parental allele maximum likelihood algorithm was applied to the FIND to estimate IGA in four samples: 869 American Indians; 1385 African Americans; 1451 Mexican Americans; and 826 European Americans. When the information in the AIMs is unbalanced, the estimates are incorrect with large error. Individual genetic admixture is highly correlated with principle components for capturing population structure. It takes ~700 SNPs to reduce the average standard error of individual admixture below 0.01. When the samples are combined, the resulting population structure creates associations between IGA and diabetic nephropathy. The identified set of AIMs, which include American Indian parental allele frequencies, may be particularly useful for estimating genetic admixture in populations from the Americas. Failure to balance information in maximum likelihood, poly-ancestry models creates biased

Family Planning Knowledge: The Role of Social Networks and Primary Care Providers as Information Sources for African American Women

ERIC Educational Resources Information Center

Blackstock, Oni J.; Mba-Jonas, Adamma; Sacajiu, Galit M.

2010-01-01

Disparities in the rates of unintended pregnancy have increased for low-income African American women as compared to other groups due, in part, to declining contraception use. Women obtain family planning information from diverse sources, which may ultimately influence contraceptive decision making. For this qualitative study, we conducted…

Data Governance and Data Sharing Agreements for Community-Wide Health Information Exchange: Lessons from the Beacon Communities

PubMed Central

Allen, Claudia; Des Jardins, Terrisca R.; Heider, Arvela; Lyman, Kristin A.; McWilliams, Lee; Rein, Alison L.; Schachter, Abigail A.; Singh, Ranjit; Sorondo, Barbara; Topper, Joan; Turske, Scott A.

2014-01-01

Purpose: Unprecedented efforts are underway across the United States to electronically capture and exchange health information to improve health care and population health, and reduce costs. This increased collection and sharing of electronic patient data raises several governance issues, including privacy, security, liability, and market competition. Those engaged in such efforts have had to develop data sharing agreements (DSAs) among entities involved in information exchange, many of whom are “nontraditional” health care entities and/or new partners. This paper shares lessons learned based on the experiences of six federally funded communities participating in the Beacon Community Cooperative Agreement Program, and offers guidance for navigating data governance issues and developing DSAs to facilitate community-wide health information exchange. Innovation: While all entities involved in electronic data sharing must address governance issues and create DSAs accordingly, until recently little formal guidance existed for doing so – particularly for community-based initiatives. Despite this lack of guidance, together the Beacon Communities’ experiences highlight promising strategies for navigating complex governance issues, which may be useful to other entities or communities initiating information exchange efforts to support delivery system transformation. Credibility: For the past three years, AcademyHealth has provided technical assistance to most of the 17 Beacon Communities, 6 of whom contributed to this collaborative writing effort. Though these communities varied widely in terms of their demographics, resources, and Beacon-driven priorities, common themes emerged as they described their approaches to data governance and DSA development. Conclusions: The 6 Beacon Communities confirmed that DSAs are necessary to satisfy legal and market-based concerns, and they identified several specific issues, many of which have been noted by others involved in

Data governance and data sharing agreements for community-wide health information exchange: lessons from the beacon communities.

PubMed

Allen, Claudia; Des Jardins, Terrisca R; Heider, Arvela; Lyman, Kristin A; McWilliams, Lee; Rein, Alison L; Schachter, Abigail A; Singh, Ranjit; Sorondo, Barbara; Topper, Joan; Turske, Scott A

2014-01-01

Unprecedented efforts are underway across the United States to electronically capture and exchange health information to improve health care and population health, and reduce costs. This increased collection and sharing of electronic patient data raises several governance issues, including privacy, security, liability, and market competition. Those engaged in such efforts have had to develop data sharing agreements (DSAs) among entities involved in information exchange, many of whom are "nontraditional" health care entities and/or new partners. This paper shares lessons learned based on the experiences of six federally funded communities participating in the Beacon Community Cooperative Agreement Program, and offers guidance for navigating data governance issues and developing DSAs to facilitate community-wide health information exchange. While all entities involved in electronic data sharing must address governance issues and create DSAs accordingly, until recently little formal guidance existed for doing so - particularly for community-based initiatives. Despite this lack of guidance, together the Beacon Communities' experiences highlight promising strategies for navigating complex governance issues, which may be useful to other entities or communities initiating information exchange efforts to support delivery system transformation. For the past three years, AcademyHealth has provided technical assistance to most of the 17 Beacon Communities, 6 of whom contributed to this collaborative writing effort. Though these communities varied widely in terms of their demographics, resources, and Beacon-driven priorities, common themes emerged as they described their approaches to data governance and DSA development. The 6 Beacon Communities confirmed that DSAs are necessary to satisfy legal and market-based concerns, and they identified several specific issues, many of which have been noted by others involved in network data sharing initiatives. More importantly, these

Socioeconomic inequalities in informal payments for health care: An assessment of the 'Robin Hood' hypothesis in 33 African countries.

PubMed

Kankeu, Hyacinthe Tchewonpi; Ventelou, Bruno

2016-02-01

In almost all African countries, informal payments are frequently made when accessing health care. Some literature suggests that the informal payment system could lead to quasi-redistribution among patients, with physicians playing a 'Robin Hood' role, subsidizing the poor at the expense of the rich. We empirically tested this assumption with data from the rounds 3 and 5 of the Afrobarometer surveys conducted in 18 and 33 African countries respectively, from 2005 to 2006 for round 3 and from 2011 to 2013 for round 5. In these surveys, nationally representative samples of people aged 18 years or more were randomly selected in each country, with sizes varying between 1048 and 2400 for round 3 and between 1190 and 2407 for round 5. We used the 'normalized' concentration index, the poor/rich gap and the odds ratio to assess the level of inequality in the payment of bribes to access care at the local public health facility and implemented two decomposition techniques to identify the contributors to the observed inequalities. We obtained that: i) the socioeconomic gradient in informal payments is in favor of the rich in almost all countries, indicating a rather regressive system; ii) this is mainly due to the socioeconomic disadvantage itself, to poor/rich differences in supply side factors like lack of medicines, absence of doctors and long waiting times, as well as regional disparities. Although essentially empirical, the paper highlights the need for African health systems to undergo substantial country-specific reforms in order to better protect the worse-off from financial risk when they seek care. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessment of Life Cycle Information Exchanges (LCie): Understanding the Value-Added Benefit of a COBie Process

DTIC Science & Technology

2013-10-01

exchange (COBie), Building Information Modeling ( BIM ), value-added analysis, business processes, project management 16. SECURITY CLASSIFICATION OF: 17...equipment. The innovative aspect of Building In- formation Modeling ( BIM ) is that it creates a computable building descrip- tion. The ability to use a...interoperability. In order for the building information to be interoperable, it must also con- form to a common data model , or schema, that defines the class

Fiscal Year 2018 National Environmental Information Exchange Network Grant Solicitation Notice

EPA Pesticide Factsheets

The Exchange Network Grant Program provides funding for projects that are in line with Exchange Network priorities. The primary outcome expected from EN assistance agreements is improved access to, and exchange of, high quality environmental data.

Patient Privacy, Consent, and Identity Management in Health Information Exchange

PubMed Central

Hosek, Susan D.; Straus, Susan G.

2013-01-01

Abstract The Military Health System (MHS) and the Veterans Health Administration (VHA) have been among the nation's leaders in health information technology (IT), including the development of health IT systems and electronic health records that summarize patients' care from multiple providers. Health IT interoperability within MHS and across MHS partners, including VHA, is one of ten goals in the current MHS Strategic Plan. As a step toward achieving improved interoperability, the MHS is seeking to develop a research roadmap to better coordinate health IT research efforts, address IT capability gaps, and reduce programmatic risk for its enterprise projects. This article contributes to that effort by identifying gaps in research, policy, and practice involving patient privacy, consent, and identity management that need to be addressed to bring about improved quality and efficiency of care through health information exchange. Major challenges include (1) designing a meaningful patient consent procedure, (2) recording patients' consent preferences and designing procedures to implement restrictions on disclosures of protected health information, and (3) advancing knowledge regarding the best technical approaches to performing patient identity matches and how best to monitor results over time. Using a sociotechnical framework, this article suggests steps for overcoming these challenges and topics for future research. PMID:28083296

Evaluation of immunization data completeness within a large community health care system exchanging data with a state immunization information system.

PubMed

Hendrickson, Bryan K; Panchanathan, Sarada S; Petitti, Diana

2015-01-01

Information systems are used by most states to maintain registries of immunization data both for monitoring population-level adherence and for use in clinical practice and research. Direct data exchange between such systems and electronic health record systems presents an opportunity to improve the completeness and quality of information available. Our goals were to describe and compare the completeness of the Arizona State Immunization System, the electronic health record at a large community health provider in Arizona exchanging electronic data with the Arizona system, and personal immunization records in an effort to contribute to the discussion on the completeness of state-run immunization registries and data exchange with these registries. Immunization histories from these sources were collected and reviewed sequentially. Unique dates of vaccination administrations were counted for each patient and tagged on the basis of comparisons across sources. We quantified completeness by combining information from all 3 sources and comparing each source with the complete set. We determined that the state registry was 71.8% complete, the hospital electronic health record was 81.9% complete, and personal records were 87.8% complete. Of the 2017 unique vaccination administrations, 65% were present in all 3 sources, 24.6% in 2 of the 3 sources, and 10.4% in only 1 source. Only 11% of patients had records in complete agreement across the 3 sources. This study highlights issues related to data completeness, exchange, and reporting of immunization information to state registries and suggests that there is some degree of deficiency in completeness of immunization registries and other sources. This study indicates that there is a need to strengthen links between electronic data sources with immunization information and describes potential improvements in completeness that such efforts could provide, enabling providers to better rely on state immunization registries and to

Seasonal patterns of mixed species groups in large East African mammals.

PubMed

Kiffner, Christian; Kioko, John; Leweri, Cecilia; Krause, Stefan

2014-01-01

Mixed mammal species groups are common in East African savannah ecosystems. Yet, it is largely unknown if co-occurrences of large mammals result from random processes or social preferences and if interspecific associations are consistent across ecosystems and seasons. Because species may exchange important information and services, understanding patterns and drivers of heterospecific interactions is crucial for advancing animal and community ecology. We recorded 5403 single and multi-species clusters in the Serengeti-Ngorongoro and Tarangire-Manyara ecosystems during dry and wet seasons and used social network analyses to detect patterns of species associations. We found statistically significant associations between multiple species and association patterns differed spatially and seasonally. Consistently, wildebeest and zebras preferred being associated with other species, whereas carnivores, African elephants, Maasai giraffes and Kirk's dik-diks avoided being in mixed groups. During the dry season, we found that the betweenness (a measure of importance in the flow of information or disease) of species did not differ from a random expectation based on species abundance. In contrast, in the wet season, we found that these patterns were not simply explained by variations in abundances, suggesting that heterospecific associations were actively formed. These seasonal differences in observed patterns suggest that interspecific associations may be driven by resource overlap when resources are limited and by resource partitioning or anti-predator advantages when resources are abundant. We discuss potential mechanisms that could drive seasonal variation in the cost-benefit tradeoffs that underpin the formation of mixed-species groups.

The African American Student Network: An Informal Networking Group as a Therapeutic Intervention for Black College Students on a Predominantly White Campus

ERIC Educational Resources Information Center

Grier-Reed, Tabitha

2013-01-01

Informal support networks as opposed to formal mental health counseling may represent a culture-specific, indigenous style of coping for Black college students. Using the African American Student Network (or as students refer to it AFAM), this article comments on the potential of an informal networking group as a culturally sensitive therapeutic…

Kin networks and poverty among African Americans: past and present.

PubMed

Miller-Cribbs, Julie E; Farber, Naomi B

2008-01-01

Trends in social welfare policy and programs place increasing expectations on families to provide members with various forms of material and socioemotional support. The historic ability of kin networks of many African Americans to provide such support has been compromised by long-term community and family poverty. The potential mismatch between the expectations of social welfare systems for kin support and the actual functional capacities of kin networks places African Americans living in poverty at great risk of chronic poverty and its long-term multiple consequences. This article reviews historical and contemporary research on the structure and function of African American kin networks. On the basis of evidence of functional decline, the authors argue that social workers must re-examine the a priori assumption of viable kin networks as a reliable source of resilience among African Americans living in poverty. Social workers must focus assessment at all levels of practice on a variety of aspects of kin networks to make accurate judgments about not only the availability of resources, but also the perceived costs and benefits of participation in exchange for resources.

Analysis of pan-African Centres of excellence in health innovation highlights opportunities and challenges for local innovation and financing in the continent

PubMed Central

2012-01-01

A pool of 38 pan-African Centres of Excellence (CoEs) in health innovation has been selected and recognized by the African Network for Drugs and Diagnostics Innovation (ANDI), through a competitive criteria based process. The process identified a number of opportunities and challenges for health R&D and innovation in the continent: i) it provides a direct evidence for the existence of innovation capability that can be leveraged to fill specific gaps in the continent; ii) it revealed a research and financing pattern that is largely fragmented and uncoordinated, and iii) it highlights the most frequent funders of health research in the continent. The CoEs are envisioned as an innovative network of public and private institutions with a critical mass of expertise and resources to support projects and a variety of activities for capacity building and scientific exchange, including hosting fellows, trainees, scientists on sabbaticals and exchange with other African and non-African institutions. PMID:22838941

Analysis of pan-African Centres of excellence in health innovation highlights opportunities and challenges for local innovation and financing in the continent.

PubMed

Nwaka, Solomon; Ochem, Alexander; Besson, Dominique; Ramirez, Bernadette; Fakorede, Foluke; Botros, Sanaa; Inyang, Uford; Mgone, Charles; Adae-Mensah, Ivan; Konde, Victor; Nyasse, Barthelemy; Okole, Blessed; Guantai, Anastasia; Loots, Glaudina; Atadja, Peter; Ndumbe, Peter; Sanou, Issa; Olesen, Ole; Ridley, Robert; Ilunga, Tshinko

2012-07-27

A pool of 38 pan-African Centres of Excellence (CoEs) in health innovation has been selected and recognized by the African Network for Drugs and Diagnostics Innovation (ANDI), through a competitive criteria based process. The process identified a number of opportunities and challenges for health R&D and innovation in the continent: i) it provides a direct evidence for the existence of innovation capability that can be leveraged to fill specific gaps in the continent; ii) it revealed a research and financing pattern that is largely fragmented and uncoordinated, and iii) it highlights the most frequent funders of health research in the continent. The CoEs are envisioned as an innovative network of public and private institutions with a critical mass of expertise and resources to support projects and a variety of activities for capacity building and scientific exchange, including hosting fellows, trainees, scientists on sabbaticals and exchange with other African and non-African institutions.

Predicting adolescents' disclosure of personal information in exchange for commercial incentives: an application of an extended theory of planned behavior.

PubMed

Heirman, Wannes; Walrave, Michel; Ponnet, Koen

2013-02-01

This study adopts a global theoretical framework to predict adolescents' disclosure of personal information in exchange for incentives offered by commercial Websites. The study postulates and tests the validity of a model based on the theory of planned behavior (TPB), including antecedent factors of attitude and perceived behavioral control (PBC). A survey was conducted among 1,042 respondents. Results from SEM analyses show that the hypothesized model fits the empirical data well. The model accounts for 61.9 percent of the variance in adolescents' intention to disclose and 43.7 percent of the variance in self-reported disclosure. Perceived social pressure exerted by significant others (subjective norm) is the most important TPB factor in predicting intention to disclose personal information in exchange for incentives. This finding suggests that in discussions of adolescents' information privacy, the importance of social factors outweighs the individually oriented TPB factors of attitude and PBC. Moreover, privacy concern and trust propensity are significant predictors of respondents' attitudes toward online disclosure in exchange for commercial incentives, whereas the frequency of Internet use significantly affects their level of PBC.

South African HIV/AIDS programming overlooks migration, urban livelihoods, and informal workplaces.

PubMed

Vearey, Jo; Richter, Marlise; Núñez, Lorena; Moyo, Khangelani

2011-01-01

South Africa has the largest population of people living with HIV globally and is associated with high population mobility. The majority of migrants move in search of improved livelihood opportunities, and many who migrate (both internally and across borders) move into urban areas, often through peripheral informal settlements where HIV prevalence is shown to be double that of urban formal areas. While the relationship between migration and the spread of HIV is acknowledged as complex, the context of migration may place individuals at increased risk for acquiring HIV. Studies have demonstrated the long-wave impact of HIV and AIDS on livelihood activities and, more recently, on patterns of migration. Many migrants engage in livelihood strategies situated within the urban 'informal economy'; these informal workplaces are often overlooked in global and national legislation governing workplace responses to health and HIV and AIDS. This study draws on existing research and limited primary data to explore the implications of HIV/AIDS programming for diverse migrant groups labouring in informal workplaces in Johannesburg, South Africa. We describe three case studies: waste-pickers at a dumpsite in a peripheral urban informal settlement; barmen and cleaners working in inner-city hotels where sex is also sold; and, migrants engaged in informal livelihood activities who are also members of burial societies. Given the importance of varied informal livelihood activities for diverse migrant groups, particularly in urban areas of South Africa, we propose that the national HIV/AIDS response can and should engage with internal and cross-border migrants in informal workplaces - which is in line with the principle of universal access and will strengthen the national response. Especially, we point out the potential for burial societies to provide an entry point for HIV/AIDS programming that targets migrant groups involved in the informal economy of South African cities.

URBANIFE: a geographical information system for monitoring internal developments in an African traditional urban area

NASA Astrophysics Data System (ADS)

Nkambwe, Musisi

Data acquisition and information organization are major constraits in monitoring developments in traditional African urban environments. The internal arrangements and developments of housing units, land uses, communication routes, etc., in these urban areas make it difficult to use cadastral mapping techniques from other continents in building an information base useful for planning. In particular, sub-divisions of plots eventually make the "plot" less meaningful for planning as they are not recorded over time. Ideas expressed in an earlier proposal for a framework for an urban information system that included a temporal component to partially overcome this problem were used to build URBANIFE, a geographical information systemfor mapping and monitoring internal developments in the urban area of Ile-Ife, in southwestern Nigeria. URBANIFE provides an information system in which x- y coordinates from cadastral maps are used to identify the location of individual buildings, while multidate aerial photographs are interpreted and supplemented with field work to provide the temporal dimensions of some of the buildings' attributes considered important in planning and administration.

A product lifecycle management framework to support the exchange of prototyping and testing information

NASA Astrophysics Data System (ADS)

Toche Fumchum, Luc Boris

2011-12-01

The modern perspective on product life cycle and the rapid evolution of Information and Communication Technologies in general have opened a new era in product representation and product information sharing between participants, both inside and outside the enterprise and throughout the product life. In particular, the Product Development Process relies on cross-functional activities involving different domains of expertise that each have their own dedicated tools. This has generated new challenges in terms of collaboration and dissemination of information at large between companies or even within the same organization. Within this context, the work reported herein focuses on a specific stakeholder within product development activities - the prototyping and testing department. Its business is typically related to the planning and building of prototypes in order to perform specific tests on the future product or one of its sub-assemblies. The research project aims at investigating an appropriate framework that leverages configured engineering product information, based on complementary information structures, to share and exchange prototyping and testing information in a Product Lifecycle Management (PLM) perspective. As a first step, a case study based on the retrofit of an aircraft engine is deployed to implement a scenario demonstrating the functionalities to be available within the intended framework. For this purpose, complementary and configurable structures are simulated within the project's PLM system. In a second step are considered the software interoperability issues that don't only affect Design -- Testing interactions, but many other interfaces within either the company -- due to the silo-arrangement -- or the consortiums with partners, in which case the whole PLM platforms could simply be incompatible. A study based on an open source initiative and relying on an improved model of communication is described to show how two natively disparate PLM tools can

The NASA Scientific and Technical Information (STI) Program's Implementation of Open Archives Initiative (OAI) for Data Interoperability and Data Exchange.

ERIC Educational Resources Information Center

Rocker, JoAnne; Roncaglia, George J.; Heimerl, Lynn N.; Nelson, Michael L.

Interoperability and data-exchange are critical for the survival of government information management programs. E-government initiatives are transforming the way the government interacts with the public. More information is to be made available through Web-enabled technologies. Programs such as the NASA's Scientific and Technical Information (STI)…

Perspectives of Low-Income African-American Women Non-adherent to Mammography Screening: the Importance of Information, Behavioral Skills, and Motivation.

PubMed

Wells, Anjanette A; Shon, En-Jung; McGowan, Kelly; James, Aimee

2017-06-01

Although information-motivation-behavioral skills (IMB) adherence model has been successfully used in many illness domains and with other populations, it has not been used in understanding mammogram screening among low-income African-American women. Thus, a qualitative examination is needed to theoretically and collectively understand the barriers to screening, given the disparities in breast cancer mortality rates among this population. Semi-structured telephone interviews were conducted with 28 low-income uninsured and underinsured African-American women, 40 to 70 years, who had not had a mammogram within the past 12 months. Women were recruited from 21 hair and nail salons and Laundromats within the five North St. Louis city zip codes with the highest breast cancer mortality rates. Transcripts were analyzed and rooted in grounded theory. This study found that the individual relevancy of information, behavioral skills-both procedural and systematic-and motivation seemed to affect screening adherence; (the results suggest the importance of reordering traditional IMB components into the following sequential order: information, behavioral skills, and motivation (IBM)). Future analyses should include a larger, more representative sample of unscreened women, in which quantitative statistical analyses could be conducted to assist in strengthening assertions about information, behavioral skills, and motivational aspects and their relationship to screening.

Adoption of health information exchange by emergency physicians at three urban academic medical centers.

PubMed

Genes, N; Shapiro, J; Vaidya, S; Kuperman, G

2011-01-01

Emergency physicians are trained to make decisions quickly and with limited patient information. Health Information Exchange (HIE) has the potential to improve emergency care by bringing relevant patient data from non-affiliated organizations to the bedside. NYCLIX (New York CLinical Information eXchange) offers HIE functionality among multiple New York metropolitan area provider organizations and has pilot users in several member emergency departments (EDs). We conducted semi-structured interviews at three participating EDs with emergency physicians trained to use NYCLIX. Among "users" with > 1 login, responses to questions regarding typical usage scenarios, successful retrieval of data, and areas for improving the interface were recorded. Among "non-users" with ≤1 login, questions about NYCLIX accessibility and utility were asked. Both groups were asked to recall items from prior training regarding data sources and availability. Eighteen NYCLIX pilot users, all board certified emergency physicians, were interviewed. Of the 14 physicians with more than one login ,half estimated successful retrieval of HIE data affecting patient care. Four non-users (one login or less) cited forgotten login information as a major reason for non-use. Though both groups made errors, users were more likely to recall true NYCLIX member sites and data elements than non-users. Improvements suggested as likely to facilitate usage included a single automated login to both the ED information system (EDIS) and HIE, and automatic notification of HIE data availability in the EDIS All respondents reported satisfaction with their training. Integrating HIE into existing ED workflows remains a challenge, though a substantial fraction of users report changes in management based on HIE data. Though interviewees believed their training was adequate, significant errors in their understanding of available NYCLIX data elements and participating sites persist.

Incentive compatibility in kidney exchange problems.

PubMed

Villa, Silvia; Patrone, Fioravante

2009-12-01

The problem of kidney exchanges shares common features with the classical problem of exchange of indivisible goods studied in the mechanism design literature, while presenting additional constraints on the size of feasible exchanges. The solution of a kidney exchange problem can be summarized in a mapping from the relevant underlying characteristics of the players (patients and their donors) to the set of matchings. The goal is to select only matchings maximizing a chosen welfare function. Since the final outcome heavily depends on the private information in possess of the players, a basic requirement in order to reach efficiency is the truthful revelation of this information. We show that for the kidney exchange problem, a class of (in principle) efficient mechanisms does not enjoy the incentive compatibility property and therefore is subject to possible manipulations made by the players in order to profit of the misrepresentation of their private information.

The benefits of health information exchange: an updated systematic review.

PubMed

Menachemi, Nir; Rahurkar, Saurabh; Harle, Christopher A; Vest, Joshua R

2018-04-28

Widespread health information exchange (HIE) is a national objective motivated by the promise of improved care and a reduction in costs. Previous reviews have found little rigorous evidence that HIE positively affects these anticipated benefits. However, early studies of HIE were methodologically limited. The purpose of the current study is to review the recent literature on the impact of HIE. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to conduct our systematic review. PubMed and Scopus databases were used to identify empirical articles that evaluated HIE in the context of a health care outcome. Our search strategy identified 24 articles that included 63 individual analyses. The majority of the studies were from the United States representing 9 states; and about 40% of the included analyses occurred in a handful of HIEs from the state of New York. Seven of the 24 studies used designs suitable for causal inference and all reported some beneficial effect from HIE; none reported adverse effects. The current systematic review found that studies with more rigorous designs all reported benefits from HIE. Such benefits include fewer duplicated procedures, reduced imaging, lower costs, and improved patient safety. We also found that studies evaluating community HIEs were more likely to find benefits than studies that evaluated enterprise HIEs or vendor-mediated exchanges. Overall, these finding bode well for the HIEs ability to deliver on anticipated improvements in care delivery and reduction in costs.

'Walk with your head high': African and African-Caribbean fatherhood, children's mental well-being and social capital.

PubMed

Williams, Robert; Hewison, Alistair; Wagstaff, Chris; Randall, Duncan

2012-01-01

The findings presented in this article were unanticipated and came to light during a study which investigated African and African-Caribbean fathers' views about preventive primary care services. This article reports findings which indicate that African and African-Caribbean fathers strive to enable and protect children's mental well-being and create social, cultural and symbolic forms of capital. It also seeks to identify implications for health and social care policy and practice in England. There is limited literature examining African and African-Caribbean fathers' health experiences in England. Consequently an exploratory research approach was required. This involved nine, in-depth, semi-structured qualitative group interviews undertaken with 46 African and African-Caribbean fathers. The data were analysed thematically using abductive reasoning, informed by Bourdieu's theoretical work. Fathers were striving to enable and protect children's mental well-being through providing authoritative, loving, affectionate fatherhood involving reasoning, good communication and promoting self-esteem. These practices were seen to be necessary if children were to prosper in a harsh social world characterised by structural hazards including racism, negative stereotypes and limited opportunities. The fathers reported their efforts to develop what Bourdieu has termed symbolic, cultural and social capital as means of promoting the mental well-being of their children and the children of others. The implications for theory, future research, public health policy and practice, in relation to the needs of African and African-Caribbean fathers and families, are also discussed, with specific focus on how to realise the potential of African and African-Caribbean fathers' positive contributions to family and community health.

Supporting multi-state collaboration on privacy and security to foster health IT and health information exchange.

PubMed

Banger, Alison K; Alakoye, Amoke O; Rizk, Stephanie C

2008-11-06

As part of the HHS funded contract, Health Information Security and Privacy Collaboration, 41 states and territories have proposed collaborative projects to address cross-state privacy and security challenges related to health IT and health information exchange. Multi-state collaboration on privacy and security issues remains complicated, and resources to support collaboration around these topics are essential to the success of such collaboration. The resources outlined here offer an example of how to support multi-stakeholder, multi-state projects.

Isotope (δ13C, δ15N, δ2H) diet-tissue discrimination in African grey parrot Psittacus erithacus: implications for forensic studies.

PubMed

Symes, Craig; Skhosana, Felix; Butler, Mike; Gardner, Brett; Woodborne, Stephan

2017-12-01

Diet-tissue isotopic relationships established under controlled conditions are informative for determining the dietary sources and geographic provenance of organisms. We analysed δ 13 C, δ 15 N, and non-exchangeable δ 2 H values of captive African grey parrot Psittacus erithacus feathers grown on a fixed mixed-diet and borehole water. Diet-feather Δ 13 C and Δ 15 N discrimination values were +3.8 ± 0.3 ‰ and +6.3 ± 0.7 ‰ respectively; significantly greater than expected. Non-exchangeable δ 2 H feather values (-62.4 ± 6.4 ‰) were more negative than water (-26.1 ± 2.5 ‰) offered during feather growth. There was no positive relationship between the δ 13 C and δ 15 N values of the samples along each feather with the associated samples of food offered, or the feather non-exchangeable hydrogen isotope values with δ 2 H values of water, emphasising the complex processes involved in carbohydrate, protein, and income water routing to feather growth. Understanding the isotopic relationship between diet and feathers may provide greater clarity in the use of stable isotopes in feathers as a tool in determining origins of captive and wild-caught African grey parrots, a species that is widespread in aviculture and faces significant threats to wild populations. We suggest that these isotopic results, determined even in controlled laboratory conditions, be used with caution.

The Role of the United States Book Exchange in the Nationwide Library and Information Services Network. National Program for Libraries and Information Services Related Paper No. 27.

ERIC Educational Resources Information Center

Ball, Alice Dulany

The National Commission on Libraries and Information Science's (NCLIS) nationwide information program is based in part on the sharing of resources. The United States Book Exchange (USBE) and its existing services may have a role in this program, since the USBE's major function is the preservation and maximum utilization of publications through…

Scalable and Resilient Middleware to Handle Information Exchange during Environment Crisis

NASA Astrophysics Data System (ADS)

Tao, R.; Poslad, S.; Moßgraber, J.; Middleton, S.; Hammitzsch, M.

2012-04-01

The EU FP7 TRIDEC project focuses on enabling real-time, intelligent, information management of collaborative, complex, critical decision processes for earth management. A key challenge is to promote a communication infrastructure to facilitate interoperable environment information services during environment events and crises such as tsunamis and drilling, during which increasing volumes and dimensionality of disparate information sources, including sensor-based and human-based ones, can result, and need to be managed. Such a system needs to support: scalable, distributed messaging; asynchronous messaging; open messaging to handling changing clients such as new and retired automated system and human information sources becoming online or offline; flexible data filtering, and heterogeneous access networks (e.g., GSM, WLAN and LAN). In addition, the system needs to be resilient to handle the ICT system failures, e.g. failure, degradation and overloads, during environment events. There are several system middleware choices for TRIDEC based upon a Service-oriented-architecture (SOA), Event-driven-Architecture (EDA), Cloud Computing, and Enterprise Service Bus (ESB). In an SOA, everything is a service (e.g. data access, processing and exchange); clients can request on demand or subscribe to services registered by providers; more often interaction is synchronous. In an EDA system, events that represent significant changes in state can be processed simply, or as streams or more complexly. Cloud computing is a virtualization, interoperable and elastic resource allocation model. An ESB, a fundamental component for enterprise messaging, supports synchronous and asynchronous message exchange models and has inbuilt resilience against ICT failure. Our middleware proposal is an ESB based hybrid architecture model: an SOA extension supports more synchronous workflows; EDA assists the ESB to handle more complex event processing; Cloud computing can be used to increase and

The Effects of Public Concern for Information Privacy on the Adoption of Health Information Exchanges (HIEs) by Healthcare Entities.

PubMed

Esmaeilzadeh, Pouyan

2018-05-08

The implementation of Health Information Exchanges (HIEs) by healthcare organizations may not achieve the desired outcomes as consumers may request that their health information remains unshared because of information privacy concerns. Drawing on the insights of concern for information privacy (CFIP) literature, this work extends the application of CFIP to the HIE domain. This study attempts to develop and test a model centered on the four dimensions of CFIP construct (collection, errors, unauthorized access, and secondary use) and their antecedents to predict consumers' opt-in behavioral intention toward HIE in the presence of the perceived health status' effects. We conducted an online survey in the United States using 826 samples. The results demonstrate that the perceived health information sensitivity and computer anxiety meaningfully contribute to information privacy concerns and CFIP construct significantly impedes consumers' opt-in decision to HIEs. Interestingly, contrary to our expectation, perceived poor health status considerably attenuates the negative effects exerted by CFIP on opt-in intention. The model proposed by this study can be used as a useful conceptual tool by both further studies and practitioners to examine the complex nature of patients' reactions to information privacy threats associated with the use of HIE technology in the healthcare industry.

Communities' readiness for health information exchange: the National Landscape in 2004.

PubMed

Overhage, J Marc; Evans, Lori; Marchibroda, Janet

2005-01-01

The Secretary of Health and Human Services recently released a report calling for the nation to create a national health information network (NHIN) that would interconnect Regional Health Information Organizations (RHIOs). These RHIOs, which others have called Local or Regional Health Information Infrastructures (LHII), would in turn interconnect local as well as national health information resources. Little data exist about the activities taking place in communities to create LHIIs. The authors analyzed data that communities submitted in response to a request for capabilities issued by the Foundation for eHealth as part of their Connecting Communities for Better Health program using descriptive statistics and subjective evaluation. The authors analyzed data from 134 responses from communities in 42 states and the District of Columbia. Communities are enthusiastic about moving forward with health information exchange to create LHIIs to improve the efficiency, quality, and safety of care. They have identified significant local sources of investment and plan to use some clinical data standards but not as broadly as was expected. The communities have not yet developed the specific technical approaches or the sustainable business models that will be required. Many communities are interested in creating an LHII and are developing the leadership commitment needed to translate that interest into an operational reality. Clinical information standards can be incorporated into a community's plans as often as they need to be. Communities have to overcome funding issues, develop deeper understanding of the technical and organizational issues, and aggressively share their learning to succeed within their community and to help other communities succeed.

Success in health information exchange projects: solving the implementation puzzle.

PubMed

Sicotte, Claude; Paré, Guy

2010-04-01

Interest in health information exchange (HIE), defined as the use of information technology to support the electronic transfer of clinical information across health care organizations, continues to grow among those pursuing greater patient safety and health care accessibility and efficiency. In this paper, we present the results of a longitudinal multiple-case study of two large-scale HIE implementation projects carried out in real time over 3-year and 2-year periods in Québec, Canada. Data were primarily collected through semi-structured interviews (n=52) with key informants, namely implementation team members and targeted users. These were supplemented with non-participants observation of team meetings and by the analysis of organizational documents. The cross-case comparison was particularly relevant given that project circumstances led to contrasting outcomes: while one project failed, the other was a success. A risk management analysis was performed taking a process view in order to capture the complexity of project implementations as evolving phenomena that are affected by interdependent pre-existing and emergent risks that tend to change over time. The longitudinal case analysis clearly demonstrates that the risk factors were closely intertwined. Systematic ripple effects from one risk factor to another were observed. This risk interdependence evolved dynamically over time, with a snowball effect that rendered a change of path progressively more difficult as time passed. The results of the cross-case analysis demonstrate a direct relationship between the quality of an implementation strategy and project outcomes. Copyright 2010 Elsevier Ltd. All rights reserved.

Physicians' Perceptions and Use of a Health Information Exchange: A Pilot Program in South Korea

PubMed Central

Lee, Sang-il; Kim, Jeong-Whun; Hwang, Hee; Cho, Eun-Young; Kim, Yoon; Ha, Kyooseob

2012-01-01

Abstract Objective: We examined physicians' perceived needs, benefits, and concerns regarding health information exchange (HIE) technology prior to experiencing it and their actual usage of exchanged information in care processes during an HIE pilot program in South Korea. Materials and Methods: We conducted a survey through a structured questionnaire to collect data on physician perceptions about an HIE prior to implementation. We analyzed responses using descriptive statistics and one-way analyses of variance. We also conducted a post-implementation survey through a computerized tool designed to collect data on physician assessment of HIE item usefulness. We defined two indices to measure the volume of information flow and usefulness for individual HIE items and analyzed the indices with Fisher's exact test. Results: Physicians' overall perceptions about the need for an HIE and benefits of the technology were positive despite their concerns about information safety and security, system costs, and disputes between care providers in cases of malpractice. We found that physician practice settings significantly influenced the details of their perceptions. In the both pre- and post-implementation studies, the most needed and valued information were pathology and lab results, diagnostic imaging, medication, and working diagnosis. Physicians most agreed with the benefit potentials in the quality domain, least agreed with those in time and cost savings of healthcare delivery, and least worried about the decrease in revenues resulting from the technology. Conclusions: The overall physician acceptance of the HIE technology in South Korea is promising, but the adoption and diffusion strategy needs to be tailored to the type of physician practice. Concerted efforts may be needed to realize the much-anticipated potential of healthcare cost savings. PMID:22352898

Barriers and facilitators to health information exchange in low- and middle-income country settings: a systematic review.

PubMed

Akhlaq, Ather; McKinstry, Brian; Muhammad, Khalid Bin; Sheikh, Aziz

2016-11-01

The exchange and use of health information can help healthcare professionals and policymakers make informed decisions on ways of improving patient and population health. Many low- and middle-income countries (LMICs) have however failed to embrace the approaches and technologies to facilitate health information exchange (HIE). We sought to understand the barriers and facilitators to the implementation and adoption of HIE in LMICs. Two reviewers independently searched 11 academic databases for published and on-going qualitative, quantitative and mixed-method studies and searched for unpublished work through the Google search engine. The searches covered the period from January 1990 to July 2014 and were not restricted by language. Eligible studies were independently, critically appraised and then thematically analysed. The searches yielded 5461 citations after de-duplication of results. Of these, 56 articles, three conference abstracts and four technical reports met the inclusion criteria. The lack of importance given to data in decision making, corruption and insecurity, lack of training and poor infrastructure were considered to be major challenges to implementing HIE, but strong leadership and clear policy direction coupled with the financial support to acquire essential technology, improve the communication network, and provide training for staff all helped to promote implementation. The body of work also highlighted how implementers of HIE needed to take into account local needs to ensure that stakeholders saw HIE as relevant and advantageous. HIE interventions implemented through leapfrog technologies such as telehealth/telemedicine and mHealth in Brazil, Kenya, and South Africa, provided successful examples of exchanging health information in LMICs despite limited resources and capability. It is important that implementation of HIE is aligned with national priorities and local needs. © The Author 2016. Published by Oxford University Press in association with

Simulation Suggests That Medical Group Mergers Won’t Undermine The Potential Utility Of Health Information Exchanges

PubMed Central

Schneider, Eric C.; Volk, Lynn A.; Szolovits, Peter; Salzberg, Claudia A.; Simon, Steven R.; Bates, David W.

2013-01-01

Substantial resources are being invested in health information exchanges (HIE), community-based consortia that enable independent health-care organizations to exchange clinical data. However, under pressure to form accountable care organizations, medical groups may merge and support private HIE, reducing the potential utility of community HIEs. Simulations of “care transitions” based on data from 10 Massachusetts communities suggest that mergers would have to be considerable to substantially reduce the potential utility of an HIE. Nonetheless, simulations also suggest that HIEs will need to recruit a large proportion of the medical groups in a community, as hospitals and the largest groups account for only 10 to 20% of care transitions in communities. PMID:22392665

Seasonal Patterns of Mixed Species Groups in Large East African Mammals

PubMed Central

Kiffner, Christian; Kioko, John; Leweri, Cecilia; Krause, Stefan

2014-01-01

Mixed mammal species groups are common in East African savannah ecosystems. Yet, it is largely unknown if co-occurrences of large mammals result from random processes or social preferences and if interspecific associations are consistent across ecosystems and seasons. Because species may exchange important information and services, understanding patterns and drivers of heterospecific interactions is crucial for advancing animal and community ecology. We recorded 5403 single and multi-species clusters in the Serengeti-Ngorongoro and Tarangire-Manyara ecosystems during dry and wet seasons and used social network analyses to detect patterns of species associations. We found statistically significant associations between multiple species and association patterns differed spatially and seasonally. Consistently, wildebeest and zebras preferred being associated with other species, whereas carnivores, African elephants, Maasai giraffes and Kirk's dik-diks avoided being in mixed groups. During the dry season, we found that the betweenness (a measure of importance in the flow of information or disease) of species did not differ from a random expectation based on species abundance. In contrast, in the wet season, we found that these patterns were not simply explained by variations in abundances, suggesting that heterospecific associations were actively formed. These seasonal differences in observed patterns suggest that interspecific associations may be driven by resource overlap when resources are limited and by resource partitioning or anti-predator advantages when resources are abundant. We discuss potential mechanisms that could drive seasonal variation in the cost-benefit tradeoffs that underpin the formation of mixed-species groups. PMID:25470495

Offering Prescriptions of Leader-Member Exchanges towards Developing Academic Talent in Higher Education

ERIC Educational Resources Information Center

Horne, Andre Leonard

2017-01-01

This paper examines leader-member exchange behaviour for the development of academic talent in higher education. Drawing from a sample of academic leaders at a large South African university, interviews conducted with the chairs of departments (CoDs) provide new insight on development practices and actions for follower development within a…

Mio-Pliocene Faunal Exchanges and African Biogeography: The Record of Fossil Bovids

PubMed Central

Bibi, Faysal

2011-01-01

The development of the Ethiopian biogeographic realm since the late Miocene is here explored with the presentation and review of fossil evidence from eastern Africa. Prostrepsiceros cf. vinayaki and an unknown species of possible caprin affinity are described from the hominid-bearing Asa Koma and Kuseralee Members (∼5.7 and ∼5.2 Ma) of the Middle Awash, Ethiopia. The Middle Awash Prostrepsiceros cf. vinayaki constitutes the first record of this taxon from Africa, previously known from the Siwaliks and Arabia. The possible caprin joins a number of isolated records of caprin or caprin-like taxa recorded, but poorly understood, from the late Neogene of Africa. The identification of these two taxa from the Middle Awash prompts an overdue review of fossil bovids from the sub-Saharan African record that demonstrate Eurasian affinities, including the reduncin Kobus porrecticornis, and species of Tragoportax. The fossil bovid record provides evidence for greater biological continuity between Africa and Eurasia in the late Miocene and earliest Pliocene than is found later in time. In contrast, the early Pliocene (after 5 Ma) saw the loss of any significant proportions of Eurasian-related taxa, and the continental dominance of African-endemic taxa and lineages, a pattern that continues today. PMID:21358825

Operation of the power information center: Performance of secretariat functions and information exchange activities in the advanced power field of the interagency advanced power group

NASA Technical Reports Server (NTRS)

1983-01-01

Highlights of activities conducted during the reporting period to facilitate the exchange of technical information among scientists and engineers both within the federal government and within industry are cited. Interagency Advanced Power Group meetings and special efforts, project briefs, and organization development are considered.

An integrated healthcare information system for end-to-end standardized exchange and homogeneous management of digital ECG formats.

PubMed

Trigo, Jesús Daniel; Martínez, Ignacio; Alesanco, Alvaro; Kollmann, Alexander; Escayola, Javier; Hayn, Dieter; Schreier, Günter; García, José

2012-07-01

This paper investigates the application of the enterprise information system (EIS) paradigm to standardized cardiovascular condition monitoring. There are many specifications in cardiology, particularly in the ECG standardization arena. The existence of ECG formats, however, does not guarantee the implementation of homogeneous, standardized solutions for ECG management. In fact, hospital management services need to cope with various ECG formats and, moreover, several different visualization applications. This heterogeneity hampers the normalization of integrated, standardized healthcare information systems, hence the need for finding an appropriate combination of ECG formats and a suitable EIS-based software architecture that enables standardized exchange and homogeneous management of ECG formats. Determining such a combination is one objective of this paper. The second aim is to design and develop the integrated healthcare information system that satisfies the requirements posed by the previous determination. The ECG formats selected include ISO/IEEE11073, Standard Communications Protocol for Computer-Assisted Electrocardiography, and an ECG ontology. The EIS-enabling techniques and technologies selected include web services, simple object access protocol, extensible markup language, or business process execution language. Such a selection ensures the standardized exchange of ECGs within, or across, healthcare information systems while providing modularity and accessibility.

Open exchange of scientific knowledge and European copyright: The case of biodiversity information

PubMed Central

Egloff, Willi; Patterson, David J.; Agosti, Donat; Hagedorn, Gregor

2014-01-01

Abstract Background. The 7th Framework Programme for Research and Technological Development is helping the European Union to prepare for an integrative system for intelligent management of biodiversity knowledge. The infrastructure that is envisaged and that will be further developed within the Programme “Horizon 2020” aims to provide open and free access to taxonomic information to anyone with a requirement for biodiversity data, without the need for individual consent of other persons or institutions. Open and free access to information will foster the re-use and improve the quality of data, will accelerate research, and will promote new types of research. Progress towards the goal of free and open access to content is hampered by numerous technical, economic, sociological, legal, and other factors. The present article addresses barriers to the open exchange of biodiversity knowledge that arise from European laws, in particular European legislation on copyright and database protection rights. We present a legal point of view as to what will be needed to bring distributed information together and facilitate its re-use by data mining, integration into semantic knowledge systems, and similar techniques. We address exceptions and limitations of copyright or database protection within Europe, and we point to the importance of data use agreements. We illustrate how exceptions and limitations have been transformed into national legislations within some European states to create inconsistencies that impede access to biodiversity information. Conclusions. The legal situation within the EU is unsatisfactory because there are inconsistencies among states that hamper the deployment of an open biodiversity knowledge management system. Scientists within the EU who work with copyright protected works or with protected databases have to be aware of regulations that vary from country to country. This is a major stumbling block to international collaboration and is an

Adapting a Program to Inform African American and Hispanic American Women About Cancer Clinical Trials

PubMed Central

Gonzalez, Jenny; Mumman, Manpreet; Cullen, Lisa; LaHousse, Sheila F.; Malcarne, Vanessa; Conde, Viridiana; Riley, Natasha

2010-01-01

The dearth of evidence-based clinical trial education programs may contribute to the underrepresentation of African American and Hispanic American women in cancer research studies. This study used focus group-derived data from 80 women distributed among eight Spanish- and English-language focus groups. These data guided the researchers’ adaptation and refinement of the National Cancer Institute’s various clinical trials education programs into a program that was specifically focused on meeting the information needs of minority women and addressing the barriers to study participation that they perceived. A “sisterhood” theme was adopted and woven throughout the presentation. PMID:20146043

Imaging of endogenous exchangeable proton signals in the human brain using frequency labeled exchange transfer imaging.

PubMed

Yadav, Nirbhay N; Jones, Craig K; Hua, Jun; Xu, Jiadi; van Zijl, Peter C M

2013-04-01

To image endogenous exchangeable proton signals in the human brain using a recently reported method called frequency labeled exchange transfer (FLEX) MRI. As opposed to labeling exchangeable protons using saturation (i.e., chemical exchange saturation transfer, or CEST), FLEX labels exchangeable protons with their chemical shift evolution. The use of short high-power frequency pulses allows more efficient labeling of rapidly exchanging protons, while time domain acquisition allows removal of contamination from semi-solid magnetization transfer effects. FLEX-based exchangeable proton signals were detected in human brain over the 1-5 ppm frequency range from water. Conventional magnetization transfer contrast and the bulk water signal did not interfere in the FLEX spectrum. The information content of these signals differed from in vivo CEST data in that the average exchange rate of these signals was 350-400 s(-1) , much faster than the amide signal usually detected using direct saturation (∼30 s(-1) ). Similarly, fast exchanging protons could be detected in egg white in the same frequency range where amide and amine protons of mobile proteins and peptides are known to resonate. FLEX MRI in the human brain preferentially detects more rapidly exchanging amide/amine protons compared to traditional CEST experiments, thereby changing the information content of the exchangeable proton spectrum. This has the potential to open up different types of endogenous applications as well as more easy detection of rapidly exchanging protons in diaCEST agents or fast exchanging units such as water molecules in paracest agents without interference of conventional magnetization transfer contrast. Copyright © 2013 Wiley Periodicals, Inc.

8 CFR 214.12 - Preliminary enrollment of schools in the Student and Exchange Visitor Information System (SEVIS).

Code of Federal Regulations, 2010 CFR

2010-01-01

... of schools in the Student and Exchange Visitor Information System (SEVIS). (a) Private elementary and private secondary schools, public high schools, post-secondary schools, language schools, and vocational... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Preliminary enrollment of schools in the...

Simultaneous determination of seven informative Y chromosome SNPs to differentiate East Asian, European, and African populations.

PubMed

Muro, Tomonori; Iida, Reiko; Fujihara, Junko; Yasuda, Toshihiro; Watanabe, Yukina; Imamura, Shinji; Nakamura, Hiroaki; Kimura-Kataoka, Kaori; Yuasa, Isao; Toga, Tomoko; Takeshita, Haruo

2011-05-01

Identification of the population origin of an individual is very useful for crime investigators who need to narrow down a suspect based on specimens left at a crime scene. Single nucleotide polymorphisms of the Y chromosome (Y-SNPs) are a class of markers of interest to forensic investigators because many of the markers indicate regional specificity, thus providing useful information about the geographic origin of a subject. We selected seven informative Y-SNPs (M168, M130, JST021355, M96, P126, P196, and P234) to differentiate the three major population groups (East Asian, European, and African) and used them to develop forensic application. SNP genotyping was carried out by multiplex PCR reaction and multiplex single base extension (MSBE) reaction followed by capillary electrophoresis of extension products. This method can be used to assign a haplogroup from both degraded male DNA samples and DNA samples containing a mixture of female and male DNA through PCR primers that generate small amplicons (less than about 150 bp) and are highly specific for targets on the Y chromosome. The allelic state of each marker was definitively determined from a total of 791 males from the three major population groups. As expected, samples from the three major population groups showed Y-haplogroups common in the region of provenance: Y haplogroups C, D, and O for East Asians; IJ and R1 for Europeans; and AB and E for Africans. Published by Elsevier Ireland Ltd.

Integration of IEEE 1451 and HL7 exchanging information for patients' sensor data.

PubMed

Kim, Wooshik; Lim, Suyoung; Ahn, Jinsoo; Nah, Jiyoung; Kim, Namhyun

2010-12-01

HL7 (Health Level 7) is a standard developed for exchanging incompatible healthcare information generated from programs or devices among heterogenous medical information systems. At present, HL7 is growing as a global standard. However, the HL7 standard does not support effective methods for treating data from various medical sensors, especially from mobile sensors. As ubiquitous systems are growing, HL7 must communicate with various medical transducers. In the area of sensor fields, IEEE 1451 is a group of standards for controlling transducers and for communicating data from/to various transducers. In this paper, we present the possibility of interoperability between the two standards, i.e., HL7 and IEEE 1451. After we present a method to integrate them and show the preliminary results of this approach.

Research Perspectives on African Education and the Informal Sector.

ERIC Educational Resources Information Center

Honig, Benson

This paper is concerned with the human capital theory of education as it is employed in designing, justifying, and funding African educational programs. According to this theory, where the most measurable and direct relationships between the world of work and that of school are purported to exist, those individuals who invest in education are…

NJDOT research peer exchange, October 2001 : information package.

DOT National Transportation Integrated Search

2001-10-01

Summary of the Peer Exchange Take Home Ideas: : Be proactive in regularly meeting with key stakeholder managers to identify their : strategic needs in moving their program responsibilities forward. : Incorporate discussion of strategic ...

Sociotechnical Analysis of Health Information Exchange Consent Processes in an HIV Clinic.

PubMed

Ramos, S Raquel; Gordon, Peter; Bakken, Suzanne; Schnall, Rebecca

Federal regulations have encouraged the electronic sharing of protected health information (PHI). As an opt-in state, New York abides by an affirmative consent model where PHI is electronically shared only after written consent is obtained. The purpose of our study was to describe sociotechnical factors that influence health information exchange (HIE) consent for persons living with HIV (PLWH) at one clinic in New York City. We employed mixed methods to gather perceptions of facilitators and barriers to HIE consent. Study participants included PLWH, staff, and clinicians. The mixed-methods approach revealed multiple interruptions in clinical workflow, staff and providers' time constraints, and lack of dedicated personnel focused on HIE consent as the major barriers to HIE consent. Although there is no one strategy to resolve barriers to HIE consent, having a dedicated person was identified as the most salient factor for facilitating HIE consent. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Assessments of the Veteran Medication Allergy Knowledge Gap and Potential Safety Improvements with the Veteran Health Information Exchange (VHIE)

PubMed Central

Pan, Eric; Botts, Nathan; Jordan, Harmon; Olinger, Lois; Donahue, Margaret; Hsing, Nelson

2016-01-01

The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly Virtual Lifetime Electronic Record, or VLER) had been deployed at all VA sites and used to exchange clinical information with private sector healthcare partners nationally. This paper examined VHIE’s effect on allergy documentation. Review of all inbound VHIE transactions in FY14 showed that VHIE use was associated with a nearly eight-fold increase in allergy documentation rate. Preliminary manual document review further showed that VA and partners had shared knowledge of only 38% ofpatient allergies, while VA had exclusive knowledge of another 58% ofpatient allergies, and partners had exclusive knowledge of the last 5% of patient allergies. To our knowledge, this is the first study that examined the effect of HIE on allergy documentation. PMID:28269897

Assessments of the Veteran Medication Allergy Knowledge Gap and Potential Safety Improvements with the Veteran Health Information Exchange (VHIE).

PubMed

Pan, Eric; Botts, Nathan; Jordan, Harmon; Olinger, Lois; Donahue, Margaret; Hsing, Nelson

2016-01-01

The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly Virtual Lifetime Electronic Record, or VLER) had been deployed at all VA sites and used to exchange clinical information with private sector healthcare partners nationally. This paper examined VHIE's effect on allergy documentation. Review of all inbound VHIE transactions in FY14 showed that VHIE use was associated with a nearly eight-fold increase in allergy documentation rate. Preliminary manual document review further showed that VA and partners had shared knowledge of only 38% ofpatient allergies, while VA had exclusive knowledge of another 58% ofpatient allergies, and partners had exclusive knowledge of the last 5% of patient allergies. To our knowledge, this is the first study that examined the effect of HIE on allergy documentation.

Cross-informant and cross-national equivalence using item-response theory (IRT) linking: A case study using the behavioral assessment for children of African heritage in the United States and Jamaica.

PubMed

Lambert, Michael Canute; Ferguson, Gail M; Rowan, George T

2016-03-01

Cross-national study of adolescents' psychological adjustment requires measures that permit reliable and valid assessment across informants and nations, but such measures are virtually nonexistent. Item-response-theory-based linking is a promising yet underutilized methodological procedure that permits more accurate assessment across informants and nations. To demonstrate this procedure, the Resilience Scale of the Behavioral Assessment for Children of African Heritage (Lambert et al., 2005) was administered to 250 African American and 294 Jamaican nonreferred adolescents and their caregivers. Multiple items without significant differential item functioning emerged, allowing scale linking across informants and nations. Calibrating item parameters via item response theory linking can permit cross-informant cross-national assessment of youth. (c) 2016 APA, all rights reserved).

Black versus Black: The Relationship among African, African American, and African Caribbean Persons.

ERIC Educational Resources Information Center

Jackson, Jennifer V.; Cothran, Mary E.

2003-01-01

Surveyed people of African descent regarding relationships among African, African-American, and African-Caribbean persons, focusing on contact and friendship, travel to countries of the diaspora, cross-cultural communication, thoughts and stereotypes, and education. Most respondents had contacts with the other groups, but groups had preconceived…

Exploring Health Information Exchange Implementation Using Qualitative Assessments of Nursing Home Leaders

PubMed Central

Alexander, Gregory L.; Popejoy, Lori; Lyons, Vanessa; Shumate, Sue; Mueller, Jessica; Galambos, Colleen; Vogelsmeier, Amy; Rantz, Marilyn; Flesner, Marcia

2016-01-01

Objectives Limited research exists on nursing home information technologies, such as health information exchange (HIE) systems. Capturing the experiences of early HIE adopters provides vital information about how these systems are used. In this study, we conduct a secondary analysis of qualitative data captured during interviews with 15 nursing home leaders representing 14 nursing homes in the midwestern United States that are part of the Missouri Quality Improvement Initiative (MOQI) national demonstration project. Methods The interviews were conducted as part of an external evaluation of the HIE vendor contracting with the MOQI initiative with the purpose of understanding the challenges and successes of HIE implementation, with a particular focus on Direct HIE services. Results Emerging themes included (1) incorporating HIE into existing work processes, (2) participation inside and outside the facility, (3) appropriate training and retraining, (4) getting others to use the HIE, (5) getting the HIE operational, and 6) putting policies for technology into place. Discussion Three essential areas should be considered for nursing homes considering HIE adoption: readiness to adopt technology, availability of technology resources, and matching of new clinical workflows. PMID:27843423

The Meaning of Career Progression to African-American Male Leaders in Information Technology Organizations

ERIC Educational Resources Information Center

Hickman, Linnel W., Jr.

2017-01-01

The purpose of this qualitative interpretive phenomenological analysis (IPA) study was to understand how white collar African American male senior executives within the defense industry contractor IT organizations make sense of their career advancement into senior management positions. The 12 African American males that participated in this study…

Quality of sexually transmitted disease treatments in the formal and informal sectors of Bangui, Central African Republic.

PubMed

Somsé, P; Mberyo-Yaah, F; Morency, P; Dubois, M J; Grésenguet, G; Pépin, J

2000-09-01

Interventions for upgrading sexually transmitted disease (STD) management in sub-Saharan Africa have focused on the public sector, and to a much lower extent on private medical practitioners and pharmacies. However, in most African cities there is a large informal sector that provides care to many patients with STD symptoms. To compare the quality of treatments offered to patients with major STD syndromes in the public sector, pharmacies, and the informal sector of the same city. Healthcare providers in health centers, pharmacies, private laboratories, and market drug peddlers in Bangui, Central African Republic, were asked to complete a short form for every patient consulting them with genital complaints. The treatments they ordered were evaluated for their potential efficacy against the major etiologic agents of the syndrome for which the patient consulted. The majority of male patients with STDs preferred to seek care in pharmacies and in the informal sector. The STD treatments offered to patients with urethral discharge or genital ulcers in pharmacies and in the informal sector tended to focus on a single etiologic agent. The quality of STD treatments offered by drug peddlers and private laboratories was poor, apart from adequate coverage of syphilis in patients with genital ulcers and of candidiasis in women with vaginal discharge. For instance, 41% and 34% of patients with urethral discharge managed by drug peddlers and private laboratories did not receive a drug active against either Neisseria gonorrhoeae or Chlamydia trachomatis, whereas this proportion was 22% in pharmacies and 14% in health centers. For patients with genital ulcers, the proportion offered a drug active against Haemophilus ducreyi was 2% if seen by drug peddlers, 0% in laboratories, 10% in pharmacies, and 25% in health centers. For each syndrome and each category of provider, between one fourth and two thirds of patients had already received another ineffective treatment elsewhere

Health and sexual behaviour among exchange students.

PubMed

Petersson, Carina; Peterson, Ulla; Swahnberg, Katarina; Oscarsson, Marie

2016-08-26

The objective was to describe the exchange students' health and sexual behaviour associated with their exchange studies, and examine the extent to which they had received preventive efforts against human immunodeficiency virus (HIV)/sexually transmitted infection (STI) and safer sex before departure. A cross-sectional study was conducted based on a web survey with questions about sexual behaviour, self-esteem and psychological well-being. Data were analysed using descriptive and analytical statistics. A total of 136 outgoing exchange students from a Swedish University participated. Most of the exchange students rated their health as good, had psychological well-being and rated their self-esteem as being high. Approximately half of the exchange students had sex with a new partner during the exchange semester, and 87% of them had sexually risky behaviour. More than half (61%) of the exchange students had received preventive efforts before departure. No statistically significant difference regarding preventive information was found between those who reported sexually risky behaviour and those who did not. The group that had sexually risky behaviour desired free condoms and access to clinics for sexual health. CONCLUSIONS EXCHANGE STUDENTS RATED THEIR HEALTH AS GOOD, AND THE MAJORITY OF THEM PARTICIPATED IN INFORMATION SESSIONS THAT ADDRESSED PREVENTIVE EFFORTS ON HIV/STI AND SAFER SEX BEFORE DEPARTURE SEXUALLY RISKY BEHAVIOUR DURING EXCHANGE STUDIES WAS REPORTED AND HIGHLIGHTS THE NEED FOR MORE EFFECTIVE PREVENTIVE MEASURES; FOR EXAMPLE, A RECOLLECTION OF READING STI INFORMATION. © Author(s) 2016.

Alert Exchange Process Protocol

NASA Technical Reports Server (NTRS)

Groen, Frank

2015-01-01

The National Aeronautics and Space Administration of the United States of America (NASA), and the European Space Agency (ESA), and the Japanese Aerospace Exploration Agency (JAXA), acknowledging that NASA, ESA and JAXA have a mutual interest in exchanging Alerts and Alert Status Lists to enhance the information base for each system participant while fortifying the general level of cooperation between the policy agreement subscribers, and each Party will exchange Alert listings on regular basis and detailed Alert information on a need to know basis to the extent permitted by law.

Patients' support for health information exchange: a literature review and classification of key factors.

PubMed

Esmaeilzadeh, Pouyan; Sambasivan, Murali

2017-04-04

Literature indicates that one of the most important factors affecting the widespread adoption of Health Information Exchange (HIE) is patient support and endorsement. In order to reap all the expected benefits of HIE, patients' acceptance of technology is a challenge that is not fully studied. There are a few studies which have focused on requirements of electronic medical information exchange from consumers' views and expectations. This study is aimed at reviewing the literature to articulate factors that affect patients to support HIE efforts. A literature review of current studies addressing patients' views on HIE from 2005 was undertaken. Five electronic research databases (Science Direct, PubMed, Web of Science, CINAHL, and Academic Search Premiere) were searched to retrieve articles reporting pros and cons of HIE from patients' opinion. One hundred and ninety six articles were initially retrieved from the databases. Out of 196, 36 studies met the inclusion criteria and were fully reviewed. Our findings indicate that patient's attitude toward HIE is affected by seven main factors: perceived benefits, perceived concerns, patient characteristics, patient participation level in HIE, type of health information, identity of recipients, and patient preferences regarding consent and features. The findings provide useful theoretical implications for research by developing a classification of significant factors and a framework based on the lessons learned from the literature to help guide HIE efforts. Our results also have fundamental practical implications for policy makers, current and potential organizers of HIEs by highlighting the role of patients in the widespread implementation of HIE. The study indicates that new approaches should be applied to completely underline HIE benefits for patients and also address their concerns.

Local Health Departments' Partners and Challenges in Electronic Exchange of Health Information

PubMed Central

Vest, Joshua R.; Lovelace, Kay; McCullough, J. Mac

2016-01-01

Background: Unprecedented amounts of data are produced by the health care and other sectors, presenting opportunities for local health departments (LHDs) to access these data. LHDs will need to participate in health information exchange (HIE) with a number of partners in order to benefit from these data resources. LHDs' participation in HIEs with specific partners has not been studied. Objectives: To describe the level of and challenges in LHD participation in HIE with other partners, and variation by LHD population size and governance type. Data and Methods: This research uses data from the 2015 Informatics Capacity and Needs Assessment Survey, with a target population of all LHDs in the United States. A representative sample of 650 LHDs was drawn using a stratified random sampling design. A total of 324 completed responses were received with a 50% response rate. Survey data were cleaned, and bivariate comparisons were conducted using χ2 and Somer's D. Results: Substantial variation existed in LHDs' participation in HIE by type of exchange partner. Although 71% participated in HIE with the state departments of health, only 12% with jail/correctional health, 14% with health or county-based purchasing plans, and 15% with home health agencies. Compared with large LHDs (jurisdiction populations of ≥500 000), smaller LHDs were more likely to participate in HIE with state departments of health, but less likely with other exchange partners. The challenges to HIE participation were technological, and organizational/interorganizational in nature and variation existed by LHDs' population size and governance structure with respect to state authority. Conclusions: Local public health agencies more commonly participate in HIE with some partners, but may need to improve HIE with many others. National strategies targeting an increase in HIE of LHDs may use our findings to focus those initiatives. PMID:27684617

Narcolepsy in African Americans.

PubMed

Kawai, Makoto; O'Hara, Ruth; Einen, Mali; Lin, Ling; Mignot, Emmanuel

2015-11-01

Although narcolepsy affects 0.02-0.05% of individuals in various ethnic groups, clinical presentation in different ethnicities has never been fully characterized. Our goal was to study phenotypic expression across ethnicities in the United States. Cases of narcolepsy from 1992 to 2013 were identified from searches of the Stanford Center for Narcolepsy Research database. International Classification of Sleep Disorders, Third Edition diagnosis criteria for type 1 and type 2 narcolepsy were used for inclusion, but subjects were separated as with and without cataplexy for the purpose of data presentation. Information extracted included demographics, ethnicity and clinical data, HLA-DQB1*06:02, polysomnography (PSG), multiple sleep latency test (MSLT) data, and cerebrospinal fluid (CSF) hypocretin-1 level. 182 African-Americans, 839 Caucasians, 35 Asians, and 41 Latinos with narcolepsy. Sex ratio, PSG, and MSLT findings did not differ across ethnicities. Epworth Sleepiness Scale (ESS) score was higher and age of onset of sleepiness earlier in African Americans compared with other ethnicities. HLA-DQB1*06:02 positivity was higher in African Americans (91.0%) versus others (76.6% in Caucasians, 80.0% in Asians, and 65.0% in Latinos). CSF hypocretin-1 level, obtained in 222 patients, was more frequently low (≤ 110 pg/ml) in African Americans (93.9%) versus Caucasians (61.5%), Asians (85.7%) and Latinos (75.0%). In subjects with low CSF hypocretin-1, African Americans (28.3%) were 4.5 fold more likely to be without cataplexy when compared with Caucasians (8.1%). Narcolepsy in African Americans is characterized by earlier symptom onset, higher Epworth Sleepiness Scale score, higher HLA-DQB1*06:02 positivity, and low cerebrospinal fluid hypocretin-1 level in the absence of cataplexy. In African Americans, more subjects without cataplexy have type 1 narcolepsy. © 2015 Associated Professional Sleep Societies, LLC.

Long QT syndrome in African-Americans.

PubMed

Fugate, Thomas; Moss, Arthur J; Jons, Christian; McNitt, Scott; Mullally, Jamie; Ouellet, Gregory; Goldenberg, Ilan; Zareba, Wojciech; Robinson, Jennifer L

2010-01-01

We evaluated the risk factors and clinical course of Long QT syndrome (LQTS) in African-American patients. The study involved 41 African-Americans and 3456 Caucasians with a QTc > or = 450 ms from the U.S. portion of the International LQTS Registry. Data included information about the medical history and clinical course of the LQTS patients with end points relating to the occurrence of syncope, aborted cardiac arrest, or LQTS-related sudden cardiac death from birth through age 40 years. The statistical analyses involved Kaplan-Meier time to event graphs and Cox regression models for multivariable risk factor evaluation. The QTc was 29 ms longer in African-Americans than Caucasians. Multivarite Cox analyses with adjustment for decade of birth revealed that the cardiac event rate was similar in African-Americans and Caucasians with LQTS and that beta-blockers were equally effective in reducing cardiac events in the two racial groups. The clinical course of LQTS in African-Americans is similar to that of Caucasians with comparable risk factors and benefit from beta-blocker therapy in the two racial groups.

African Ancestry is a Risk Factor for Asthma and High Total IgE Levels in African Admixed Populations

PubMed Central

Vergara, Candelaria; Murray, Tanda; Rafaels, Nicholas; Lewis, Rachel; Campbell, Monica; Foster, Cassandra; Gao, Li; Faruque, Mezbah; Oliveira, Ricardo Riccio; Carvalho, Edgar; Araujo, Maria Ilma; Cruz, Alvaro A.; Watson, Harold; Mercado, Dilia; Knight-Madden, Jennifer; Ruczinski, Ingo; Dunston, Georgia; Ford, Jean; Caraballo, Luis; Beaty, Terri H.; Mathias, Rasika A.; Barnes, Kathleen C.

2014-01-01

Characterization of genetic admixture of populations in the Americas and the Caribbean is of interest for anthropological, epidemiological, and historical reasons. Asthma has a higher prevalence and is more severe in populations with a high African component. Association of African ancestry with asthma has been demonstrated. We estimated admixture proportions of samples from six trihybrid populations of African descent and determined the relationship between African ancestry and asthma and total serum IgE levels (tIgE). We genotyped 237 ancestry informative markers in asthmatics and nonasthmatic controls from Barbados (190/277), Jamaica (177/529), Brazil (40/220), Colombia (508/625), African Americans from New York (207/171), and African Americans from Baltimore/Washington, D.C. (625/757). We estimated individual ancestries and evaluated genetic stratification using Structure and principal component analysis. Association of African ancestry and asthma and tIgE was evaluated by regression analysis. Mean SD African ancestry ranged from 0.76 ± 0.10 among Barbadians to 0.33 ± 0.13 in Colombians. The European component varied from 0.14 ± 0.05 among Jamaicans and Barbadians to 0.26 ± 0.08 among Colombians. African ancestry was associated with risk for asthma in Colombians (odds ratio (OR) = 4.5, P = 0.001) Brazilians (OR = 136.5, P = 0.003), and African Americans of New York (OR: 4.7; P = 0.040). African ancestry was also associated with higher tIgE levels among Colombians (β = 1.3, P = 0.04), Barbadians (β = 3.8, P = 0.03), and Brazilians (β = 1.6, P = 0.03). Our findings indicate that African ancestry can account for, at least in part, the association between asthma and its associated trait, tIgE levels. PMID:23554133

A snapshot of health information exchange across five nations: an investigation of frontline clinician experiences in emergency care.

PubMed

Klapman, Seth; Sher, Emily; Adler-Milstein, Julia

2018-06-01

Ensuring the ability to exchange patient information among disparate electronic health records systems is a top priority and a domain of substantial public investment across countries. However, we know little about the extent to which current capabilities meet the needs of frontline clinicians. We conducted in-person, semistructured interviews with emergency care physicians and nurses in select hospitals in Canada, Denmark, Finland, Germany, and the USA. We characterized the state of health information exchange (HIE) by country and used thematic analysis to identify the perceived benefits of access to complete past medical history (PMH), the conditions under which PMH is sought, and the challenges to accessing and using HIE capabilities. HIE approaches, and the information electronically accessible to clinicians, differed by country. Benefits of access to PMH included safer care, reduced patient length of stay, and fewer lab and imaging orders. Conditions under which PMH was sought included moderate-acuity patients, patients with chronic conditions, and instances where accessing PMH was convenient. Challenges to HIE access and use included difficulty knowing where information is located, delay in receiving information, and difficulty finding information within documents. Even with different HIE approaches across countries, all clinicians reported shortcomings in their country's approach. Notably, challenges were similar and shaped the conditions under which PMH was sought. As countries continue to pursue broad-based HIE, they appear to be facing similar challenges in realizing HIE value and therefore have an opportunity to learn from one another.

Narcolepsy in African Americans

PubMed Central

Kawai, Makoto; O'Hara, Ruth; Einen, Mali; Lin, Ling; Mignot, Emmanuel

2015-01-01

Study Objectives: Although narcolepsy affects 0.02–0.05% of individuals in various ethnic groups, clinical presentation in different ethnicities has never been fully characterized. Our goal was to study phenotypic expression across ethnicities in the United States. Design/Setting: Cases of narcolepsy from 1992 to 2013 were identified from searches of the Stanford Center for Narcolepsy Research database. International Classification of Sleep Disorders, Third Edition diagnosis criteria for type 1 and type 2 narcolepsy were used for inclusion, but subjects were separated as with and without cataplexy for the purpose of data presentation. Information extracted included demographics, ethnicity and clinical data, HLA-DQB1*06:02, polysomnography (PSG), multiple sleep latency test (MSLT) data, and cerebrospinal fluid (CSF) hypocretin-1 level. Patients: 182 African-Americans, 839 Caucasians, 35 Asians, and 41 Latinos with narcolepsy. Results: Sex ratio, PSG, and MSLT findings did not differ across ethnicities. Epworth Sleepiness Scale (ESS) score was higher and age of onset of sleepiness earlier in African Americans compared with other ethnicities. HLA-DQB1*06:02 positivity was higher in African Americans (91.0%) versus others (76.6% in Caucasians, 80.0% in Asians, and 65.0% in Latinos). CSF hypocretin-1 level, obtained in 222 patients, was more frequently low (≤ 110 pg/ml) in African Americans (93.9%) versus Caucasians (61.5%), Asians (85.7%) and Latinos (75.0%). In subjects with low CSF hypocretin-1, African Americans (28.3%) were 4.5 fold more likely to be without cataplexy when compared with Caucasians (8.1%). Conclusions: Narcolepsy in African Americans is characterized by earlier symptom onset, higher Epworth Sleepiness Scale score, higher HLA-DQB1*06:02 positivity, and low cerebrospinal fluid hypocretin-1 level in the absence of cataplexy. In African Americans, more subjects without cataplexy have type 1 narcolepsy. Citation: Kawai M, O'Hara R, Einen M, Lin L

The Department of Veterans Affairs' (VA) implementation of the Virtual Lifetime Electronic Record (VLER): findings and lessons learned from Health Information Exchange at 12 sites.

PubMed

Byrne, Colene M; Mercincavage, Lauren M; Bouhaddou, Omar; Bennett, Jamie R; Pan, Eric C; Botts, Nathan E; Olinger, Lois M; Hunolt, Elaine; Banty, Karl H; Cromwell, Tim

2014-08-01

We describe the Department of Veterans Affairs' (VA) Virtual Lifetime Health Electronic Record (VLER) pilot phase in 12 communities to exchange health information with private sector health care organizations and the Department of Defense (DoD), key findings, lessons, and implications for advancing Health Information Exchanges (HIE), nationally. A mixed methods approach was used to monitor and evaluate the status of VLER Health Exchange pilot phase implementation from December 2009 through October 2012. Selected accomplishments, contributions, challenges, and early lessons that are relevant to the growth of nationwide HIE are discussed. Veteran patient and provider acceptance, trust, and perceived value of VLER Health Exchange are found to be high, and usage by providers is steadily growing. Challenges and opportunities to improve provider use are identified, such as better data quality and integration with workflow. Key findings and lessons for advancing HIE are identified. VLER Health Exchange has made great strides in advancing HIE nationally by addressing important technical and policy issues that have impeded scalability, and by increasing trust and confidence in the value and accuracy of HIE among users. VLER Health Exchange has advanced HIE interoperability standards and patient consent policies nationally. Policy, programmatic, technology, and health Information Technology (IT) standards implications to advance HIE for improved delivery and coordination of health care are discussed. The pilot phase success led to VA-wide deployment of this data sharing capability in 2013. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Improving performance in the ED through laboratory information exchange systems.

PubMed

Raymond, Louis; Paré, Guy; Maillet, Éric; Ortiz de Guinea, Ana; Trudel, Marie-Claude; Marsan, Josianne

2018-03-12

The accessibility of laboratory test results is crucial to the performance of emergency departments and to the safety of patients. This study aims to develop a better understanding of which laboratory information exchange (LIE) systems emergency care physicians (ECPs) are using to consult their patients' laboratory test results and which benefits they derive from such use. A survey of 163 (36%) ECPs in Quebec was conducted in collaboration with the Quebec's Department of Health and Social Services. Descriptive statistics, chi-square tests, cluster analyses, and ANOVAs were conducted. The great majority of respondents indicated that they use several LIE systems including interoperable electronic health record (iEHR) systems, laboratory results viewers (LRVs), and emergency department information systems (EDIS) to consult their patients' laboratory results. Three distinct profiles of LIE users were observed. The extent of LIE usage was found to be primarily determined by the functional design differences between LIE systems available in the EDs. Our findings also indicate that the more widespread LIE usage, the higher the perceived benefits. More specifically, physicians who make extensive use of iEHR systems and LRVs obtain the widest range of benefits in terms of efficiency, quality, and safety of emergency care. Extensive use of LIE systems allows ECPs to better determine and monitor the health status of their patients, verify their diagnostic assumptions, and apply evidence-based practices in laboratory medicine. But for such benefits to be possible, ECPs must be provided with LIE systems that produce accurate, up-to-date, complete, and easy-to-interpret information.

How could health information exchange better meet the needs of care practitioners?

PubMed

Kierkegaard, P; Kaushal, R; Vest, J R

2014-01-01

Health information exchange (HIE) has the potential to improve the quality of healthcare by enabling providers with better access to patient information from multiple sources at the point of care. However, HIE efforts have historically been difficult to establish in the US and the failure rates of organizations created to foster HIE have been high. We sought to better understand how RHIO-based HIE systems were used in practice and the challenges care practitioners face using them. The objective of our study were to so investigate how HIE can better meet the needs of care practitioners. We performed a multiple-case study using qualitative methods in three communities in New York State. We conducted interviews onsite and by telephone with HIE users and non-users and observed the workflows of healthcare professionals at multiple healthcare organizations participating in a local HIE effort in New York State. The empirical data analysis suggests that challenges still remain in increasing provider usage, optimizing HIE implementations and connecting HIE systems across geographic regions. Important determinants of system usage and perceived value includes users experienced level of available information and the fit of use for physician workflows. Challenges still remain in increasing provider adoption, optimizing HIE implementations, and demonstrating value. The inability to find information reduced usage of HIE. Healthcare organizations, HIE facilitating organizations, and states can help support HIE adoption by ensuring patient information is accessible to providers through increasing patient consents, fostering broader participation, and by ensuring systems are usable.

Association between use of a health information exchange system and hospital admissions.

PubMed

Vest, J R; Kern, L M; Campion, T R; Silver, M D; Kaushal, R

2014-01-01

Relevant patient information is frequently difficult to obtain in emergency department (ED) visits. Improved provider access to previously inaccessible patient information may improve the quality of care and reduce hospital admissions. Health information exchange (HIE) systems enable access to longitudinal, community-wide patient information at the point of care. However, the ability of HIE to avert admissions is not well demonstrated. We sought to determine if HIE system usage is correlated with a reduction in admissions via the ED. We identified 15,645 adults from New York State with an ED visit during a 6-month period, all of whom consented to have their information accessible in the HIE system, and were continuously enrolled in two area health plans. Using claims we determined if the ED encounter resulted in an admission. We used the HIE's system log files to determine usage during the encounter. We determined the association between HIE system use and the likelihood of admission to the hospital from the ED and potential cost savings. The HIE system was accessed during 2.4% of encounters. The odds of an admission were 30% lower when the system was accessed after controlling for confounding (odds ratio = 0.70; 95%C I= 0.52, 0.95). The annual savings in the sample was $357,000. These findings suggest that the use of an HIE system may reduce hospitalizations from the ED with resultant cost savings. This is an important outcome given the substantial financial investment in interventions designed to improve provider access to patient information in the US.

Health information exchange associated with improved emergency department care through faster accessing of patient information from outside organizations.

PubMed

Everson, Jordan; Kocher, Keith E; Adler-Milstein, Julia

2017-04-01

To assess whether electronic health information exchange (HIE) is associated with improved emergency department (ED) care processes and utilization through more timely clinician viewing of information from outside organizations. Our data included 2163 patients seen in the ED of a large academic medical center for whom clinicians requested and viewed outside information from February 14, 2014, to February 13, 2015. Outside information requests w.ere fulfilled via HIE (Epic's Care Everywhere) or fax/scan to the electronic health record (EHR). We used EHR audit data to capture the time between the information request and when a clinician accessed the data. We assessed whether the relationship between method of information return and ED outcomes (length of visit, odds of imaging [computed tomography (CT), magnetic resonance imaging (MRI), radiographs] and hospitalization, and total charges) was mediated by request-to-access time, controlling for patient demographics, case mix, and acuity. In multivariate analysis, there was no direct association between return of information via HIE vs fax/scan and ED outcomes. HIE was associated with faster outside information access (58.5 minutes on average), and faster access was associated with changes in ED care. For each 1-hour reduction in access time, visit length was 52.9 minutes shorter, the likelihood of imaging was lower (by 2.5, 1.6, and 2.4 percentage points for CT, MRI, and radiographs, respectively), the likelihood of admission was 2.4 percentage points lower, and average charges were $1187 lower ( P  ≤ .001 for all). The relationship between HIE and improved care processes and reduced utilization in the ED is mediated by faster accessing of information from outside organizations. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Advancing breast cancer survivorship among African-American women.

PubMed

Coughlin, Steven S; Yoo, Wonsuk; Whitehead, Mary S; Smith, Selina A

2015-09-01

Advances have occurred in breast cancer survivorship but, for many African-American women, challenges and gaps in relevant information remain. This article identifies opportunities to address disparities in breast cancer survival and quality of life, and thereby to increase breast cancer survivorship among African-American women. For breast cancer survivors, common side effects, lasting for long periods after cancer treatment, include fatigue, loss of strength, difficulty sleeping, and sexual dysfunction. For addressing physical and mental health concerns, a variety of interventions have been evaluated, including exercise and weight training, dietary interventions, yoga and mindfulness-based stress reduction, and support groups or group therapy. Obesity has been associated with breast cancer recurrence and poorer survival. Relative to white survivors, African-American breast cancer survivors are more likely to be obese and less likely to engage in physical activity, although exercise improves overall quality of life and cancer-related fatigue. Considerable information exists about the effectiveness of such interventions for alleviating distress and improving quality of life among breast cancer survivors, but few studies have focused specifically on African-American women with a breast cancer diagnosis. Studies have identified a number of personal factors that are associated with resilience, increased quality of life, and positive adaptation to a breast cancer diagnosis. There is a need for a better understanding of breast cancer survivorship among African-American women. Additional evaluations of interventions for improving the quality of life and survival of African-American breast cancer survivors are desirable.

Is this what you need? Direct feedback help climate change information exchange

NASA Astrophysics Data System (ADS)

Bachelet, D. M.; Brown, M.; Gough, M.; Basin, D.

2015-12-01

The combination of projected climate change and land use adds uncertainty to the long-term effectiveness of current management strategies. Managers need reliable information to adjust their strategies as population density increases. However they are currently overwhelmed by the diversity of available information and the multiplicity of sources. CBI's goal is to centralize and package effectively the usable information for land managers and for the general public in order to increase awareness and promote preparation for the challenges ahead. We are designing conservation planning atlases in Data Basin for a number of landscape conservation cooperatives to address this need. We are adding some user-friendly tools to specifically serve the available climate projections and land use data in a meaningful way. By working closely with a group of managers, our goal is to understand how consideration of these projections figures into the decision-making process and refine the ways we can deliver relevant metrics. We have been holding interviews to gather information and critical feedback on existing climate-related web pages and tools, providing us with benchmarks for improvement. As it turned out, the student-manager dialogue added a component of climate change education and awareness of available tools to the project. Through an iterative process we plan to continue this exchange and address the variety of issues managers continually have to face to maintain healthy ecosystems.

Negro, Black, Black African, African Caribbean, African American or what? Labelling African origin populations in the health arena in the 21st century

PubMed Central

Agyemang, C.; Bhopal, R.; Bruijnzeels, M.

2005-01-01

Broad terms such as Black, African, or Black African are entrenched in scientific writings although there is considerable diversity within African descent populations and such terms may be both offensive and inaccurate. This paper outlines the heterogeneity within African populations, and discusses the strengths and limitations of the term Black and related labels from epidemiological and public health perspectives in Europe and the USA. This paper calls for debate on appropriate terminologies for African descent populations and concludes with the proposals that (1) describing the population under consideration is of paramount importance (2) the word African origin or simply African is an appropriate and necessary prefix for an ethnic label, for example, African Caribbean or African Kenyan or African Surinamese (3) documents should define the ethnic labels (4) the label Black should be phased out except when used in political contexts. PMID:16286485

Informed Decision-Making and Satisfaction with a Church-Based Men's Health Workshop Series for African-American Men: Men-Only vs. Mixed-Gender Format.

PubMed

Holt, Cheryl L; Le, Daisy; Saunders, Darlene R; Wang, Min Qi; Slade, Jimmie L; Muwwakkil, Bettye; Williams, Ralph; Atkinson, Nancy L; Whitehead, Tony L; Naslund, Michael

2015-09-01

Prostate cancer incidence and mortality are highest among African-American men, and coupled with the controversy around routine prostate cancer screening, reaching African-American men with interventions to help them make an informed decision about whether or not to be screened is critical. This study compares two approaches to delivering a church-based peer community health advisor intervention consisting of a series of four men's health workshops on informed decision-making for prostate cancer screening. In the men-only group, male community health advisors teach group workshops consisting only of men. In the health partner group, male-female pairs of community health advisors teach workshops in a mixed-gender format in which enrolled men are asked to invite a significant woman in their lives (e.g., wife/partner, sister, daughter, friend) with them to the workshops. Eighteen African-American churches were randomized to receive one of the two approaches, and 283 eligible men enrolled in the intervention. Main findings suggested that the workshops had an impact on stage of decision-making, and this increased significantly over time in the health partner group only. The intervention was highly rated by men in both groups, and these ratings increased over time, with some study group differences. Within-workshop study group differences favored the health partner group in some instances; however, men in the men-only groups reported greater increases in their ratings of trust in the workshops over time. The health partner intervention strategy appears to be promising for reaching men of color with health information.

The utilization rate of the regional health information exchange: how it impacts on health care delivery outcomes.

PubMed

Mäenpää, Tiina; Asikainen, Paula; Gissler, Mika; Siponen, Kimmo; Maass, Marianne; Saranto, Kaija; Suominen, Tarja

2012-01-01

Interest in improving quality and effectiveness is the primary driver for health information exchange efforts across a health care system to improve the provision of public health care services. The aim here was to describe and identify the impact of a regional health information exchange (HIE) using quantitative statistics for 2004-2008 in one hospital district in Finland. We conducted a comparative, longitudinal 5-year follow-up study to evaluate the utilization rates of HIE, and the impact on health care delivery outcomes. The selected outcomes were total laboratory tests, radiology examinations, appointments, emergency visits, and referrals. The HIE utilization rates increased annually in all 10 federations of municipalities, and the viewing of reference information increased steadily in each professional group over the 5-year study period. In these federations, a significant connection was found to the number of laboratory tests and radiology examinations, with a statistically significant increase in the number of viewed references and use of HIE. The higher the numbers of emergency visits and appointments, the higher the numbers of emergency referrals to specialized care, viewed references, and HIE usage among the groups of different health care professionals. There is increasing interest in HIE usage through regional health information system among health professionals to improve health care delivery regionally and bring information on the patient directly to care delivery. It will be important to study which changes in working methods in the service system are explained by RHIS. Also, the experiences of the change that has taken place should be studied among the different stakeholders, administrative representatives, and patients.

A qualitative study of sign-out processes between primary and on-call residents: relationships in information exchange, responsibility and accountability.

PubMed

Lee, Soo-Hoon; Fisher, Dale A; Mah, Heidi; Goh, Wei-Ping; Phan, Phillip H

2017-10-01

To review a quality improvement event on the process of sign-outs between the primary and on-call residents. A retrospective qualitative study using semi-structured interviews. A tertiary academic medical center in Singapore with 283 inpatient Medicine beds served by 28 consultants, 29 registrars, 45 residents and 30 interns during the day but 5 residents and 3 interns at night. Residents, registrars and consultants. Quality improvement event on sign-out. Effectiveness of sign-out comprises exchange of patient information, professional responsibility and task accountability. The following process of sign-outs was noted. Primary teams were accountable to the on-call resident by selecting at-risk patients and preparing contingency plans for sign-out. Structured information exchanged included patient history, active problems and plans of care. On-call residents took ownership of at-risk patients by actively asking questions during sign-out and reporting back the agreed care plan. On-call residents were accountable to the primary team by reporting back at-risk patients the next day. A structured information exchange at sign-out increased the on-call resident's ability to care for at-risk patients when it was supported by two-way transfers of responsibility and accountability. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The Veteran-Initiated Electronic Care Coordination: A Multisite Initiative to Promote and Evaluate Consumer-Mediated Health Information Exchange.

PubMed

Klein, Dawn M; Pham, Kassi; Samy, Leila; Bluth, Adam; Nazi, Kim M; Witry, Matthew; Klutts, J Stacey; Grant, Kathleen M; Gundlapalli, Adi V; Kochersberger, Gary; Pfeiffer, Laurie; Romero, Sergio; Vetter, Brian; Turvey, Carolyn L

2017-04-01

Information continuity is critical to person-centered care when patients receive care from multiple healthcare systems. Patients can access their electronic health record data through patient portals to facilitate information exchange. This pilot was developed to improve care continuity for rural Veterans by (1) promoting the use of the Department of Veterans Affairs (VA) patient portal to share health information with non-VA providers, and (2) evaluating the impact of health information sharing at a community appointment. Veterans from nine VA healthcare systems were trained to access and share their VA Continuity of Care Document (CCD) with their non-VA providers. Patients and non-VA providers completed surveys on their experiences. Participants (n = 620) were primarily older, white, and Vietnam era Veterans. After training, 78% reported the CCD would help them be more involved in their healthcare and 86% planned to share it regularly with non-VA providers. Veterans (n = 256) then attended 277 community appointments. Provider responses from these appointments (n = 133) indicated they were confident in the accuracy of the information (97%) and wanted to continue to receive the CCD (96%). Ninety percent of providers reported the CCD improved their ability to have an accurate medication list and helped them make medication treatment decisions. Fifty percent reported they did not order a laboratory test or another procedure because of information available in the CCD. This pilot demonstrates feasibility and value of patient access to a CCD to facilitate information sharing between VA and non-VA providers. Outreach and targeted education are needed to promote consumer-mediated health information exchange.

Having our Say: African American Women, Diversity, and Counseling

ERIC Educational Resources Information Center

Bryant, Rhonda M.; Coker, Angela D.; Durodoye, Beth A.; McCollum, Vivian J.; Pack-Brown, Sherlon P.; Constantine, Madonna G.; O'Bryant, Beverly J.

2005-01-01

This article presents the voices of seven African American female counselor educators. The authors, having formally and informally collaborated in multiple settings over the past few years, decided to illuminate the challenges and successes of African American female counselor educators to add another dimension to our profession's discussion on…

The development of a health information exchange to enhance care and improve patient outcomes among HIV+ individuals in rural North Carolina.

PubMed

Messer, Lynne C; Parnell, Heather; Huffaker, Renee; Wooldredge, Rich; Wilkin, Aimee

2012-10-01

The Regional Health Information Integration Project (RHIIP) has developed the Carolina HIV Information Cooperative regional health information organization (CHIC RHIO). The CHIC RHIO was implemented to improve patient care and health outcomes by enhancing communication among geographically disconnected networks of HIV care providers in rural North Carolina. CHIC RHIO comprises one medical clinic and five AIDS Service Organizations (ASOs) serving clients in eight rural counties. Communication among the CHIC RHIO members is facilitated by CAREWare software. The RHIIP team assessed organizational readiness to change, facilitated relationship-building for CHIC RHIO, created the CHIC RHIO and used both qualitative and quantitative approaches to evaluate the process-related effects of implementing a data-sharing intervention. We found the CHIC RHIO member organizations were ready to engage in the IT intervention prior to its implementation, which most likely contributed to its successful adoption. The qualitative findings indicate that CHIC RHIO members personally benefited - and perceived their clients benefited - from participation in the information exchange. The quantitative results echoed the qualitative findings; following the CHIC RHIO intervention, quality improvements were noted in the ASO and medical clinic relationships, information exchange, and perceived level of patient care. Furthermore, hopes for what data sharing would accomplish were overly high at the beginning of the project, thus requiring a recalibration of expectations as the project came to a close. Innovative strategies for health information exchange can be implemented in rural communities to increase communication among providers. With this increased communication comes the potential for improved health outcomes and, in turn, healthier communities. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Scoliosis and the Social Media: Facebook as a Means of Information Exchange.

PubMed

Ng, Jonathan P; Tarazi, Nadim; Byrne, Damien P; Baker, Joseph F; McCabe, John P

2017-03-01

Over the last decade, the emergence of social networking websites such as Facebook have revolutionized information dissemination and broadened opportunities to engage in discussions. In particular, having been widely adopted in the younger generation, the use of this medium has become more prevalent in health disorders such as scoliosis in the adolescent population. However, the quality of information on Facebook is unregulated and variable, which may mislead patients in their decision making. To document the various types of information available and assess the quality of information on Facebook discussion boards using recognized scoring systems. To evaluate the quality of information on the social network. A search for the keyword "scoliosis" on Facebook was performed and the first 100 pages generated were reviewed. SCSS and DISCERN score. Content analysis was performed on discussion boards and personal blogs. Two independent examiners evaluated each site according to scoliosis-specific content score (SCSS) and the DISCERN criteria, both previously used instruments to judge the quality of information on the Internet pertaining to scoliosis. The SCSS range from 0 to 32 (higher score better) and the DISCERN 16 to 80 (higher score better). Of the 100 sites reviewed, 33 were discussion boards and personal blogs. Of these, the overall average SCSS was 5.7 (SD 5.8, range 0-20) and the DISCERN was 22.5 (SD 7.6, range 16-45), indicating that using general scoring systems the quality of information provided was overall poor. Using recognized scoring systems to analyze Facebook pages used as discussion forums or blogs, we showed that the quality in general was poor. For modern practices to adapt to an era of information exchange via the social network, the orthopedic community should develop ways to incorporate the social media in future patient education. Copyright © 2016 Scoliosis Research Society. All rights reserved.

Association of substance use disorders with childhood trauma but not African genetic heritage in an African American cohort.

PubMed

Ducci, Francesca; Roy, Alec; Shen, Pei-Hong; Yuan, Qiaoping; Yuan, Nicole P; Hodgkinson, Colin A; Goldman, Lynn R; Goldman, David

2009-09-01

Genetic variation influences differential vulnerability to addiction within populations. However, it remains unclear whether differences in frequencies of vulnerability alleles contribute to disparities between populations and to what extent ancestry correlates with differential exposure to environmental risk factors, including poverty and trauma. The authors used 186 ancestry-informative markers to measure African ancestry in 407 addicts and 457 comparison subjects self-identified as African Americans. The reference group was 1,051 individuals from the Human Genome Diversity Cell Line Panel, which includes 51 diverse populations representing most worldwide genetic diversity. African Americans varied in degrees of African, European, Middle Eastern, and Central Asian genetic heritage. The overall level of African ancestry was actually smaller among cocaine, opiate, and alcohol addicts (proportion=0.76-0.78) than nonaddicted African American comparison subjects (proportion=0.81). African ancestry was associated with living in impoverished neighborhoods, a factor previously associated with risk. There was no association between African ancestry and exposure to childhood abuse or neglect, a factor that strongly predicted all types of addictions. These results suggest that African genetic heritage does not increase the likelihood of genetic risk for addictions. They highlight the complex interrelation between genetic ancestry and social, economic, and environmental conditions and the strong relation of those factors to addiction. Studies of epidemiological samples characterized for genetic ancestry and social, psychological, demographic, economic, cultural, and historical factors are needed to better disentangle the effects of genetic and environmental factors underlying interpopulation differences in vulnerability to addiction and other health disparities.

Association of Substance Use Disorders With Childhood Trauma but not African Genetic Heritage in an African American Cohort

PubMed Central

Ducci, Francesca; Roy, Alec; Shen, Pei-Hong; Yuan, Qiaoping; Yuan, Nicole P.; Hodgkinson, Colin A.; Goldman, Lynn R.; Goldman, David

2009-01-01

Objective Genetic variation influences differential vulnerability to addiction within populations. However, it remains unclear whether differences in frequencies of vulnerability alleles contribute to disparities between populations and to what extent ancestry correlates with differential exposure to environmental risk factors, including poverty and trauma. Method The authors used 186 ancestry-informative markers to measure African ancestry in 407 addicts and 457 comparison subjects self-identified as African Americans. The reference group was 1,051 individuals from the Human Genome Diversity Cell Line Panel, which includes 51 diverse populations representing most worldwide genetic diversity. Results African Americans varied in degrees of African, European, Middle Eastern, and Central Asian genetic heritage. The overall level of African ancestry was actually smaller among cocaine, opiate, and alcohol addicts (proportion=0.76–0.78) than nonaddicted African American comparison subjects (proportion=0.81). African ancestry was associated with living in impoverished neighborhoods, a factor previously associated with risk. There was no association between African ancestry and exposure to childhood abuse or neglect, a factor that strongly predicted all types of addictions. Conclusions These results suggest that African genetic heritage does not increase the likelihood of genetic risk for addictions. They highlight the complex interrelation between genetic ancestry and social, economic, and environmental conditions and the strong relation of those factors to addiction. Studies of epidemiological samples characterized for genetic ancestry and social, psychological, demographic, economic, cultural, and historical factors are needed to better disentangle the effects of genetic and environmental factors underlying interpopulation differences in vulnerability to addiction and other health disparities. PMID:19605534

African Genetic Ancestry is Associated with Sleep Depth in Older African Americans

PubMed Central

Halder, Indrani; Matthews, Karen A.; Buysse, Daniel J.; Strollo, Patrick J.; Causer, Victoria; Reis, Steven E.; Hall, Martica H.

2015-01-01

Study Objectives: The mechanisms that underlie differences in sleep characteristics between European Americans (EA) and African Americans (AA) are not fully known. Although social and psychological processes that differ by race are possible mediators, the substantial heritability of sleep characteristics also suggests genetic underpinnings of race differences. We hypothesized that racial differences in sleep phenotypes would show an association with objectively measured individual genetic ancestry in AAs. Design: Cross sectional. Setting: Community-based study. Participants: Seventy AA adults (mean age 59.5 ± 6.7 y; 62% female) and 101 EAs (mean age 60.5 ± 7 y, 39% female). Measurements and Results: Multivariate tests were used to compare the Pittsburgh Sleep Quality Index (PSQI) and in-home polysomnographic measures of sleep duration, sleep efficiency, apnea-hypopnea index (AHI), and indices of sleep depth including percent visually scored slow wave sleep (SWS) and delta EEG power of EAs and AAs. Sleep duration, efficiency, and sleep depth differed significantly by race. Individual % African ancestry (%AF) was measured in AA subjects using a panel of 1698 ancestry informative genetic markers and ranged from 10% to 88% (mean 67%). Hierarchical linear regression showed that higher %AF was associated with lower percent SWS in AAs (β (standard error) = −4.6 (1.5); P = 0.002), and explained 11% of the variation in SWS after covariate adjustment. A similar association was observed for delta power. No association was observed for sleep duration and efficiency. Conclusion: African genetic ancestry is associated with indices of sleep depth in African Americans. Such an association suggests that part of the racial differences in slow-wave sleep may have genetic underpinnings. Citation: Halder I, Matthews KA, Buysse DJ, Strollo PJ, Causer V, Reis SE, Hall MH. African genetic ancestry is associated with sleep depth in older African Americans. SLEEP 2015;38(8):1185–1193

DOD Commissaries and Exchanges: Plan and Additional Information Needed on Cost Savings and Metrics for DOD Efforts to Achieve Budget Neutrality

DTIC Science & Technology

2016-11-14

the best practices in project management related to the establishment of goals and time frames.9 We obtained documentary and testimonial evidence...have created new incentives for DOD to assess its approach for managing the commissaries and exchanges. Congress identified $1.3 billion in fiscal...have relevant and reliable information to help management make informed decisions.8 We also reviewed relevant information in the report compared with

Stigma, lack of knowledge and prevalence maintain HIV risk among Black Africans in New Zealand.

PubMed

Henrickson, Mark; Dickson, Nigel; Mhlanga, Fungai; Ludlam, Adrian

2015-02-01

The AfricaNZ Health project aimed explore HIV risks in Black African communities in NZ with a view to informing HIV infection prevention and health promotion programs. AfricaNZ Health was completed in two phases. The first developed desk estimates of the resident Black African population in New Zealand, and Africans living with HIV. The second comprised two arms: an anonymous survey administered at African community events and a series of focus groups around the country. High levels of knowledge and positive attitudes about HIV were more often found in older than younger age groups. Condom use was higher in the younger group than in older age groups. Traditional attitudes still inform some beliefs about HIV. Stigma about HIV and anyone at risk for HIV remains very high among Africans. Western sexual identity constructs are not meaningful. A culturally informed strategy for risk and stigma reduction is urgently needed. The existing prevention and care infrastructure, informed by MSM experiences, must address increased risk to Black African new settlers, but this is not a reason to discriminate or further stigmatise an already vulnerable population. © 2014 Public Health Association of Australia.

Association Between Use of a Health Information Exchange System and Hospital Admissions

PubMed Central

Vest, J.R.; Kern, L.M.; Campion, T.R.; Silver, M.D.; Kaushal, R.

2014-01-01

Summary Objective Relevant patient information is frequently difficult to obtain in emergency department (ED) visits. Improved provider access to previously inaccessible patient information may improve the quality of care and reduce hospital admissions. Health information exchange (HIE) systems enable access to longitudinal, community-wide patient information at the point of care. However, the ability of HIE to avert admissions is not well demonstrated. We sought to determine if HIE system usage is correlated with a reduction in admissions via the ED. Methods We identified 15,645 adults from New York State with an ED visit during a 6-month period, all of whom consented to have their information accessible in the HIE system, and were continuously enrolled in two area health plans. Using claims we determined if the ED encounter resulted in an admission. We used the HIE’s system log files to determine usage during the encounter. We determined the association between HIE system use and the likelihood of admission to the hospital from the ED and potential cost savings. Results The HIE system was accessed during 2.4% of encounters. The odds of an admission were 30% lower when the system was accessed after controlling for confounding (odds ratio = 0.70; 95%C I= 0.52, 0.95). The annual savings in the sample was $357,000. Conclusion These findings suggest that the use of an HIE system may reduce hospitalizations from the ED with resultant cost savings. This is an important outcome given the substantial financial investment in interventions designed to improve provider access to patient information in the US. PMID:24734135

How could Health Information Exchange Better Meet the Needs of Care Practitioners?

PubMed Central

Kaushal, R.; Vest, J.R.

2014-01-01

Summary Background Health information exchange (HIE) has the potential to improve the quality of healthcare by enabling providers with better access to patient information from multiple sources at the point of care. However, HIE efforts have historically been difficult to establish in the US and the failure rates of organizations created to foster HIE have been high. Objectives We sought to better understand how RHIO-based HIE systems were used in practice and the challenges care practitioners face using them. The objective of our study were to so investigate how HIE can better meet the needs of care practitioners. Methods We performed a multiple-case study using qualitative methods in three communities in New York State. We conducted interviews onsite and by telephone with HIE users and non-users and observed the workflows of healthcare professionals at multiple healthcare organizations participating in a local HIE effort in New York State. Results The empirical data analysis suggests that challenges still remain in increasing provider usage, optimizing HIE implementations and connecting HIE systems across geographic regions. Important determinants of system usage and perceived value includes users experienced level of available information and the fit of use for physician workflows. Conclusions Challenges still remain in increasing provider adoption, optimizing HIE implementations, and demonstrating value. The inability to find information reduced usage of HIE. Healthcare organizations, HIE facilitating organizations, and states can help support HIE adoption by ensuring patient information is accessible to providers through increasing patient consents, fostering broader participation, and by ensuring systems are usable. PMID:25589903

Minimizing back exchange in the hydrogen exchange-mass spectrometry experiment.

PubMed

Walters, Benjamin T; Ricciuti, Alec; Mayne, Leland; Englander, S Walter

2012-12-01

The addition of mass spectrometry (MS) analysis to the hydrogen exchange (HX) proteolytic fragmentation experiment extends powerful HX methodology to the study of large biologically important proteins. A persistent problem is the degradation of HX information due to back exchange of deuterium label during the fragmentation-separation process needed to prepare samples for MS measurement. This paper reports a systematic analysis of the factors that influence back exchange (solution pH, ionic strength, desolvation temperature, LC column interaction, flow rates, system volume). The many peptides exhibit a range of back exchange due to intrinsic amino acid HX rate differences. Accordingly, large back exchange leads to large variability in D-recovery from one residue to another as well as one peptide to another that cannot be corrected for by reference to any single peptide-level measurement. The usual effort to limit back exchange by limiting LC time provides little gain. Shortening the LC elution gradient by 3-fold only reduced back exchange by ~2%, while sacrificing S/N and peptide count. An unexpected dependence of back exchange on ionic strength as well as pH suggests a strategy in which solution conditions are changed during sample preparation. Higher salt should be used in the first stage of sample preparation (proteolysis and trapping) and lower salt (<20 mM) and pH in the second stage before electrospray injection. Adjustment of these and other factors together with recent advances in peptide fragment detection yields hundreds of peptide fragments with D-label recovery of 90% ± 5%.

Minimizing Back Exchange in the Hydrogen Exchange-Mass Spectrometry Experiment

NASA Astrophysics Data System (ADS)

Walters, Benjamin T.; Ricciuti, Alec; Mayne, Leland; Englander, S. Walter

2012-12-01

The addition of mass spectrometry (MS) analysis to the hydrogen exchange (HX) proteolytic fragmentation experiment extends powerful HX methodology to the study of large biologically important proteins. A persistent problem is the degradation of HX information due to back exchange of deuterium label during the fragmentation-separation process needed to prepare samples for MS measurement. This paper reports a systematic analysis of the factors that influence back exchange (solution pH, ionic strength, desolvation temperature, LC column interaction, flow rates, system volume). The many peptides exhibit a range of back exchange due to intrinsic amino acid HX rate differences. Accordingly, large back exchange leads to large variability in D-recovery from one residue to another as well as one peptide to another that cannot be corrected for by reference to any single peptide-level measurement. The usual effort to limit back exchange by limiting LC time provides little gain. Shortening the LC elution gradient by 3-fold only reduced back exchange by ~2 %, while sacrificing S/N and peptide count. An unexpected dependence of back exchange on ionic strength as well as pH suggests a strategy in which solution conditions are changed during sample preparation. Higher salt should be used in the first stage of sample preparation (proteolysis and trapping) and lower salt (<20 mM) and pH in the second stage before electrospray injection. Adjustment of these and other factors together with recent advances in peptide fragment detection yields hundreds of peptide fragments with D-label recovery of 90 % ± 5 %.

Health information exchange technology on the front lines of healthcare: workflow factors and patterns of use

PubMed Central

Johnson, Kevin B; Lorenzi, Nancy M

2011-01-01

Objective The goal of this study was to develop an in-depth understanding of how a health information exchange (HIE) fits into clinical workflow at multiple clinical sites. Materials and Methods The ethnographic qualitative study was conducted over a 9-month period in six emergency departments (ED) and eight ambulatory clinics in Memphis, Tennessee, USA. Data were collected using direct observation, informal interviews during observation, and formal semi-structured interviews. The authors observed for over 180 h, during which providers used the exchange 130 times. Results HIE-related workflow was modeled for each ED site and ambulatory clinic group and substantial site-to-site workflow differences were identified. Common patterns in HIE-related workflow were also identified across all sites, leading to the development of two role-based workflow models: nurse based and physician based. The workflow elements framework was applied to the two role-based patterns. An in-depth description was developed of how providers integrated HIE into existing clinical workflow, including prompts for HIE use. Discussion Workflow differed substantially among sites, but two general role-based HIE usage models were identified. Although providers used HIE to improve continuity of patient care, patient–provider trust played a significant role. Types of information retrieved related to roles, with nurses seeking to retrieve recent hospitalization data and more open-ended usage by nurse practitioners and physicians. User and role-specific customization to accommodate differences in workflow and information needs may increase the adoption and use of HIE. Conclusion Understanding end users' perspectives towards HIE technology is crucial to the long-term success of HIE. By applying qualitative methods, an in-depth understanding of HIE usage was developed. PMID:22003156

Africans in America: America's Journey through Slavery. Teacher's Guide.

ERIC Educational Resources Information Center

WGBH-TV, Boston, MA.

This printed guide for viewing the Public Television series, "Africans in America," first points out that the series, told from multiple perspectives and informed by "leading-edge" scholars, illuminates U.S. history from 1607 to 1861: how Africans and Europeans together built a new nation even as they struggled over the meaning…

Advancing Breast Cancer Survivorship among African American Women

PubMed Central

Coughlin, Steven S.; Yoo, Wonsuk; Whitehead, Mary S.; Smith, Selina A.

2015-01-01

Purpose Advances have occurred in breast cancer survivorship but, for many African American women, challenges and gaps in relevant information remain. Methods This article identifies opportunities to address disparities in breast cancer survival and quality of life, and thereby to increase breast cancer survivorship among African American women. Results For breast cancer survivors, common side effects, lasting for long periods after cancer treatment, include fatigue, loss of strength, difficulty sleeping, and sexual dysfunction. For addressing physical and mental health concerns, a variety of interventions have been evaluated, including exercise and weight training, dietary interventions, yoga and mindfulness-based stress reduction, and support groups or group therapy. Obesity has been associated with breast cancer recurrence and poorer survival. Relative to white survivors, African American breast cancer survivors are more likely to be obese and less likely to engage in physical activity, although exercise improves overall quality of life and cancer-related fatigue. Considerable information exists about the effectiveness of such interventions for alleviating distress and improving quality of life among breast cancer survivors, but few studies have focused specifically on African American women with a breast cancer diagnosis. Studies have identified a number of personal factors that are associated with resilience, increased quality of life, and positive adaptation to a breast cancer diagnosis. Conclusions There is a need for a better understanding of breast cancer survivorship among African American women. Additional evaluations of interventions for improving the quality of life and survival of African American breast cancer survivors are desirable. PMID:26303657

Development of a spiritually based educational intervention to increase informed decision making for prostate cancer screening among church-attending African American men.

PubMed

Holt, Cheryl L; Wynn, Theresa A; Southward, Penny; Litaker, Mark S; Jeames, Sanford; Schulz, Emily

2009-09-01

One way of developing culturally relevant health communication in the African American church setting is to develop spiritually based interventions, in which the health message is framed by relevant spiritual themes and scripture. In this article we describe the development of a community health advisor(CHA)-led intervention aimed at increasing informed decision making (IDM) for prostate cancer screening among church-attending African American men. Full-color print educational booklets were developed and pilot tested with extensive community participation of church-attending African American men age-eligible for screening. The intervention development phase consisted of ideas solicited from an advisory panel of African American men (N = 10), who identified core content and developed the spiritual themes. In the intervention pilot testing phase, prototypes of the intervention materials were pilot tested for graphic appeal in two focus groups (N = 16), and content was tested for acceptability and comprehension using individual cognitive response interviews (N = 10). Recommendations were made for project branding and logo and for use of graphics of real people in the educational materials. Significant feedback was obtained from the focus groups, on the graphics, colors, fonts, continuity, titles, and booklet size/shape. The importance of working closely with the community when developing interventions is discussed, as well as the importance of pilot testing of educational materials.

Information technology equipment cooling method

DOEpatents

Schultz, Mark D.

2015-10-20

According to one embodiment, a system for removing heat from a rack of information technology equipment may include a sidecar indoor air to liquid heat exchanger that cools air utilized by the rack of information technology equipment to cool the rack of information technology equipment. The system may also include a liquid to liquid heat exchanger and an outdoor heat exchanger. The system may further include configurable pathways to connect and control fluid flow through the sidecar heat exchanger, the liquid to liquid heat exchanger, the rack of information technology equipment, and the outdoor heat exchanger based upon ambient temperature and/or ambient humidity to remove heat generated by the rack of information technology equipment.

International School Health Network: an informal network for advocacy and knowledge exchange.

PubMed

McCall, Douglas S; Rootman, Irving; Bayley, Dale

2005-01-01

mechanism with a focus on school health that brings together the following stakeholders: educational organisations with public health organisations; researchers with government officials and practitioners; those who work in Spanish, English, French and other languages; issue-specific networks with health generalists. An invitation is given to government officials, researchers and national school health associations to join an informal International School Health Network (ISHN) (soon available at: www.internationalschoolhealt.org). Discussions about the formation of the ISHN have been held with a number of participants at several international meetings and have culminated in a fledgling network that will focus on electronic and web-based exchanges of information, developing a global school health research agenda, exchanging effective materials and tools, informing policy-makers about effective practices, policies and programs. This network would build on and not duplicate the work of existing networks and include participation from WHO, OECD, UNESCO, the IUHPE and the World Bank. The next large meeting of the ISHN will occur at the IUHPE 2007 Conference in Vancouver, Canada (www.iuhpe conference.org). Before then the ISHN will organise several on-line projects and teleconferences. For more information, contact dmccall@jcsh-cces.ca.

Informed consent in paediatric critical care research--a South African perspective.

PubMed

Morrow, Brenda M; Argent, Andrew C; Kling, Sharon

2015-09-09

child participant and parent. Where appropriate, alternatives to prospective informed consent should be considered to ensure that important paediatric critical care research can be undertaken in South Africa, whilst being cognisant of research risk. This document could provide a basis for debate on consent options in paediatric critical care research and contribute to efforts to advocate for South African law reform.

European ancestry as a risk factor for atrial fibrillation in African Americans.

PubMed

Marcus, Gregory M; Alonso, Alvaro; Peralta, Carmen A; Lettre, Guillaume; Vittinghoff, Eric; Lubitz, Steven A; Fox, Ervin R; Levitzky, Yamini S; Mehra, Reena; Kerr, Kathleen F; Deo, Rajat; Sotoodehnia, Nona; Akylbekova, Meggie; Ellinor, Patrick T; Paltoo, Dina N; Soliman, Elsayed Z; Benjamin, Emelia J; Heckbert, Susan R

2010-11-16

Despite a higher burden of standard atrial fibrillation (AF) risk factors, African Americans have a lower risk of AF than whites. It is unknown whether the higher risk is due to genetic or environmental factors. Because African Americans have varying degrees of European ancestry, we sought to test the hypothesis that European ancestry is an independent risk factor for AF. We studied whites (n=4543) and African Americans (n=822) in the Cardiovascular Health Study (CHS) and whites (n=10 902) and African Americans (n=3517) in the Atherosclerosis Risk in Communities (ARIC) Study (n=3517). Percent European ancestry in African Americans was estimated with 1747 ancestry informative markers from the Illumina custom ITMAT-Broad-CARe array. Among African Americans without baseline AF, 120 of 804 CHS participants and 181 of 3517 ARIC participants developed incident AF. A meta-analysis from the 2 studies revealed that every 10% increase in European ancestry increased the risk of AF by 13% (hazard ratio, 1.13; 95% confidence interval, 1.03 to 1.23; P=0.007). After adjustment for potential confounders, European ancestry remained a predictor of incident AF in each cohort alone, with a combined estimated hazard ratio for each 10% increase in European ancestry of 1.17 (95% confidence interval, 1.07 to 1.29; P=0.001). A second analysis using 3192 ancestry informative markers from a genome-wide Affymetrix 6.0 array in ARIC African Americans yielded similar results. European ancestry predicted risk of incident AF. Our study suggests that investigating genetic variants contributing to differential AF risk in individuals of African versus European ancestry will be informative.

Help-Seeking Behaviors and Depression among African American Adolescent Boys

ERIC Educational Resources Information Center

Lindsey, Michael A.; Korr, Wynne S.; Broitman, Marina; Bone, Lee; Green, Alan; Leaf, Philip J.

2006-01-01

This study examined the help-seeking behaviors of depressed, African American adolescents. Qualitative interviews were conducted with 18 urban, African American boys, ages 14 to 18, who were recruited from community-based mental health centers and after-school programs for youths. Interviews covered sociodemographic information, questions…

Building resilience to face recurring environmental crisis in African Sahel

NASA Astrophysics Data System (ADS)

Boyd, Emily; Cornforth, Rosalind J.; Lamb, Peter J.; Tarhule, Aondover; Lélé, M. Issa; Brouder, Alan

2013-07-01

The present food shortages in the Horn of Africa and the West African Sahel are affecting 31 million people. Such continuing and future crises require that people in the region adapt to an increasing and potentially irreversible global sustainability challenge. Given this situation and that short-term weather and seasonal climate forecasting have limited skill for West Africa, the Rainwatch project illustrates the value of near real-time monitoring and improved communication for the unfavourable 2011 West African monsoon, the resulting severe drought-induced humanitarian impacts continuing into 2012, and their exacerbation by flooding in 2012. Rainwatch is now coupled with a boundary organization (Africa Climate Exchange, AfClix) with the aim of integrating the expertise and actions of relevant institutions, agencies and stakeholders to broker ground-based dialogue to promote resilience in the face of recurring crisis.

Investigating onychophoran gas exchange and water balance as a means to inform current controversies in arthropod physiology.

PubMed

Clusella-Trullas, Susana; Chown, Steven L

2008-10-01

Several controversies currently dominate the fields of arthropod metabolic rate, gas exchange and water balance, including the extent to which modulation of gas exchange reduces water loss, the origins of discontinuous gas exchange, the relationship between metabolic rate and life-history strategies, and the causes of Palaeozoic gigantism. In all of these areas, repeated calls have been made for the investigation of groups that might most inform the debates, especially of taxa in key phylogenetic positions. Here we respond to this call by investigating metabolic rate, respiratory water loss and critical oxygen partial pressure (Pc) in the onychophoran Peripatopsis capensis, a member of a group basal to the arthropods, and by synthesizing the available data on the Onychophora. The rate of carbon dioxide release (VCO2) at 20 degrees C in P. capensis is 0.043 ml CO2 h(-1), in keeping with other onychophoran species; suggesting that low metabolic rates in some arthropod groups are derived. Continuous gas exchange suggests that more complex gas exchange patterns are also derived. Total water loss in P. capensis is 57 mg H2O h(-1) at 20 degrees C, similar to modern estimates for another onychophoran species. High relative respiratory water loss rates ( approximately 34%; estimated using a regression technique) suggest that the basal condition in arthropods may be a high respiratory water loss rate. Relatively high Pc values (5-10% O2) suggest that substantial safety margins in insects are also a derived condition. Curling behaviour in P. capensis appears to be a strategy to lower energetic costs when resting, and the concomitant depression of water loss is a proximate consequence of this behaviour.