Desktop document delivery using portable document format (PDF) files and the Web.

PubMed

Shipman, J P; Gembala, W L; Reeder, J M; Zick, B A; Rainwater, M J

1998-07-01

Desktop access to electronic full-text literature was rated one of the most desirable services in a client survey conducted by the University of Washington Libraries. The University of Washington Health Sciences Libraries (UW HSL) conducted a ten-month pilot test from August 1996 to May 1997 to determine the feasibility of delivering electronic journal articles via the Internet to remote faculty. Articles were scanned into Adobe Acrobat Portable Document Format (PDF) files and delivered to individuals using Multipurpose Internet Mail Extensions (MIME) standard e-mail attachments and the Web. Participants retrieved scanned articles and used the Adobe Acrobat Reader software to view and print files. The pilot test required a special programming effort to automate the client notification and file deletion processes. Test participants were satisfied with the pilot test despite some technical difficulties. Desktop delivery is now offered as a routine delivery method from the UW HSL.

Electronic availability of microgravity experiments safety and integration requirements documents

NASA Technical Reports Server (NTRS)

Hogan, Jean M.

1995-01-01

This follow-on to NASA Contractor Report 195447, Microgravity Experiments Safety and Integration Requirements Document Tree, provides the details for accessing the systems that contain the official, electronic versions of the documents initially researched in NASA Contractor Report 195447. The data in this report serves as a valuable information source for the NASA Lewis Research Center Project Documentation Center (PDC), as well as for all developers of space experiments. The PDC has acquired the hardware, software, ID's, and passwords necessary to access most of these systems and is now able to provide customers with current document information as well as immediate delivery of available documents in either electronic or hard copy format.

A Document-Based EHR System That Controls the Disclosure of Clinical Documents Using an Access Control List File Based on the HL7 CDA Header.

PubMed

Takeda, Toshihiro; Ueda, Kanayo; Nakagawa, Akito; Manabe, Shirou; Okada, Katsuki; Mihara, Naoki; Matsumura, Yasushi

2017-01-01

Electronic health record (EHR) systems are necessary for the sharing of medical information between care delivery organizations (CDOs). We developed a document-based EHR system in which all of the PDF documents that are stored in our electronic medical record system can be disclosed to selected target CDOs. An access control list (ACL) file was designed based on the HL7 CDA header to manage the information that is disclosed.

Electronic Document Delivery: OCLC's Prototype System.

ERIC Educational Resources Information Center

Hickey, Thomas B.; Calabrese, Andrew M.

1986-01-01

Describes development of system for retrieval of documents from magnetic storage that uses stored font definition codes to control an inexpensive laser printer in the production of copies that closely resemble original document. Trends in information equipment and printing industries that will govern future application of this technology are…

18 CFR 284.12 - Standards for pipeline business operations and communications.

Code of Federal Regulations, 2011 CFR

2011-04-01

... all such electronic information and documents. The pipeline must make this archived information... the following business practice and electronic communication standards promulgated by the North... (Version 1.9, September 30, 2009); (v) Quadrant Electronic Delivery Mechanism Related Standards (Version 1...

The Marriage of Fax and Online.

ERIC Educational Resources Information Center

Basch, Reva

1995-01-01

Discusses the use of fax transmissions. Highlights include searching by fax, including online service, print and electronic publishing, and database producers; customer service, including documentation updates, new product announcements, and marketing materials; document delivery; problems; and fax messaging. (four references) (LRW)

Annual Review of Database Developments: 1993.

ERIC Educational Resources Information Center

Basch, Reva

1993-01-01

Reviews developments in the database industry for 1993. Topics addressed include scientific and technical information; environmental issues; social sciences; legal information; business and marketing; news services; documentation; databases and document delivery; electronic bulletin boards and the Internet; and information industry organizational…

18 CFR 284.12 - Standards for pipeline business operations and communications.

Code of Federal Regulations, 2013 CFR

2013-04-01

... under this section and be able to recover and regenerate all such electronic information and documents... the following business practice and electronic communication standards promulgated by the North... Corrections Applied Through June 3, 2011); (v) Quadrant Electronic Delivery Mechanism Related Standards...

18 CFR 284.12 - Standards for pipeline business operations and communications.

Code of Federal Regulations, 2014 CFR

2014-04-01

... under this section and be able to recover and regenerate all such electronic information and documents... the following business practice and electronic communication standards promulgated by the North... Corrections Applied Through June 3, 2011); (v) Quadrant Electronic Delivery Mechanism Related Standards...

New Jersey: Libraries and the Information Superhighway.

ERIC Educational Resources Information Center

Livingstone, John H.

1996-01-01

Describes New Jersey libraries' specific goals for providing the public with electronic access to bibliographic data and government information as well as electronic interlibrary loan and document delivery. Other highlights include results of a public library survey concerning electronic access to information, dial-in access to online public…

Electronic Publishing and Document Delivery; A Case Study of Commercial Information Services on the Internet.

ERIC Educational Resources Information Center

Abbott, Anthony

1992-01-01

Discusses the electronic publishing activities of Meckler Publishing on the Internet, including a publications catalog, an electronic journal, and tables of contents databases. Broader issues of commercial network publishing are also addressed, including changes in the research process, changes in publishing, bibliographic control,…

Libraries and the Changing Scholarly Process. Occasional Paper 1.

ERIC Educational Resources Information Center

Simpson, Donald B.

Arguing that new technologies such as telefacsimile, electronic publishing, and electronic document delivery are altering the processes of communication and the response of libraries to scholars' needs, this paper provides a vision for the future, particularly with regard to the impact of electronic publishing on the traditional roles of academic…

Large-Scale Document Automation: The Systems Integration Issue.

ERIC Educational Resources Information Center

Kalthoff, Robert J.

1985-01-01

Reviews current technologies for electronic imaging and its recording and transmission, including digital recording, optical data disks, automated image-delivery micrographics, high-density-magnetic recording, and new developments in telecommunications and computers. The role of the document automation systems integrator, who will bring these…

48 CFR 1446.671 - Inspection, receiving and acceptance certification.

Code of Federal Regulations, 2012 CFR

2012-10-01

... INTERIOR CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports § 1446.671... documentation shall be completed via manual or electronic means for each delivery of supplies or services in... except as noted below or on attached documents. ______ Signature and typed name of authorized Government...

48 CFR 1446.671 - Inspection, receiving and acceptance certification.

Code of Federal Regulations, 2014 CFR

2014-10-01

... INTERIOR CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports § 1446.671... documentation shall be completed via manual or electronic means for each delivery of supplies or services in... except as noted below or on attached documents. ______ Signature and typed name of authorized Government...

48 CFR 1446.671 - Inspection, receiving and acceptance certification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... INTERIOR CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports § 1446.671... documentation shall be completed via manual or electronic means for each delivery of supplies or services in... except as noted below or on attached documents. ______ Signature and typed name of authorized Government...

48 CFR 1446.671 - Inspection, receiving and acceptance certification.

Code of Federal Regulations, 2011 CFR

2011-10-01

... INTERIOR CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports § 1446.671... documentation shall be completed via manual or electronic means for each delivery of supplies or services in... except as noted below or on attached documents. ______ Signature and typed name of authorized Government...

48 CFR 1446.671 - Inspection, receiving and acceptance certification.

Code of Federal Regulations, 2013 CFR

2013-10-01

... INTERIOR CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports § 1446.671... documentation shall be completed via manual or electronic means for each delivery of supplies or services in... except as noted below or on attached documents. ______ Signature and typed name of authorized Government...

Smart roadside initiative : system requirements specifications.

DOT National Transportation Integrated Search

2015-09-01

This document describes the system requirements specifications (SyRS) for the Smart Roadside Initiative (SRI) Prototype for the delivery of capabilities related to wireless roadside inspections, electronic screening/virtual weigh stations, universal ...

Academic Librarians and Publishers: Customers versus Producers or Partners in the Planning of Electronic Publishing?

ERIC Educational Resources Information Center

Hunter, Karen

1988-01-01

Proposes that academic librarians and publishers should view themselves as partners rather than adversaries. Following a discussion of premises, problems, and attitudes related to librarian-publisher cooperation, several areas for joint development are suggested: new products and services; CD-ROM; electronic document delivery; scholarly book…

Implementation of Electronic Checklists in an Oncology Medical Record: Initial Clinical Experience

PubMed Central

Albuquerque, Kevin V.; Miller, Alexis A.; Roeske, John C.

2011-01-01

Purpose: The quality of any medical treatment depends on the accurate processing of multiple complex components of information, with proper delivery to the patient. This is true for radiation oncology, in which treatment delivery is as complex as a surgical procedure but more dependent on hardware and software technology. Uncorrected errors, even if small or infrequent, can result in catastrophic consequences for the patient. We developed electronic checklists (ECLs) within the oncology electronic medical record (EMR) and evaluated their use and report on our initial clinical experience. Methods: Using the Mosaiq EMR, we developed checklists within the clinical assessment section. These checklists are based on the process flow of information from one group to another within the clinic and enable the processing, confirmation, and documentation of relevant patient information before the delivery of radiation therapy. The clinical use of the ECL was documented by means of a customized report. Results: Use of ECL has reduced the number of times that physicians were called to the treatment unit. In particular, the ECL has ensured that therapists have a better understanding of the treatment plan before the initiation of treatment. An evaluation of ECL compliance showed that, with additional staff training, > 94% of the records were completed. Conclusion: The ECL can be used to ensure standardization of procedures and documentation that the pretreatment checks have been performed before patient treatment. We believe that the implementation of ECLs will improve patient safety and reduce the likelihood of treatment errors. PMID:22043184

DIRECT secure messaging as a common transport layer for reporting structured and unstructured lab results to outpatient providers.

PubMed

Sujansky, Walter; Wilson, Tom

2015-04-01

This report describes a grant-funded project to explore the use of DIRECT secure messaging for the electronic delivery of laboratory test results to outpatient physicians and electronic health record systems. The project seeks to leverage the inherent attributes of DIRECT secure messaging and electronic provider directories to overcome certain barriers to the delivery of lab test results in the outpatient setting. The described system enables laboratories that generate test results as HL7 messages to deliver these results as structured or unstructured documents attached to DIRECT secure messages. The system automatically analyzes generated HL7 messages and consults an electronic provider directory to determine the appropriate DIRECT address and delivery format for each indicated recipient. The system also enables lab results delivered to providers as structured attachments to be consumed by HL7 interface engines and incorporated into electronic health record systems. Lab results delivered as unstructured attachments may be printed or incorporated into patient records as PDF files. The system receives and logs acknowledgement messages to document the status of each transmitted lab result, and a graphical interface allows searching and review of this logged information. The described system is a fully implemented prototype that has been tested in a laboratory setting. Although this approach is promising, further work is required to pilot test the system in production settings with clinical laboratories and outpatient provider organizations. Copyright © 2015 Elsevier Inc. All rights reserved.

IFLA General Conference, 1987. Division of Collections and Services. Interlending and Document Delivery Section. Serial Publications Section. Papers.

ERIC Educational Resources Information Center

International Federation of Library Associations, The Hague (Netherlands).

The five papers compiled here cover topics related to electronic publishing, library collections and services, interlibrary loan, and serials. In "The Impact of Electronic Publishing on Library Collection and Services: An American View," Joseph W. Price considers possible consequences on library collections and services in the United…

Web-based document image processing

NASA Astrophysics Data System (ADS)

Walker, Frank L.; Thoma, George R.

1999-12-01

Increasing numbers of research libraries are turning to the Internet for electron interlibrary loan and for document delivery to patrons. This has been made possible through the widespread adoption of software such as Ariel and DocView. Ariel, a product of the Research Libraries Group, converts paper-based documents to monochrome bitmapped images, and delivers them over the Internet. The National Library of Medicine's DocView is primarily designed for library patrons are beginning to reap the benefits of this new technology, barriers exist, e.g., differences in image file format, that lead to difficulties in the use of library document information. To research how to overcome such barriers, the Communications Engineering Branch of the Lister Hill National Center for Biomedical Communications, an R and D division of NLM, has developed a web site called the DocMorph Server. This is part of an ongoing intramural R and D program in document imaging that has spanned many aspects of electronic document conversion and preservation, Internet document transmission and document usage. The DocMorph Server Web site is designed to fill two roles. First, in a role that will benefit both libraries and their patrons, it allows Internet users to upload scanned image files for conversion to alternative formats, thereby enabling wider delivery and easier usage of library document information. Second, the DocMorph Server provides the design team an active test bed for evaluating the effectiveness and utility of new document image processing algorithms and functions, so that they may be evaluated for possible inclusion in other image processing software products being developed at NLM or elsewhere. This paper describes the design of the prototype DocMorph Server and the image processing functions being implemented on it.

North Carolina: Statewide Automation and Connectivity Efforts.

ERIC Educational Resources Information Center

Christian, Elaine J., Ed.

1996-01-01

Describes statewide information automation and connectivity efforts in North Carolina. Highlights include Triangle Research Libraries Network Document Delivery System; cooperative networking projects; public library connectivity to the state library; rural access projects; community college automation; K-12 technology plans; electronic government…

Documentation of e-cigarette use and associations with smoking from 2012 to 2015 in an integrated healthcare delivery system.

PubMed

Young-Wolff, Kelly C; Klebaner, Daniella; Folck, Bruce; Tan, Andy S L; Fogelberg, Renee; Sarovar, Varada; Prochaska, Judith J

2018-04-01

It is unclear whether use of electronic nicotine delivery systems (ENDS) precedes cigarette smoking initiation, relapse, and/or quitting. Healthcare systems with electronic health records (EHRs) provide unique data to examine ENDS use and changes in smoking. We examined the incidence of ENDS use (2012-2015) based on clinician documentation and tested whether EHR documented ENDS use is associated with twelve-month changes in patient smoking status using a matched retrospective cohort design. The sample was Kaiser Permanente Northern California (KPNC) patients aged ≥12 with documented ENDS use (N = 7926); 57% were current smokers, 35% former smokers, and 8% never-smokers. ENDS documentation incidence peaked in 2014 for current and former smokers and in 2015 for never-smokers. We matched patients with documented ENDS use to KPNC patients without documented ENDS use (N = 7926) on age, sex, race/ethnicity, and smoking status. Documented ENDS use predicted the likelihood of smoking in the following year. Among current smokers, ENDS use was associated with greater odds of quitting smoking (OR = 1.17, 95%CI = 1.05-1.31). Among former smokers, ENDS use was associated with greater odds of smoking relapse (OR = 1.53, 95%CI = 1.22-1.92). Among never-smokers, ENDS use was associated with greater odds of initiating smoking (OR = 7.41, 95%CI = 3.14-17.5). The overall number of current smokers at 12 months was slightly higher among patients with (N = 3931) versus without (N = 3850) documented ENDS use. Results support both potential harm reduction of ENDS use (quitting combustibles among current smokers) and potential for harm (relapse to combustibles among former smokers, initiation for never-smokers). Copyright © 2018 Elsevier Inc. All rights reserved.

Quality of nursing documentation: Paper-based health records versus electronic-based health records.

PubMed

Akhu-Zaheya, Laila; Al-Maaitah, Rowaida; Bany Hani, Salam

2018-02-01

To assess and compare the quality of paper-based and electronic-based health records. The comparison examined three criteria: content, documentation process and structure. Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organised within the system known as the electronic health records. Nursing documentation must be completed at the highest standards, to ensure the safety and quality of healthcare services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus electronic health records is more qualified. A retrospective, descriptive, comparative design was used to address the study's purposes. A convenient number of patients' records, from two public hospitals, were audited using the Cat-ch-Ing audit instrument. The sample size consisted of 434 records for both paper-based health records and electronic health records from medical and surgical wards. Electronic health records were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than electronic health records. The study affirmed the poor quality of nursing documentation and lack of nurses' knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Both forms of documentation revealed drawbacks in terms of content, process and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nursing practice to improve the quality of nursing care and patients' outcomes. © 2017 John Wiley & Sons Ltd.

Serial Killers: Academic Libraries Respond to Soaring Costs.

ERIC Educational Resources Information Center

McCarthy, Paul

1994-01-01

Discusses ways in which academic libraries are responding to rising costs of serials. Topics addressed include pricing by publishers; the effect of journal cancellations on research activities; interlibrary loans and document delivery services; coordinated cancelling; electronic journals; and experiences at the University of Arizona. (LRW)

Document Delivery from Full-Text Online Files: A Pilot Project.

ERIC Educational Resources Information Center

Gillikin, David P.

1990-01-01

Describes the Electronic Journal Retrieval Project (EJRP) developed at the University of Tennessee, Knoxville Libraries, to provide full-text journal articles from online systems. Highlights include costs of various search strategies; implications for library services; collection development and interlibrary loan considerations; and suggestions…

Australian Academic Use of the Internet.

ERIC Educational Resources Information Center

Applebee, Andrelyn C.; Clayton, Peter; Pascoe, Celina

1997-01-01

A study of academic staff at the University of Canberra (Australia) in 1995 determined use of electronic mail, Telnet, file transfer protocol (FTP) software, World Wide Web, library and document delivery services, discussion groups, and student communication. Examined demographic characteristics of faculty (discipline, employment status, gender,…

Instant replay.

PubMed

Rosenthal, David I

2013-06-01

With widespread adoption of electronic health records (EHRs) and electronic clinical documentation, health care organizations now have greater faculty to review clinical data and evaluate the efficacy of quality improvement efforts. Unfortunately, I believe there is a fundamental gap between actual health care delivery and what we document in the current EHR systems. This process of capturing the patient encounter, which I'll refer to as transcription, is prone to significant data loss due to inadequate methods of data capture, multiple points of view, and bias and subjectivity in the transcriptional process. Our current EHR, text-based clinical documentation systems are lossy abstractions - one sided accounts of what take place between patients and providers. Our clinical notes contain the breadcrumbs of relationships, conversations, physical exams, and procedures but often lack the ability to capture the form, the emotions, the images, the nonverbal communication, and the actual narrative of interactions between human beings. I believe that a video record, in conjunction with objective transcriptional services and other forms of data capture, may provide a closer approximation to the truth of health care delivery and may be a valuable tool for healthcare improvement. Copyright © 2013 Elsevier Inc. All rights reserved.

Is documentation of TOLAC counseling a good measure of quality of care?

PubMed

Friedman, Alexander Michael; Srinivas, Sindhu K

2016-01-01

The objective of this study is to determine whether chart documentation of patient counseling on trial of labor after cesarean (TOLAC) during prenatal care is associated with patient knowledge of risks and benefits of TOLAC and repeat cesarean delivery (RCD). Prenatal patients eligible for TOLAC completed a questionnaire that assessed their knowledge of basic maternal and neonatal risks and benefits of TOLAC versus planned repeat cesarean delivery. Patient electronic medical records were reviewed for documentation of TOLAC counseling. Women were included at both early and late time points in pregnancy to include those who both had and had not undergone counseling. Patients with documented completed TOLAC counseling did not perform better on the knowledge survey. Patients who had documentation of counseling on specific subjects such as TOLAC success rates, risk of uterine rupture, and downstream health risks of cesarean section were no more likely to answer questions on these topics correctly than patients without counseling. However, patients with documented completed counseling generally felt that they were well informed. Chart documentation of TOLAC counseling was not correlated with patient knowledge. Patients may not be gaining the knowledge from counseling that providers believe is important for informed decision making.

Implementation of the Zambia Electronic Perinatal Record System for comprehensive prenatal and delivery care

PubMed Central

Chi, Benjamin H.; Vwalika, Bellington; Killam, William P.; Wamalume, Chibesa; Giganti, Mark J.; Mbewe, Reuben; Stringer, Elizabeth M.; Chintu, Namwinga T.; Putta, Nande B.; Liu, Katherine C.; Chibwesha, Carla J.; Rouse, Dwight J.; Stringer, Jeffrey S.A.

2011-01-01

Objective To characterize prenatal and delivery care in an urban African setting. Methods The Zambia Electronic Perinatal Record System (ZEPRS) was implemented to record demographic characteristics, past medical and obstetric history, prenatal care, and delivery and newborn care for pregnant women across 25 facilities in the Lusaka public health sector. Results From June 1, 2007, to January 31, 2010, 115 552 pregnant women had prenatal and delivery information recorded in ZEPRS. Median gestation age at first prenatal visit was 23 weeks (interquartile range [IQR] 19–26). Syphilis screening was documented in 95 663 (83%) pregnancies: 2449 (2.6%) women tested positive, of whom 1589 (64.9%) were treated appropriately. 111 108 (96%) women agreed to HIV testing, of whom 22% were diagnosed with HIV. Overall, 112 813 (98%) of recorded pregnancies resulted in a live birth, and 2739 (2%) in a stillbirth. The median gestational age was 38 weeks (IQR 35–40) at delivery; the median birth weight of newborns was 3000 g (IQR 2700–3300 g). Conclusion The results demonstrate the feasibility of using a comprehensive electronic medical record in an urban African setting, and highlight its important role in ongoing efforts to improve clinical care. PMID:21315347

Medication order communication using fax and document-imaging technologies.

PubMed

Simonian, Armen I

2008-03-15

The implementation of fax and document-imaging technology to electronically communicate medication orders from nursing stations to the pharmacy is described. The evaluation of a commercially available pharmacy order imaging system to improve order communication and to make document retrieval more efficient led to the selection and customization of a system already licensed and used in seven affiliated hospitals. The system consisted of existing fax machines and document-imaging software that would capture images of written orders and send them from nursing stations to a central database server. Pharmacists would then retrieve the images and enter the orders in an electronic medical record system. The pharmacy representatives from all seven hospitals agreed on the configuration and functionality of the custom application. A 30-day trial of the order imaging system was successfully conducted at one of the larger institutions. The new system was then implemented at the remaining six hospitals over a period of 60 days. The transition from a paper-order system to electronic communication via a standardized pharmacy document management application tailored to the specific needs of this health system was accomplished. A health system with seven affiliated hospitals successfully implemented electronic communication and the management of inpatient paper-chart orders by using faxes and document-imaging technology. This standardized application eliminated the problems associated with the hand delivery of paper orders, the use of the pneumatic tube system, and the printing of traditional faxes.

Electronic cigarettes. A position statement of the forum of international respiratory societies.

PubMed

Schraufnagel, Dean E; Blasi, Francesco; Drummond, M Bradley; Lam, David C L; Latif, Ehsan; Rosen, Mark J; Sansores, Raul; Van Zyl-Smit, Richard

2014-09-15

Awareness and usage of electronic cigarettes has exponentially increased during the last few years, especially among young people and women in some countries. The rapid acceptance of electronic cigarettes may be attributed in part to the perception created by marketing and the popular press that they are safer than combustible cigarettes. To alert and advise policy makers about electronic cigarettes and their potential hazards. Using The Union's position paper on electronic cigarettes as the starting template, the document was written using an iterative process. Portions of the manuscript have been taken directly from the position papers of participating societies. Because electronic cigarettes generate less tar and carcinogens than combustible cigarettes, use of electronic cigarettes may reduce disease caused by those components. However, the health risks of electronic cigarettes have not been adequately studied. Studies looking at whether electronic cigarettes can aid smoking cessation have had inconsistent results. Moreover, the availability of electronic cigarettes may have an overall adverse health impact by increasing initiation and reducing cessation of combustible nicotine delivery products. The health and safety claims regarding electronic nicotine delivery devices should be subject to evidentiary review. The potential benefits of electronic cigarettes to an individual smoker should be weighed against potential harm to the population of increased social acceptability of smoking and use of nicotine, the latter of which has addictive power and untoward effects. As a precaution, electronic nicotine delivery devices should be restricted or banned until more information about their safety is available. If they are allowed, they should be closely regulated as medicines or tobacco products.

An Electronic Nursing Patient Care Plan Helps in Clinical Decision Support.

PubMed

Wong, C M; Wu, S Y; Ting, W H; Ho, K H; Tong, L H; Cheung, N T

2015-01-01

Information technology can help to improve health care delivery. The utilisation of informatics principle enhances the quality of nursing practices through improved communication, documentation and efficiency. The Nursing Profession constitutes 34% of the total workforce in the Hong Kong Hospital Authority (HA) and includes 21,000 nurses in 2012. To enhance the quality of care and patient safety in both hospitals and community care setting, it is essential that an integrated electronic decision support system for nurses is designed to track documentation and support care or service including observations, decisions, actions and outcomes throughout the care process at each point-of-care. The Patient Care Plan project was set up to achieve these objectives. The Project adheres to strict documentation information architecture to ensure data sharing is freely available. Preliminary results showed very promising improvement in clinical care.

5 CFR 1203.13 - Filing pleadings.

Code of Federal Regulations, 2010 CFR

2010-01-01

... delivery, by facsimile, or by e-filing in accordance with § 1201.14 of this chapter. If the document was... submitted by e-filing, it is considered to have been filed on the date of electronic submission. (e... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Filing pleadings. 1203.13 Section 1203.13...

Validation of a Novel Electronic Health Record Patient Portal Advance Care Planning Delivery System.

PubMed

Bose-Brill, Seuli; Feeney, Michelle; Prater, Laura; Miles, Laura; Corbett, Angela; Koesters, Stephen

2018-06-26

Advance care planning allows patients to articulate their future care preferences should they no longer be able to make decisions on their own. Early advance care planning in outpatient settings provides benefits such as less aggressive care and fewer hospitalizations, yet it is underutilized due to barriers such as provider time constraints and communication complexity. Novel methods, such as patient portals, provide a unique opportunity to conduct advance care planning previsit planning for outpatient care. This follow-up to our pilot study aimed to conduct pragmatic testing of a novel electronic health record-tethered framework and its effects on advance care planning delivery in a real-world primary care setting. Our intervention tested a previsit advance care planning workflow centered around a framework sent via secure electronic health record-linked patient portal in a real-world clinical setting. The primary objective of this study was to determine its impact on frequency and quality of advance care planning documentation. We conducted a pragmatic trial including 2 sister clinical sites, one site implementing the intervention and the other continuing standard care. A total of 419 patients aged between 50 and 93 years with active portal accounts received intervention (n=200) or standard care (n=219). Chart review analyzed the presence of advance care planning and its quality and was graded with previously established scoring criteria based on advance care planning best practice guidelines from multiple nations. A total of 19.5% (39/200) of patients who received previsit planning responded to the framework. We found that the intervention site had statistically significant improvement in new advance care planning documentation rates (P<.01) and quality (P<.01) among all eligible patients. Advance care planning documentation rates increased by 105% (19/39 to 39/39) and quality improved among all patients who engaged in the previsit planning framework (n=39). Among eligible patients aged between 50 and 60 years at the intervention site, advance care planning documentation rates increased by 37% (27/96 to 37/96). Advance care planning documentation rates increased 34% among high users (27/67 to 36/67). Advance care planning previsit planning using a secure electronic health record-supported patient portal framework yielded improvement in the presence of advance care planning documentation, with highest improvement in active patient portal users and patients aged between 50 and 60 years. Targeted previsit patient portal advance care planning delivery in these populations can potentially improve the quality of care in these populations. ©Seuli Bose-Brill, Michelle Feeney, Laura Prater, Laura Miles, Angela Corbett, Stephen Koesters. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.06.2018.

Real-Time Control of the Embedded Waveform for External Defibrillation

DTIC Science & Technology

2001-10-25

independently from transthoracic electrical impedance changes during shock time. Keywords - External defibrillation, real-time control I. INTRODUCTION ...Additional such possibilities may be useful for development a new electrotherapy methods, as electrochemotherapy for cancer treatment [6]. II...Department, Moscow State Institute of Electronic Technology , Moscow, Russia Fig.1. High voltage delivery unit. Report Documentation Page Report Date 25

Provider documentation of patient education: a lean investigation*

PubMed Central

Shipman, Jean P.; Lake, Erica W.; Van Der Volgen, Jessica; Doman, Darrin

2016-01-01

Purpose The study evaluates how providers give patient education materials and identifies improvements to comply with Meaningful Use (MU) requirements. Methods Thirty-eight patient-provider interactions in two health care outpatient clinics were observed. Results Providers do not uniformly know MU patient education requirements. Providers have individual preferences and find gaps in what is available. Accessing and documenting patient education varies among providers. Embedded electronic health record (EHR) materials, while available, have technical access barriers. Conclusions Providers' EHR skills and knowledge levels contribute to non-standardized patient education delivery. PMID:27076805

Improved overall delivery documentation following implementation of a standardized shoulder dystocia delivery form

PubMed Central

Moragianni, Vasiliki A.; Hacker, Michele R.; Craparo, Frank J.

2013-01-01

Objective Our objective was to evaluate whether using a standardized shoulder dystocia delivery form improved documentation. A standardized delivery form was added to our institution’s obstetrical record in August 2003. Methods A retrospective cohort study was conducted comparing 100 vaginal deliveries complicated by shoulder dystocia before, and 81 after implementation of the standardized delivery form. The two groups were compared in terms of obstetric characteristics, neonatal outcomes and documentation components. Results Charts that included the standardized delivery form were more likely to contain documentation of estimated fetal weight (82.7% vs. 39.0% without the form, P<0.001) and head-to-shoulder delivery interval (76.5% vs. 15.0% without the form, P<0.001). Both groups were statistically similar in terms of documenting estimated blood loss and fetal weight, umbilical cord pH, type and order of maneuvers utilized to relieve the shoulder dystocia, and second stage duration. Conclusions Inclusion of a standardized form in the delivery record improves the rate of documentation of both shoulder dystocia-specific and general delivery components. PMID:22017330

[Resources of information in the field of bioethics in Italy: survey of the present state and perspectives].

PubMed

Della Seta, Maurella; Sellitri, Cinzia

2004-01-01

The research project "Collection and dissemination of bioethical information through an integrated electronic system", started in 2001 by the Istituto Superiore di Sanità (ISS), had among its objectives, the realization of an integrated system for data collection and exchange of documents related to bioethics. The system should act as a reference tool for those research activities impacting on citizens' health and welfare. This paper aims at presenting some initiatives, developed in the project framework, in order to establish an Italian documentation network, among which: a) exchange of ISS publications with Italian institutions active in this field; b) survey through a questionnaire aimed at assessing Italian informative resources, state-of-the-art and holdings of documentation centres and ethical committees; c) Italian Internet resources analysis. The results of the survey, together with the analysis of web sites, show that at present in Italy there are many interesting initiatives for collecting and spreading of documentation in the bioethical fields, but there is an urgent need for an integration of such resources. Ethical committees generally speaking need a larger availability of documents, while there are good potentialities for the establishment of an electronic network for document retrieval and delivery.

Issues in Commercial Document Delivery.

ERIC Educational Resources Information Center

Marcinko, Randall Wayne

1997-01-01

Discusses (1) the history of document delivery; (2) the delivery process--end-user request, intermediary request, vendor reference, citation verification, obtaining document and source relations, quality control, transferring document to client, customer service and status, invoicing and billing, research and development, and copyright; and (3)…

Use of speech-to-text technology for documentation by healthcare providers.

PubMed

Ajami, Sima

2016-01-01

Medical records are a critical component of a patient's treatment. However, documentation of patient-related information is considered a secondary activity in the provision of healthcare services, often leading to incomplete medical records and patient data of low quality. Advances in information technology (IT) in the health system and registration of information in electronic health records (EHR) using speechto- text conversion software have facilitated service delivery. This narrative review is a literature search with the help of libraries, books, conference proceedings, databases of Science Direct, PubMed, Proquest, Springer, SID (Scientific Information Database), and search engines such as Yahoo, and Google. I used the following keywords and their combinations: speech recognition, automatic report documentation, voice to text software, healthcare, information, and voice recognition. Due to lack of knowledge of other languages, I searched all texts in English or Persian with no time limits. Of a total of 70, only 42 articles were selected. Speech-to-text conversion technology offers opportunities to improve the documentation process of medical records, reduce cost and time of recording information, enhance the quality of documentation, improve the quality of services provided to patients, and support healthcare providers in legal matters. Healthcare providers should recognize the impact of this technology on service delivery.

Development of TOPS

NASA Astrophysics Data System (ADS)

Tanaka, Yoshiyuki; Tsugiishi, Shigemi

The off-line patent and utility model information management system at Teijin Ltd. had been developed and operated since 1980. To achieve efficient business management through office automation and to get ready for easy access to electronic document delivery so-called Paperless project being developed by Japan Patent Office, the system was reviewed and new online system was constructed in 1985. The paper describes its details.

Interlending and Document Delivery. IATUL Proceedings, Vol. 16.

ERIC Educational Resources Information Center

Fjallbrant, Nancy, Ed.

1984-01-01

This issue of the IATUL (International Association of Technological University Libraries) Proceedings provides an overview of interlending and document delivery in a number of countries. The document comprises: (1) "Interlibrary Lending in the United Kingdom" (Maurice B. Line); (2) "Interlending and Document Delivery in the Federal…

Building electronic forms for elderly program: integrated care model for high risk elders in Hong Kong.

PubMed

Yiu, Rex; Fung, Vicky; Szeto, Karen; Hung, Veronica; Siu, Ricky; Lam, Johnny; Lai, Daniel; Maw, Christina; Cheung, Adah; Shea, Raman; Choy, Anna

2013-01-01

In Hong Kong, elderly patients discharged from hospital are at high risk of unplanned readmission. The Integrated Care Model (ICM) program is introduced to provide continuous and coordinated care for high risk elders from hospital to community to prevent unplanned readmission. A multidisciplinary working group was set up to address the requirements on developing the electronic forms for ICM program. Six (6) forms were developed. These forms can support ICM service delivery for the high risk elders, clinical documentation, statistical analysis and information sharing.

Beyond the rhetoric: what do we mean by a 'model of care'?

PubMed

Davidson, Patricia; Halcomb, Elizabeth; Hickman, L; Phillips, J; Graham, B

2006-01-01

Contemporary health care systems are constantly challenged to revise traditional methods of health care delivery. These challenges are multifaceted and stem from: (1) novel pharmacological and non-pharmacological treatments; (2) changes in consumer demands and expectations; (3) fiscal and resource constraints; (4) changes in societal demographics in particular the ageing of society; (5) an increasing burden of chronic disease; (6) documentation of limitations in traditional health care delivery; (7) increased emphasis on transparency, accountability, evidence-based practice (EBP) and clinical governance structures; and (8) the increasing cultural diversity of the community. These challenges provoke discussion of potential alternative models of care, with scant reference to defining what constitutes a model of care. This paper aims to define what is meant by the term 'model of care' and document the pragmatic systems and processes necessary to develop, plan, implement and evaluate novel models of care delivery. Searches of electronic databases, the reference lists of published materials, policy documents and the Internet were conducted using key words including 'model*', 'framework*', 'models, theoretical' and 'nursing models, theoretical'. The collated material was then analysed and synthesised into this review. This review determined that in addition to key conceptual and theoretical perspectives, quality improvement theory (eg. collaborative methodology), project management methods and change management theory inform both pragmatic and conceptual elements of a model of care. Crucial elements in changing health care delivery through the development of innovative models of care include the planning, development, implementation, evaluation and assessment of the sustainability of the new model. Regardless of whether change in health care delivery is attempted on a micro basis (eg. ward level) or macro basis (eg. national or state system) in order to achieve sustainable, effective and efficient changes a well-planned, systematic process is essential.

Progress update on cryogenic system for ARIEL E-linac at TRIUMF

NASA Astrophysics Data System (ADS)

Koveshnikov, A.; Bylinskii, I.; Hodgson, G.; Yosifov, D.

2014-01-01

TRIUMF is involved in a major upgrade. The Advanced Rare IsotopeE Laboratory (ARIEL) has become a fully funded project in July 2010. A 10 mA 50 MeV SRF electron linac (e-linac) operating CW at 1.3 GHz is the key component of this initiative. This machine will serve as a second independent photo-fission driver for Rare Isotope Beams (RIB) production at TRIUMF's Isotope Separator and Accelerator (ISAC) facility. The cryogens delivery system requirements are driven by the electron accelerator cryomodule design [1, 2]. Since commencement of the project in 2010 the cryogenic system of e-linac has moved from the conceptual design phase into engineering design and procurement stage. The present document summarizes the progress in cryogenic system development and construction. Current status of e-linac cryogenic system including details of LN2 storage and delivery systems, and helium subatmospheric (SA) system is presented. The first phase of e-linac consisting of two cryomodules, cryogens storage, delivery, and distribution systems, and a 600 W class liquid helium cryoplant is scheduled for installation and commissioning by year 2014.

Negotiating the Digital Library: Document Delivery.

ERIC Educational Resources Information Center

Jacobs, Neil; Morris, Anne

1999-01-01

The eLib-funded FIDDO (Focused Investigation of Document Delivery Options) project provides library managers/others with information to support policy decisions. Senior libraries were interviewed about the future of document delivery and interviews were analyzed with the support of NUD*IST (Nonnumerical Unstructured Data by Indexing, Searching and…

Are electronic health records ready for genomic medicine?

PubMed

Scheuner, Maren T; de Vries, Han; Kim, Benjamin; Meili, Robin C; Olmstead, Sarah H; Teleki, Stephanie

2009-07-01

The goal of this project was to assess genetic/genomic content in electronic health records. Semistructured interviews were conducted with key informants. Questions addressed documentation, organization, display, decision support and security of family history and genetic test information, and challenges and opportunities relating to integrating genetic/genomics content in electronic health records. There were 56 participants: 10 electronic health record specialists, 18 primary care clinicians, 16 medical geneticists, and 12 genetic counselors. Few clinicians felt their electronic record met their current genetic/genomic medicine needs. Barriers to integration were mostly related to problems with family history data collection, documentation, and organization. Lack of demand for genetics content and privacy concerns were also mentioned as challenges. Data elements and functionality requirements that clinicians see include: pedigree drawing; clinical decision support for familial risk assessment and genetic testing indications; a patient portal for patient-entered data; and standards for data elements, terminology, structure, interoperability, and clinical decision support rules. Although most said that there is little impact of genetics/genomics on electronic records today, many stated genetics/genomics would be a driver of content in the next 5-10 years. Electronic health records have the potential to enable clinical integration of genetic/genomic medicine and improve delivery of personalized health care; however, structured and standardized data elements and functionality requirements are needed.

Document Delivery for the '90s and Beyond.

ERIC Educational Resources Information Center

Fitzsimmons, Joseph J.

1996-01-01

The story of the pony express offers lessons for today's document delivery. Pricing, policy, competition, and evolving technology need to be considered. To evaluate future options, researchers need to examine: types of document delivery; benefits of combining outside services with in-house systems; criteria for selecting technologies and…

Evaluation of Evidence-Based Nursing Pain Management Practice

PubMed Central

Song, Wenjia; Eaton, Linda H.; Gordon, Debra B.; Hoyle, Christine; Doorenbos, Ardith Z.

2014-01-01

Background It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. Aims This study aimed to (a) modify and test an evaluation tool for nursing cancer pain documentation, and (b) describe the frequency and quality of nursing pain documentation in one oncology unit via electronic medical system. Design and Setting A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Methods Medical records were examined for 37 adults hospitalized during April and May of 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. Results The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. Conclusions The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. PMID:26256215

Shoulder dystocia documentation: an evaluation of a documentation training intervention.

PubMed

LeRiche, Tammy; Oppenheimer, Lawrence; Caughey, Sharon; Fell, Deshayne; Walker, Mark

2015-03-01

To evaluate the quality and content of nurse and physician shoulder dystocia delivery documentation before and after MORE training in shoulder dystocia management skills and documentation. Approximately 384 charts at the Ottawa Hospital General Campus involving a diagnosis of shoulder dystocia between the years of 2000 and 2006 excluding the training year of 2003 were identified. The charts were evaluated for 14 key components derived from a validated instrument. The delivery notes were then scored based on these components by 2 separate investigators who were blinded to delivery note author, date, and patient identification to further quantify delivery record quality. Approximately 346 charts were reviewed for physician and nurse delivery documentation. The average score for physician notes was 6 (maximum possible score of 14) both before and after the training intervention. The nurses' average score was 5 before and after the training intervention. Negligible improvement was observed in the content and quality of shoulder dystocia documentation before and after nurse and physician training.

Using Wearable Computers in Shuttle Processing: A Feasibility Study

NASA Technical Reports Server (NTRS)

Centeno, Martha A.; Correa, Daisy; Groh-Hammond, Marcia

2001-01-01

Shuttle processing operations are performed following prescribed instructions compiled in a Work Authorization Document (WAD). Until very recently, WADs were printed so that they could be properly executed, including the buy off of each and every step by the appropriate authorizing agent. However, with the development of EPICs, Maximo, and PeopleSoft applications, some of these documents are now available in electronic format; hence, it is possible for technicians and engineers to access them on line and buy off the steps electronically. To take full advantage of these developments, technicians need access to such documents at the point of job execution. Body wearable computers present an opportunity to develop a WAD delivery system that enables access while preserving technician's mobility, safety levels, and quality of work done. The primary objectives of this project were to determine if body wearable computers are a feasible delivery system for WADs. More specifically, identify and recommend specific brands of body wearable computers readily available on the market. Thus, this effort has field-tested this technology in two areas of shuttle processing, and it has examined the usability of the technology. Results of two field tests and a Human Factors Usability Test are presented. Section 2 provides a description of the body wearable computer technology. Section 3 presents the test at the Space Shuttle Main Engine (SSME) Shop. Section 4 presents the results of the integration test at the Solid Rocket Boosters Assembly and Refurbishing Facility (SRBARF). Section 5 presents the results of the usability test done at the Operations Support Building (OSB).

Three Years of Unmediated Document Delivery: An Analysis and Consideration of Collection Development Priorities.

PubMed

Chan, Emily K; Mune, Christina; Wang, YiPing; Kendall, Susan L

2016-01-01

Like most academic libraries, San José State University Library is struggling to meet users' rising expectations for immediate information within the financial confines of a flat budget. To address acquisition of nonsubscribed article content, particularly outside of business hours, San José State University Library implemented Copyright Clearance Center's Get It Now, a document delivery service. Three academic years of analyzed data, which involves more than 10,000 requests, and the subsequent collection development actions taken by the library will be discussed. The value and challenges of patron-driven, unmediated document delivery services in conjunction with traditional document delivery services will be considered.

Anesthetic and Obstetric Management of Syringomyelia During Labor and Delivery: A Case Series and Systematic Review.

PubMed

Garvey, Gráinne Patricia; Wasade, Vibhangini S; Murphy, Kellie E; Balki, Mrinalini

2017-09-01

Syringomyelia is a rare, slowly progressive neurological condition characterized by the presence of a syrinx within the spinal cord. Consensus regarding the safest mode of delivery and anesthetic management in patients with syringomyelia remains controversial and presents management dilemmas. This study reviews the cases of syringomyelia at our institution and provides a systematic review of the literature to guide decisions regarding labor and delivery management. A retrospective review of cases at our hospital from 2002 to 2014 and a systematic review of the literature from 1946 to 2014 were undertaken. Hospital records and electronic databases were interrogated using International Classification of Diseases, 10th Revision codes and the keywords "syringomyelia," "syringobulbia," and "pregnancy." Data regarding demographics, diagnosis, radiology reports, neurological symptoms, mode of delivery, anesthetic management, and maternal-fetal outcomes were collected. We collected and analyzed data on a total of 43 pregnancies in 39 patients. The most common location for syrinx was in the cervicothoracic region (41.9%). The large majority of patients (n = 34; 87%) demonstrated signs and symptoms associated with syringomyelia before delivery. Syringomyelia associated with Arnold Chiari malformation was documented in 49% (n = 21) cases. General anesthesia was the most commonly used (n = 21/30, 70%) anesthetic technique for cesarean delivery. The majority (n = 9/13, 69%) of patients had an epidural sited for labor analgesia. There were no maternal or neonatal complications associated with neuraxial anesthesia; however, 3 cases (14%) raised concerns regarding general anesthesia including difficult intubation, transient worsening of neurological symptoms postpartum, and prolonged muscle paralysis after atracurium. Despite concerns regarding aggravation of the syrinx with vaginal delivery, this mode of delivery has never caused any documented long-term worsening of neurological condition. All techniques of anesthesia have been performed successfully without major lasting complications. All cases necessitate patient counseling and individualized multidisciplinary involvement to ensure maternal safety.

Procedures for EPA Libraries to Obtain Materials through Interlibrary Loan/Document Delivery

EPA Pesticide Factsheets

The purpose of this document is to establish Agency-wide procedures by which EPA libraries obtain materials for Agency employees and authorized EPA contractors through interlibrary loan (ILL) and other document delivery methods.

Identifying health facilities outside the enterprise: challenges and strategies for supporting health reform and meaningful use.

PubMed

Dixon, Brian E; Colvard, Cyril; Tierney, William M

2014-06-24

Objective: To support collation of data for disability determination, we sought to accurately identify facilities where care was delivered across multiple, independent hospitals and clinics. Methods: Data from various institutions' electronic health records were merged and delivered as continuity of care documents to the United States Social Security Administration (SSA). Results: Electronic records for nearly 8000 disability claimants were exchanged with SSA. Due to the lack of standard nomenclature for identifying the facilities in which patients received the care documented in the electronic records, SSA could not match the information received with information provided by disability claimants. Facility identifiers were generated arbitrarily by health care systems and therefore could not be mapped to the existing international standards. Discussion: We propose strategies for improving facility identification in electronic health records to support improved tracking of a patient's care between providers to better serve clinical care delivery, disability determination, health reform and meaningful use. Conclusion: Accurately identifying the facilities where health care is delivered to patients is important to a number of major health reform and improvement efforts underway in many nations. A standardized nomenclature for identifying health care facilities is needed to improve tracking of care and linking of electronic health records.

Evaluation of Evidence-based Nursing Pain Management Practice.

PubMed

Song, Wenjia; Eaton, Linda H; Gordon, Debra B; Hoyle, Christine; Doorenbos, Ardith Z

2015-08-01

It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. The aim of this study was to modify and test an evaluation tool for nursing cancer pain documentation, and describe the frequency and quality of nursing pain documentation in one oncology unit via the electronic medical system. A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Medical records were examined for 37 adults hospitalized during April and May 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score ranging from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Electronic document delivery using the Internet.

PubMed Central

Bennett, V M; Palmer, E M

1994-01-01

The Health Sciences Libraries Consortium (HSLC) was established in 1985 by thirteen founding member institutions in Pennsylvania and Delaware. In 1989, the Interlibrary Loan, Document Delivery, and Union List Task Force, appointed by the HSLC Board of Directors, successfully demonstrated the feasibility of supplying 94% of all interlibrary loan (ILL) photocopy requests in forty-eight hours or less by a network application of group 3-level memory telefacsimiles. However, the expenses associated with the telefacsimile operation and the limitations associated with network polling protocols challenged participants to seek new alternatives for ILL. In 1990, the HSLC introduced HSLC HealthNET, an online wide-area network linking eleven of the thirteen institutions and their resources while providing access to the Internet. The HSLC HealthNET additionally supports a centralized shared library system, several locally mounted databases, and consortiumwide electronic mail. In 1991, a project was initiated to evaluate Ariel software, pioneered by the Research Libraries Group (RLG), compared to the existing network application of group 3-level telefacsimiles. Factors identified as critical to Ariel's potential to replace the telefacsimile network were the proprietary software specifications for Internet access, the use of HSLC's existing wide-area network (WAN), and a hardware platform that was optimal for an ILL environment. This article describes the Ariel project history, the transition to Ariel from the telefacsimile network, evaluation of equipment features for processing efficiency, and operational issues affecting ILL policy. PMID:8004018

17 CFR 4.31 - Required delivery of Disclosure Document to prospective clients.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Disclosure Document to prospective clients. 4.31 Section 4.31 Commodity and Securities Exchanges COMMODITY... Advisors § 4.31 Required delivery of Disclosure Document to prospective clients. (a) Each commodity trading... prospective client a Disclosure Document containing the information set forth in §§ 4.34 and 4.35 for the...

Fee Based Document Delivery by a National Library: Publishing in the New Millennium.

ERIC Educational Resources Information Center

Smith, Malcolm D.

1996-01-01

An overview of the development of document supply relationships between libraries and publishers, based on the British Library's Document Supply Centre, reveals four areas leading to fee based (copyright) document delivery: libraries as markets for publishers; making users aware of what is published; making publications more accessible; and the…

Project delivery acceleration tool box : improvements to the Department of Transportation's project delivery process.

DOT National Transportation Integrated Search

2004-05-01

The purpose of this document is to provide to Caltrans' employees, as well as external partners, some valuable tools that can be used to help accelerate project delivery. This document contains a compilation of all the Department's recent acceleratio...

Crossing the "digital divide:" implementing an electronic medical record system in a rural Kenyan health center to support clinical care and research.

PubMed

Tierney, William M; Rotich, Joseph K; Smith, Faye E; Bii, John; Einterz, Robert M; Hannan, Terry J

2002-01-01

To improve care, one must measure it. In the US, electronic medical record systems have been installed in many institutions to support health care management, quality improvement, and research. Developing countries lack such systems and thus have difficulties managing scarce resources and investigating means of improving health care delivery and outcomes. We describe the implementation and use of the first documented electronic medical record system in ambulatory care in sub-Saharan Africa. After one year, it has captured data for more than 13,000 patients making more than 26,000 visits. We present lessons learned and modifications made to this system to improve its capture of data and ability to support a comprehensive clinical care and research agenda.

Does teaching of documentation of shoulder dystocia delivery through simulation result in improved documentation in real life?

PubMed

Comeau, Robyn; Craig, Catherine

2014-03-01

Documentation of deliveries complicated by shoulder dystocia is a valuable communication skill necessary for residents to attain during residency training. Our objective was to determine whether the teaching of documentation of shoulder dystocia in a simulation environment would translate to improved documentation of the event in an actual clinical situation. We conducted a cohort study involving obstetrics and gynaecology residents in years 2 to 5 between November 2010 and December 2012. Each resident participated in a shoulder dystocia simulation teaching session and was asked to write a delivery note immediately afterwards. They were given feedback regarding their performance of the delivery and their documentation of the events. Following this, dictated records of shoulder dystocia deliveries immediately before and after the simulation session were identified through the Meditech system. An itemized checklist was used to assess the quality of residents' dictated documentation before and after the simulation session. All eligible residents (18) enrolled in the study, and 17 met the inclusion criteria. For 10 residents (59%) documentation of a delivery with shoulder dystocia was present before and after the simulation session, for five residents (29%) it was only present before the session, and for two residents (18%) it was only present after the session. When residents were assessed as a group, there were no differences in the proportion of residents recording items on the checklist before and after the simulation session (P > 0.05 for all). Similarly, analysis of the performance of the10 residents who had dictated documentation both before and after the session showed no differences in the number of elements recorded on dictations done before and after the simulation session (P > 0.05 for all). The teaching of shoulder dystocia documentation through simulation did not result in a measurable improvement in the quality of documentation of shoulder dystocia in actual clinical situations.

[Stimulation of labour with oxytocin and ventouse deliveries are inadequately documented].

PubMed

Lindved, Birgitte Freilev; Kierkegaard, Ole; Anhøj, Jacob

2014-09-15

A retrospective sample of 180 records from four regional hospitals and five university hospitals in Denmark was collected and the documentation for use of oxytocin in augmentation of labour and ventouse deliveries according to the national guidelines was registered. Only approximately half of the elements in the national guidelines were documented. This shows that there is a potential for improvement in the ongoing Danish national quality improvement project Safe Deliveries (Sikre Fødsler).

A Taxonomy of Delivery and Documentation Deviations During Delivery of High-Fidelity Simulations.

PubMed

McIvor, William R; Banerjee, Arna; Boulet, John R; Bekhuis, Tanja; Tseytlin, Eugene; Torsher, Laurence; DeMaria, Samuel; Rask, John P; Shotwell, Matthew S; Burden, Amanda; Cooper, Jeffrey B; Gaba, David M; Levine, Adam; Park, Christine; Sinz, Elizabeth; Steadman, Randolph H; Weinger, Matthew B

2017-02-01

We developed a taxonomy of simulation delivery and documentation deviations noted during a multicenter, high-fidelity simulation trial that was conducted to assess practicing physicians' performance. Eight simulation centers sought to implement standardized scenarios over 2 years. Rules, guidelines, and detailed scenario scripts were established to facilitate reproducible scenario delivery; however, pilot trials revealed deviations from those rubrics. A taxonomy with hierarchically arranged terms that define a lack of standardization of simulation scenario delivery was then created to aid educators and researchers in assessing and describing their ability to reproducibly conduct simulations. Thirty-six types of delivery or documentation deviations were identified from the scenario scripts and study rules. Using a Delphi technique and open card sorting, simulation experts formulated a taxonomy of high-fidelity simulation execution and documentation deviations. The taxonomy was iteratively refined and then tested by 2 investigators not involved with its development. The taxonomy has 2 main classes, simulation center deviation and participant deviation, which are further subdivided into as many as 6 subclasses. Inter-rater classification agreement using the taxonomy was 74% or greater for each of the 7 levels of its hierarchy. Cohen kappa calculations confirmed substantial agreement beyond that expected by chance. All deviations were classified within the taxonomy. This is a useful taxonomy that standardizes terms for simulation delivery and documentation deviations, facilitates quality assurance in scenario delivery, and enables quantification of the impact of deviations upon simulation-based performance assessment.

7 CFR 1488.8 - Documents required after delivery.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Financing of Export Sales of Agricultural Commodities From Private Stocks Under CCC Export Credit Sales Program (GSM-5) Documents Required for Financing § 1488.8 Documents required after delivery. (a) CCC will... regulations within forty-five days, or any extension thereof by the Treasurer or Assistant Treasurer, CCC...

7 CFR 1488.8 - Documents required after delivery.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Financing of Export Sales of Agricultural Commodities From Private Stocks Under CCC Export Credit Sales Program (GSM-5) Documents Required for Financing § 1488.8 Documents required after delivery. (a) CCC will... regulations within forty-five days, or any extension thereof by the Treasurer or Assistant Treasurer, CCC...

7 CFR 1488.8 - Documents required after delivery.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Financing of Export Sales of Agricultural Commodities From Private Stocks Under CCC Export Credit Sales Program (GSM-5) Documents Required for Financing § 1488.8 Documents required after delivery. (a) CCC will... regulations within forty-five days, or any extension thereof by the Treasurer or Assistant Treasurer, CCC...

Health professionals' use of documents obtained through the Regional Medical Library Network.

PubMed

Lovas, I; Graham, E; Flack, V

1991-01-01

The Pacific Southwest Regional Medical Library Service (PSRMLS) studied how health professionals use documents obtained through the regional medical library (RML) network and how various factors, such as delivery time, affected that use. A random sample of libraries in Region 7 of the RML network was selected to survey health professionals who had received documents through the interlibrary loan (ILL) network. The survey provided data about the purposes for which health professionals requested documents, how the immediacy of need for the items affected their usefulness, what effect the obtained information had on the health professionals' work, and whether the illustrations represented an important part of the information content of the items. Survey results provided a positive assessment of the ILL network. Results also verified the basic value of the materials provided to health professionals through ILL and identified some areas for consideration in future network development. Users of the documents indicated that the network works efficiently and effectively to provide timely and useful information needed by health professionals. Technological developments in electronic information transmission and imaging will further enhance network operation in the future.

48 CFR 227.7203-8 - Deferred delivery and deferred ordering of computer software and computer software documentation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... deferred ordering of computer software and computer software documentation. 227.7203-8 Section 227.7203-8... GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Computer Software and Computer Software Documentation 227.7203-8 Deferred delivery and deferred ordering of computer software and computer...

48 CFR 227.7203-8 - Deferred delivery and deferred ordering of computer software and computer software documentation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... deferred ordering of computer software and computer software documentation. 227.7203-8 Section 227.7203-8... GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Computer Software and Computer Software Documentation 227.7203-8 Deferred delivery and deferred ordering of computer software and computer...

48 CFR 227.7203-8 - Deferred delivery and deferred ordering of computer software and computer software documentation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... deferred ordering of computer software and computer software documentation. 227.7203-8 Section 227.7203-8... GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Computer Software and Computer Software Documentation 227.7203-8 Deferred delivery and deferred ordering of computer software and computer...

48 CFR 227.7203-8 - Deferred delivery and deferred ordering of computer software and computer software documentation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... deferred ordering of computer software and computer software documentation. 227.7203-8 Section 227.7203-8... GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Computer Software and Computer Software Documentation 227.7203-8 Deferred delivery and deferred ordering of computer software and computer...

48 CFR 227.7203-8 - Deferred delivery and deferred ordering of computer software and computer software documentation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... deferred ordering of computer software and computer software documentation. 227.7203-8 Section 227.7203-8... GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Computer Software and Computer Software Documentation 227.7203-8 Deferred delivery and deferred ordering of computer software and computer...

Description and Documentation of the Dental School Dental Delivery System.

ERIC Educational Resources Information Center

Chase, Rosen and Wallace, Inc., Alexandria, VA.

A study was undertaken to describe and document the dental school dental delivery system using an integrated systems approach. In late 1976 and early 1977, a team of systems analysts and dental consultants visited three dental schools to observe the delivery of dental services and patient flow and to interview administrative staff and faculty.…

Problems with the electronic health record.

PubMed

de Ruiter, Hans-Peter; Liaschenko, Joan; Angus, Jan

2016-01-01

One of the most significant changes in modern healthcare delivery has been the evolution of the paper record to the electronic health record (EHR). In this paper we argue that the primary change has been a shift in the focus of documentation from monitoring individual patient progress to recording data pertinent to Institutional Priorities (IPs). The specific IPs to which we refer include: finance/reimbursement; risk management/legal considerations; quality improvement/safety initiatives; meeting regulatory and accreditation standards; and patient care delivery/evidence based practice. Following a brief history of the transition from the paper record to the EHR, the authors discuss unintended or contested consequences resulting from this change. These changes primarily reflect changes in the organization and amount of clinician work and clinician-patient relationships. The paper is not a research report but was informed by an institutional ethnography the aim of which was to understand how the EHR impacted clinicians and administrators in a large, urban hospital in the United States. The paper was also informed by other sources, including the philosophies of Jacques Ellul, Don Idhe, and Langdon Winner. © 2015 John Wiley & Sons Ltd.

49 CFR 386.6 - Service.

Code of Federal Regulations, 2010 CFR

2010-10-01

... valid as of the date and the time the document was mailed, or the date personal delivery of the document was refused. Service by delivery after 5 p.m. in the time zone in which the recipient will receive...

Plan for DoD Wide Demonstrations of a DoD Improved Interactive Electronic Technical Manual (IETM) Architecture

DTIC Science & Technology

1998-07-01

all the MS Word files into FrameMaker + SGML format and use the FrameMaker application to SGML tag all of the data in accordance with the Army TM...Document Type Definitions (DTDs) in MIL-STD- 2361. The edited SGML tagged files are saved as PDF files for delivery to the field. The FrameMaker ...as TIFF files and being imported into FrameMaker prior to saving the TMs as PDF files. Since the hardware to be used by the AN/PPS-5 technician is

Communications data delivery system analysis : public workshop read-ahead document.

DOT National Transportation Integrated Search

2012-04-09

This document presents an overview of work conducted to date around development and analysis of communications data delivery systems for supporting transactions in the connected vehicle environment. It presents the results of technical analysis of co...

Document Delivery: Evaluating the Options.

ERIC Educational Resources Information Center

Ward, Suzanne M.

1997-01-01

Discusses options available to libraries for document delivery. Topics include users' needs; cost; copyright compliance; traditional interlibrary loan; types of suppliers; selection criteria, including customer service; new developments in interlibrary loan, including outsourcing arrangements; and the need to evaluate suppliers. (LRW)

The perinatal quality collaborative of North Carolina's 39 weeks project: a quality improvement program to decrease elective deliveries before 39 weeks of gestation.

PubMed

Berrien, Kate; Devente, James; French, Amanda; Cochran, Keith M; McCaffrey, Marty; Horton, Bethany J; Chescheir, Nancy

2014-01-01

Despite long-standing guidelines from the American College of Obstetricians and Gynecologists that call for avoiding elective births prior to 39 weeks of gestation, elective deliveries make up almost one-third of US births occurring in weeks 36-38. Poor outcomes are more likely for infants born electively before 39 weeks than for those born at 39 weeks. The Perinatal Quality Collaborative of North Carolina (PQCNC) undertook the 39 Weeks Project in 2009-2010 with the aim of reducing the number of early-term elective deliveries in North Carolina hospitals. Participating hospitals (N = 33) provided retrospective data on all early-term deliveries and created new policies, or amended or enforced existing policies, to accomplish the project's goals. Project activities included in-person learning sessions, regional meetings, webinars, electronic newsletters, a secure extranet Web site where participating hospitals could share relevant materials, and individual leadership consultations with hospital teams. Hospitals submitted monthly data to PQCNC, which provided ongoing training and data analysis. Elective deliveries before 39 weeks of gestation decreased 45% over the project period, from 2% to 1.1% of all deliveries. The proportion of elective deliveries among all scheduled early-term deliveries also decreased, from 23.63% to 16.19%. There was an increase in the proportion of patients with documented evidence of medical indications for early delivery, from 62.4% to 88.2%. No data were collected to determine whether outcomes changed for patients whose deliveries were deferred. The project also depended on each hospital to code its own data. The PQCNC's 39 Weeks Project successfully decreased the rate of early-term elective deliveries in participating hospitals.

Accuracy of outpatient service data for activity-based funding in New South Wales, Australia.

PubMed

Munyisia, Esther N; Reid, David; Yu, Ping

2017-05-01

Despite increasing research on activity-based funding (ABF), there is no empirical evidence on the accuracy of outpatient service data for payment. This study aimed to identify data entry errors affecting ABF in two drug and alcohol outpatient clinic services in Australia. An audit was carried out on healthcare workers' (doctors, nurses, psychologists, social workers, counsellors, and aboriginal health education officers) data entry errors in an outpatient electronic documentation system. Of the 6919 data entries in the electronic documentation system, 7.5% (518) had errors, 68.7% of the errors were related to a wrong primary activity, 14.5% were due to a wrong activity category, 14.5% were as a result of a wrong combination of primary activity and modality of care, 1.9% were due to inaccurate information on a client's presence during service delivery and 0.4% were related to a wrong modality of care. Data entry errors may affect the amount of funding received by a healthcare organisation, which in turn may affect the quality of treatment provided to clients due to the possibility of underfunding the organisation. To reduce errors or achieve an error-free environment, there is a need to improve the naming convention of data elements, their descriptions and alignment with the national standard classification of outpatient services. It is also important to support healthcare workers in their data entry by embedding safeguards in the electronic documentation system such as flags for inaccurate data elements.

Desktop Access to Full-Text NACA and NASA Reports: Systems Developed by NASA Langley Technical Library

NASA Technical Reports Server (NTRS)

Ambur, Manjula Y.; Adams, David L.; Trinidad, P. Paul

1997-01-01

NASA Langley Technical Library has been involved in developing systems for full-text information delivery of NACA/NASA technical reports since 1991. This paper will describe the two prototypes it has developed and the present production system configuration. The prototype systems are a NACA CD-ROM of thirty-three classic paper NACA reports and a network-based Full-text Electronic Reports Documents System (FEDS) constructed from both paper and electronic formats of NACA and NASA reports. The production system is the DigiDoc System (DIGItal Documents) presently being developed based on the experiences gained from the two prototypes. DigiDoc configuration integrates the on-line catalog database World Wide Web interface and PDF technology to provide a powerful and flexible search and retrieval system. It describes in detail significant achievements and lessons learned in terms of data conversion, storage technologies, full-text searching and retrieval, and image databases. The conclusions from the experiences of digitization and full- text access and future plans for DigiDoc system implementation are discussed.

NILDE, Network Inter Library Document Exchange: An Italian Document Delivery System

NASA Astrophysics Data System (ADS)

Brunetti, F.; Gasperini, A.; Mangiaracina, S.

2007-10-01

This poster presents NILDE, a document delivery system supporting the exchange of documents via the internet. The system has been set up by the Central Library of the National Research Council of Bologna (Italy) in order to make use of new internet technology, to promote cooperation between Italian university libraries and research libraries, and to achieve quick response times in satisfying DD requests. The Arcetri Astrophysical Observatory Library was the first astronomical library to join the NILDE project from its earliest days in 2002. Many were the reasons for this choice: automation of the DD processes, security and reliability of the network, creation of usage statistics and reports, reduction of DD System management costs and so on. This work describes the benefits of NILDE and discusses the role of an organized document delivery system as an important tool to cope with the difficult constraints of the publishing market.

The Catch to Confidentiality: The Use of Electronic Health Records in Adolescent Health Care.

PubMed

Stablein, Timothy; Loud, Keith J; DiCapua, Christopher; Anthony, Denise L

2018-05-01

This study aims to understand pediatric health-care providers' expectations and the practices they employ to protect confidentiality in electronic health records (EHRs) and subsequently how EHRs affect the documentation and dissemination of information in the course of health-care delivery to adolescent minors. Twenty-six pediatric health-care providers participated in in-depth interviews about their experiences using EHRs to understand a broad spectrum of expectations and practices guiding the documentation and dissemination of information in the EHR. A thematic analysis of interviews was conducted to draw findings and conclusions. Two themes and several subthemes emerged centering on how EHRs affected confidentiality expectations and practices. Participants expressed confidentiality concerns due to the EHR's longevity as a legacy record, its multidimensional uses, and increased access by users (theme 1). These concerns affected practices for protecting adolescent confidentiality within the EHR (theme 2). Practices included selectively omitting or concealing information and utilizing sets of personal and collective codes designed to alert providers or teams of providers to confidential information within a patient's record. EHRs create new and unresolved challenges for pediatric health care as they alter expectations of confidentiality and the documentation and dissemination of information within the record. This is particularly relevant in the course of care to adolescent minors as EHRs may compromise the tenuous balance providers maintain between protecting confidentiality and effective documentation within the record. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

An observational study of the accuracy and completeness of an anesthesia information management system: recommendations for documentation system changes.

PubMed

Wilbanks, Bryan A; Moss, Jacqueline A; Berner, Eta S

2013-08-01

Anesthesia information management systems must often be tailored to fit the environment in which they are implemented. Extensive customization necessitates that systems be analyzed for both accuracy and completeness of documentation design to ensure that the final record is a true representation of practice. The purpose of this study was to determine the accuracy of a recently installed system in the capture of key perianesthesia data. This study used an observational design and was conducted using a convenience sample of nurse anesthetists. Observational data of the nurse anesthetists'delivery of anesthesia care were collected using a touch-screen tablet computer utilizing an Access database customized observational data collection tool. A questionnaire was also administered to these nurse anesthetists to assess perceived accuracy, completeness, and satisfaction with the electronic documentation system. The major sources of data not documented in the system were anesthesiologist presence (20%) and placement of intravenous lines (20%). The major sources of inaccuracies in documentation were gas flow rates (45%), medication administration times (30%), and documentation of neuromuscular function testing (20%)-all of the sources of inaccuracies were related to the use of charting templates that were not altered to reflect the actual interventions performed.

Back to the future: An online OSCE Management Information System for nursing OSCEs.

PubMed

Meskell, Pauline; Burke, Eimear; Kropmans, Thomas J B; Byrne, Evelyn; Setyonugroho, Winny; Kennedy, Kieran M

2015-11-01

The Objective Structured Clinical Examination (OSCE) is an established tool in the repertoire of clinical assessment methods in nurse education. The use of OSCEs facilitates the assessment of psychomotor skills as well as knowledge and attitudes. Identified benefits of OSCE assessment include development of students' confidence in their clinical skills and preparation for clinical practice. However, a number of challenges exist with the traditional paper methodology, including documentation errors and inadequate student feedback. To explore electronic OSCE delivery and evaluate the benefits of using an electronic OSCE management system. To explore assessors' perceptions of and attitudes to the computer based package. This study was conducted using electronic software in the management of a four station OSCE assessment with a cohort of first year undergraduate nursing students delivered over two consecutive years (n=203) in one higher education institution in Ireland. A quantitative descriptive survey methodology was used to obtain the views of the assessors on the process and outcome of using the software. OSCE documentation was converted to electronic format. Assessors were trained in the use of the OSCE management software package and laptops were procured to facilitate electronic management of the OSCE assessment. Following the OSCE assessment, assessors were invited to evaluate the experience. Electronic software facilitated the storage and analysis of overall group and individual results thereby offering considerable time savings. Submission of electronic forms was allowed only when fully completed thus removing the potential for missing data. The feedback facility allowed the student to receive timely evaluation on their performance and to benchmark their performance against the class. Assessors' satisfaction with the software was high. Analysis of assessment results can highlight issues around internal consistency being moderate and examiners variability. Regression analysis increases fairness of result calculations. Copyright © 2015. Published by Elsevier Ltd.

Evolving health information technology and the timely availability of visit diagnoses from ambulatory visits: a natural experiment in an integrated delivery system.

PubMed

Bardach, Naomi S; Huang, Jie; Brand, Richard; Hsu, John

2009-07-17

Health information technology (HIT) may improve health care quality and outcomes, in part by making information available in a timelier manner. However, there are few studies documenting the changes in timely availability of data with the use of a sophisticated electronic medical record (EMR), nor a description of how the timely availability of data might differ with different types of EMRs. We hypothesized that timely availability of data would improve with use of increasingly sophisticated forms of HIT. We used an historical observation design (2004-2006) using electronic data from office visits in an integrated delivery system with three types of HIT: Basic, Intermediate, and Advanced. We calculated the monthly percentage of visits using the various types of HIT for entry of visit diagnoses into the delivery system's electronic database, and the time between the visit and the availability of the visit diagnoses in the database. In January 2004, when only Basic HIT was available, 10% of office visits had diagnoses entered on the same day as the visit and 90% within a week; 85% of office visits used paper forms for recording visit diagnoses, 16% used Basic at that time. By December 2006, 95% of all office visits had diagnoses available on the same day as the visit, when 98% of office visits used some form of HIT for entry of visit diagnoses (Advanced HIT for 67% of visits). Use of HIT systems is associated with dramatic increases in the timely availability of diagnostic information, though the effects may vary by sophistication of HIT system. Timely clinical data are critical for real-time population surveillance, and valuable for routine clinical care.

Use of Electronic Documentation for Quality Improvement in Hospice

PubMed Central

Cagle, John G.; Rokoske, Franziska S.; Durham, Danielle; Schenck, Anna P.; Spence, Carol; Hanson, Laura C.

2015-01-01

Little evidence exists on the use of electronic documentation in hospice and its relationship to quality improvement practices. The purposes of this study were to: (1) estimate the prevalence of electronic documentation use in hospice; (2) identify organizational characteristics associated with use of electronic documentation; and (3) determine whether quality measurement practices differed based on documentation format (electronic vs. nonelectronic). Surveys concerning the use of electronic documentation for quality improvement practices and the monitoring of quality-related care and outcomes were collected from 653 hospices. Users of electronic documentation were able to monitor a wider range of quality-related data than users of nonelectronic documentation. Quality components such as advanced care planning, cultural needs, experience during care of the actively dying, and the number/types of care being delivered were more likely to be documented by users of electronic documentation. Use of electronic documentation may help hospices to monitor quality and compliance. PMID:22267819

Repeat cesarean delivery: what indications are recorded in the medical chart?

PubMed

Lydon-Rochelle, Mona T; Gardella, Carolyn; Cárdenas, Vicky; Easterling, Thomas R

2006-03-01

National surveillance estimates reported a troubling 63 percent decline in the rate of vaginal birth after cesarean delivery (VBAC) from 1996 (28.3%) to 2003 (10.6%), with subsequent rising rates of repeat cesarean delivery. The study objective was to examine patterns of documented indications for repeat cesarean delivery in women with and without labor. We conducted a population-based validation study of 19 nonfederal short-stay hospitals in Washington state. Of the 4,541 women who had live births in 2000, 11 percent (n = 493) had repeat cesarean without labor and 3 percent (n = 138) had repeat cesarean with labor. Incidence of medical conditions and pregnancy complications, patterns of documented indications for repeat cesarean delivery, and perioperative complications in relation to repeat cesarean delivery with and without labor were calculated. Of the 493 women who underwent a repeat cesarean delivery without labor, "elective"(36%) and "maternal request"(18%) were the most common indications. Indications for maternal medical conditions (3.0%) were uncommon. Among the 138 women with repeat cesarean delivery with labor, 60.1 percent had failure to progress, 24.6 percent a non-reassuring fetal heart rate, 8.0 percent cephalopelvic disproportion, and 7.2 percent maternal request during labor. Fetal indications were less common (5.8%). Breech, failed vacuum, abruptio placentae, maternal complications, and failed forceps were all indicated less than 5.0 percent. Women's perioperative complications did not vary significantly between women without and with labor. Regardless of a woman's labor status, nearly 10 percent of women with repeat cesarean delivery had no documented indication as to why a cesarean delivery was performed. "Elective" and "maternal request" were common indications among women undergoing repeat cesarean delivery without labor, and nearly 10 percent of women had undocumented indications for repeat cesarean delivery in their medical record. Improvements in standardization of indication nomenclature and documentation of indication are especially important for understanding falling VBAC rates. Future research should examine how clinicians and women anticipate, discuss, and make decisions about childbirth after a previous cesarean delivery within the context of actual antepartum care.

78 FR 47427 - AUC, LLC Reno Creek, In Situ

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

...-Filing system also distributes an email notice that provides access to the document to the NRC's Office...) courier, express mail, or expedited delivery service to the Office of the Secretary, Sixteenth Floor, One... the mail, or by courier, express mail, or expedited delivery service upon depositing the document with...

By Our Own Bootstraps: Making Document Delivery Work in Oregon.

ERIC Educational Resources Information Center

Burkholder, Sue A.

1992-01-01

Describes the development of a courier service in Oregon for document delivery between libraries to support coordinated collection development activities. Organization of the service by individual libraries without dependence on the Library Services and Construction Act is discussed, and costs and response time are considered. (two references)…

ADONIS: One Library's Experience with a CD-ROM Document Delivery System.

ERIC Educational Resources Information Center

Pereira, Monica

Academic libraries have traditionally used interlibrary lending to facilitate document delivery. The trend of stagnating or dwindling serials budgets in libraries, coupled with increased journal costs, has served to increase libraries' reliance on the benefits of consortium pricing and shared costs, by utilizing interlibrary lending of journals.…

Automation of the CAS Document Delivery Service.

ERIC Educational Resources Information Center

Steensland, M. C.; Soukup, K. M.

1986-01-01

The automation of online order retrieval for Chemical Abstracts Service Document Delivery Service was accomplished by shifting to an order retrieval/dispatch process linked to a Unix network. The Unix-based environment, its terminal emulation, page-break, and user-friendly interface software, and later enhancements are reviewed. Resultant increase…

Delivered! A Mid-Sized Academic Library's Experience with Distance Education

ERIC Educational Resources Information Center

Bartnik, Linda

2010-01-01

Murray State University (Kentucky) has been experimenting with various means of document delivery and research instruction for its online only and satellite campuses. These include ILLiad-based document delivery, Camtasia-to-UTube tutorials, a discipline-based service called Library on Blackboard, Eluminate and other virtual instructional methods.…

Cost analysis and student survey results of library support for distance education

PubMed Central

Rodman, Ruey L.

2003-01-01

This paper describes the costs associated with providing library support for a series of distance-education courses at The Ohio State University (OSU). These courses are designed as a pilot program offered by the OSU Office of Geriatrics and Gerontology. Costs to the library are analyzed for document delivery, electronic reserves, reference services, and librarian activities. Also included are the results of a student evaluation survey. The students are full-time working professionals who cannot attend regularly scheduled classes on campus. Conclusions extrapolate costs for each course, student, and service. PMID:12568160

Improving the quality of care of patients with rheumatic disease using patient-centric electronic redesign software.

PubMed

Newman, Eric D; Lerch, Virginia; Billet, Jon; Berger, Andrea; Kirchner, H Lester

2015-04-01

Electronic health records (EHRs) are not optimized for chronic disease management. To improve the quality of care for patients with rheumatic disease, we developed electronic data capture, aggregation, display, and documentation software. The software integrated and reassembled information from the patient (via a touchscreen questionnaire), nurse, physician, and EHR into a series of actionable views. Core functions included trends over time, rheumatology-related demographics, and documentation for patient and provider. Quality measures collected included patient-reported outcomes, disease activity, and function. The software was tested and implemented in 3 rheumatology departments, and integrated into routine care delivery. Post-implementation evaluation measured adoption, efficiency, productivity, and patient perception. Over 2 years, 6,725 patients completed 19,786 touchscreen questionnaires. The software was adopted for use by 86% of patients and rheumatologists. Chart review and documentation time trended downward, and productivity increased by 26%. Patient satisfaction, activation, and adherence remained unchanged, although pre-implementation values were high. A strong correlation was seen between use of the software and disease control (weighted Pearson's correlation coefficient 0.5927, P = 0.0095), and a relative increase in patients with low disease activity of 3% per quarter was noted. We describe innovative software that aggregates, stores, and displays information vital to improving the quality of care for patients with chronic rheumatic disease. The software was well-adopted by patients and providers. Post-implementation, significant improvements in quality of care, efficiency of care, and productivity were demonstrated. Copyright © 2015 by the American College of Rheumatology.

Dosimetric verification of gated delivery of electron beams using a 2D ion chamber array

PubMed Central

Yoganathan, S. A.; Das, K. J. Maria; Raj, D. Gowtham; Kumar, Shaleen

2015-01-01

The purpose of this study was to compare the dosimetric characteristics; such as beam output, symmetry and flatness between gated and non-gated electron beams. Dosimetric verification of gated delivery was carried for all electron beams available on Varian CL 2100CD medical linear accelerator. Measurements were conducted for three dose rates (100 MU/min, 300 MU/min and 600 MU/min) and two respiratory motions (breathing period of 4s and 8s). Real-time position management (RPM) system was used for the gated deliveries. Flatness and symmetry values were measured using Imatrixx 2D ion chamber array device and the beam output was measured using plane parallel ion chamber. These detector systems were placed over QUASAR motion platform which was programmed to simulate the respiratory motion of target. The dosimetric characteristics of gated deliveries were compared with non-gated deliveries. The flatness and symmetry of all the evaluated electron energies did not differ by more than 0.7 % with respect to corresponding non-gated deliveries. The beam output variation of gated electron beam was less than 0.6 % for all electron energies except for 16 MeV (1.4 %). Based on the results of this study, it can be concluded that Varian CL2100 CD is well suitable for gated delivery of non-dynamic electron beams. PMID:26170552

78 FR 35066 - Applications and Amendments to Facility Operating Licenses and Combined Licenses Involving...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

... also distributes an email notice that provides access to the document to the NRC's Office of the...) courier, express mail, or expedited delivery service to the Office of the Secretary, Sixteenth Floor, One... the mail, or by courier, express mail, or expedited delivery service upon depositing the document with...

TOC/DOC: "It Has Changed the Way I Do Science".

ERIC Educational Resources Information Center

Douglas, Kimberly; Roth, Dana L.

1997-01-01

Describes a user-based automated service developed at the California Institute of Technology that combines access to journal article databases with an in-house document delivery system. TOC/DOC (Tables of Contents/Document Delivery) has undergone a conceptual change from a catalog of locally-held journal articles to a broader, more retrospective…

A User-Centered View of Document Delivery and Interlibrary Loan.

ERIC Educational Resources Information Center

Martin, Harry S., III; Kendrick, Curtis L.

1994-01-01

Discusses reasons why libraries are being forced to seek new forms of information storage. A hypothetical scenario of user-initiated document delivery alternatives integrated with a search process used by a professor using the Harvard OnLine Library Information System is presented. Extensive notes elaborate on the process and the technology…

Global Document Delivery, User Studies, and Service Evaluation: The Gateway Experience

ERIC Educational Resources Information Center

Miller, Rush; Xu, Hong; Zou, Xiuying

2008-01-01

This study examines user and service data from 2002-2006 at the East Asian Gateway Service for Chinese and Korean Academic Journal Publications (Gateway Service), the University of Pittsburgh. Descriptive statistical analysis reveals that the Gateway Service has been consistently playing the leading role in global document delivery service as well…

43 CFR 1822.11 - What must I do to make an official filing with BLM?

Code of Federal Regulations, 2011 CFR

2011-10-01

... file your application and any other required documents during regular office hours at the appropriate BLM office having jurisdiction over the lands or records involved. You must file any document with BLM through personal delivery or by mailing via the United States Postal Service or other delivery service...

Ondigita: A Platform for the Management and Delivery of Digital Documents

ERIC Educational Resources Information Center

Mazza, Riccardo; Baldassari, Andrea; Guidi, Roberto

2013-01-01

This paper presents Ondigita, a platform developed at the University of Applied Sciences of Southern Switzerland for the management and delivery of digital documents to students enrolled in bachelor's courses in various curricula within the field of engineering. Ondigita allows our organization to have a cloud-based repository of educational…

Expanding services in a shrinking economy: desktop document delivery in a dental school library.

PubMed

Gushrowski, Barbara A

2011-07-01

How can library staff develop and promote a document delivery service and then expand the service to a wide audience? The setting is the library at the Indiana University School of Dentistry (IUSD), Indianapolis. A faculty survey and a citation analysis were conducted to determine potential use of the service. Volume of interlibrary loan transactions and staff and equipment capacity were also studied. IUSD Library staff created a desktop delivery service (DDSXpress) for faculty and then expanded the service to practicing dental professionals and graduate students. The number of faculty using DDSXpress remains consistent. The number of practicing dental professionals using the service is low. Graduate students have been quick to adopt the service. Through careful analysis of capacity and need for the service, staff successfully expanded document delivery service without incurring additional costs. Use of DDSXpress is continually monitored, and opportunities to market the service to practicing dental professionals are being investigated.

Planning and Implementing Augmentative Communication Service Delivery, 2: Proceedings of the National Planners Conference on Assistive Device Service Delivery.

ERIC Educational Resources Information Center

Coston, Caroline A., Ed.

The document consists of 30 author contributed chapters concerned with augmentative communication service delivery. Chapter titles and authors are: "Communication Options for Persons Who Cannot Speak: Planning for Service Delivery" (David Beukelman); "Planning Service Delivery Systems" (Roland Hahn II); "Planning Ohio's…

Future of electronic health records: implications for decision support.

PubMed

Rothman, Brian; Leonard, Joan C; Vigoda, Michael M

2012-01-01

The potential benefits of the electronic health record over traditional paper are many, including cost containment, reductions in errors, and improved compliance by utilizing real-time data. The highest functional level of the electronic health record (EHR) is clinical decision support (CDS) and process automation, which are expected to enhance patient health and healthcare. The authors provide an overview of the progress in using patient data more efficiently and effectively through clinical decision support to improve health care delivery, how decision support impacts anesthesia practice, and how some are leading the way using these systems to solve need-specific issues. Clinical decision support uses passive or active decision support to modify clinician behavior through recommendations of specific actions. Recommendations may reduce medication errors, which would result in considerable savings by avoiding adverse drug events. In selected studies, clinical decision support has been shown to decrease the time to follow-up actions, and prediction has proved useful in forecasting patient outcomes, avoiding costs, and correctly prompting treatment plan modifications by clinicians before engaging in decision-making. Clinical documentation accuracy and completeness is improved by an electronic health record and greater relevance of care data is delivered. Clinical decision support may increase clinician adherence to clinical guidelines, but educational workshops may be equally effective. Unintentional consequences of clinical decision support, such as alert desensitization, can decrease the effectiveness of a system. Current anesthesia clinical decision support use includes antibiotic administration timing, improved documentation, more timely billing, and postoperative nausea and vomiting prophylaxis. Electronic health record implementation offers data-mining opportunities to improve operational, financial, and clinical processes. Using electronic health record data in real-time for decision support and process automation has the potential to both reduce costs and improve the quality of patient care. © 2012 Mount Sinai School of Medicine.

Measuring use of electronic health record functionality using system audit information.

PubMed

Bowes, Watson A

2010-01-01

Meaningful and efficient methods for measuring Electronic Health Record (EHR) adoption and functional usage patterns have recently become important for hospitals, clinics, and health care networks in the United State due to recent government initiatives to increase EHR use. To date, surveys have been the method of choice to measure EHR adoption. This paper describes another method for measuring EHR adoption which capitalizes on audit logs, which are often common components of modern EHRs. An Audit Data Mart is described which identified EHR functionality within 836 Departments, within 22 Hospitals and 170 clinics at Intermountain Healthcare, a large integrated delivery system. The Audit Data Mart successfully identified important and differing EHR functional usage patterns. These patterns were useful in strategic planning, tracking EHR implementations, and will likely be utilized to assist in documentation of "Meaningful Use" of EHR functionality.

Final Report: MaRSPlus Sensor System Electrical Cable Management and Distributed Motor Control Computer Interface

NASA Technical Reports Server (NTRS)

Reil, Robin

2011-01-01

The success of JPL's Next Generation Imaging Spectrometer (NGIS) in Earth remote sensing has inspired a follow-on instrument project, the MaRSPlus Sensor System (MSS). One of JPL's responsibilities in the MSS project involves updating the documentation from the previous JPL airborne imagers to provide all the information necessary for an outside customer to operate the instrument independently. As part of this documentation update, I created detailed electrical cabling diagrams to provide JPL technicians with clear and concise build instructions and a database to track the status of cables from order to build to delivery. Simultaneously, a distributed motor control system is being developed for potential use on the proposed 2018 Mars rover mission. This system would significantly reduce the mass necessary for rover motor control, making more mass space available to other important spacecraft systems. The current stage of the project consists of a desktop computer talking to a single "cold box" unit containing the electronics to drive a motor. In order to test the electronics, I developed a graphical user interface (GUI) using MATLAB to allow a user to send simple commands to the cold box and display the responses received in a user-friendly format.

Sensitivity Analysis of Algan/GAN High Electron Mobility Transistors to Process Variation

DTIC Science & Technology

2008-02-01

delivery system gas panel including both hydride and alkyl delivery modules and the vent/valve configurations [14...Reactor Gas Delivery Systems A basic schematic diagram of an MOCVD reactor delivery gas panel is shown in Figure 13. The reactor gas delivery...system, or gas panel , consists of a network of stainless steel tubing, automatic valves and electronic mass flow controllers (MFC). There are separate

Software Build and Delivery Systems

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

Robey, Robert W.

2016-07-10

This presentation deals with the hierarchy of software build and delivery systems. One of the goals is to maximize the success rate of new users and developers when first trying your software. First impressions are important. Early successes are important. This also reduces critical documentation costs. This is a presentation focused on computer science and goes into detail about code documentation.

77 FR 33782 - License Amendment To Construct and Operate New In Situ Leach Uranium Recovery Facility; Uranium...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-07

...-Filing system also distributes an email notice that provides access to the document to the NRC's Office... mail, or expedited delivery service to the Office of the Secretary, Sixteenth Floor, One White Flint... courier, express mail, or expedited delivery service upon depositing the document with the provider of the...

Modeling Standards of Care for an Online Environment

PubMed Central

Jones-Schenk, Jan; Rossi, Julia

1998-01-01

At Intermountain Health Care in Salt Lake City a team was created to develop core standards for clinical practice that would enhance consistency of care across the care continuum. The newly developed Standards of Care had to meet the following criteria: electronic delivery, research-based, and support an interdisciplinary care environment along with an exception-based documentation system. The process has slowly evolved and the team has grown to include clinicians from multiple sites and disciplines who have met on a regular basis for over a year. The first challenge was to develop a model for the standards of care that would be suitable for an online environment.

Expanding services in a shrinking economy: desktop document delivery in a dental school library

PubMed Central

Gushrowski, Barbara A

2011-01-01

Question: How can library staff develop and promote a document delivery service and then expand the service to a wide audience? Setting: The setting is the library at the Indiana University School of Dentistry (IUSD), Indianapolis. Method: A faculty survey and a citation analysis were conducted to determine potential use of the service. Volume of interlibrary loan transactions and staff and equipment capacity were also studied. Main results: IUSD Library staff created a desktop delivery service (DDSXpress) for faculty and then expanded the service to practicing dental professionals and graduate students. The number of faculty using DDSXpress remains consistent. The number of practicing dental professionals using the service is low. Graduate students have been quick to adopt the service. Conclusion: Through careful analysis of capacity and need for the service, staff successfully expanded document delivery service without incurring additional costs. Use of DDSXpress is continually monitored, and opportunities to market the service to practicing dental professionals are being investigated. PMID:21753911

Electronic Health Record Challenges, Workarounds, and Solutions Observed in Practices Integrating Behavioral Health and Primary Care.

PubMed

Cifuentes, Maribel; Davis, Melinda; Fernald, Doug; Gunn, Rose; Dickinson, Perry; Cohen, Deborah J

2015-01-01

This article describes the electronic health record (EHR)-related experiences of practices striving to integrate behavioral health and primary care using tailored, evidenced-based strategies from 2012 to 2014; and the challenges, workarounds and initial health information technology (HIT) solutions that emerged during implementation. This was an observational, cross-case comparative study of 11 diverse practices, including 8 primary care clinics and 3 community mental health centers focused on the implementation of integrated care. Practice characteristics (eg, practice ownership, federal designation, geographic area, provider composition, EHR system, and patient panel characteristics) were collected using a practice information survey and analyzed to report descriptive information. A multidisciplinary team used a grounded theory approach to analyze program documents, field notes from practice observation visits, online diaries, and semistructured interviews. Eight primary care practices used a single EHR and 3 practices used 2 different EHRs, 1 to document behavioral health and 1 to document primary care information. Practices experienced common challenges with their EHRs' capabilities to 1) document and track relevant behavioral health and physical health information, 2) support communication and coordination of care among integrated teams, and 3) exchange information with tablet devices and other EHRs. Practices developed workarounds in response to these challenges: double documentation and duplicate data entry, scanning and transporting documents, reliance on patient or clinician recall for inaccessible EHR information, and use of freestanding tracking systems. As practices gained experience with integration, they began to move beyond workarounds to more permanent HIT solutions ranging in complexity from customized EHR templates, EHR upgrades, and unified EHRs. Integrating behavioral health and primary care further burdens EHRs. Vendors, in cooperation with clinicians, should intentionally design EHR products that support integrated care delivery functions, such as data documentation and reporting to support tracking patients with emotional and behavioral problems over time and settings, integrated teams working from shared care plans, template-driven documentation for common behavioral health conditions such as depression, and improved registry functionality and interoperability. This work will require financial support and cooperative efforts among clinicians, EHR vendors, practice assistance organizations, regulators, standards setters, and workforce educators. © Copyright 2015 by the American Board of Family Medicine.

E-cigarettes: An update on considerations for the otolaryngologist.

PubMed

Biyani, Sneh; Derkay, Craig S

2017-03-01

We provide an update in the literature and national regulations regarding electronic cigarettes with special attention to the pediatric population. Electronic nicotine delivery systems (ENDS) are handheld battery operated devices that vaporize nicotine-containing liquids for inhalation. Use of these products has dramatically increased over the last several years, particularly among the youth. ENDS are being marketed with advertising techniques and flavors which appeal to the adolescent and young adult population. More reports of accidental pediatric exposures are being documented, as are suicides from abuse of liquid nicotine. Federal regulation has only now become required of these devices. Use of e cigarettes among adolescents increases each year. Government oversight is needed to protect our children from the re-normalization of tobacco. Otolaryngologists should be prepared to counsel their patients and families regarding the latest in ENDS use. Copyright © 2017 Elsevier B.V. All rights reserved.

78 FR 64294 - Loan Guaranty: Mandatory Electronic Delivery of Loan Files for Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... DEPARTMENT OF VETERANS AFFAIRS Loan Guaranty: Mandatory Electronic Delivery of Loan Files for... through either electronic upload or in hard copy form. Effective January 1, 2014, LGY will require the electronic uploading of all loan files, pursuant to 38 CFR 36.4333. DATES: Effective January 1, 2014, VA will...

Sci—Thur PM: Planning and Delivery — 03: Automated delivery and quality assurance of a modulated electron radiation therapy plan

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

Connell, T; Papaconstadopoulos, P; Alexander, A

2014-08-15

Modulated electron radiation therapy (MERT) offers the potential to improve healthy tissue sparing through increased dose conformity. Challenges remain, however, in accurate beamlet dose calculation, plan optimization, collimation method and delivery accuracy. In this work, we investigate the accuracy and efficiency of an end-to-end MERT plan and automated-delivery workflow for the electron boost portion of a previously treated whole breast irradiation case. Dose calculations were performed using Monte Carlo methods and beam weights were determined using a research-based treatment planning system capable of inverse optimization. The plan was delivered to radiochromic film placed in a water equivalent phantom for verification,more » using an automated motorized tertiary collimator. The automated delivery, which covered 4 electron energies, 196 subfields and 6183 total MU was completed in 25.8 minutes, including 6.2 minutes of beam-on time with the remainder of the delivery time spent on collimator leaf motion and the automated interfacing with the accelerator in service mode. The delivery time could be reduced by 5.3 minutes with minor electron collimator modifications and the beam-on time could be reduced by and estimated factor of 2–3 through redesign of the scattering foils. Comparison of the planned and delivered film dose gave 3%/3 mm gamma pass rates of 62.1, 99.8, 97.8, 98.3, and 98.7 percent for the 9, 12, 16, 20 MeV, and combined energy deliveries respectively. Good results were also seen in the delivery verification performed with a MapCHECK 2 device. The results showed that accurate and efficient MERT delivery is possible with current technologies.« less

Exploring and validating physicochemical properties of mangiferin through GastroPlus® software

PubMed Central

Khurana, Rajneet Kaur; Kaur, Ranjot; Kaur, Manninder; Kaur, Rajpreet; Kaur, Jasleen; Kaur, Harpreet; Singh, Bhupinder

2017-01-01

Aim: Mangiferin (Mgf), a promising therapeutic polyphenol, exhibits poor oral bioavailability. Hence, apt delivery systems are required to facilitate its gastrointestinal absorption. The requisite details on its physicochemical properties have not yet been well documented in literature. Accordingly, in order to have explicit insight into its physicochemical characteristics, the present work was undertaken using GastroPlus™ software. Results: Aqueous solubility (0.38 mg/ml), log P (-0.65), Peff (0.16 × 10-4 cm/s) and ability to act as P-gp substrate were defined. Potency to act as a P-gp substrate was verified through Caco-2 cells, while Peff was estimated through single pass intestinal perfusion studies. Characterization of Mgf through transmission electron microscopy, differential scanning calorimetry, infrared spectroscopy and powder x-ray diffraction has also been reported. Conclusion: The values of physicochemical properties for Mgf reported in the current manuscript would certainly enable the researchers to develop newer delivery systems for Mgf. PMID:28344830

Challenges in using electronic health record data for CER: experience of 4 learning organizations and solutions applied.

PubMed

Bayley, K Bruce; Belnap, Tom; Savitz, Lucy; Masica, Andrew L; Shah, Nilay; Fleming, Neil S

2013-08-01

To document the strengths and challenges of using electronic health records (EHRs) for comparative effectiveness research (CER). A replicated case study of comparative effectiveness in hypertension treatment was conducted across 4 health systems, with instructions to extract data and document problems encountered using a specified list of required data elements. Researchers at each health system documented successes and challenges, and suggested solutions for addressing challenges. Data challenges fell into 5 categories: missing data, erroneous data, uninterpretable data, inconsistencies among providers and over time, and data stored in noncoded text notes. Suggested strategies to address these issues include data validation steps, use of surrogate markers, natural language processing, and statistical techniques. A number of EHR issues can hamper the extraction of valid data for cross-health system comparative effectiveness studies. Our case example cautions against a blind reliance on EHR data as a single definitive data source. Nevertheless, EHR data are superior to administrative or claims data alone, and are cheaper and timelier than clinical trials or manual chart reviews. All 4 participating health systems are pursuing pathways to more effectively use EHR data for CER.A partnership between clinicians, researchers, and information technology specialists is encouraged as a way to capitalize on the wealth of information contained in the EHR. Future developments in both technology and care delivery hold promise for improvement in the ability to use EHR data for CER.

48 CFR 204.270 - Electronic Document Access.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Electronic Document Access..., DEPARTMENT OF DEFENSE GENERAL ADMINISTRATIVE MATTERS Contract Distribution 204.270 Electronic Document Access. Follow the procedures at PGI 204.270 relating to obtaining an account in the Electronic Document Access...

48 CFR 204.270 - Electronic Document Access.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Electronic Document Access..., DEPARTMENT OF DEFENSE GENERAL ADMINISTRATIVE MATTERS Contract Distribution 204.270 Electronic Document Access. Follow the procedures at PGI 204.270 relating to obtaining an account in the Electronic Document Access...

48 CFR 204.270 - Electronic Document Access.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false Electronic Document Access..., DEPARTMENT OF DEFENSE GENERAL ADMINISTRATIVE MATTERS Contract Distribution 204.270 Electronic Document Access. Follow the procedures at PGI 204.270 relating to obtaining an account in the Electronic Document Access...

48 CFR 204.270 - Electronic Document Access.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Electronic Document Access..., DEPARTMENT OF DEFENSE GENERAL ADMINISTRATIVE MATTERS Contract Distribution 204.270 Electronic Document Access. Follow the procedures at PGI 204.270 relating to obtaining an account in the Electronic Document Access...

48 CFR 204.270 - Electronic Document Access.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 3 2012-10-01 2012-10-01 false Electronic Document Access..., DEPARTMENT OF DEFENSE GENERAL ADMINISTRATIVE MATTERS Contract Distribution 204.270 Electronic Document Access. Follow the procedures at PGI 204.270 relating to obtaining an account in the Electronic Document Access...

The Effect of an Electronic SBAR Communication Tool on Documentation of Acute Events in the Pediatric Intensive Care Unit.

PubMed

Panesar, Rahul S; Albert, Ben; Messina, Catherine; Parker, Margaret

2016-01-01

The Situation, Background, Assessment, Recommendation (SBAR) handoff tool is designed to improve communication. The effects of integrating an electronic medical record (EMR) with a SBAR template are unclear. The research team hypothesizes that an electronic SBAR template improves documentation and communication between nurses and physicians. In all, 84 patient events were recorded from 542 admissions to the pediatric intensive care unit. Three time periods were studied: (a) paper documentation only, (b) electronic documentation, and (c) electronic documentation with an SBAR template. Documentation quality was assessed using a 4-point scoring system. The frequency of event notes increased progressively during the 3 study periods. Mean quality scores improved significantly from paper documentation to EMR free-text notes and to electronic SBAR-template notes, as did nurse and attending physician notification. The implementation of an electronic SBAR note is associated with more complete documentation and increased frequency of documentation of communication among nurses and physicians. © The Author(s) 2014.

Measuring Use of Evidence-Based Psychotherapy for PTSD in VA Residential Treatment Settings with Clinician Survey and Electronic Medical Record Templates.

PubMed

Shiner, Brian; Leonard Westgate, Christine; Simiola, Vanessa; Thompson, Richard; Schnurr, Paula P; Cook, Joan M

2018-03-14

Available studies on implementation of evidence-based psychotherapy (EBP) for patients attending Department of Veterans Affairs (VA) residential post-traumatic stress disorder (PTSD) programs rely on therapist self-report of EBP delivery. Patient-level data on receipt of EBP are needed both to corroborate therapist self-report and to understand patient factors that predict receipt of EBPs for PTSD. We identified 159 therapists from 38 VA residential PTSD programs who responded to a survey about EBP implementation during the 2015 fiscal year (FY15). Therapists self-reported their use of two EBPs, including prolonged exposure delivered in an individual format (PE-I) and cognitive processing therapy delivered in individual and group formats (CPT-I and CPT-G). Using electronic medical record (EMR) templates mandated for EBP documentation in FY15, we measured contemporaneous patient-level receipt of EBPs for PTSD. We assessed the degree of correlation between therapist self-reported EBP delivery and patient receipt of EBT as measured by EMR templates using polychoric correlation coefficients. We determined patient and therapist factors that predicted the receipt of EBPs with multivariable logistic regression, using random effects and robust standard error estimation, and controlling for site. The Veterans IRB of Northern New England provided a waiver of informed consent; as this was a retrospective review, no patients or therapists were contacted, and all data were stored, transmitted, and analyzed on secure VA servers. The VA Connecticut Health Care System Human Research Protection Program approved secondary use of therapist survey data for this project. When EMR template use became mandated in FY15, the proportion of patients in residential PTSD programs who received at least one EBP session that was recorded with an EMR template increased dramatically from 8.8% to 33.9%. There was adequate correlation and between survey-based and EMR-based measures of EBP receipt, with polychoric correlation values of 0.77 for PE-I, 0.69 for CPT-I, and 0.82 for CPT-G. Multiple patient factors were positive (e.g., female gender) and negative (e.g., depressive disorders) predictors of receipt of EBPs, even after controlling for site. Among therapist factors, only EBP consultant or trainer status was a positive predictor of EBP provision and only therapist race was a negative predictor of EBT provision after controlling for site. Following a FY15 mandate, EMR templates documenting EBP delivery were widely used by therapists working in VA residential PTSD programs. EBP receipt measured using EMR templates was consistent with therapist self-report of EBT delivery. There were several patient-level predictors of EBP receipt and therapist-level predictors of EBP delivery. However, therapists most likely to deliver EBPs were clustered at a limited number of sites.

NGNP Data Management and Analysis System Analysis and Web Delivery Capabilities

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

Cynthia D. Gentillon

2011-09-01

Projects for the Very High Temperature Reactor (VHTR) Technology Development Office provide data in support of Nuclear Regulatory Commission licensing of the very high temperature reactor. Fuel and materials to be used in the reactor are tested and characterized to quantify performance in high-temperature and high-fluence environments. The NGNP Data Management and Analysis System (NDMAS) at the Idaho National Laboratory has been established to ensure that VHTR data are (1) qualified for use, (2) stored in a readily accessible electronic form, and (3) analyzed to extract useful results. This document focuses on the third NDMAS objective. It describes capabilities formore » displaying the data in meaningful ways and for data analysis to identify useful relationships among the measured quantities. The capabilities are described from the perspective of NDMAS users, starting with those who just view experimental data and analytical results on the INL NDMAS web portal. Web display and delivery capabilities are described in detail. Also the current web pages that show Advanced Gas Reactor, Advanced Graphite Capsule, and High Temperature Materials test results are itemized. Capabilities available to NDMAS developers are more extensive, and are described using a second series of examples. Much of the data analysis efforts focus on understanding how thermocouple measurements relate to simulated temperatures and other experimental parameters. Statistical control charts and correlation monitoring provide an ongoing assessment of instrument accuracy. Data analysis capabilities are virtually unlimited for those who use the NDMAS web data download capabilities and the analysis software of their choice. Overall, the NDMAS provides convenient data analysis and web delivery capabilities for studying a very large and rapidly increasing database of well-documented, pedigreed data.« less

7 CFR 900.31 - Electronic submission of hearing documents.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 8 2013-01-01 2013-01-01 false Electronic submission of hearing documents. 900.31... and Marketing Orders § 900.31 Electronic submission of hearing documents. To the extent practicable..., USDA. All documents should reference the docket number of the proceeding. Instructions for electronic...

7 CFR 900.31 - Electronic submission of hearing documents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Electronic submission of hearing documents. 900.31... and Marketing Orders § 900.31 Electronic submission of hearing documents. To the extent practicable..., USDA. All documents should reference the docket number of the proceeding. Instructions for electronic...

Early childhood education: Status trends, and issues related to electronic delivery

NASA Technical Reports Server (NTRS)

Rothenberg, D.

1973-01-01

The status of, and trends and issues within, early childhood education which are related to the possibilities of electronic delivery of educational service are considered in a broader investigation of the role of large scale, satellite based educational telecommunications systems. Data are analyzed and trends and issues discussed to provide information useful to the system designer who wishes to identify and assess the opportunities for large scale electronic delivery in early childhood education.

Vocational technical and adult education: Status, trends and issues related to electronic delivery

NASA Technical Reports Server (NTRS)

Rothenberg, D.

1973-01-01

Data are analyzed, and trends and issues are discussed to provide information useful to the systems designer who wishes to identify and assess the opportunities for large scale electronic delivery in vocational/technical and adult education. Issues connected with vocational/technical education are investigated, with emphasis on those issues in the current spotlight which are relevant to the possibilities of electronic delivery. The current role of media is examined in vocational/technical instruction.

7 CFR 1488.8 - Documents required after delivery.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AGRICULTURAL COMMODITIES Financing of Export Sales of Agricultural Commodities From Private Stocks Under CCC... delivery. (a) CCC will purchase an exporter's account receivable only if the Treasurer, Commodity Credit... or Assistant Treasurer, CCC, after date of delivery of commodities exported or to be exported under...

7 CFR 1488.8 - Documents required after delivery.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AGRICULTURAL COMMODITIES Financing of Export Sales of Agricultural Commodities From Private Stocks Under CCC... delivery. (a) CCC will purchase an exporter's account receivable only if the Treasurer, Commodity Credit... or Assistant Treasurer, CCC, after date of delivery of commodities exported or to be exported under...

Vaping versus smoking: A quest for efficacy and safety of E-cigarette.

PubMed

Rehan, Harmeet Singh; Maini, Jahnavi; Hungin, A Ps

2018-02-26

Electronic cigarettes (ECIGs) are devices with a heating element which produces aerosol for inhalation. They have been propagated as a healthier alternative to tobacco smoking and a potential device for smoking cessation, despite non-documentation of their long-term adverse health effects. With the glorification of ECIG, its use has increased even among non-tobacco users. This makes it critical to understand and discuss a true picture about safety and utility of ECIGs by reviewing the literature. Literature search for narrative review was done on PubMed, Scopus and Web of Science databases using the keywords viz electronic cigarette, e-cigarette, electronic nicotine delivery systems, NRT, vaping and electronic nicotine delivery device. Review was sub-categorized into four themes (potential role in smoking cessation, chemicals in the smoke of traditional cigarette and ECIGs, pharmacology of nicotine delivery via ECIG and current regulatory status across the globe). Search revealed a total of 40 articles out of which 29 were included in the review. ECIGs achieved modest cessation rates with benefits of behavioural and sensory gratification. On the contrary, in many studies where ECIGs were introduced as an intervention, participants continued to use them to maintain their habit instead of quitting. A total of 22 toxic substances apart from nicotine were reported in liquid of ECIG cartridges and its emissions. Many compounds had lower concentrations in ECIG compared to tobacco smoke. There existed a wide variation in the content of ECIG cartridges and strengths of nicotine in refill solutions. It has been observed that the second generation ECIGs delivered nicotine with similar kinetic profile as conventional cigarettes. In 2013 US FDA gave market authorization to ECIG as substitutes for quitting smoking and cigarette substitutes. In 2014, the Royal College of Physicians, London, UK also advocated its use for smoking cessation. India along with many other countries still need to come up with a formal regulatory stand regarding ECIGs. There is a need to conduct large long term global clinical trials in real life settings to ascertain the potential uses, adverse effects of ECIG and achieve harmonization of nicotine solution concentration. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

10 CFR 2.302 - Filing of documents.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Officer Powers, and General Hearing Management for NRC Adjudicatory Hearings § 2.302 Filing of documents... electronic transmission when the filer performs the last act that it must perform to transmit a document, in... electronic documents. The exempt participant is permitted to file electronic documents by physically...

10 CFR 2.302 - Filing of documents.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Officer Powers, and General Hearing Management for NRC Adjudicatory Hearings § 2.302 Filing of documents... electronic transmission when the filer performs the last act that it must perform to transmit a document, in... electronic documents. The exempt participant is permitted to file electronic documents by physically...

The Apollo experiment for document delivery via satellite communication

NASA Astrophysics Data System (ADS)

1985-03-01

Dutch participation possibilities in the Apollo document delivery project, wishes and idea's of potential user and tender groups, and plans and activities of Dutch institutes and companies, are surveyed. The Apollo storage and transport system, demand and administration network, potential markets, and subject areas of the documents are investigated. Utilization areas (scientific, technical, administration, and business information) are listed. High tariffs and the lack of necessary provision make a direct participation strategy impossible. However, in the experimental phase, Dutch companies must be allowed to contribute in technical developments and availability of organizational and technical facilities must be stimulated.

Transforming to a computerized system for nursing care: organizational success within Magnet idealism.

PubMed

Lindgren, Carolyn L; Elie, Leslie G; Vidal, Elizabeth C; Vasserman, Alex

2010-01-01

In reaching the goal for standardized, quality care, a not-for-profit healthcare system consisting of seven institutional entities is transforming nursing practice guidelines, patient care workflow, and patient documents into electronic, online, real-time modalities for use across departments and all healthcare delivery entities of the system. Organizational structure and a strategic plan were developed for the 2-year Clinical Transformation Project. The Siemens Patient Care Document System was adopted and adapted to the hospitals' documentation and information needs. Two fast-track sessions of more than 100 nurses and representatives from other health disciplines were held to standardize assessments, histories, care protocols, and interdisciplinary plans of care for the top 10 diagnostic regulatory groups. Education needs of the users were addressed. After the first year, a productive, functional system is evidenced. For example, the bar-coded Medication Administration Check System is in full use on the clinical units of one of the hospitals, and the other institutional entities are at substantial stages of implementation of Patient Care Documentation System. The project requires significant allocation of personnel and financial resources for a highly functional informatics system that will transform clinical care. The project exemplifies four of the Magnet ideals and serves as a model for others who may be deciding about launching a similar endeavor.

Development and Evaluation of a Faculty Designed Courseware

ERIC Educational Resources Information Center

Sternberger, Carol

2006-01-01

Electronic delivery of courses presents an evolving process and one that necessitates a change in the architecture of learning designs. Moving beyond the adaptation of familiar methodology for electronic delivery is challenging and requires innovation. The inclusion of interactive courseware in an electronically delivered course addresses varied…

Electronic Documentation Support Tools and Text Duplication in the Electronic Medical Record

ERIC Educational Resources Information Center

Wrenn, Jesse

2010-01-01

In order to ease the burden of electronic note entry on physicians, electronic documentation support tools have been developed to assist in note authoring. There is little evidence of the effects of these tools on attributes of clinical documentation, including document quality. Furthermore, the resultant abundance of duplicated text and…

Feedback mechanisms including real-time electronic alerts to achieve near 100% timely prophylactic antibiotic administration in surgical cases.

PubMed

Nair, Bala G; Newman, Shu-Fang; Peterson, Gene N; Wu, Wei-Ying; Schwid, Howard A

2010-11-01

Administration of prophylactic antibiotics during surgery is generally performed by the anesthesia providers. Timely antibiotic administration within the optimal time window before incision is critical for prevention of surgical site infections. However, this often becomes a difficult task for the anesthesia team during the busy part of a case when the patient is being anesthetized. Starting with the implementation of an anesthesia information management system (AIMS), we designed and implemented several feedback mechanisms to improve compliance of proper antibiotic delivery and documentation. This included generating e-mail feedback of missed documentation, distributing monthly summary reports, and generating real-time electronic alerts with a decision support system. In 20,974 surgical cases for the period, June 2008 to January 2010, the interventions of AIMS install, e-mail feedback, summary reports, and real-time alerts changed antibiotic compliance by -1.5%, 2.3%, 4.9%, and 9.3%, respectively, when compared with the baseline value of 90.0% ± 2.9% when paper anesthesia records were used. Highest antibiotic compliance was achieved when using real-time alerts. With real-time alerts, monthly compliance was >99% for every month between June 2009 and January 2010. Installation of AIMS itself did not improve antibiotic compliance over that achieved with paper anesthesia records. However, real-time guidance and reminders through electronic messages generated by a computerized decision support system (Smart Anesthesia Messenger, or SAM) significantly improved compliance. With such a system a consistent compliance of >99% was achieved.

49 CFR 375.701 - May I provide for a release of liability on my delivery receipt?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false May I provide for a release of liability on my... REGULATIONS Delivery of Shipments § 375.701 May I provide for a release of liability on my delivery receipt? (a) Your delivery receipt or shipping document must not contain any language purporting to release or...

27 CFR 73.31 - May I submit forms electronically to TTB?

Code of Federal Regulations, 2014 CFR

2014-04-01

...; ELECTRONIC SUBMISSION OF FORMS Electronic Filing of Documents with TTB § 73.31 May I submit forms... above; (c) You submit the electronic form to an electronic document receiving system that we have... submit the form through an electronic document receiving system that TTB has designated for the receipt...

Improving access to skilled attendance at delivery: a policy brief for Uganda.

PubMed

Nabudere, Harriet; Asiimwe, Delius; Amandua, Jacinto

2013-04-01

This study describes the process of production, findings for a policy brief on Increasing Access to Skilled Birth Attendance, and subsequent use of the report by policy makers and others from the health sector in Uganda. The methods used to prepare the policy brief use the SUPPORT Tools for evidence-informed health policy making. The problem that this evidence brief addresses was identified through an explicit priority setting process involving policy makers and other stakeholders, further clarification with key informant interviews of relevant policy makers, and review of relevant documents. A working group of national stakeholder representatives and external reviewers commented on and contributed to successive drafts of the report. Research describing the problem, policy options, and implementation considerations was identified by reviewing government documents, routinely collected data, electronic literature searches, contact with key informants, and reviewing the reference lists of relevant documents that were retrieved. The proportion of pregnant women delivering from public and private non-profit facilities was low at 34 percent in 2008/09. The three policy options discussed in the report could be adopted independently or complementary to the other to increase access to skilled care. The Ministry of Health in deliberating to provide intrapartum care at first level health facilities from the second level of care, requested for research evidence to support these decisions. Maternal waiting shelters and working with the private-for-profit sector to facilitate deliveries in health facilities are promising complementary interventions that have been piloted in both the public and private health sector. A combination of strategies is needed to effectively implement the proposed options as discussed further in this article. The policy brief report was used as a background document for two stakeholder dialogue meetings involving members of parliament, policy makers, health managers, researchers, civil society, professional organizations, and the media.

From a Content Delivery Portal to a Knowledge Management System for Standardized Cancer Documentation.

PubMed

Schlue, Danijela; Mate, Sebastian; Haier, Jörg; Kadioglu, Dennis; Prokosch, Hans-Ulrich; Breil, Bernhard

2017-01-01

Heterogeneous tumor documentation and its challenges of interpretation of medical terms lead to problems in analyses of data from clinical and epidemiological cancer registries. The objective of this project was to design, implement and improve a national content delivery portal for oncological terms. Data elements of existing handbooks and documentation sources were analyzed, combined and summarized by medical experts of different comprehensive cancer centers. Informatics experts created a generic data model based on an existing metadata repository. In order to establish a national knowledge management system for standardized cancer documentation, a prototypical tumor wiki was designed and implemented. Requirements engineering techniques were applied to optimize this platform. It is targeted to user groups such as documentation officers, physicians and patients. The linkage to other information sources like PubMed and MeSH was realized.

7 CFR 735.402 - Providers of other electronic documents.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Providers of other electronic documents. 735.402... Electronic Providers § 735.402 Providers of other electronic documents. (a) To establish a USWA-authorized...) Records; (6) Conflict of interest requirements; (7) USDA common electronic information requirements; (8...

7 CFR 735.402 - Providers of other electronic documents.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 7 2012-01-01 2012-01-01 false Providers of other electronic documents. 735.402... Electronic Providers § 735.402 Providers of other electronic documents. (a) To establish a USWA-authorized...) Records; (6) Conflict of interest requirements; (7) USDA common electronic information requirements; (8...

Status of Statewide Career Information Delivery Systems.

ERIC Educational Resources Information Center

Dunn, Wynonia L.

Intended as a resource document as well as a status report on all the statewide career information delivery systems (CIDS) in operation, this report examines the status of 39 statewide information systems. (Career information delivery systems are computer-based systems that provide national, state, and local information to individuals who are in…

Legal considerations for document delivery services.

PubMed

Bunting, A

1994-04-01

Health sciences libraries that provide fee-based information services must consider and develop policies and procedures for complying with legal requirements. This paper reviews the provisions of copyright law that pertain to document delivery, including two court decisions concerning copyright. Also discussed are recent actions by publishers to reinforce their view of libraries' responsibilities for royalty fees for articles copied and their use of licenses to impose additional restrictions on the use of and reproduction of materials.

NASA STI Program Seminar: Electronic documents

NASA Technical Reports Server (NTRS)

1994-01-01

The theme of this NASA Scientific and Technical Information Program Seminar was electronic documents. Topics covered included Electronic Documents Management at the CASI, the Impact of Electronic Publishing on User Expectations and Searching Image Record Management, Secondary Publisher Considerations for Electronic Journal Literature, and the Technical Manual Publishing On Demand System (TMPODS).

Acquisition plan for Digital Document Storage (DDS) prototype system

NASA Technical Reports Server (NTRS)

1990-01-01

NASA Headquarters maintains a continuing interest in and commitment to exploring the use of new technology to support productivity improvements in meeting service requirements tasked to the NASA Scientific and Technical Information (STI) Facility, and to support cost effective approaches to the development and delivery of enhanced levels of service provided by the STI Facility. The DDS project has been pursued with this interest and commitment in mind. It is believed that DDS will provide improved archival blowback quality and service for ad hoc requests for paper copies of documents archived and serviced centrally at the STI Facility. It will also develop an operating capability to scan, digitize, store, and reproduce paper copies of 5000 NASA technical reports archived annually at the STI Facility and serviced to the user community. Additionally, it will provide NASA Headquarters and field installations with on-demand, remote, electronic retrieval of digitized, bilevel, bit mapped report images along with branched, nonsequential retrieval of report subparts.

Implementation of a web-based medication tracking system in a large academic medical center.

PubMed

Calabrese, Sam V; Williams, Jonathan P

2012-10-01

Pharmacy workflow efficiencies achieved through the use of an electronic medication-tracking system are described. Medication dispensing turnaround times at the inpatient pharmacy of a large hospital were evaluated before and after transition from manual medication tracking to a Web-based tracking process involving sequential bar-code scanning and real-time monitoring of medication status. The transition was carried out in three phases: (1) a workflow analysis, including the identification of optimal points for medication scanning with hand-held wireless devices, (2) the phased implementation of an automated solution and associated hardware at a central dispensing pharmacy and three satellite locations, and (3) postimplementation data collection to evaluate the impact of the new tracking system and areas for improvement. Relative to the manual tracking method, electronic medication tracking allowed the capture of far more data points, enabling the pharmacy team to delineate the time required for each step of the medication dispensing process and to identify the steps most likely to involve delays. A comparison of baseline and postimplementation data showed substantial reductions in overall medication turnaround times with the use of the Web-based tracking system (time reductions of 45% and 22% at the central and satellite sites, respectively). In addition to more accurate projections and documentation of turnaround times, the Web-based tracking system has facilitated quality-improvement initiatives. Implementation of an electronic tracking system for monitoring the delivery of medications provided a comprehensive mechanism for calculating turnaround times and allowed the pharmacy to identify bottlenecks within the medication distribution system. Altering processes removed these bottlenecks and decreased delivery turnaround times.

St. Louis Regional Library Network Manuals: Delivery System Manual, INFO-PASS Manual, Interlibrary Loan Protocol, Procedures and Policies Manual.

ERIC Educational Resources Information Center

Saint Louis Regional Library Network, MO.

Included in this set of manuals are: (1) guidelines for document delivery to member libraries within the St. Louis Regional Library Network (SLRLN) in which eligible materials are described, addressing and packing are outlined, routing and deliveries are discussed, and a list of delivery system participants is provided; (2) a descriptive guide to…

Fluorescent Microscope System to Monitor Real-Time Interactions between Focused Ultrasound, Echogenic Drug Delivery Vehicles, and Live Cell Membranes

PubMed Central

Ibsen, Stuart; Benchimol, Michael; Esener, Sadik

2012-01-01

Rapid development in the field of ultrasound triggered drug delivery has made it essential to study the real-time interaction between the membranes of live cells and the membranes of echogenic delivery vehicles under exposure to focused ultrasound. The objective of this work was to design an analysis system that combined fluorescent imagining, high speed videography, and definable pulse sequences of focused ultrasound to allow for real time observations of both cell and vehicle membranes. Documenting the behavior of the membranes themselves has not previously been possible due to limitations with existing optical systems used to understand the basic physics of microbubble/ultrasound interaction and the basic interaction between microbubbles and cells. The performance of this new system to monitor membrane behavior was demonstrated by documenting the modes of vehicle fragmentation at different ultrasound intensity levels. At 1.5 MPa the membranes were shown to completely fragment while at intensities below 1 MPa there is a popping and slow unfolding. The interaction between these vehicles and cell membranes was also documented by the removal of fluorescent particles from the surfaces of live cells out to 20 μm from the microbubble location. The fluid flow created by microstreaming around ensonated microbubbles was documented at video recording speeds from 60 to 18,000 frames per second. This information about membrane behavior allows the chemical and physical properties of the drug delivery vehicle to be designed along with the ultrasound pulse sequence to cause the most efficient drug delivery. PMID:22749476

Fluorescent microscope system to monitor real-time interactions between focused ultrasound, echogenic drug delivery vehicles, and live cell membranes.

PubMed

Ibsen, Stuart; Benchimol, Michael; Esener, Sadik

2013-01-01

Rapid development in the field of ultrasound triggered drug delivery has made it essential to study the real-time interaction between the membranes of live cells and the membranes of echogenic delivery vehicles under exposure to focused ultrasound. The objective of this work was to design an analysis system that combined fluorescent imagining, high speed videography, and definable pulse sequences of focused ultrasound to allow for real time observations of both cell and vehicle membranes. Documenting the behavior of the membranes themselves has not previously been possible due to limitations with existing optical systems used to understand the basic physics of microbubble/ultrasound interaction and the basic interaction between microbubbles and cells. The performance of this new system to monitor membrane behavior was demonstrated by documenting the modes of vehicle fragmentation at different ultrasound intensity levels. At 1.5MPa the membranes were shown to completely fragment while at intensities below 1MPa the membranes pop open and slowly unfold. The interaction between these vehicles and cell membranes was also documented by the removal of fluorescent particles from the surfaces of live cells out to 20μm from the microbubble location. The fluid flow created by microstreaming around ensonated microbubbles was documented at video recording speeds from 60 to 18,000 frames per second. This information about membrane behavior allows the chemical and physical properties of the drug delivery vehicle to be designed along with the ultrasound pulse sequence to cause the most efficient drug delivery. Copyright © 2012 Elsevier B.V. All rights reserved.

Integration of clinical research documentation in electronic health records.

PubMed

Broach, Debra

2015-04-01

Clinical trials of investigational drugs and devices are often conducted within healthcare facilities concurrently with clinical care. With implementation of electronic health records, new communication methods are required to notify nonresearch clinicians of research participation. This article reviews clinical research source documentation, the electronic health record and the medical record, areas in which the research record and electronic health record overlap, and implications for the research nurse coordinator in documentation of the care of the patient/subject. Incorporation of clinical research documentation in the electronic health record will lead to a more complete patient/subject medical record in compliance with both research and medical records regulations. A literature search provided little information about the inclusion of clinical research documentation within the electronic health record. Although regulations and guidelines define both source documentation and the medical record, integration of research documentation in the electronic health record is not clearly defined. At minimum, the signed informed consent(s), investigational drug or device usage, and research team contact information should be documented within the electronic health record. Institutional policies should define a standardized process for this integration in the absence federal guidance. Nurses coordinating clinical trials are in an ideal position to define this integration.

29 CFR 1921.17 - Service; copies of documents and pleadings.

Code of Federal Regulations, 2014 CFR

2014-07-01

... service. A certificate of the person serving the pleading or other document by personal delivery or by... 29 Labor 7 2014-07-01 2014-07-01 false Service; copies of documents and pleadings. 1921.17 Section... LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT Miscellaneous § 1921.17 Service; copies of documents and...

29 CFR 1921.17 - Service; copies of documents and pleadings.

Code of Federal Regulations, 2012 CFR

2012-07-01

... service. A certificate of the person serving the pleading or other document by personal delivery or by... 29 Labor 7 2012-07-01 2012-07-01 false Service; copies of documents and pleadings. 1921.17 Section... LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT Miscellaneous § 1921.17 Service; copies of documents and...

29 CFR 1921.17 - Service; copies of documents and pleadings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... service. A certificate of the person serving the pleading or other document by personal delivery or by... 29 Labor 7 2010-07-01 2010-07-01 false Service; copies of documents and pleadings. 1921.17 Section... LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT Miscellaneous § 1921.17 Service; copies of documents and...

29 CFR 1921.17 - Service; copies of documents and pleadings.

Code of Federal Regulations, 2011 CFR

2011-07-01

... service. A certificate of the person serving the pleading or other document by personal delivery or by... 29 Labor 7 2011-07-01 2011-07-01 false Service; copies of documents and pleadings. 1921.17 Section... LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT Miscellaneous § 1921.17 Service; copies of documents and...

29 CFR 1921.17 - Service; copies of documents and pleadings.

Code of Federal Regulations, 2013 CFR

2013-07-01

... service. A certificate of the person serving the pleading or other document by personal delivery or by... 29 Labor 7 2013-07-01 2013-07-01 false Service; copies of documents and pleadings. 1921.17 Section... LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT Miscellaneous § 1921.17 Service; copies of documents and...

12 CFR 1202.9 - How do I appeal a response denying my FOIA request?

Code of Federal Regulations, 2013 CFR

2013-01-01

... writing directly to the FOIA Appeals Officer through electronic mail, mail, delivery service, or facsimile. The electronic mail address is: [email protected] For mail or delivery service, the mailing address is... by marking electronic mail, letters, or facsimiles and the subject line, envelope, or facsimile cover...

12 CFR 1202.9 - How do I appeal a response denying my FOIA request?

Code of Federal Regulations, 2014 CFR

2014-01-01

... writing directly to the FOIA Appeals Officer through electronic mail, mail, delivery service, or facsimile. The electronic mail address is: [email protected] For mail or delivery service, the mailing address is... by marking electronic mail, letters, or facsimiles and the subject line, envelope, or facsimile cover...

Legal considerations for document delivery services.

PubMed Central

Bunting, A

1994-01-01

Health sciences libraries that provide fee-based information services must consider and develop policies and procedures for complying with legal requirements. This paper reviews the provisions of copyright law that pertain to document delivery, including two court decisions concerning copyright. Also discussed are recent actions by publishers to reinforce their view of libraries' responsibilities for royalty fees for articles copied and their use of licenses to impose additional restrictions on the use of and reproduction of materials. PMID:8004023

Improving the Quality of Electronic Documentation in Critical Care Nursing

ERIC Educational Resources Information Center

Stevens, Brent

2017-01-01

Electronic nursing documentation systems can facilitate complete, accurate, timely documentation practices, but without effective policies and procedures in place, a gap in practice exists and quality of care may be impacted. This systematic review of literature examined current evidence regarding electronic nursing documentation quality. General…

Frito-Lay Electric Delivery Truck Testing | Transportation Research | NREL

Science.gov Websites

Frito-Lay Electric Delivery Truck Evaluation Frito-Lay Electric Delivery Truck Evaluation Photo of . The on-road portion of this 12-month evaluation, launched in 2013, focuses on collecting and analyzing . Publications The following documents provide more information about the study. Field Evaluation of Medium-Duty

75 FR 63140 - National Oil and Hazardous Substances Pollution Contingency Plan; National Priorities List...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-14

..., Denver, Colorado 80202- 1129. Hand Delivery: 1595 Wynkoop Street, Denver, Colorado 80202-1129. Such deliveries are only accepted during the Docket's normal hours of operation, and special arrangements should be made for deliveries of boxed information. Docket: All documents in the docket are listed in the...

75 FR 10508 - Duke Energy Carolinas, LLC; Notice of Consideration of Issuance of Amendment to Facility...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-08

... delivery service to the Office of the Secretary, Sixteenth Floor, One White Flint North, 11555 Rockville..., or expedited delivery service upon depositing the document with the provider of the service. A... General Counsel, Washington, DC 20555-0001. The expedited delivery or courier mail address for both...

75 FR 10513 - Duke Energy Carolinas, LLC; Notice of Consideration of Issuance of Amendment to Facility...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-08

... delivery service to the Office of the Secretary, Sixteenth Floor, One White Flint North, 11555 Rockville..., or expedited delivery service upon depositing the document with the provider of the service. A... General Counsel, Washington, DC 20555-0001. The expedited delivery or courier mail address for both...

76 FR 39136 - Applications and Amendments to Facility Operating Licenses Involving Proposed No Significant...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

...) courier, express mail, or expedited delivery service to the Office of the Secretary, Sixteenth Floor, One... the mail, or by courier, express mail, or expedited delivery service upon depositing the document with..., Office of the General Counsel, Washington, DC 20555-0001. The expedited delivery or courier mail address...

Polymer-Enhanced Subsurface Delivery and Distribution of Permanganate

DTIC Science & Technology

2013-02-01

Subsurface Delivery and Distribution of Permanganate February 2013 Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for...SUBTITLE Polymer-Enhanced Subsurface Delivery and Distribution of Permanganate 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6...SAMPLING RESULTS ........................................................................................ 28 5.6.1 Permanganate Distribution and Sweep

Critical Infrastructure References: Documented Literature Search

DTIC Science & Technology

2012-10-01

the literature search document can be a resource for DRDC and external partners. Future plans: At present, the electronic copies of the reference...Personal Information Protection and Electronic Documents Act (S.C. 2000, c. 5) Title: Personal Information Protection and Electronic Documents Act (S.C...2011 Overview: • "An Act to support and promote electronic commerce by protecting personal information that is collected, used or disclosed in

29 CFR 2520.104b-1 - Disclosure.

Code of Federal Regulations, 2011 CFR

2011-07-01

... documents furnished in electronic form at any location where the participant is reasonably expected to... or non-electronic form, to receiving documents through electronic media and has not withdrawn such consent; (B) In the case of documents to be furnished through the Internet or other electronic...

29 CFR 2520.104b-1 - Disclosure.

Code of Federal Regulations, 2014 CFR

2014-07-01

... documents furnished in electronic form at any location where the participant is reasonably expected to... or non-electronic form, to receiving documents through electronic media and has not withdrawn such consent; (B) In the case of documents to be furnished through the Internet or other electronic...

29 CFR 2520.104b-1 - Disclosure.

Code of Federal Regulations, 2012 CFR

2012-07-01

... documents furnished in electronic form at any location where the participant is reasonably expected to... or non-electronic form, to receiving documents through electronic media and has not withdrawn such consent; (B) In the case of documents to be furnished through the Internet or other electronic...

29 CFR 2520.104b-1 - Disclosure.

Code of Federal Regulations, 2013 CFR

2013-07-01

... documents furnished in electronic form at any location where the participant is reasonably expected to... or non-electronic form, to receiving documents through electronic media and has not withdrawn such consent; (B) In the case of documents to be furnished through the Internet or other electronic...

Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction

PubMed Central

Gilliam, Meredith; Krein, Sarah L; Belanger, Karen; Fowler, Karen E; Dimcheff, Derek E; Solomon, Gabriel

2017-01-01

Background: Incomplete or delayed access to discharge information by outpatient providers and patients contributes to discontinuity of care and poor outcomes. Objective: To evaluate the effect of a new electronic discharge summary tool on the timeliness of documentation and communication with outpatient providers. Methods: In June 2012, we implemented an electronic discharge summary tool at our 145-bed university-affiliated Veterans Affairs hospital. The tool facilitates completion of a comprehensive discharge summary note that is available for patients and outpatient medical providers at the time of hospital discharge. Discharge summary note availability, outpatient provider satisfaction, and time between the decision to discharge a patient and discharge note completion were all evaluated before and after implementation of the tool. Results: The percentage of discharge summary notes completed by the time of first post-discharge clinical contact improved from 43% in February 2012 to 100% in September 2012 and was maintained at 100% in 2014. A survey of 22 outpatient providers showed that 90% preferred the new summary and 86% found it comprehensive. Despite increasing required documentation, the time required to discharge a patient, from physician decision to discharge note completion, improved from 5.6 h in 2010 to 4.1 h in 2012 (p = 0.04), and to 2.8 h in 2015 (p < 0.001). Conclusion: The implementation of a novel discharge summary tool improved the timeliness and comprehensiveness of discharge information as needed for the delivery of appropriate, high-quality follow-up care, without adversely affecting the efficiency of the discharge process. PMID:28491308

Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction.

PubMed

Gilliam, Meredith; Krein, Sarah L; Belanger, Karen; Fowler, Karen E; Dimcheff, Derek E; Solomon, Gabriel

2017-01-01

Incomplete or delayed access to discharge information by outpatient providers and patients contributes to discontinuity of care and poor outcomes. To evaluate the effect of a new electronic discharge summary tool on the timeliness of documentation and communication with outpatient providers. In June 2012, we implemented an electronic discharge summary tool at our 145-bed university-affiliated Veterans Affairs hospital. The tool facilitates completion of a comprehensive discharge summary note that is available for patients and outpatient medical providers at the time of hospital discharge. Discharge summary note availability, outpatient provider satisfaction, and time between the decision to discharge a patient and discharge note completion were all evaluated before and after implementation of the tool. The percentage of discharge summary notes completed by the time of first post-discharge clinical contact improved from 43% in February 2012 to 100% in September 2012 and was maintained at 100% in 2014. A survey of 22 outpatient providers showed that 90% preferred the new summary and 86% found it comprehensive. Despite increasing required documentation, the time required to discharge a patient, from physician decision to discharge note completion, improved from 5.6 h in 2010 to 4.1 h in 2012 (p = 0.04), and to 2.8 h in 2015 (p < 0.001). The implementation of a novel discharge summary tool improved the timeliness and comprehensiveness of discharge information as needed for the delivery of appropriate, high-quality follow-up care, without adversely affecting the efficiency of the discharge process.

Accidental fetal lacerations during cesarean delivery: experience in an Italian level III university hospital.

PubMed

Dessole, Salvatore; Cosmi, Erich; Balata, Antonio; Uras, Luisa; Caserta, Donatella; Capobianco, Giampiero; Ambrosini, Guido

2004-11-01

The purpose of this study was to investigate the incidence, type, location, and risk factors of accidental fetal lacerations during cesarean delivery. Total deliveries, cesarean deliveries, and neonatal records for documented accidental fetal lacerations were reviewed retrospectively in our level III university hospital. The gestational age, the presenting part of the fetus, the cesarean delivery indication, the type of incision, and the surgeon who performed the procedure were recorded. Cesarean deliveries were divided into scheduled, unscheduled, and emergency procedures. Fetal lacerations were divided into mild, moderate, and severe. Neonatal follow-up examinations regarding laceration sequelae were available for 6 months. Of 14926 deliveries, 3108 women were delivered by cesarean birth (20.82%). Neonatal records documented 97 accidental fetal lacerations. Of these accidental lacerations, 94 were mild; 2 were moderate, and 1 was severe. The overall rate of accidental fetal laceration per cesarean delivery was 3.12%; the accidental laceration rate in the cohort of fetuses was 2.46%. The crude odds ratios were 0.34 for scheduled procedures, 0.57 for unscheduled procedures, and 1.7 for emergency procedures. The risk for fetal accidental lacerations was higher in fetuses who underwent emergency cesarean birth and lower for unscheduled and scheduled cesarean births (P < .001). Fetal accidental laceration may occur during cesarean delivery; the incidence is significantly higher during emergency cesarean delivery compared with elective procedures. The patient should be counseled about the occurrence of fetal laceration during cesarean delivery to avoid litigation.

The effect of electronic health record software design on resident documentation and compliance with evidence-based medicine.

PubMed

Rodriguez Torres, Yasaira; Huang, Jordan; Mihlstin, Melanie; Juzych, Mark S; Kromrei, Heidi; Hwang, Frank S

2017-01-01

This study aimed to determine the role of electronic health record software in resident education by evaluating documentation of 30 elements extracted from the American Academy of Ophthalmology Dry Eye Syndrome Preferred Practice Pattern. The Kresge Eye Institute transitioned to using electronic health record software in June 2013. We evaluated the charts of 331 patients examined in the resident ophthalmology clinic between September 1, 2011, and March 31, 2014, for an initial evaluation for dry eye syndrome. We compared documentation rates for the 30 evidence-based elements between electronic health record chart note templates among the ophthalmology residents. Overall, significant changes in documentation occurred when transitioning to a new version of the electronic health record software with average compliance ranging from 67.4% to 73.6% (p < 0.0005). Electronic Health Record A had high compliance (>90%) in 13 elements while Electronic Health Record B had high compliance (>90%) in 11 elements. The presence of dialog boxes was responsible for significant changes in documentation of adnexa, puncta, proptosis, skin examination, contact lens wear, and smoking exposure. Significant differences in documentation were correlated with electronic health record template design rather than individual resident or residents' year in training. Our results show that electronic health record template design influences documentation across all resident years. Decreased documentation likely results from "mouse click fatigue" as residents had to access multiple dialog boxes to complete documentation. These findings highlight the importance of EHR template design to improve resident documentation and integration of evidence-based medicine into their clinical notes.

IDC System Specification Document.

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

Clifford, David J.

2014-12-01

This document contains the system specifications derived to satisfy the system requirements found in the IDC System Requirements Document for the IDC Reengineering Phase 2 project. Revisions Version Date Author/Team Revision Description Authorized by V1.0 12/2014 IDC Reengineering Project Team Initial delivery M. Harris

7 CFR 900.41 - Electronic document submission standards.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 8 2012-01-01 2012-01-01 false Electronic document submission standards. 900.41... Agreements and Marketing Orders § 900.41 Electronic document submission standards. To the extent practicable.... Instructions for electronic filing shall be provided at the amendatory formal rulemaking hearing and in each...

7 CFR 900.41 - Electronic document submission standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Electronic document submission standards. 900.41... Agreements and Marketing Orders § 900.41 Electronic document submission standards. To the extent practicable.... Instructions for electronic filing shall be provided at the amendatory formal rulemaking hearing and in each...

7 CFR 900.41 - Electronic document submission standards.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 8 2014-01-01 2014-01-01 false Electronic document submission standards. 900.41... Agreements and Marketing Orders § 900.41 Electronic document submission standards. To the extent practicable.... Instructions for electronic filing shall be provided at the amendatory formal rulemaking hearing and in each...

7 CFR 900.41 - Electronic document submission standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Electronic document submission standards. 900.41... Agreements and Marketing Orders § 900.41 Electronic document submission standards. To the extent practicable.... Instructions for electronic filing shall be provided at the amendatory formal rulemaking hearing and in each...

7 CFR 900.41 - Electronic document submission standards.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 8 2013-01-01 2013-01-01 false Electronic document submission standards. 900.41... Agreements and Marketing Orders § 900.41 Electronic document submission standards. To the extent practicable.... Instructions for electronic filing shall be provided at the amendatory formal rulemaking hearing and in each...

Perspective: “The Financial Impact of Alternative Water Project Delivery Models” in the Water Sector

EPA Pesticide Factsheets

The Water Finance Center developed this companion perspective document to a UNC EFC report on Alternative Water Project Delivery Models to broaden understanding of this alternative procurement method.

Syringe injectable electronics

PubMed Central

Hong, Guosong; Zhou, Tao; Jin, Lihua; Duvvuri, Madhavi; Jiang, Zhe; Kruskal, Peter; Xie, Chong; Suo, Zhigang; Fang, Ying; Lieber, Charles M.

2015-01-01

Seamless and minimally-invasive three-dimensional (3D) interpenetration of electronics within artificial or natural structures could allow for continuous monitoring and manipulation of their properties. Flexible electronics provide a means for conforming electronics to non-planar surfaces, yet targeted delivery of flexible electronics to internal regions remains difficult. Here, we overcome this challenge by demonstrating syringe injection and subsequent unfolding of submicrometer-thick, centimeter-scale macroporous mesh electronics through needles with a diameter as small as 100 micrometers. Our results show that electronic components can be injected into man-made and biological cavities, as well as dense gels and tissue, with > 90% device yield. We demonstrate several applications of syringe injectable electronics as a general approach for interpenetrating flexible electronics with 3D structures, including (i) monitoring of internal mechanical strains in polymer cavities, (ii) tight integration and low chronic immunoreactivity with several distinct regions of the brain, and (iii) in vivo multiplexed neural recording. Moreover, syringe injection enables delivery of flexible electronics through a rigid shell, delivery of large volume flexible electronics that can fill internal cavities and co-injection of electronics with other materials into host structures, opening up unique applications for flexible electronics. PMID:26053995

Syringe-injectable electronics.

PubMed

Liu, Jia; Fu, Tian-Ming; Cheng, Zengguang; Hong, Guosong; Zhou, Tao; Jin, Lihua; Duvvuri, Madhavi; Jiang, Zhe; Kruskal, Peter; Xie, Chong; Suo, Zhigang; Fang, Ying; Lieber, Charles M

2015-07-01

Seamless and minimally invasive three-dimensional interpenetration of electronics within artificial or natural structures could allow for continuous monitoring and manipulation of their properties. Flexible electronics provide a means for conforming electronics to non-planar surfaces, yet targeted delivery of flexible electronics to internal regions remains difficult. Here, we overcome this challenge by demonstrating the syringe injection (and subsequent unfolding) of sub-micrometre-thick, centimetre-scale macroporous mesh electronics through needles with a diameter as small as 100 μm. Our results show that electronic components can be injected into man-made and biological cavities, as well as dense gels and tissue, with >90% device yield. We demonstrate several applications of syringe-injectable electronics as a general approach for interpenetrating flexible electronics with three-dimensional structures, including (1) monitoring internal mechanical strains in polymer cavities, (2) tight integration and low chronic immunoreactivity with several distinct regions of the brain, and (3) in vivo multiplexed neural recording. Moreover, syringe injection enables the delivery of flexible electronics through a rigid shell, the delivery of large-volume flexible electronics that can fill internal cavities, and co-injection of electronics with other materials into host structures, opening up unique applications for flexible electronics.

Syringe-injectable electronics

NASA Astrophysics Data System (ADS)

Liu, Jia; Fu, Tian-Ming; Cheng, Zengguang; Hong, Guosong; Zhou, Tao; Jin, Lihua; Duvvuri, Madhavi; Jiang, Zhe; Kruskal, Peter; Xie, Chong; Suo, Zhigang; Fang, Ying; Lieber, Charles M.

2015-07-01

Seamless and minimally invasive three-dimensional interpenetration of electronics within artificial or natural structures could allow for continuous monitoring and manipulation of their properties. Flexible electronics provide a means for conforming electronics to non-planar surfaces, yet targeted delivery of flexible electronics to internal regions remains difficult. Here, we overcome this challenge by demonstrating the syringe injection (and subsequent unfolding) of sub-micrometre-thick, centimetre-scale macroporous mesh electronics through needles with a diameter as small as 100 μm. Our results show that electronic components can be injected into man-made and biological cavities, as well as dense gels and tissue, with >90% device yield. We demonstrate several applications of syringe-injectable electronics as a general approach for interpenetrating flexible electronics with three-dimensional structures, including (1) monitoring internal mechanical strains in polymer cavities, (2) tight integration and low chronic immunoreactivity with several distinct regions of the brain, and (3) in vivo multiplexed neural recording. Moreover, syringe injection enables the delivery of flexible electronics through a rigid shell, the delivery of large-volume flexible electronics that can fill internal cavities, and co-injection of electronics with other materials into host structures, opening up unique applications for flexible electronics.

Architecture of a consent management suite and integration into IHE-based Regional Health Information Networks.

PubMed

Heinze, Oliver; Birkle, Markus; Köster, Lennart; Bergh, Björn

2011-10-04

The University Hospital Heidelberg is implementing a Regional Health Information Network (RHIN) in the Rhine-Neckar-Region in order to establish a shared-care environment, which is based on established Health IT standards and in particular Integrating the Healthcare Enterprise (IHE). Similar to all other Electronic Health Record (EHR) and Personal Health Record (PHR) approaches the chosen Personal Electronic Health Record (PEHR) architecture relies on the patient's consent in order to share documents and medical data with other care delivery organizations, with the additional requirement that the German legislation explicitly demands a patients' opt-in and does not allow opt-out solutions. This creates two issues: firstly the current IHE consent profile does not address this approach properly and secondly none of the employed intra- and inter-institutional information systems, like almost all systems on the market, offers consent management solutions at all. Hence, the objective of our work is to develop and introduce an extensible architecture for creating, managing and querying patient consents in an IHE-based environment. Based on the features offered by the IHE profile Basic Patient Privacy Consent (BPPC) and literature, the functionalities and components to meet the requirements of a centralized opt-in consent management solution compliant with German legislation have been analyzed. Two services have been developed and integrated into the Heidelberg PEHR. The standard-based Consent Management Suite consists of two services. The Consent Management Service is able to receive and store consent documents. It can receive queries concerning a dedicated patient consent, process it and return an answer. It represents a centralized policy enforcement point. The Consent Creator Service allows patients to create their consents electronically. Interfaces to a Master Patient Index (MPI) and a provider index allow to dynamically generate XACML-based policies which are stored in a CDA document to be transferred to the first service. Three workflows have to be considered to integrate the suite into the PEHR: recording the consent, publishing documents and viewing documents. Our approach solves the consent issue when using IHE profiles for regional health information networks. It is highly interoperable due to the use of international standards and can hence be used in any other region to leverage consent issues and substantially promote the use of IHE for regional health information networks in general.

Architecture of a consent management suite and integration into IHE-based regional health information networks

PubMed Central

2011-01-01

Background The University Hospital Heidelberg is implementing a Regional Health Information Network (RHIN) in the Rhine-Neckar-Region in order to establish a shared-care environment, which is based on established Health IT standards and in particular Integrating the Healthcare Enterprise (IHE). Similar to all other Electronic Health Record (EHR) and Personal Health Record (PHR) approaches the chosen Personal Electronic Health Record (PEHR) architecture relies on the patient's consent in order to share documents and medical data with other care delivery organizations, with the additional requirement that the German legislation explicitly demands a patients' opt-in and does not allow opt-out solutions. This creates two issues: firstly the current IHE consent profile does not address this approach properly and secondly none of the employed intra- and inter-institutional information systems, like almost all systems on the market, offers consent management solutions at all. Hence, the objective of our work is to develop and introduce an extensible architecture for creating, managing and querying patient consents in an IHE-based environment. Methods Based on the features offered by the IHE profile Basic Patient Privacy Consent (BPPC) and literature, the functionalities and components to meet the requirements of a centralized opt-in consent management solution compliant with German legislation have been analyzed. Two services have been developed and integrated into the Heidelberg PEHR. Results The standard-based Consent Management Suite consists of two services. The Consent Management Service is able to receive and store consent documents. It can receive queries concerning a dedicated patient consent, process it and return an answer. It represents a centralized policy enforcement point. The Consent Creator Service allows patients to create their consents electronically. Interfaces to a Master Patient Index (MPI) and a provider index allow to dynamically generate XACML-based policies which are stored in a CDA document to be transferred to the first service. Three workflows have to be considered to integrate the suite into the PEHR: recording the consent, publishing documents and viewing documents. Conclusions Our approach solves the consent issue when using IHE profiles for regional health information networks. It is highly interoperable due to the use of international standards and can hence be used in any other region to leverage consent issues and substantially promote the use of IHE for regional health information networks in general. PMID:21970788

25 CFR 559.7 - May a tribe submit documents required by this part electronically?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 2 2013-04-01 2013-04-01 false May a tribe submit documents required by this part... NOTIFICATIONS AND SUBMISSIONS § 559.7 May a tribe submit documents required by this part electronically? Yes. Tribes wishing to submit documents electronically should contact the Commission for guidance on...

25 CFR 559.7 - May a tribe submit documents required by this part electronically?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 2 2014-04-01 2014-04-01 false May a tribe submit documents required by this part... NOTIFICATIONS AND SUBMISSIONS § 559.7 May a tribe submit documents required by this part electronically? Yes. Tribes wishing to submit documents electronically should contact the Commission for guidance on...

17 CFR 232.401 - XBRL-Related Document submissions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Xbrl-Related Documents § 232.401 XBRL-Related Document submissions. (a) Only an electronic filer that is an investment company registered under... XBRL-Related Documents relate; or, if the electronic filer is eligible to file a Form 8-K (§ 249.308 of...

17 CFR 232.401 - XBRL-Related Document submissions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Xbrl-Related Documents § 232.401 XBRL-Related Document submissions. (a) Only an electronic filer that is an investment company registered under... XBRL-Related Documents relate; or, if the electronic filer is eligible to file a Form 8-K (§ 249.308 of...

17 CFR 232.401 - XBRL-Related Document submissions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Xbrl-Related Documents § 232.401 XBRL-Related Document submissions. (a) Only an electronic filer that is an investment company registered under... XBRL-Related Documents relate; or, if the electronic filer is eligible to file a Form 8-K (§ 249.308 of...

17 CFR 232.401 - XBRL-Related Document submissions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Xbrl-Related Documents § 232.401 XBRL-Related Document submissions. (a) Only an electronic filer that is an investment company registered under... XBRL-Related Documents relate; or, if the electronic filer is eligible to file a Form 8-K (§ 249.308 of...

17 CFR 232.401 - XBRL-Related Document submissions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Xbrl-Related Documents § 232.401 XBRL-Related Document submissions. (a) Only an electronic filer that is an investment company registered under... XBRL-Related Documents relate; or, if the electronic filer is eligible to file a Form 8-K (§ 249.308 of...

The changes in caregivers' perceptions about the quality of information and benefits of nursing documentation associated with the introduction of an electronic documentation system in a nursing home.

PubMed

Munyisia, Esther N; Yu, Ping; Hailey, David

2011-02-01

To date few studies have compared nursing home caregivers' perceptions about the quality of information and benefits of nursing documentation in paper and electronic formats. With the increased interest in the use of information technology in nursing homes, it is important to obtain information on the benefits of newer approaches to nursing documentation so as to inform investment, organisational and care service decisions in the aged care sector. This study aims to investigate caregivers' perceptions about the quality of information and benefits of nursing documentation before and after the introduction of an electronic documentation system in a nursing home. A self-administered questionnaire survey was conducted three months before, and then six, 18 and 31 months after the introduction of an electronic documentation system. Further evidence was obtained through informal discussions with caregivers. Scores for questionnaire responses showed that the benefits of the electronic documentation system were perceived by the caregivers as provision of more accurate, legible and complete information, and reduction of repetition in data entry, with consequential managerial benefits. However, caregivers' perceptions of relevance and reliability of information, and of their communication and decision-making abilities were perceived to be similar either using an electronic or a paper-based documentation system. Improvement in some perceptions about the quality of information and benefits of nursing documentation was evident in the measurement conducted six months after the introduction of the electronic system, but were not maintained 18 or 31 months later. The electronic documentation system was perceived to perform better than the paper-based system in some aspects, with subsequent benefits to management of aged care services. In other areas, perceptions of additional benefits from the electronic documentation system were not maintained. In a number of attributes, there were similar perceptions on the two types of systems. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Information Delivery Options over Three Decades.

ERIC Educational Resources Information Center

Kennedy, H. E.

1986-01-01

Reviews the development of technological innovations in information delivery, including microforms, electronic processing, online distribution, full-text abstracts online, floppy disks, downloading, vertical integration, electronic publishing, and optical disks. The impact of technology on the information industry and the need to use technology…

Fetal laceration injury at cesarean delivery.

PubMed

Smith, J F; Hernandez, C; Wax, J R

1997-09-01

To investigate the incidence of fetal laceration injury in cesarean delivery. A retrospective review was conducted using a computer-based data coding system. All neonatal records were reviewed for infants delivered by cesarean during a 2-year period. Maternal records were reviewed in those cases of documented fetal laceration injury. The Fisher exact test was used when indicated. There were 904 cesarean deliveries performed during the study period; of these, 896 neonatal records (98.4%) were available for review. Seventeen laceration injuries were recorded (1.9%). The incidence of laceration appeared higher when the indication for cesarean was nonvertex (6.0% versus 1.4%, P = .02). One of 17 (5.9%) maternal records indicated the presence of the laceration of the fetus. Fetal laceration injury at cesarean delivery is not rare, especially when it is performed for nonvertex presentation. The minority of obstetric records show documentation of such lacerations, suggesting that this complication often may not be recognized by obstetricians.

Electronic News Delivery Needs Only FCC Encouragement for Invasion of U.S.A.

ERIC Educational Resources Information Center

Edwards, Kenneth

The electronic newspaper, using a television screen and a small keying mechanism to call for specific pages of interest, currently exists in England and may soon be common in the United States. Three systems of electronic information delivery (teletext) now operate in England: CEEFAX, ORACLE, and VIEWDATA. The first two make use of two television…

Impact of electronic health record clinical decision support on the management of pediatric obesity.

PubMed

Shaikh, Ulfat; Berrong, Jeanette; Nettiksimmons, Jasmine; Byrd, Robert S

2015-01-01

Clinicians vary significantly in their adherence to clinical guidelines for overweight/obesity. This study assessed the impact of electronic health record-based clinical decision support in improving the diagnosis and management of pediatric obesity. The study team programmed a point-of-care alert linked to a checklist and standardized documentation templates to appear during health maintenance visits for overweight/obese children in an outpatient teaching clinic and compared outcomes through medical record reviews of 574 (287 control and 287 intervention) visits. The results demonstrated a statistically significant increase in the diagnosis of overweight/obesity, scheduling of follow-up appointments, frequency of ordering recommended laboratory investigations, and assessment and counseling for nutrition and physical activity. Although clinical guideline adherence increased significantly, it was far from universal. It is unknown if modest improvements in adherence to clinical guidelines translate to improvements in children's health. However, this intervention was relatively easy to implement and produced measurable improvements in health care delivery. © 2014 by the American College of Medical Quality.

Testing Orr's document delivery test on biomedical journals in South Africa.

PubMed Central

Steynberg, S; Rossouw, S F

1995-01-01

This paper describes the use of a document delivery test (DDT) to measure the availability of biomedical research journals in South African health sciences libraries. The methodology employed was developed twenty years ago by a team of researchers from the Institute for the Advancement of Medical Communication under the direction of R. H. Orr. The testing of the methodology was in itself an objective of the present research. A citation pool consisting of 307 items was constructed from references to journal articles in papers published in 1989 by South African biomedical researchers. The availability of each article was determined at each of seven medical library sites; the performance was measured and presented as an arithmetical value or document delivery capability index (CI). The results of the tests show a high level of availability, ranging from CI = 81.68 to CI = 92.97 for the journals sampled. The DDT methodology was found to be practical, applicable to such studies, and flexible. Its use is recommended for similar studies. Images PMID:7703944

RFID Tag Helix Antenna Sensors for Wireless Drug Dosage Monitoring

PubMed Central

Huang, Haiyu; Zhao, Peisen; Chen, Pai-Yen; Ren, Yong; Liu, Xuewu; Ferrari, Mauro; Hu, Ye; Akinwande, Deji

2014-01-01

Miniaturized helix antennas are integrated with drug reservoirs to function as RFID wireless tag sensors for real-time drug dosage monitoring. The general design procedure of this type of biomedical antenna sensors is proposed based on electromagnetic theory and finite element simulation. A cost effective fabrication process is utilized to encapsulate the antenna sensor within a biocompatible package layer using PDMS material, and at the same time form a drug storage or drug delivery unit inside the sensor. The in vitro experiment on two prototypes of antenna sensor-drug reservoir assembly have shown the ability to monitor the drug dosage by tracking antenna resonant frequency shift from 2.4–2.5-GHz ISM band with realized sensitivity of 1.27 \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$\\mu~{\\rm l}/{\\rm MHz}$\\end{document} for transdermal drug delivery monitoring and 2.76-\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$\\mu~{\\rm l}/{\\rm MHz}$\\end{document} sensitivity for implanted drug delivery monitoring. PMID:27170865

Recommendations for bridge and tunnel security

DOT National Transportation Integrated Search

2000-02-01

This guide identifies worldwide document delivery suppliers who provide, upon request and usually a service fee, copies of research reports, journal articles, conference proceedings, standards and regulations, gray papers, and other types of document...

Radiation-Tolerant DC-DC Converters

NASA Technical Reports Server (NTRS)

Skutt, Glenn; Sable, Dan; Leslie, Leonard; Graham, Shawn

2012-01-01

A document discusses power converters suitable for space use that meet the DSCC MIL-PRF-38534 Appendix G radiation hardness level P classification. A method for qualifying commercially produced electronic parts for DC-DC converters per the Defense Supply Center Columbus (DSCC) radiation hardened assurance requirements was developed. Development and compliance testing of standard hybrid converters suitable for space use were completed for missions with total dose radiation requirements of up to 30 kRad. This innovation provides the same overall performance as standard hybrid converters, but includes assurance of radiation- tolerant design through components and design compliance testing. This availability of design-certified radiation-tolerant converters can significantly reduce total cost and delivery time for power converters for space applications that fit the appropriate DSCC classification (30 kRad).

25 CFR 2.12 - Service of appeal documents.

Code of Federal Regulations, 2011 CFR

2011-04-01

... personal delivery or by mail to the record address as specified in § 2.14. Service on a tribe shall be to... 25 Indians 1 2011-04-01 2011-04-01 false Service of appeal documents. 2.12 Section 2.12 Indians... ACTIONS § 2.12 Service of appeal documents. (a) Persons filing documents in an appeal must serve copies of...

25 CFR 2.12 - Service of appeal documents.

Code of Federal Regulations, 2014 CFR

2014-04-01

... personal delivery or by mail to the record address as specified in § 2.14. Service on a tribe shall be to... 25 Indians 1 2014-04-01 2014-04-01 false Service of appeal documents. 2.12 Section 2.12 Indians... ACTIONS § 2.12 Service of appeal documents. (a) Persons filing documents in an appeal must serve copies of...

25 CFR 2.12 - Service of appeal documents.

Code of Federal Regulations, 2013 CFR

2013-04-01

... personal delivery or by mail to the record address as specified in § 2.14. Service on a tribe shall be to... 25 Indians 1 2013-04-01 2013-04-01 false Service of appeal documents. 2.12 Section 2.12 Indians... ACTIONS § 2.12 Service of appeal documents. (a) Persons filing documents in an appeal must serve copies of...

25 CFR 2.12 - Service of appeal documents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... personal delivery or by mail to the record address as specified in § 2.14. Service on a tribe shall be to... 25 Indians 1 2010-04-01 2010-04-01 false Service of appeal documents. 2.12 Section 2.12 Indians... ACTIONS § 2.12 Service of appeal documents. (a) Persons filing documents in an appeal must serve copies of...

25 CFR 2.12 - Service of appeal documents.

Code of Federal Regulations, 2012 CFR

2012-04-01

... personal delivery or by mail to the record address as specified in § 2.14. Service on a tribe shall be to... 25 Indians 1 2012-04-01 2011-04-01 true Service of appeal documents. 2.12 Section 2.12 Indians... ACTIONS § 2.12 Service of appeal documents. (a) Persons filing documents in an appeal must serve copies of...

Methods, media, and systems for detecting attack on a digital processing device

DOEpatents

Stolfo, Salvatore J.; Li, Wei-Jen; Keromylis, Angelos D.; Androulaki, Elli

2014-07-22

Methods, media, and systems for detecting attack are provided. In some embodiments, the methods include: comparing at least part of a document to a static detection model; determining whether attacking code is included in the document based on the comparison of the document to the static detection model; executing at least part of the document; determining whether attacking code is included in the document based on the execution of the at least part of the document; and if attacking code is determined to be included in the document based on at least one of the comparison of the document to the static detection model and the execution of the at least part of the document, reporting the presence of an attack. In some embodiments, the methods include: selecting a data segment in at least one portion of an electronic document; determining whether the arbitrarily selected data segment can be altered without causing the electronic document to result in an error when processed by a corresponding program; in response to determining that the arbitrarily selected data segment can be altered, arbitrarily altering the data segment in the at least one portion of the electronic document to produce an altered electronic document; and determining whether the corresponding program produces an error state when the altered electronic document is processed by the corresponding program.

Methods, media, and systems for detecting attack on a digital processing device

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

Stolfo, Salvatore J.; Li, Wei-Jen; Keromytis, Angelos D.

Methods, media, and systems for detecting attack are provided. In some embodiments, the methods include: comparing at least part of a document to a static detection model; determining whether attacking code is included in the document based on the comparison of the document to the static detection model; executing at least part of the document; determining whether attacking code is included in the document based on the execution of the at least part of the document; and if attacking code is determined to be included in the document based on at least one of the comparison of the document tomore » the static detection model and the execution of the at least part of the document, reporting the presence of an attack. In some embodiments, the methods include: selecting a data segment in at least one portion of an electronic document; determining whether the arbitrarily selected data segment can be altered without causing the electronic document to result in an error when processed by a corresponding program; in response to determining that the arbitrarily selected data segment can be altered, arbitrarily altering the data segment in the at least one portion of the electronic document to produce an altered electronic document; and determining whether the corresponding program produces an error state when the altered electronic document is processed by the corresponding program.« less

XML and its impact on content and structure in electronic health care documents.

PubMed Central

Sokolowski, R.; Dudeck, J.

1999-01-01

Worldwide information networks have the requirement that electronic documents must be easily accessible, portable, flexible and system-independent. With the development of XML (eXtensible Markup Language), the future of electronic documents, health care informatics and the Web itself are about to change. The intent of the recently formed ASTM E31.25 subcommittee, "XML DTDs for Health Care", is to develop standard electronic document representations of paper-based health care documents and forms. A goal of the subcommittee is to work together to enhance existing levels of interoperability among the various XML/SGML standardization efforts, products and systems in health care. The ASTM E31.25 subcommittee uses common practices and software standards to develop the implementation recommendations for XML documents in health care. The implementation recommendations are being developed to standardize the many different structures of documents. These recommendations are in the form of a set of standard DTDs, or document type definitions that match the electronic document requirements in the health care industry. This paper discusses recent efforts of the ASTM E31.25 subcommittee. PMID:10566338

SGML and HTML: The Merging of Document Management and Electronic Document Publishing.

ERIC Educational Resources Information Center

Dixon, Ross

1996-01-01

Document control is an issue for organizations that use SGML/HTML. The prevalent approach is to apply the same techniques to document elements that are applied to full documents, a practice that has led to an overlap of electronic publishing and document management. Lists requirements for the management of SGML/HTML documents. (PEN)

Optimizing Wartime Materiel Delivery: An Overview of DoD containerization. Volume 3. Annotated Bibliography

DOT National Transportation Integrated Search

1988-10-01

This annotated bibliography, Volume III of the study entitled, Optimizing Wartime Materiel Delivery: An overview of DOD Containerization Efforts, documents studies related to containerization. Several objectives of the study were defined. These inclu...

76 FR 411 - Regulatory Guidance Concerning Electronic Signatures and Documents

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-04

... Concerning Electronic Signatures and Documents AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Notice of regulatory guidance. SUMMARY: FMCSA issues regulatory guidance concerning the... regulatory guidance concerning the use of electronic signatures and documents to comply with FMCSA...

4 CFR 201.3 - Publicly available documents and electronic reading room.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 4 Accounts 1 2011-01-01 2011-01-01 false Publicly available documents and electronic reading room. 201.3 Section 201.3 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PUBLIC INFORMATION AND REQUESTS § 201.3 Publicly available documents and electronic reading room. (a) Many Board records are available electronically at the Board's Web sit...

4 CFR 201.3 - Publicly available documents and electronic reading room.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 4 Accounts 1 2012-01-01 2012-01-01 false Publicly available documents and electronic reading room. 201.3 Section 201.3 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PUBLIC INFORMATION AND REQUESTS § 201.3 Publicly available documents and electronic reading room. (a) Many Board records are available electronically at the Board's Web sit...

4 CFR 201.3 - Publicly available documents and electronic reading room.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 4 Accounts 1 2013-01-01 2013-01-01 false Publicly available documents and electronic reading room. 201.3 Section 201.3 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PUBLIC INFORMATION AND REQUESTS § 201.3 Publicly available documents and electronic reading room. (a) Many Board records are available electronically at the Board's Web sit...

4 CFR 201.3 - Publicly available documents and electronic reading room.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 4 Accounts 1 2014-01-01 2013-01-01 true Publicly available documents and electronic reading room. 201.3 Section 201.3 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PUBLIC INFORMATION AND REQUESTS § 201.3 Publicly available documents and electronic reading room. (a) Many Board records are available electronically at the Board's Web site...

Electronic Information Delivery Systems. Proceedings of the Library of Congress Network Advisory Committee Meeting (Washington, D.C., April 18-20, 1984). Network Planning Paper Number 9.

ERIC Educational Resources Information Center

Library of Congress, Washington, DC.

The Program Session of the April 1984 meeting of the Library of Congress Network Advisory Committee (NAC) was devoted to discussion of electronic information delivery systems. Recent developments in six areas were covered: (1) electronic manuscript generation and transmission; (2) online full-text searching and retrieval; (3) online database…

[About free delivery of therapeutical and preventive drugs to the people during Ottoman Empire].

PubMed

Cubukçu, B

2001-01-01

In this study, free delivery of medical drugs (dispensed in Ottoman Empire hospital pharmacies) to the outpatients in addition to the inpatients in Darüşşifas (patient care houses) have been investigated in the chronological order from the Vakfiye enrollments and documents of Ottoman Empire. On the other hand free delivery of drugs dispensed in the Palaces, Mesir paste delivery and other preventive drugs for the epidemic diseases have been studied.

10 CFR 2.302 - Filing of documents.

Code of Federal Regulations, 2012 CFR

2012-01-01

... electronic documents. The exempt participant is permitted to file electronic documents by physically... 10 Energy 1 2012-01-01 2012-01-01 false Filing of documents. 2.302 Section 2.302 Energy NUCLEAR... General Applicability: Hearing Requests, Petitions To Intervene, Availability of Documents, Selection of...

10 CFR 2.302 - Filing of documents.

Code of Federal Regulations, 2011 CFR

2011-01-01

... electronic documents. The exempt participant is permitted to file electronic documents by physically... 10 Energy 1 2011-01-01 2011-01-01 false Filing of documents. 2.302 Section 2.302 Energy NUCLEAR... General Applicability: Hearing Requests, Petitions To Intervene, Availability of Documents, Selection of...

Critical issues in an electronic documentation system.

PubMed

Weir, Charlene R; Nebeker, Jonathan R

2007-10-11

The Veterans Health Administration (VHA), of the U.S. Department of Veteran Affairs has instituted a medical record (EMR) that includes electronic documentation of all narrative components of the medical record. To support clinicians using the system, multiple efforts have been instituted to ease the creation of narrative reports. Although electronic documentation is easier to read and improves access to information, it also may create new and additional hazards for users. This study is the first step in a series of studies to evaluate the issues surrounding the creation and use of electronic documentation. Eighty-eight providers across multiple clinical roles were interviewed in 10 primary care sites in the VA system. Interviews were tape-recorded, transcribed and qualitatively analyzed for themes. In addition, specific questions were asked about perceived harm due to electronic documentation practices. Five themes relating to difficulties with electronic documentation were identified: 1) information overload; 2) hidden information; 3) lack of trust; 4) communication; 5) decision-making. Three providers reported that they knew of an incident where current documentation practices had caused patient harm and over 75% of respondents reported significant mis-trust of the system.

Rapid Implementation of Inpatient Electronic Physician Documentation at an Academic Hospital

PubMed Central

Hahn, J.S.; Bernstein, J.A.; McKenzie, R.B.; King, B.J.; Longhurst, C.A.

2012-01-01

Electronic physician documentation is an essential element of a complete electronic medical record (EMR). At Lucile Packard Children’s Hospital, a teaching hospital affiliated with Stanford University, we implemented an inpatient electronic documentation system for physicians over a 12-month period. Using an EMR-based free-text editor coupled with automated import of system data elements, we were able to achieve voluntary, widespread adoption of the electronic documentation process. When given the choice between electronic versus dictated report creation, the vast majority of users preferred the electronic method. In addition to increasing the legibility and accessibility of clinical notes, we also decreased the volume of dictated notes and scanning of handwritten notes, which provides the opportunity for cost savings to the institution. PMID:23620718

Prosperity Games prototyping with the board of governors of the Electronic Industries Association, January 20--21, 1994

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

Bermann, M.; VanDevender, J.P.

1994-08-01

Prosperity Games are an outgrowth and adaptation of move/countermove and seminar War Games. Prosperity Games are simulations that explore complex issues in a variety of areas including economics, politics, sociology, environment, education and research. These issues can be examined from a variety of perspectives ranging from a global, macroeconomic and geopolitical viewpoint down to the details of customer/supplier/market interactions in specific industries. All Prosperity Games are unique in that both the game format and the player contributions vary from game to game. This report documents the Prosperity Game conducted under the sponsorship of the Electronic Industries Association. Almost all ofmore » the players were from the electronics industry. The game explored policy changes that could enhance US competitiveness in the manufacturing of consumer electronics. Four teams simulated a presidentially appointed commission comprised of high-level representatives from government, industry, universities and national laboratories. A single team represented the foreign equivalent of this commission, formed to develop counter strategies for any changes in US policies. The deliberations and recommendations of these teams provide valuable insights as to the views of this industry concerning policy changes, foreign competition, and the development, delivery and commercialization of new technologies.« less

A systematic approach to baseline assessment of nursing documentation and enterprise-wide prioritization for electronic conversion.

PubMed

Dykes, Patricia C; Spurr, Cindy; Gallagher, Joan; Li, Qi; Ives Erickson, Jeanette

2006-01-01

An important challenge associated with making the transition from paper to electronic documentation systems is achieving consensus regarding priorities for electronic conversion across diverse groups. In our work we focus on applying a systematic approach to evaluating the baseline state of nursing documentation across a large healthcare system and establishing a unified vision for electronic conversion. A review of the current state of nursing documentation across PHS was conducted using structured tools. Data from this assessment was employed to facilitate an evidence-based approach to decision-making regarding conversion to electronic documentation at local and PHS levels. In this paper we present highlights of the assessment process and the outcomes of this multi-site collaboration.

Electronic Medical Consultation: A New Zealand Perspective

PubMed Central

Brebner, Campbell; Jones, Raymond; Marshall, Wendy; Parry, Graham

2001-01-01

Electronic medical consultation is available worldwide through access to the World Wide Web (WWW). This article outlines a research study on the adoption of electronic medical consultation as a means of health delivery. It focuses on the delivery of healthcare specifically for New Zealanders, by New Zealanders. It is acknowledged that the WWW is a global marketplace and that it is therefore difficult to identify New Zealanders' use of such a global market; nevertheless, we attempt to provide a New Zealand perspective on electronic medical consultation. PMID:11720955

Potential for off-peak freight deliveries to commercial areas : implementation plan

DOT National Transportation Integrated Search

2007-12-21

This document discusses three groups of policies to foster off-peak deliveries. The first group, Industry wide policies, considers policies that target specific industry segments, e.g., tax incentives to restaurants in exchange for their commitment t...

7 CFR 735.401 - Electronic warehouse receipt and USWA electronic document providers.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 7 2013-01-01 2013-01-01 false Electronic warehouse receipt and USWA electronic... UNITED STATES WAREHOUSE ACT Electronic Providers § 735.401 Electronic warehouse receipt and USWA electronic document providers. (a) To establish a USWA-authorized system to issue and transfer EWR's and USWA...

7 CFR 735.401 - Electronic warehouse receipt and USWA electronic document providers.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 7 2014-01-01 2014-01-01 false Electronic warehouse receipt and USWA electronic... UNITED STATES WAREHOUSE ACT Electronic Providers § 735.401 Electronic warehouse receipt and USWA electronic document providers. (a) To establish a USWA-authorized system to issue and transfer EWR's and USWA...

7 CFR 735.401 - Electronic warehouse receipt and USWA electronic document providers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Electronic warehouse receipt and USWA electronic... UNITED STATES WAREHOUSE ACT Electronic Providers § 735.401 Electronic warehouse receipt and USWA electronic document providers. (a) To establish a USWA-authorized system to issue and transfer EWR's and USWA...

7 CFR 735.401 - Electronic warehouse receipt and USWA electronic document providers.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 7 2012-01-01 2012-01-01 false Electronic warehouse receipt and USWA electronic... UNITED STATES WAREHOUSE ACT Electronic Providers § 735.401 Electronic warehouse receipt and USWA electronic document providers. (a) To establish a USWA-authorized system to issue and transfer EWR's and USWA...

7 CFR 735.401 - Electronic warehouse receipt and USWA electronic document providers.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Electronic warehouse receipt and USWA electronic... UNITED STATES WAREHOUSE ACT Electronic Providers § 735.401 Electronic warehouse receipt and USWA electronic document providers. (a) To establish a USWA-authorized system to issue and transfer EWR's and USWA...

GUI-Based Document Access via SATCOMMS: Online Electronic Document Retrieval at the European Telecommunications Satellite Organization EUTELSAT.

ERIC Educational Resources Information Center

Burton, Adrian P.

1995-01-01

Discusses accessing online electronic documents at the European Telecommunications Satellite Organization (EUTELSAT). Highlights include off-site paper document storage, the document management system, benefits, the EUTELSAT Standard IBM Access software, implementation, the development process, and future enhancements. (AEF)

Script identification from images using cluster-based templates

DOEpatents

Hochberg, J.G.; Kelly, P.M.; Thomas, T.R.

1998-12-01

A computer-implemented method identifies a script used to create a document. A set of training documents for each script to be identified is scanned into the computer to store a series of exemplary images representing each script. Pixels forming the exemplary images are electronically processed to define a set of textual symbols corresponding to the exemplary images. Each textual symbol is assigned to a cluster of textual symbols that most closely represents the textual symbol. The cluster of textual symbols is processed to form a representative electronic template for each cluster. A document having a script to be identified is scanned into the computer to form one or more document images representing the script to be identified. Pixels forming the document images are electronically processed to define a set of document textual symbols corresponding to the document images. The set of document textual symbols is compared to the electronic templates to identify the script. 17 figs.

Script identification from images using cluster-based templates

DOEpatents

Hochberg, Judith G.; Kelly, Patrick M.; Thomas, Timothy R.

1998-01-01

A computer-implemented method identifies a script used to create a document. A set of training documents for each script to be identified is scanned into the computer to store a series of exemplary images representing each script. Pixels forming the exemplary images are electronically processed to define a set of textual symbols corresponding to the exemplary images. Each textual symbol is assigned to a cluster of textual symbols that most closely represents the textual symbol. The cluster of textual symbols is processed to form a representative electronic template for each cluster. A document having a script to be identified is scanned into the computer to form one or more document images representing the script to be identified. Pixels forming the document images are electronically processed to define a set of document textual symbols corresponding to the document images. The set of document textual symbols is compared to the electronic templates to identify the script.

ModSAF Software Architecture Design and Overview Document

DTIC Science & Technology

1993-12-20

ADVANCED DISTRIBUTED SIMULATIONTECHNOLOGY AD-A282 740 ModSAF SOFTWARE ARCHITECTURE DESIGN AND OVERVIEW DOCUMENT Ver 1.0 - 20 December 1993 D T...AND SUBTITLE 5. FUNDING NUMBERS MOdSAF SOFTWARE ARCHITECTURE DESIGN AND OVERVIEW DOCUMENT C N61339-91-D-O00, Delivery Order (0021), ModSAF (CDRL A004) 6

Lesson 5: Defining Valid Electronic Signatures

EPA Pesticide Factsheets

A valid electronic signature on an electronic document is one that is created with an electronic signature device that is uniquely entitled to a signatory, not compromised, and used by a signatory who is authorized to sign the electronic document.

E-cigarettes and E-hookahs

MedlinePlus

Electronic cigarettes; Electronic hookahs; Vaping; Electronic nicotine delivery systems; Smoking - electronic cigarettes ... Elsevier Saunders; 2016:chap 46. Callahan-Lyon P. Electronic cigarettes: human health effects. Tob Control . 2014;23( ...

Prosperity game for the national electronics manufacturing initiative

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

Berman, M.; VanDevender, J.P.; Berry, I.

1995-05-01

Prosperity Games are an outgrowth and adaptation of move/countermove and seminar War Games. Prosperity Games are simulations that explore complex issues in a variety of areas including economics, politics, sociology, environment, education and research. These issues can be examined from a variety of perspectives ranging from a global, macroeconomic and geopolitical viewpoint down to the details of customer/supplier/market interactions in specific industries. All Prosperity Games are unique in that both the game format and the player contributions vary from game to game. This report documents the Prosperity Game conducted under the sponsorship of the Electronics Subcommittee of the Civilian Industrialmore » Technology Committee (under the National Science and Technology Council), and the Electronics Partnership Project. Players were drawn from the electronics industry, from government, national laboratories, and universities, and from Japan and Austria. The primary objectives of this game were: To connect the technical and non-technical (i.e., policy) issues that were developed in the roadmap-making endeavor of the National Electronics Manufacturing Initiative (NENI);to provide energy, enthusiasm and people to help the roadmap succeed; and to provide insight into high-leverage public and private investments. The deliberations and recommendations of these teams provide valuable insights as to the views of this diverse group of decision makers concerning policy changes, foreign competition, the robustness of strategic thinking and planning, and the development, delivery and commercialization of new technologies.« less

Prosperity Games prototyping with the American Electronics Association, March 8--9, 1994

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

Berman, M.; VanDevender, J.P.

1994-08-01

Prosperity Games are an outgrowth and adaptation of move/countermove and seminar War Games. Prosperity Games are simulations that explore complex issues in a variety of areas including economics, politics, sociology, environment, education and research. These issues can be examined from a variety of perspectives ranging from a global, macroeconomic and geopolitical viewpoint down to the details of customer/supplier/market interactions in specific industries. All Prosperity Games are unique in that both the game format and the player contributions vary from game to game. This report documents the Prosperity Game conducted under the sponsorship of the American Electronics Association in conjunction withmore » the Electronics Subcommittee of the Civilian Industrial Technology Committee of the National Science and Technology Council. Players were drawn from government, national laboratories, and universities, as well as from the electronics industry. The game explored policy changes that could enhance US competitiveness in the manufacturing of consumer electronics. Two teams simulated a presidentially appointed commission comprised of high-level representatives from government, industry, universities and national laboratories. A single team represented the foreign equivalent of this commission, formed to develop counter strategies for any changes in US policies. The deliberations and recommendations of these teams provide valuable insights as to the views of this diverse group of decision makers concerning policy changes, foreign competition, and the development, delivery and commercialization of new technologies.« less

Electronic Document Management Using Inverted Files System

NASA Astrophysics Data System (ADS)

Suhartono, Derwin; Setiawan, Erwin; Irwanto, Djon

2014-03-01

The amount of documents increases so fast. Those documents exist not only in a paper based but also in an electronic based. It can be seen from the data sample taken by the SpringerLink publisher in 2010, which showed an increase in the number of digital document collections from 2003 to mid of 2010. Then, how to manage them well becomes an important need. This paper describes a new method in managing documents called as inverted files system. Related with the electronic based document, the inverted files system will closely used in term of its usage to document so that it can be searched over the Internet using the Search Engine. It can improve document search mechanism and document save mechanism.

Learning From Experience: Development of a Cognitive Task List to Perform a Safe and Successful Non-Rotational Forceps Delivery.

PubMed

Simpson, Andrea N; Gurau, David; Secter, Michael; Mocarski, Eva; Pittini, Richard; Snelgrove, John; Hodges, Ryan; Windrim, Rory; Higgins, Mary

2015-07-01

Increased rates of delivery by Caesarean section have resulted in a reduction in rates of instrumental deliveries. This has led to a new educational challenge for teaching and development of skills. In teaching trainees, there are subconscious tasks that the supervising staff may not review because they are automatic. This study aimed to create a new tool to meet this challenge: to identify the core steps required to perform a non-rotational forceps delivery safely and successfully. Labour and delivery nursing staff of three large teaching hospitals were asked to identify clinicians they considered to be particularly skilled in non-rotational forceps deliveries. Obstetricians who were identified consistently in this way were invited to participate in the study. After providing written consent, participants were then filmed performing a non-rotational forceps delivery on a model. Two clinicians reviewed all videos and documented verbal and non-verbal components of the assessment. Thematic analysis combined findings into an integrated summary. The initial summary was then circulated to all participants for their approval. Seventeen clinicians were identified and consented. Themes identified included the need for careful assessment of suitability for operative delivery, the role of the multidisciplinary team, the need for careful and appropriate communication with the parents, the technique of delivery itself, and postpartum care and documentation. In the core steps identified, the clinicians balanced respect for the "elegant technique" of non-rotational forceps deliveries with careful assessment and knowing when to stop if safety criteria were not met.

Secure content objects

DOEpatents

Evans, William D [Cupertino, CA

2009-02-24

A secure content object protects electronic documents from unauthorized use. The secure content object includes an encrypted electronic document, a multi-key encryption table having at least one multi-key component, an encrypted header and a user interface device. The encrypted document is encrypted using a document encryption key associated with a multi-key encryption method. The encrypted header includes an encryption marker formed by a random number followed by a derivable variation of the same random number. The user interface device enables a user to input a user authorization. The user authorization is combined with each of the multi-key components in the multi-key encryption key table and used to try to decrypt the encrypted header. If the encryption marker is successfully decrypted, the electronic document may be decrypted. Multiple electronic documents or a document and annotations may be protected by the secure content object.

Electronic cigarettes: product characterisation and design considerations.

PubMed

Brown, Christopher J; Cheng, James M

2014-05-01

To review the available evidence regarding electronic cigarette (e-cigarette) product characterisation and design features in order to understand their potential impact on individual users and on public health. Systematic literature searches in 10 reference databases were conducted through October 2013. A total of 14 articles and documents and 16 patents were included in this analysis. Numerous disposable and reusable e-cigarette product options exist, representing wide variation in product configuration and component functionality. Common e-cigarette components include an aerosol generator, a flow sensor, a battery and a nicotine-containing solution storage area. e-cigarettes currently include many interchangeable parts, enabling users to modify the character of the delivered aerosol and, therefore, the product's 'effectiveness' as a nicotine delivery product. Materials in e-cigarettes may include metals, rubber and ceramics. Some materials may be aerosolised and have adverse health effects. Several studies have described significant performance variability across and within e-cigarette brands. Patent applications include novel product features designed to influence aerosol properties and e-cigarette efficiency at delivering nicotine. Although e-cigarettes share a basic design, engineering variations and user modifications result in differences in nicotine delivery and potential product risks. e-cigarette aerosols may include harmful and potentially harmful constituents. Battery explosions and the risks of exposure to the e-liquid (especially for children) are also concerns. Additional research will enhance the current understanding of basic e-cigarette design and operation, aerosol production and processing, and functionality. A standardised e-cigarette testing regime should be developed to allow product comparisons.

78 FR 12042 - Electric Grid Integration Technical Workshops

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-21

.... The documents are the Electricity Distribution System Workshop Discussion Summary and the Electricity... FURTHER INFORMATION CONTACT: Caitlin A. Callaghan, National Electricity Delivery Division, Office of Electricity Delivery and Energy Reliability, U.S. Department of Energy, Forrestal Building, Room 8E-032, 1000...

22 CFR 201.13 - Eligibility of delivery services.

Code of Federal Regulations, 2011 CFR

2011-04-01

... COMMODITY TRANSACTIONS FINANCED BY USAID Conditions Governing the Eligibility of Procurement Transactions... commodities may be financed under the implementing document provided the delivery services meet the.... USAID will finance inspection of USAID-financed commodities when inspection is required by USAID, or in...

The Electronic Documentation Project in the NASA mission control center environment

NASA Technical Reports Server (NTRS)

Wang, Lui; Leigh, Albert

1994-01-01

NASA's space programs like many other technical programs of its magnitude is supported by a large volume of technical documents. These documents are not only diverse but also abundant. Management, maintenance, and retrieval of these documents is a challenging problem by itself; but, relating and cross-referencing this wealth of information when it is all on a medium of paper is an even greater challenge. The Electronic Documentation Project (EDP) is to provide an electronic system capable of developing, distributing and controlling changes for crew/ground controller procedures and related documents. There are two primary motives for the solution. The first motive is to reduce the cost of maintaining the current paper based method of operations by replacing paper documents with electronic information storage and retrieval. And, the other is to improve the efficiency and provide enhanced flexibility in document usage. Initially, the current paper based system will be faithfully reproduced in an electronic format to be used in the document viewing system. In addition, this metaphor will have hypertext extensions. Hypertext features support basic functions such as full text searches, key word searches, data retrieval, and traversal between nodes of information as well as speeding up the data access rate. They enable related but separate documents to have relationships, and allow the user to explore information naturally through non-linear link traversals. The basic operational requirements of the document viewing system are to: provide an electronic corollary to the current method of paper based document usage; supplement and ultimately replace paper-based documents; maintain focused toward control center operations such as Flight Data File, Flight Rules and Console Handbook viewing; and be available NASA wide.

The Role of Telecommunications in the Regional Delivery of Education Services: A Study of the Potential Use of Instructional Television for Vocational Education in the Appalachian States.

ERIC Educational Resources Information Center

INTASA, Inc., Menlo Park, CA.

This report documents a research project focusing on the role of telecommunications technology in the regional delivery of educational services, including assessment of needs, factors in choosing the technology for implementation, alternative delivery systems, cost analysis, and a study of possible demonstration projects in South Carolina,…

Electronic Information Delivery Systems: Reports on Five Projects Sponsored by the Fred Meyer Charitable Trust.

ERIC Educational Resources Information Center

Ferguson, Douglas K.; And Others

1987-01-01

Describes five research projects that are setting up electronic information delivery systems to serve rural areas in the Pacific Northwest. The technologies being evaluated include simultaneous remote searching, facsimile transmissions, bit map image transmissions, and a combination of optical character recognition equipment and television…

12 CFR 41.26 - Delivery of opt-out notices.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 1 2011-01-01 2011-01-01 false Delivery of opt-out notices. 41.26 Section 41.26 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY FAIR CREDIT REPORTING... provided electronically, the notice may be provided in compliance with either the electronic disclosure...

12 CFR 717.26 - Delivery of opt-out notices.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Delivery of opt-out notices. 717.26 Section 717.26 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS FAIR... electronic disclosure provisions in this subpart or the provisions in section 101 of the Electronic...

12 CFR 571.26 - Delivery of opt-out notices.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 5 2011-01-01 2011-01-01 false Delivery of opt-out notices. 571.26 Section 571.26 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY FAIR CREDIT REPORTING... provided electronically, the notice may be provided in compliance with either the electronic disclosure...

78 FR 79708 - Notice of Receipt of Complaint; Solicitation of Comments Relating to the Public Interest

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-31

... accessed on the Commission's Electronic Document Information System (EDIS) at EDIS,\\1\\ and will be...-2000. \\1\\ Electronic Document Information System (EDIS): http://edis.usitc.gov . General information... the Commission's Electronic Document Information System (EDIS) at EDIS.\\3\\ Hearing-impaired persons...

Tablet-based cardiac arrest documentation: a pilot study.

PubMed

Peace, Jack M; Yuen, Trevor C; Borak, Meredith H; Edelson, Dana P

2014-02-01

Conventional paper-based resuscitation transcripts are notoriously inaccurate, often lacking the precision that is necessary for recording a fast-paced resuscitation. The aim of this study was to evaluate whether a tablet computer-based application could improve upon conventional practices for resuscitation documentation. Nurses used either the conventional paper code sheet or a tablet application during simulated resuscitation events. Recorded events were compared to a gold standard record generated from video recordings of the simulations and a CPR-sensing defibrillator/monitor. Events compared included defibrillations, medication deliveries, and other interventions. During the study period, 199 unique interventions were observed in the gold standard record. Of these, 102 occurred during simulations recorded by the tablet application, 78 by the paper code sheet, and 19 during scenarios captured simultaneously by both documentation methods These occurred over 18 simulated resuscitation scenarios, in which 9 nurses participated. The tablet application had a mean sensitivity of 88.0% for all interventions, compared to 67.9% for the paper code sheet (P=0.001). The median time discrepancy was 3s for the tablet, and 77s for the paper code sheet when compared to the gold standard (P<0.001). Similar to prior studies, we found that conventional paper-based documentation practices are inaccurate, often misreporting intervention delivery times or missing their delivery entirely. However, our study also demonstrated that a tablet-based documentation method may represent a means to substantially improve resuscitation documentation quality, which could have implications for resuscitation quality improvement and research. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Recording signs of deterioration in acute patients: The documentation of vital signs within electronic health records in patients who suffered in-hospital cardiac arrest.

PubMed

Stevenson, Jean E; Israelsson, Johan; Nilsson, Gunilla C; Petersson, Göran I; Bath, Peter A

2016-03-01

Vital sign documentation is crucial to detecting patient deterioration. Little is known about the documentation of vital signs in electronic health records. This study aimed to examine documentation of vital signs in electronic health records. We examined the vital signs documented in the electronic health records of patients who had suffered an in-hospital cardiac arrest and on whom cardiopulmonary resuscitation was attempted between 2007 and 2011 (n = 228), in a 372-bed district general hospital. We assessed the completeness of vital sign data compared to VitalPAC™ Early Warning Score and the location of vital signs within the electronic health records. There was a noticeable lack of completeness of vital signs. Vital signs were fragmented through various sections of the electronic health records. The study identified serious shortfalls in the representation of vital signs in the electronic health records, with consequential threats to patient safety. © The Author(s) 2014.

Impacts of EHR Certification and Meaningful Use Implementation on an Integrated Delivery Network.

PubMed

Bowes, Watson A

2014-01-01

Three years ago Intermountain Healthcare made the decision to participate in the Medicare and Medicaid Electronic Heath Record (EHR) Incentive Program which required that hospitals and providers use a certified EHR in a meaningful way. At that time, the barriers to enhance our home grown system, and change clinician workflows were numerous and large. This paper describes the time and effort required to enhance our legacy systems in order to pass certification, including filling 47 gaps in (EHR) functionality. We also describe the processes and resources that resulted in successful changes to many clinical workflows required by clinicians to meet meaningful use requirements. In 2011 we set meaningful use targets of 75% of employed physicians and 75% of our hospitals to meet Stage 1 of meaningful use by 2013. By the end of 2013, 87% of 696 employed eligible professionals and 100% of 22 Intermountain hospitals had successfully attested for Stage 1. This paper describes documented and perceived costs to Intermountain including time, effort, resources, postponement of other projects, as well as documented and perceived benefits of attainment of meaningful use.

76 FR 1173 - Draft Guidance for Industry on Electronic Source Documentation in Clinical Investigations...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-07

...] Draft Guidance for Industry on Electronic Source Documentation in Clinical Investigations; Availability... Documentation in Clinical Investigations.'' This document provides guidance to sponsors, contract research organizations (CROs), data management centers, and clinical investigators on capturing, using, and archiving...

14 CFR 13.43 - Service and filing of pleadings, motions, and documents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... date of personal delivery shall be the date of service. (e) The date of filing is the date the document... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Service and filing of pleadings, motions... Hearings § 13.43 Service and filing of pleadings, motions, and documents. (a) Copies of all pleadings...

Technology-mediated therapy for chronic pain management: the challenges of adapting behavior change interventions for delivery with pervasive communication technology.

PubMed

Rosser, Benjamin A; McCullagh, Paul; Davies, Richard; Mountain, Gail A; McCracken, Lance; Eccleston, Christopher

2011-04-01

Adapting therapeutic practice from traditional face-to-face exchange to remote technology-based delivery presents challenges for the therapist, patient, and technical writer. This article documents the process of therapy adaptation and the resultant specification for the SMART2 project-a technology-based self-management system for assisting long-term health conditions, including chronic pain. Focus group discussions with healthcare professionals and patients were conducted to inform selection of therapeutic objectives and appropriate technology. Pertinent challenges are identified, relating to (1) reduction and definition of therapeutic objectives, and (2) how to approach adaptation of therapy to a form suited to technology delivery. The requirement of the system to provide dynamic and intelligent responses to patient experience and behavior is also emphasized. Solutions to these challenges are described in the context of the SMART2 technology-based intervention. More explicit discussion and documentation of therapy adaptation to technology-based delivery within the literature is encouraged.

75 FR 32984 - Policy on the Retention of Supporting Documents and the Use of Electronic Mobile Communication...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-10

...-0168] Policy on the Retention of Supporting Documents and the Use of Electronic Mobile Communication/Tracking Technology in Assessing Motor Carriers' and Commercial Motor Vehicle Drivers' Compliance With the... changes regarding the retention of supporting documents and the use of electronic mobile communication...

The Post-Secondary Student Support Program: An Examination of Alternative Delivery Mechanisms. A Report to the Indian and Northern Affairs Canada

ERIC Educational Resources Information Center

Usher, Alex

2009-01-01

The purpose of this document is to examine the Department of Indian and Northern Affairs Canada (INAC)'s Post-Secondary Student Support Program (PSSSP) and analyse the advantages and disadvantages of both the existing system of program delivery and a trio of alternative delivery mechanisms. It does not issue any recommendation with respect to a…

Adolescent use of electronic nicotine delivery systems.

PubMed

Vincent, Debra; Potts, Jeanne; Durbin, Jessica; Moore, Jill M; Eley, Susan

2018-03-12

Use of electronic nicotine delivery systems is flourishing among adolescents. The long-term effects have not been fully determined; however, literature suggests there is potential for significant harm. Providers must be aware of usage trends, device safety, and product knowledge. Adolescents should be evaluated through routine screening, and cessation counseling should be initiated.

Electronic Delivery of Lectures in the University Environment: An Empirical Comparison of Three Delivery Styles

ERIC Educational Resources Information Center

Stephenson, Julia E.; Brown, Clifford; Griffin, Darren K.

2008-01-01

The purpose of this study was to consider the efficacy and popularity of "Virtual Lectures" (text-based, structured electronic courseware with information presented in manageable "chunks", interaction and multimedia) and "e-Lectures" (on-screen synchrony of PowerPoint slides and recorded voice) as alternatives to traditional lectures. We…

NASAwide electronic publishing system: Prototype STI electronic document distribution, stage-4 evaluation report

NASA Technical Reports Server (NTRS)

Tuey, Richard C.; Collins, Mary; Caswell, Pamela; Haynes, Bob; Nelson, Michael L.; Holm, Jeanne; Buquo, Lynn; Tingle, Annette; Cooper, Bill; Stiltner, Roy

1996-01-01

This evaluation report contains an introduction, seven chapters, and five appendices. The Introduction describes the purpose, conceptual frame work, functional description, and technical report server of the STI Electronic Document Distribution (EDD) project. Chapter 1 documents the results of the prototype STI EDD in actual operation. Chapter 2 documents each NASA center's post processing publication processes. Chapter 3 documents each center's STI software, hardware, and communications configurations. Chapter 7 documents STI EDD policy, practices, and procedures. The appendices, which arc contained in Part 2 of this document, consist of (1) STI EDD Project Plan, (2) Team members, (3) Phasing Schedules, (4) Accessing On-line Reports, and (5) Creating an HTML File and Setting Up an xTRS. In summary, Stage 4 of the NASAwide Electronic Publishing System is the final phase of its implementation through the prototyping and gradual integration of each NASA center's electronic printing systems, desktop publishing systems, and technical report servers to be able to provide to NASA's engineers, researchers, scientists, and external users the widest practicable and appropriate dissemination of information concerning its activities and the result thereof to their work stations.

Infrared free electron laser enhanced transdermal drug delivery

NASA Astrophysics Data System (ADS)

Awazu, Kunio; Uchizono, Takeyuki; Suzuki, Sachiko; Yoshikawa, Kazushi

2005-08-01

It is necessary to control enhancement of transdermal drug delivery with non-invasive. The present study was investigated to assess the effectivity of enhancing the drug delivery by irradiating 6-μm region mid infrared free electron laser (MIR-FEL). The enhancement of transdermal drug (lidocaine) delivery of the samples (hairless mouse skin) irradiated with lasers was examined for flux (μg/cm2/h) and total penetration amount (μg/cm2) of lidocaine by High performance Liquid Chromatography (HPLC). The flux and total amount penatration date was enhanced 200-300 fold faster than the control date by the laser irradiation. FEL irradiating had the stratum corneum, and had the less thermal damage in epidermis. The effect of 6-μm region MIR-FEL has the enhancement of transdermal drug delivery without removing the stratum corneum because it has the less thermal damage. It leads to enhancement drug delivery system with non-invasive laser treatment.

Intermediate load modules for test and evaluation

NASA Technical Reports Server (NTRS)

1984-01-01

Photovoltaic modules were tested for qualification. Tests involved the following: (1) delivery of 20 solar cells for use as reference cells; (2) module documentation and inspection plans specifying the 10 Group I modules; (3) design review of module documentation from Group I modules; (4) revise module documentation to overcome any problems of deficiencies associated with the Group I modules; (5) delivery of 10 Group II modules built to revised specifications; (6) testing of Group II modules to the criteria as outlined in qualification specification. It is found that the solarvolt MSP43E40B satisfies the design criteria of qualification specification for intermediate load modules. Design changes were made in the Group I modules to overcome the deficiencies which allowed Group II modules to pass the qualification tests.

The quality of paper-based versus electronic nursing care plan in Australian aged care homes: A documentation audit study.

PubMed

Wang, Ning; Yu, Ping; Hailey, David

2015-08-01

The nursing care plan plays an essential role in supporting care provision in Australian aged care. The implementation of electronic systems in aged care homes was anticipated to improve documentation quality. Standardized nursing terminologies, developed to improve communication and advance the nursing profession, are not required in aged care practice. The language used by nurses in the nursing care plan and the effect of the electronic system on documentation quality in residential aged care need to be investigated. To describe documentation practice for the nursing care plan in Australian residential aged care homes and to compare the quantity and quality of documentation in paper-based and electronic nursing care plans. A nursing documentation audit was conducted in seven residential aged care homes in Australia. One hundred and eleven paper-based and 194 electronic nursing care plans, conveniently selected, were reviewed. The quantity of documentation in a care plan was determined by the number of phrases describing a resident problem and the number of goals and interventions. The quality of documentation was measured using 16 relevant questions in an instrument developed for the study. There was a tendency to omit 'nursing problem' or 'nursing diagnosis' in the nursing process by changing these terms (used in the paper-based care plan) to 'observation' in the electronic version. The electronic nursing care plan documented more signs and symptoms of resident problems and evaluation of care than the paper-based format (48.30 vs. 47.34 out of 60, P<0.01), but had a lower total mean quality score. The electronic care plan contained fewer problem or diagnosis statements, contributing factors and resident outcomes than the paper-based system (P<0.01). Both types of nursing care plan were weak in documenting measurable and concrete resident outcomes. The overall quality of documentation content for the nursing process was no better in the electronic system than in the paper-based system. Omission of the nursing problem or diagnosis from the nursing process may reflect a range of factors behind the practice that need to be understood. Further work is also needed on qualitative aspects of the nurse care plan, nurses' attitudes towards standardized terminologies and the effect of different documentation practice on care quality and resident outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

27 CFR 73.33 - Am I legally bound by a form I sign electronically?

Code of Federal Regulations, 2010 CFR

2010-04-01

... TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) PROCEDURES AND PRACTICES ELECTRONIC SIGNATURES; ELECTRONIC SUBMISSION OF FORMS Electronic Filing of Documents with TTB § 73.33 Am I legally bound... paper document submitted to satisfy the same reporting requirement. Persons using electronic signatures...

The Storied Experiences of Registered Nurses' Transition from Paper to Electronic Nursing Documentation

ERIC Educational Resources Information Center

Smith, Jeff S.

2010-01-01

This narrative inquiry was designed to bring to life the storied experiences of registered nurses who have transitioned from paper to electronic nursing documentation and to provide a foundation for others who may be preparing to implement electronic documentation and wish to consider the significance of these nurses' stories of change in their…

41 CFR 301-71.3 - May we use electronic signatures on travel documents?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 41 Public Contracts and Property Management 4 2012-07-01 2012-07-01 false May we use electronic signatures on travel documents? 301-71.3 Section 301-71.3 Public Contracts and Property Management Federal... ACCOUNTABILITY REQUIREMENTS General § 301-71.3 May we use electronic signatures on travel documents? Yes, if you...

41 CFR 301-71.3 - May we use electronic signatures on travel documents?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 4 2011-07-01 2011-07-01 false May we use electronic signatures on travel documents? 301-71.3 Section 301-71.3 Public Contracts and Property Management Federal... ACCOUNTABILITY REQUIREMENTS General § 301-71.3 May we use electronic signatures on travel documents? Yes, if you...

41 CFR 301-71.3 - May we use electronic signatures on travel documents?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 41 Public Contracts and Property Management 4 2014-07-01 2014-07-01 false May we use electronic signatures on travel documents? 301-71.3 Section 301-71.3 Public Contracts and Property Management Federal... ACCOUNTABILITY REQUIREMENTS General § 301-71.3 May we use electronic signatures on travel documents? Yes, if you...

41 CFR 301-71.3 - May we use electronic signatures on travel documents?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 4 2013-07-01 2012-07-01 true May we use electronic signatures on travel documents? 301-71.3 Section 301-71.3 Public Contracts and Property Management Federal... ACCOUNTABILITY REQUIREMENTS General § 301-71.3 May we use electronic signatures on travel documents? Yes, if you...

41 CFR 301-71.3 - May we use electronic signatures on travel documents?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false May we use electronic signatures on travel documents? 301-71.3 Section 301-71.3 Public Contracts and Property Management Federal... ACCOUNTABILITY REQUIREMENTS General § 301-71.3 May we use electronic signatures on travel documents? Yes, if you...

A Comparison of Product Realization Frameworks

DTIC Science & Technology

1993-10-01

software (integrated FrameMaker ). Also included are BOLD for on-line documentation delivery, printer/plotter support, and 18 network licensing support. AMPLE...are built with DSS. Documentation tools include an on-line information system (BOLD), text editing (Notepad), word processing (integrated FrameMaker ...within an application. FrameMaker is fully integrated with the Falcon Framework to provide consistent documentation capabilities within engineering

IDC System Specification Document Version 1.1.

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

Harris, James M.; Lober, Randall R.

2015-02-01

This document contains the system specifications derived to satisfy the system requirements found in the IDC System Requirements Document for the IDC Reengineering Phase 2 project. Revisions Version Date Author/Team Revision Description Authorized by V1.0 12/2014 IDC Reengineering Project Team Initial delivery M. Harris V1.1 2/2015 IDC Reengineering Project Team Iteration I2 Review Comments M. Harris

10 CFR 2.1013 - Use of the electronic docket during the proceeding.

Code of Federal Regulations, 2010 CFR

2010-01-01

... bi-tonal documents. (v) Electronic submissions must be generated in the appropriate PDF output format by using: (A) PDF—Formatted Text and Graphics for textual documents converted from native applications; (B) PDF—Searchable Image (Exact) for textual documents converted from scanned documents; and (C...

14 CFR 302.3 - Filing of documents.

Code of Federal Regulations, 2013 CFR

2013-01-01

... in Washington, DC. Documents may be filed either on paper or by electronic means using the process set at the DOT Dockets Management System (DMS) internet website. (2) Such documents will be deemed to... below the space provided for signature. Electronic filers need only submit one copy of the document...

14 CFR 302.3 - Filing of documents.

Code of Federal Regulations, 2012 CFR

2012-01-01

... in Washington, DC. Documents may be filed either on paper or by electronic means using the process set at the DOT Dockets Management System (DMS) internet website. (2) Such documents will be deemed to... below the space provided for signature. Electronic filers need only submit one copy of the document...

5 CFR 850.303 - Return of personal documents.

Code of Federal Regulations, 2014 CFR

2014-01-01

... REGULATIONS (CONTINUED) ELECTRONIC RETIREMENT PROCESSING Records § 850.303 Return of personal documents. An..., OPM may provide the individual with a copy of the document that is derived from electronic records. ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Return of personal documents. 850.303...

14 CFR 302.3 - Filing of documents.

Code of Federal Regulations, 2014 CFR

2014-01-01

... in Washington, DC. Documents may be filed either on paper or by electronic means using the process set at the DOT Dockets Management System (DMS) internet website. (2) Such documents will be deemed to... below the space provided for signature. Electronic filers need only submit one copy of the document...

14 CFR 302.3 - Filing of documents.

Code of Federal Regulations, 2011 CFR

2011-01-01

... in Washington, DC. Documents may be filed either on paper or by electronic means using the process set at the DOT Dockets Management System (DMS) internet website. (2) Such documents will be deemed to... below the space provided for signature. Electronic filers need only submit one copy of the document...

17 CFR 232.105 - Limitation on use of HTML documents and hypertext links.

Code of Federal Regulations, 2014 CFR

2014-04-01

... submit the following documents in ASCII: Form N-SAR (§ 274.101 of this chapter) and Form 13F (§ 249.325... exhibits to Form N-SAR in HTML. (b) Electronic filers may not include in any HTML document hypertext links... documents within the current submission and to documents previously filed electronically and located in the...

17 CFR 232.105 - Limitation on use of HTML documents and hypertext links.

Code of Federal Regulations, 2013 CFR

2013-04-01

... submit the following documents in ASCII: Form N-SAR (§ 274.101 of this chapter) and Form 13F (§ 249.325... exhibits to Form N-SAR in HTML. (b) Electronic filers may not include in any HTML document hypertext links... documents within the current submission and to documents previously filed electronically and located in the...

17 CFR 232.105 - Limitation on use of HTML documents and hypertext links.

Code of Federal Regulations, 2011 CFR

2011-04-01

... submit the following documents in ASCII: Form N-SAR (§ 274.101 of this chapter) and Form 13F (§ 249.325... exhibits to Form N-SAR in HTML. (b) Electronic filers may not include in any HTML document hypertext links... documents within the current submission and to documents previously filed electronically and located in the...

17 CFR 232.105 - Limitation on use of HTML documents and hypertext links.

Code of Federal Regulations, 2012 CFR

2012-04-01

... submit the following documents in ASCII: Form N-SAR (§ 274.101 of this chapter) and Form 13F (§ 249.325... exhibits to Form N-SAR in HTML. (b) Electronic filers may not include in any HTML document hypertext links... documents within the current submission and to documents previously filed electronically and located in the...

29 CFR 500.267 - Filing and service.

Code of Federal Regulations, 2011 CFR

2011-07-01

... SEASONAL AGRICULTURAL WORKER PROTECTION Administrative Proceedings Modification Or Vacation of Order of... copies. An original and two copies of all documents shall be filed. (c) Computation of time for delivery... by personal delivery or by mail. Service by mail is deemed effected at the time of mailing to the...

29 CFR 500.267 - Filing and service.

Code of Federal Regulations, 2010 CFR

2010-07-01

... SEASONAL AGRICULTURAL WORKER PROTECTION Administrative Proceedings Modification Or Vacation of Order of... copies. An original and two copies of all documents shall be filed. (c) Computation of time for delivery... by personal delivery or by mail. Service by mail is deemed effected at the time of mailing to the...

Challenging the Courtesy Bias Interpretation of Favorable Clients' Perceptions of Family Planning Delivery

ERIC Educational Resources Information Center

Len, Federico R.; Lundgren, Rebecka; Huapaya, Ana; Sinai, Irit; Jennings, Victoria

2007-01-01

Favorable client perceptions of provider's interpersonal behavior in contraceptive delivery, documented in clinic exit questionnaires, appear to contradict results from qualitative evaluations and are attributed to clients' courtesy bias. In this study, trained simulated clients requested services from Ministry of Health providers in three…

Physical Access in ARL Libraries. SPEC Kit 27.

ERIC Educational Resources Information Center

Association of Research Libraries, Washington, DC. Office of Management Studies.

Resulting from the Association of Research Libraries' (ARL) 1975 survey on user services, this kit presents documentation on and discusses developments in physical access services--services which facilitate the actual delivery of information sources to the user--including circulation, interlibrary loan, book delivery, and new media services. As…

Redefining Information Access to Serials Information.

ERIC Educational Resources Information Center

Chen, Ching-chih

1992-01-01

Describes full-text document delivery services that have been introduced in conjunction with available databases in response to economic and technological changes affecting libraries: (1) CARL System's UnCover database and UnCover2 service; (2) Research Libraries Group's CitaDel delivery service; and (3) Faxon Research Service's Faxon Finder and…

Distance Delivery of Vocational Education Technologies and Planning Matrixes.

ERIC Educational Resources Information Center

Norenberg, Curtis D.; Lundblad, Larry

This document presents a general review of distance education as it currently pertains to secondary, postsecondary, and adult education. Chapter I discusses the general concepts of distance education. It addresses the nature of distance education and distance delivery, the distance learner, the distance instructor, and distance education learning…

76 FR 52561 - Timely Mailing Treated as Timely Filing

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-23

... to the only ways to establish prima facie evidence of delivery of documents that have a filing... (PDS) designated under criteria established by the IRS, will constitute prima facie evidence of... taxpayers to be able to establish the postmark date and prima facie evidence of delivery when using...

Microprocessor Based Temperature Control of Liquid Delivery with Flow Disturbances.

ERIC Educational Resources Information Center

Kaya, Azmi

1982-01-01

Discusses analytical design and experimental verification of a PID control value for a temperature controlled liquid delivery system, demonstrating that the analytical design techniques can be experimentally verified by using digital controls as a tool. Digital control instrumentation and implementation are also demonstrated and documented for…

Modification of Instructional Delivery and Student Learning with the Use of Educational Technologies

ERIC Educational Resources Information Center

Rogers, Jeffrey Ray

2012-01-01

The purpose of this study was to determine if educational technologies, including LCD projectors, interactive whiteboards, tablets, document cameras, and student response systems, modify instructional delivery and student learning. This case study was researched in four classrooms, including an English, math, science and social studies classroom…

Design and dosimetry of a few leaf electron collimator for energy modulated electron therapy

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

Al-Yahya, Khalid; Verhaegen, Frank; Seuntjens, Jan

2007-12-15

Despite the capability of energy modulated electron therapy (EMET) to achieve highly conformal dose distributions in superficial targets it has not been widely implemented due to problems inherent in electron beam radiotherapy such as planning dosimetry accuracy, and verification as well as a lack of systems for automated delivery. In previous work we proposed a novel technique to deliver EMET using an automated 'few leaf electron collimator' (FLEC) that consists of four motor-driven leaves fit in a standard clinical electron beam applicator. Integrated with a Monte Carlo based optimization algorithm that utilizes patient-specific dose kernels, a treatment delivery was incorporatedmore » within the linear accelerator operation. The FLEC was envisioned to work as an accessory tool added to the clinical accelerator. In this article the design and construction of the FLEC prototype that match our compact design goals are presented. It is controlled using an in-house developed EMET controller. The structure of the software and the hardware characteristics of the EMET controller are demonstrated. Using a parallel plate ionization chamber, output measurements were obtained to validate the Monte Carlo calculations for a range of fields with different energies and sizes. Further verifications were also performed for comparing 1-D and 2-D dose distributions using energy independent radiochromic films. Comparisons between Monte Carlo calculations and measurements of complex intensity map deliveries show an overall agreement to within {+-}3%. This work confirms our design objectives of the FLEC that allow for automated delivery of EMET. Furthermore, the Monte Carlo dose calculation engine required for EMET planning was validated. The result supports the potential of the prototype FLEC for the planning and delivery of EMET.« less

Electronic cigarette sales to minors via the internet.

PubMed

Williams, Rebecca S; Derrick, Jason; Ribisl, Kurt M

2015-03-01

Electronic cigarettes (e-cigarettes) entered the US market in 2007 and, with little regulatory oversight, grew into a $2-billion-a-year industry by 2013. The Centers for Disease Control and Prevention has reported a trend of increasing e-cigarette use among teens, with use rates doubling from 2011 to 2012. While several studies have documented that teens can and do buy cigarettes online, to our knowledge, no studies have yet examined age verification among Internet tobacco vendors selling e-cigarettes. To estimate the extent to which minors can successfully purchase e-cigarettes online and assess compliance with North Carolina's 2013 e-cigarette age-verification law. In this cross-sectional study conducted from February 2014 to June 2014, 11 nonsmoking minors aged 14 to 17 years made supervised e-cigarette purchase attempts from 98 Internet e-cigarette vendors. Purchase attempts were made at the University of North Carolina Internet Tobacco Vendors Study project offices using credit cards. Rate at which minors can successfully purchase e-cigarettes on the Internet. Minors successfully received deliveries of e-cigarettes from 76.5% of purchase attempts, with no attempts by delivery companies to verify their ages at delivery and 95% of delivered orders simply left at the door. All delivered packages came from shipping companies that, according to company policy or federal regulation, do not ship cigarettes to consumers. Of the total orders, 18 failed for reasons unrelated to age verification. Only 5 of the remaining 80 youth purchase attempts were rejected owing to age verification, resulting in a youth buy rate of 93.7%. None of the vendors complied with North Carolina's e-cigarette age-verification law. Minors are easily able to purchase e-cigarettes from the Internet because of an absence of age-verification measures used by Internet e-cigarette vendors. Federal law should require and enforce rigorous age verification for all e-cigarette sales as with the federal PACT (Prevent All Cigarette Trafficking) Act's requirements for age verification in Internet cigarette sales.

Lessons Learned from Migrating to an Online Electronic Business Management Course

ERIC Educational Resources Information Center

Walstrom, Kent A.

2014-01-01

This article describes the lessons learned while migrating an Electronic Business Management course from traditional face-to-face delivery to online delivery across a six and a half year time frame. The course under review teaches students how to develop and construct a working information-based online business using free versions of online…

Education of the handicapped child: Status, trend, and issues related to electronic delivery

NASA Technical Reports Server (NTRS)

Rothenberg, D.

1973-01-01

This study is part of a broader investigation of the role of large-scale educational telecommunications systems. Thus, data are analyzed and trends and issues discussed to provide information useful to the systems designer who wishes to identify and assess the opportunities for large-scale electronic delivery of education for the handicapped.

27 CFR 73.35 - Do I need to keep paper copies of forms I submit to TTB electronically?

Code of Federal Regulations, 2010 CFR

2010-04-01

... Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) PROCEDURES AND PRACTICES ELECTRONIC SIGNATURES; ELECTRONIC SUBMISSION OF FORMS Electronic Filing of Documents with TTB § 73... unless TTB otherwise authorizes you to maintain electronic copies of these documents through a general...

NLS Flight Simulation Laboratory (FSL) documentation

NASA Technical Reports Server (NTRS)

1995-01-01

The Flight Simulation Laboratory (FSL) Electronic Documentation System design consists of modification and utilization of the MSFC Integrated Engineering System (IES), translation of the existing FSL documentation to an electronic format, and generation of new drawings to represent the Engine Flight Simulation Laboratory design and implementation. The intent of the electronic documentation is to provide ease of access, local print/plot capabilities, as well as the ability to correct and/or modify the stored data by network users who are authorized to access this information.

Safety and fitness electronic records (SAFER) system : logical architecture document : working draft

DOT National Transportation Integrated Search

1997-01-31

This Logical Architecture Document includes the products developed during the functional analysis of the Safety and Fitness Electronic Records (SAFER) System. This document, along with the companion Operational Concept and Physical Architecture Docum...

26 CFR 1.6050W-2 - Electronic furnishing of information statements for payments made in settlement of payment card...

Code of Federal Regulations, 2014 CFR

2014-04-01

... statements required by section 6050W(f) electronically on a website instead of in a paper format. The letter... website, downloading the consent document, completing the consent document, and e-mailing the completed consent back to F. The consent document posted on the website uses the same electronic format that F uses...

26 CFR 1.6050W-2 - Electronic furnishing of information statements for payments made in settlement of payment card...

Code of Federal Regulations, 2012 CFR

2012-04-01

... statements required by section 6050W(f) electronically on a website instead of in a paper format. The letter... website, downloading the consent document, completing the consent document, and e-mailing the completed consent back to F. The consent document posted on the website uses the same electronic format that F uses...

26 CFR 1.6050W-2 - Electronic furnishing of information statements for payments made in settlement of payment card...

Code of Federal Regulations, 2013 CFR

2013-04-01

... statements required by section 6050W(f) electronically on a website instead of in a paper format. The letter... website, downloading the consent document, completing the consent document, and e-mailing the completed consent back to F. The consent document posted on the website uses the same electronic format that F uses...

Understanding Clinician Information Demands and Synthesis of Clinical Documents in Electronic Health Record Systems

ERIC Educational Resources Information Center

Farri, Oladimeji Feyisetan

2012-01-01

Large quantities of redundant clinical data are usually transferred from one clinical document to another, making the review of such documents cognitively burdensome and potentially error-prone. Inadequate designs of electronic health record (EHR) clinical document user interfaces probably contribute to the difficulties clinicians experience while…

10 CFR 2.304 - Formal requirements for documents; signatures; acceptance for filing.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., and General Hearing Management for NRC Adjudicatory Hearings § 2.304 Formal requirements for documents... section, it may be struck. (1) An electronic document must be signed using a participant's or a... paragraph (d) of this section. (i) When signing an electronic document using a digital ID certificate, the...

10 CFR 2.304 - Formal requirements for documents; signatures; acceptance for filing.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., and General Hearing Management for NRC Adjudicatory Hearings § 2.304 Formal requirements for documents... section, it may be struck. (1) An electronic document must be signed using a participant's or a... paragraph (d) of this section. (i) When signing an electronic document using a digital ID certificate, the...

10 CFR 2.304 - Formal requirements for documents; signatures; acceptance for filing.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Management for NRC Adjudicatory Hearings § 2.304 Formal requirements for documents; signatures; acceptance... section, it may be struck. (1) An electronic document must be signed using a participant's or a... paragraph (d) of this section. (i) When signing an electronic document using a digital ID certificate, the...

10 CFR 2.304 - Formal requirements for documents; signatures; acceptance for filing.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Management for NRC Adjudicatory Hearings § 2.304 Formal requirements for documents; signatures; acceptance... section, it may be struck. (1) An electronic document must be signed using a participant's or a... paragraph (d) of this section. (i) When signing an electronic document using a digital ID certificate, the...

Longitudinal analysis on utilization of medical document management system in a hospital with EPR implementation.

PubMed

Kuwata, Shigeki; Yamada, Hitomi; Park, Keunsik

2011-01-01

Document management systems (DMS) have widespread in major hospitals in Japan as a platform to digitize the paper-based records being out of coverage by EPR. This study aimed to examine longitudinal trends of actual use of DMS in a hospital in which EPR had been in operation, which would be conducive to planning the further information management system in the hospital. Degrees of utilization of electronic documents and templates with DMS were analyzed based on data extracted from a university-affiliated hospital with EPR. As a result, it was found that the number of electronic documents as well as scanned documents circulating at the hospital tended to increase. The result indicated that replacement of paper-based documents with electronic documents did not occur. Therefore it was anticipated that the need for DMS would continue to increase in the hospital. The methods used this study to analyze the trend of DMS utilization would be applicable to other hospitals with with a variety of DMS implementation, such as electronic storage by scanning documents or paper preservation that is compatible with EPR.

Genetic data and electronic health records: a discussion of ethical, logistical and technological considerations

PubMed Central

Shoenbill, Kimberly; Fost, Norman; Tachinardi, Umberto; Mendonca, Eneida A

2014-01-01

Objective The completion of sequencing the human genome in 2003 has spurred the production and collection of genetic data at ever increasing rates. Genetic data obtained for clinical purposes, as is true for all results of clinical tests, are expected to be included in patients’ medical records. With this explosion of information, questions of what, when, where and how to incorporate genetic data into electronic health records (EHRs) have reached a critical point. In order to answer these questions fully, this paper addresses the ethical, logistical and technological issues involved in incorporating these data into EHRs. Materials and methods This paper reviews journal articles, government documents and websites relevant to the ethics, genetics and informatics domains as they pertain to EHRs. Results and discussion The authors explore concerns and tasks facing health information technology (HIT) developers at the intersection of ethics, genetics, and technology as applied to EHR development. Conclusions By ensuring the efficient and effective incorporation of genetic data into EHRs, HIT developers will play a key role in facilitating the delivery of personalized medicine. PMID:23771953

78 FR 77354 - Procedural Rules To Permit Parties To File and Serve Documents Electronically

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

... by handwriting his or her signature. For documents filed by electronic transmission, a party may sign... transmission. A party or representative of the party shall sign a document by handwriting his signature. (2...

Development of a short course in transportation planning for electronic delivery to DOTD.

DOT National Transportation Integrated Search

2000-12-01

This report describes the preparation, delivery, and evaluation of a short course developed for delivery through compressed video to remote sites. The course covered basics of travel demand models and involved approximately 28 hours of classroom cont...

NASAwide electronic publishing system-prototype STI electronic document distribution: Stage-4 evaluation report. Part 2; Appendices

NASA Technical Reports Server (NTRS)

Tuey, Richard C.; Collins, Mary; Caswell, Pamela; Haynes, Bob; Nelson, Michael L.; Holm, Jeanne; Buquo, Lynn; Tingle, Annette; Cooper, Bill; Stiltner, Roy

1996-01-01

This evaluation report contains an introduction, seven chapters, and five appendices. The Introduction describes the purpose, conceptual framework, functional description, and technical report server of the Scientific and Technical Information (STI) Electronic Document Distribution (EDD) project. Chapter 1 documents the results of the prototype STI EDD in actual operation. Chapter 2 documents each NASA center's post processing publication processes. Chapter 3 documents each center's STI software, hardware. and communications configurations. Chapter 7 documents STI EDD policy, practices, and procedures. The appendices consist of (A) the STI EDD Project Plan, (B) Team members, (C) Phasing Schedules, (D) Accessing On-line Reports, and (E) Creating an HTML File and Setting Up an xTRS. In summary, Stage 4 of the NASAwide Electronic Publishing System is the final phase of its implementation through the prototyping and gradual integration of each NASA center's electronic printing systems, desk top publishing systems, and technical report servers, to be able to provide to NASA's engineers, researchers, scientists, and external users, the widest practicable and appropriate dissemination of information concerning its activities and the result thereof to their work stations.

Intrathecal Pump Exposure to Electromagnetic Interference: A Report of Device Interrogation following Multiple ECT Sessions.

PubMed

Bicket, Mark C; Hanna, George M

2016-02-01

Intrathecal drug delivery systems represent an increasingly common treatment modality for patients with a variety of conditions, including chronic pain and spasticity. Pumps rely on electronic programming to properly control and administer highly concentrated medications. Electromagnetic interference (EMI) is a known exposure that may cause a potential patient safety issue stemming from direct patient injury, pump damage, or changes to pump operation or flow rate. The objective of our case report was to describe an approach to evaluating a patient with a pump prior to and following exposure to EMI from electroconvulsive therapy (ECT), as well as to document findings from device interrogations associated with this event. Case report. Academic university-based pain management center. We present the case of a patient with an intrathecal pump who underwent multiple exposures to EMI in the form of 42 ECT sessions. Interrogation of the intrathecal drug delivery system revealed no safety issues following ECT sessions. At no time were error messages, unintentional changes in event logs, unintentional changes in pump settings, or evidence of pump stall or over-infusion noted. Communication with multiple entities (patient, family, consulting physicians, and device manufacturer) and maintaining vigilance through device interrogation both before and after EMI exposure are appropriate safeguards to mitigate the risk and detect potential adverse events of EMI with intrathecal drug delivery systems. Given the infrequent reports of device exposure to ECT, best practices may be derived from experience with EMI exposure from magnetic resonance imaging (MRI). Although routine EMI exposure to intrathecal drug delivery systems should be avoided, we describe one patient with repeated exposure to ECT without apparent complication.

Regulating plant physiology with organic electronics.

PubMed

Poxson, David J; Karady, Michal; Gabrielsson, Roger; Alkattan, Aziz Y; Gustavsson, Anna; Doyle, Siamsa M; Robert, Stéphanie; Ljung, Karin; Grebe, Markus; Simon, Daniel T; Berggren, Magnus

2017-05-02

The organic electronic ion pump (OEIP) provides flow-free and accurate delivery of small signaling compounds at high spatiotemporal resolution. To date, the application of OEIPs has been limited to delivery of nonaromatic molecules to mammalian systems, particularly for neuroscience applications. However, many long-standing questions in plant biology remain unanswered due to a lack of technology that precisely delivers plant hormones, based on cyclic alkanes or aromatic structures, to regulate plant physiology. Here, we report the employment of OEIPs for the delivery of the plant hormone auxin to induce differential concentration gradients and modulate plant physiology. We fabricated OEIP devices based on a synthesized dendritic polyelectrolyte that enables electrophoretic transport of aromatic substances. Delivery of auxin to transgenic Arabidopsis thaliana seedlings in vivo was monitored in real time via dynamic fluorescent auxin-response reporters and induced physiological responses in roots. Our results provide a starting point for technologies enabling direct, rapid, and dynamic electronic interaction with the biochemical regulation systems of plants.

Regulating plant physiology with organic electronics

PubMed Central

Poxson, David J.; Karady, Michal; Alkattan, Aziz Y.; Gustavsson, Anna; Robert, Stéphanie; Grebe, Markus; Berggren, Magnus

2017-01-01

The organic electronic ion pump (OEIP) provides flow-free and accurate delivery of small signaling compounds at high spatiotemporal resolution. To date, the application of OEIPs has been limited to delivery of nonaromatic molecules to mammalian systems, particularly for neuroscience applications. However, many long-standing questions in plant biology remain unanswered due to a lack of technology that precisely delivers plant hormones, based on cyclic alkanes or aromatic structures, to regulate plant physiology. Here, we report the employment of OEIPs for the delivery of the plant hormone auxin to induce differential concentration gradients and modulate plant physiology. We fabricated OEIP devices based on a synthesized dendritic polyelectrolyte that enables electrophoretic transport of aromatic substances. Delivery of auxin to transgenic Arabidopsis thaliana seedlings in vivo was monitored in real time via dynamic fluorescent auxin-response reporters and induced physiological responses in roots. Our results provide a starting point for technologies enabling direct, rapid, and dynamic electronic interaction with the biochemical regulation systems of plants. PMID:28420793

The Development of Electronic Distance Education Delivery Systems in the United States. Recurring and Emerging Themes in History and Philosophy of Education.

ERIC Educational Resources Information Center

Buckland, Michael; Dye, Charles M.

This paper presents a history of electronic distance education in the United States. Three broad categories of delivery systems are described: (1) over-the-air open circuit systems such as VHF-UHF stations, microwave, instructional television fixed service (ITFS), communications satellites, and educational radio and television; (2)…

Application of process improvement principles to increase the frequency of complete airway management documentation.

PubMed

McCarty, L Kelsey; Saddawi-Konefka, Daniel; Gargan, Lauren M; Driscoll, William D; Walsh, John L; Peterfreund, Robert A

2014-12-01

Process improvement in healthcare delivery settings can be difficult, even when there is consensus among clinicians about a clinical practice or desired outcome. Airway management is a medical intervention fundamental to the delivery of anesthesia care. Like other medical interventions, a detailed description of the management methods should be documented. Despite this expectation, airway documentation is often insufficient. The authors hypothesized that formal adoption of process improvement methods could be used to increase the rate of "complete" airway management documentation. The authors defined a set of criteria as a local practice standard of "complete" airway management documentation. The authors then employed selected process improvement methodologies over 13 months in three iterative and escalating phases to increase the percentage of records with complete documentation. The criteria were applied retrospectively to determine the baseline frequency of complete records, and prospectively to measure the impact of process improvements efforts over the three phases of implementation. Immediately before the initial intervention, a retrospective review of 23,011 general anesthesia cases over 6 months showed that 13.2% of patient records included complete documentation. At the conclusion of the 13-month improvement effort, documentation improved to a completion rate of 91.6% (P<0.0001). During the subsequent 21 months, the completion rate was sustained at an average of 90.7% (SD, 0.9%) across 82,571 general anesthetic records. Systematic application of process improvement methodologies can improve airway documentation and may be similarly effective in improving other areas of anesthesia clinical practice.

Electronic Flight Bag (EFB) 2015 Industry Survey.

DOT National Transportation Integrated Search

2015-10-01

This document provides an overview of Electronic Flight Bag (EFB) hardware and software capabilities, including portable electronic devices (PEDs) used as EFBs, as of July 2015. This document updates and replaces the Volpe Centers previous EFB ind...

Research Area 14.3 Microbiology and Biodegradation: Development of RNA-based Vectors for in vivo Delivery of siRNAs

DTIC Science & Technology

2014-09-08

P.O. Box 12211 Research Triangle Park, NC 27709-2211 Vector, RNAi, delivery REPORT DOCUMENTATION PAGE 11. SPONSOR/MONITOR’S REPORT NUMBER(S) 10...suggesstions for reducing this burden, to Washington Headquarters Services , Directorate for Information Operations and Reports, 1215 Jefferson Davis...Shapiro, Alissa M Pham, Benjamin R tenOever. In Vivo Delivery of Cytoplasmic RNA Virus-derived miRNAs, Molecular Therapy, (11 2011): 0. doi

29 CFR 801.71 - Filing and service.

Code of Federal Regulations, 2011 CFR

2011-07-01

... EMPLOYEE POLYGRAPH PROTECTION ACT OF 1988 Administrative Proceedings Modification Or Vacation of Decision... of time for delivery by mail. Documents are not deemed filed with the Secretary until actually... Secretary either on or before the due date. No additional time shall be added where service of a document...

29 CFR 801.71 - Filing and service.

Code of Federal Regulations, 2010 CFR

2010-07-01

... EMPLOYEE POLYGRAPH PROTECTION ACT OF 1988 Administrative Proceedings Modification Or Vacation of Decision... of time for delivery by mail. Documents are not deemed filed with the Secretary until actually... Secretary either on or before the due date. No additional time shall be added where service of a document...

Ohio Health Technology Competency Profile.

ERIC Educational Resources Information Center

Boudreau, Joyce; Miller, Lavonna F.

This document, which was jointly developed by representatives from a broad cross-section of Ohio's health care industries and educators representing Ohio's schools and colleges, is intended as a foundation for developing an integrated delivery system to prepare students for careers in health care. The document's introductory section presents…

Mechanized Packing and Delivery System for Entomopathogenic Nematodes in Infected Mealworm Cadavers

USDA-ARS?s Scientific Manuscript database

This document describes a mechanized system to pack mealworm (Tenebrio molitor) cadavers infected with entomopathogenic nematodes between two sheets of masking tape. The document is also an operation manual for the machine and provides all the machine specifications, and wiring and pneumatic diagram...

34 CFR 300.196 - Filing requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... written submission under § 300.194 must be filed by hand-delivery, by mail, or by facsimile transmission...) The filing date under paragraph (a) of this section is the date the document is— (1) Hand-delivered..., may require the filing of a follow-up hard copy by hand-delivery or by mail within a reasonable period...

43 CFR 4.413 - Service of notice of appeal and of other documents.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 25007 (D-105), Denver Federal Center, Denver, CO 80225; Other Delivery Services: Regional Solicitor..., Lakewood, CO 80215; (v) BLM Eastern States Office, including all District and Area Offices within its area... Interior, P.O. Box 31394, Billings, MT 59107-1394; Other Delivery Services: Field Solicitor, U.S...

Wyoming Academic Libraries Resource Project: Developing a Statewide Ariel Document Delivery Network. Final Report.

ERIC Educational Resources Information Center

Lange, Karen

The Wyoming Academic Libraries Resource Project was initiated to improve cooperation and resource sharing by developing an interconnected information access and delivery system among Wyoming's academic libraries and the State Library. The goal was to formalize communication, cooperation, and resource sharing by developing an Ariel document…

78 FR 51808 - 34th Meeting: RTCA Special Committee 206, Aeronautical Information and Meteorological Data Link...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-21

... to Support ATC Winds SC-214 Briefing TOR Changes Other business Sub-Groups meetings Sep 24-26... MET Delivery Architecture Recommendations review Sep 27, Friday, Closing Plenary Sub-Groups reports Appoval for AIS and MET Delivery Architecture Recommendations document to enter FRAC Action item review...

Telemedicine and security. Confidentiality, integrity, and availability: a Canadian perspective.

PubMed

Jennett, P; Watanabe, M; Igras, E; Premkumar, K; Hall, W

1996-01-01

The health care system is undergoing major reform, characterized by organized delivery systems (regionalization, decentralization, devolution, etc); shifts in care delivery sites; changing health provider roles; increasing consumer responsibilities; and accountability. Rapid advances in information technology and telecommunications have led to a new type of information infrastructure which can play a major role in this reform. Compatible health information systems are now being integrated and connected across institutional, regional, and sectorial boundaries. In the near future, these information systems will readily be accessed and shared by health providers, researchers, policy makers, health consumers, and the public. SECURITY is a critical characteristic of any health information system. This paper will address three fields associated with SECURITY: confidentiality, integrity, and availability. These will be defined and examined as they relate to specific aspects of Telemedicine, such as electronic integrated records and clinical databases; electronic transfer of documents; as well as data storage and disposal. The guiding principles, standards, and safeguards being considered and put in place to ensure that telemedicine information intrastructures can protect and benefit all stakeholders' rights and needs in both primary and secondary uses of information will be reviewed. Implemented, proposed, and tested institutional, System, and Network solutions will be discussed; for example, encryption-decryption methods; data transfer standards; individual and terminal access and entry I.D. and password levels; smart card access and PIN number control; data loss prevention strategies; interference alerts; information access keys; algorithm safeguards; and active marketing to users of standards and principles. Issues such as policy, implementation, and ownership will be addressed.

Development of electronic medical record charting for hospital-based transfusion and apheresis medicine services: Early adoption perspectives

PubMed Central

Levy, Rebecca; Pantanowitz, Liron; Cloutier, Darlene; Provencher, Jean; McGirr, Joan; Stebbins, Jennifer; Cronin, Suzanne; Wherry, Josh; Fenton, Joseph; Donelan, Eileen; Johari, Vandita; Andrzejewski, Chester

2010-01-01

Background: Electronic medical records (EMRs) provide universal access to health care information across multidisciplinary lines. In pathology departments, transfusion and apheresis medicine services (TAMS) involved in direct patient care activities produce data and documentation that typically do not enter the EMR. Taking advantage of our institution's initiative for implementation of a paperless medical record, our TAMS division set out to develop an electronic charting (e-charting) strategy within the EMR. Methods: A focus group of our hospital's transfusion committee consisting of transfusion medicine specialists, pathologists, residents, nurses, hemapheresis specialists, and information technologists was constituted and charged with the project. The group met periodically to implement e-charting TAMS workflow and produced electronic documents within the EMR (Cerner Millenium) for various service line functions. Results: The interdisciplinary working group developed and implemented electronic versions of various paper-based clinical documentation used by these services. All electronic notes collectively gather and reside within a unique Transfusion Medicine Folder tab in the EMR, available to staff with access to patient charts. E-charting eliminated illegible handwritten notes, resulted in more consistent clinical documentation among staff, and provided greater realered. However, minor updates and corrections to documents as well as select work re-designs were required for optimal use of e-charting-time review/access of hemotherapy practices. No major impediments to workflow or inefficiencies have been encount by these services. Conclusion: Documentation of pathology subspecialty activities such as TAMS can be successfully incorporated into the EMR. E-charting by staff enhances communication and helps promote standardized documentation of patient care within and across service lines. Well-constructed electronic documents in the EMR may also enhance data mining, quality improvement, and biovigilance monitoring activities. PMID:20805955

OC28 - Effect of mode of delivery on early oral colonization and childhood dental caries: a systematic review.

PubMed

Antão, Celeste; Teixeira, Cristina; Gomes, Maria José

2016-05-09

Theme: Multidisciplinary team working. Oral colonization starts at birth by vertical transmission. To determine whether mode of delivery influences the oral colonization of infants and contributes to the risk of childhood dental caries. A systematic review was conducted in the electronic database Web of Science for articles published from January 1995 to December 2015 by using a set of keywords. From 2,644 citations identified through electronic search, ten studies met the inclusion criteria. According to the studies mode of delivery influences oral microbial density, oral microbial profile and the timing of oral colonization by cariogenic microbiota. However, there are no consistent results concerning either the prevalence of children harboring cariogenic microbiota or the prevalence of early childhood caries by mode of delivery. Mode of delivery influences early oral colonization. However, it seems that other determinants rather than mode of delivery could be major contributors to the development of early childhood caries.

Development of a high average current polarized electron source with long cathode operational lifetime

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

C. K. Sinclair; P. A. Adderley; B. M. Dunham

Substantially more than half of the electromagnetic nuclear physics experiments conducted at the Continuous Electron Beam Accelerator Facility of the Thomas Jefferson National Accelerator Facility (Jefferson Laboratory) require highly polarized electron beams, often at high average current. Spin-polarized electrons are produced by photoemission from various GaAs-based semiconductor photocathodes, using circularly polarized laser light with photon energy slightly larger than the semiconductor band gap. The photocathodes are prepared by activation of the clean semiconductor surface to negative electron affinity using cesium and oxidation. Historically, in many laboratories worldwide, these photocathodes have had short operational lifetimes at high average current, and havemore » often deteriorated fairly quickly in ultrahigh vacuum even without electron beam delivery. At Jefferson Lab, we have developed a polarized electron source in which the photocathodes degrade exceptionally slowly without electron emission, and in which ion back bombardment is the predominant mechanism limiting the operational lifetime of the cathodes during electron emission. We have reproducibly obtained cathode 1/e dark lifetimes over two years, and 1/e charge density and charge lifetimes during electron beam delivery of over 2?105???C/cm2 and 200 C, respectively. This source is able to support uninterrupted high average current polarized beam delivery to three experimental halls simultaneously for many months at a time. Many of the techniques we report here are directly applicable to the development of GaAs photoemission electron guns to deliver high average current, high brightness unpolarized beams.« less

eC3--a modern telecommunications matrix for cervical cancer prevention in Zambia.

PubMed

Parham, Groesbeck P; Mwanahamuntu, Mulindi H; Pfaendler, Krista S; Sahasrabuddhe, Vikrant V; Myung, Daniel; Mkumba, Gracilia; Kapambwe, Sharon; Mwanza, Bianca; Chibwesha, Carla; Hicks, Michael L; Stringer, Jeffrey S A

2010-07-01

Low physician density, undercapacitated laboratory infrastructures, and limited resources are major limitations to the development and implementation of widely accessible cervical cancer prevention programs in sub-Saharan Africa. We developed a system operated by nonphysician health providers that used widely available and affordable communication technology to create locally adaptable and sustainable public sector cervical cancer prevention program in Zambia, one of the world's poorest countries. Nurses were trained to perform visual inspection with acetic acid aided by digital cervicography using predefined criteria. Electronic digital images (cervigrams) were reviewed with patients, and distance consultation was sought as necessary. Same-visit cryotherapy or referral for further evaluation by a gynecologist was offered. The Zambian system of "electronic cervical cancer control" bypasses many of the historic barriers to the delivery of preventive health care to women in low-resource environments while facilitating monitoring, evaluation, and continued education of primary health care providers, patient education, and medical records documentation. The electronic cervical cancer control system uses appropriate technology to bridge the gap between screening and diagnosis, thereby facilitating the conduct of "screen-and-treat" programs. The inherent flexibility of the system lends itself to the integration with future infrastructures using rapid molecular human papillomavirus-based screening approaches and wireless telemedicine communications.

Seamless Management of Paper and Electronic Documents for Task Knowledge Sharing

NASA Astrophysics Data System (ADS)

Kojima, Hiroyuki; Iwata, Ken

Due to the progress of Internet technology and the increase of distributed information on networks, the present knowledge management has been based more and more on the performance of various experienced users. In addition to the increase of electronic documents, the use of paper documents has not been reduced because of their convenience. This paper describes a method of tracking paper document locations and contents using radio frequency identification (RFID) technology. This research also focuses on the expression of a task process and the seamless structuring of related electronic and paper documents as a result of task knowledge formalization using information organizing. A system is proposed here that implements information organization for both Web documents and paper documents with the task model description and RFID technology. Examples of a prototype system are also presented.

Intervention research to enhance community pharmacists' cognitive services: a systematic review.

PubMed

Patwardhan, Pallavi D; Amin, Mohamed E; Chewning, Betty A

2014-01-01

Positive impact of community pharmacists' cognitive pharmaceutical services (CPS) is well documented. However, community pharmacists have been slow to expand CPS roles. This systematic review explores how community pharmacy intervention research can help inform efforts to expand cognitive pharmaceutical service delivery. To: 1) identify community pharmacy CPS intervention studies that report data on pharmacist behaviors, either as a final study outcome itself or as a fidelity measure in patient outcome studies, and 2) describe the state of this research to help frame future research agendas. Empirical articles examining improvement or expansion of community pharmacist cognitive services published through December 2010 were searched using various search engines, bibliography searches and authors' libraries. Studies were included if they: 1) reported findings on pharmacist behaviors during cognitive service delivery, 2) employed a minimum of pre-post design or two study arms for pharmacists/pharmacies, and 3) were in community-based pharmacies. A total of 50 studies evaluated impact of community pharmacy based CPS delivery; however, only 21 included a pharmacist behavior outcome measure as a final outcome or as a fidelity measure. The majority (14 out of 21) of studies used a randomized controlled trial design. Nearly half (10 of 21) addressed asthma or tobacco cessation. Limited details were provided about interventions to prepare pharmacists for CPS delivery. The most frequent measures of pharmacist behavior were patient surveys and observation of pharmacists' behavior by secret shoppers; electronic data sets were rarely used. There is a need for well-designed intervention research that evaluates how interventions impact on pharmacist cognitive service behavior. Positive findings from this review reinforce that planned interventions have the potential to improve and expand pharmacist cognitive service delivery; however, more detail is needed in study publications for this potential to be fully realized. Copyright © 2014 Elsevier Inc. All rights reserved.

Development of a prediction model on the acceptance of electronic laboratory notebooks in academic environments.

PubMed

Kloeckner, Frederik; Farkas, Robert; Franken, Tobias; Schmitz-Rode, Thomas

2014-04-01

Documentation of research data plays a key role in the biomedical engineering innovation processes. It makes an important contribution to the protection of intellectual property, the traceability of results and fulfilling the regulatory requirement. Because of the increasing digitalization in laboratories, an electronic alternative to the commonly-used paper-bound notebooks could contribute to the production of sophisticated documentation. However, compared to in an industrial environment, the use of electronic laboratory notebooks is not widespread in academic laboratories. Little is known about the acceptance of an electronic documentation system and the underlying reasons for this. Thus, this paper aims to establish a prediction model on the potential preference and acceptance of scientists either for paper-based or electronic documentation. The underlying data for the analysis originate from an online survey of 101 scientists in industrial, academic and clinical environments. Various parameters were analyzed to identify crucial factors for the system preference using binary logistic regression. The analysis showed significant dependency between the documentation system preference and the supposed workload associated with the documentation system (p<0.006; odds ratio=58.543) and an additional personal component. Because of the dependency of system choice on specific parameters it is possible to predict the acceptance of an electronic laboratory notebook before implementation.

49 CFR 236.1037 - Records retention.

Code of Federal Regulations, 2010 CFR

2010-10-01

... railroad shall: (1) Report the inconsistency in writing by mail, facsimile, e-mail, or hand delivery to the... approved Type Approval, if any, PTCDP, and PTCSP that it holds; (2) Adequate documentation to demonstrate..., DC 20590, within 15 days of discovery. Documents that are hand delivered must not be enclosed in an...

33 CFR 20.304 - Service of documents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... other filed document (i) Mail.(ii) Personal delivery. (iii) Express-courier service. (iv) Fax. (v) Other... representative. Is not represented The last known address of the residence or principal place of business of the...) Delivered to the person's office during business hours. (iii) Delivered to the person's residence and...

Prostate Dose Escalation by Innovative Inverse Planning-Driven IMRT

DTIC Science & Technology

2005-11-01

Galvin, J. M.; Low, D.; Palta , J. R.; Rosen, I.; Sharpe, M. B.; Xia, P.; Xiao, Y.; Xing, L.; Yu, C. X., Guidance document on delivery, treatment planning... Palta , J., Implementing IMRT in clinical practice: ajoint document of the American Society for Therapeutic Radiology and Oncology and the American

ISS Crew Transportation and Services Requirements Document

NASA Technical Reports Server (NTRS)

Bayt, Robert L. (Compiler); Lueders, Kathryn L. (Compiler)

2016-01-01

The ISS Crew Transportation and Services Requirements Document (CCT-REQ-1130) contains all technical, safety, and crew health medical requirements that are mandatory for achieving a Crew Transportation System Certification that will allow for International Space Station delivery and return of NASA crew and limited cargo. Previously approved on TN23183.

IFLA General Conference, 1986. Pre-Session Seminar, Kanasawa. Papers.

ERIC Educational Resources Information Center

International Federation of Library Associations and Institutions, The Hague (Netherlands).

The two papers in this document were presented at a pre-session held before the IFLA general conference in 1986. In "Problems of Document Delivery in the Science and Technology Information Environment--An African View," Lucilda Hunter (Sierra Leone) discusses typical difficulties encountered in the process of information retrieval in…

Electronics Teacher's Guide. Science and Technology Document Series No. 40.

ERIC Educational Resources Information Center

Lewis, John

This is the second document on the teaching of electronics to appear as part of UNESCO's science and technology education program. An introductory section describes the role that electronics plays as part of the physics curriculum. The following section outlines the content of the electronics course. The outline includes guidelines for determining…

Creating a Living Portfolio: Documenting Student Growth with Electronic Portfolios.

ERIC Educational Resources Information Center

Siegle, Del

2002-01-01

This article explains how teachers can use electronic portfolios of students' work to document learner progress. It considers different file formats for storing student work, describes steps to creating an electronic portfolio, and discusses an art and literature electronic magazine created by one school featuring work from student portfolios. (CR)

Inter-professional electronic documents and child health: a study of persisting non-electronic communication in the use of electronic documents.

PubMed

Saario, Sirpa; Hall, Christopher; Peckover, Sue

2012-12-01

Information and communication technologies are widely used in health and social care settings to replace previous means of record keeping, assessment and communication. Commentary on the strengths and weaknesses of such systems abound, thus it is useful to examine how they are used in practice. This article draws on findings from two separate studies, conducted between 2005 and 2007, which examined how child health and welfare professionals use electronic documents in Finland and England. Known respectively as Miranda and CAF, these systems are different in terms of structure and function but in their everyday use common features are identified, notably the continued use of and reliance on non-electronic means of communication. Based on interviews with professionals, three forms of non-electronic communication are described: alternative records, phone calls and letters, which facilitate the sharing of the electronic record. Finally, the electronic documents are further analysed as potential boundary objects which aim to create common understanding between sites and professionals. Copyright © 2012 Elsevier Ltd. All rights reserved.

5 CFR 1201.4 - General definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... documents associated with electronic filings under paragraph (h) of § 1201.14, on the MSPB. (l) Date of... date of electronic submission. (m) Electronic filing (e-filing). Filing and receiving documents in... of Personnel Management reconsideration decisions concerning retirement benefits, and appeals of...

5 CFR 1201.4 - General definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... documents associated with electronic filings under paragraph (h) of § 1201.14, on the MSPB. (l) Date of... date of electronic submission. (m) Electronic filing (e-filing). Filing and receiving documents in... of Personnel Management reconsideration decisions concerning retirement benefits, and appeals of...

46 CFR 67.218 - Optional filing of instruments in portable document format as attachments to electronic mail.

Code of Federal Regulations, 2010 CFR

2010-10-01

... recording under § 67.200 may be submitted in portable document format (.pdf) as an attachment to electronic... submitted for filing in .pdf format pertains to a vessel that is not a currently documented vessel, a... with the National Vessel Documentation Center or must be submitted in .pdf format with the instrument...

12 CFR 1209.29 - Discovery.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the timely, cost-effective management of document discovery (including, if applicable, electronically... discovery plan shall specify the form of electronic productions, if any. Documents are to be produced in... proceeding under this part may obtain document discovery by serving upon any other party in the proceeding a...

12 CFR 1209.29 - Discovery.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the timely, cost-effective management of document discovery (including, if applicable, electronically... discovery plan shall specify the form of electronic productions, if any. Documents are to be produced in... proceeding under this part may obtain document discovery by serving upon any other party in the proceeding a...

12 CFR 1209.29 - Discovery.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the timely, cost-effective management of document discovery (including, if applicable, electronically... discovery plan shall specify the form of electronic productions, if any. Documents are to be produced in... proceeding under this part may obtain document discovery by serving upon any other party in the proceeding a...

Electronic health records: eliciting behavioral health providers' beliefs.

PubMed

Shank, Nancy; Willborn, Elizabeth; Pytlikzillig, Lisa; Noel, Harmonijoie

2012-04-01

Interviews with 32 community behavioral health providers elicited perceived benefits and barriers of using electronic health records. Themes identified were (a) quality of care, (b) privacy and security, and (c) delivery of services. Benefits to quality of care were mentioned by 100% of the providers, and barriers by 59% of providers. Barriers involving privacy and security concerns were mentioned by 100% of providers, and benefits by 22%. Barriers to delivery of services were mentioned by 97% of providers, and benefits by 66%. Most providers (81%) expressed overall positive support for electronic behavioral health records.

Impact of an EHR-based diabetes management form on quality and outcomes of diabetes care in primary care practices.

PubMed

Herrin, Jeph; da Graca, Briget; Aponte, Phil; Stanek, H Greg; Cowling, Terianne; Fullerton, Cliff; Hollander, Priscilla; Ballard, David J

2015-01-01

Health information technology shows promise for improving chronic disease care. This study assessed the impact of a diabetes management form (DMF), accessible within an electronic health record. From 2007 to 2009, 2108 diabetes patients were seen in 20 primary care practices; 1103 visits involved use of the DMF in 2008. The primary outcome was "optimal care": HbA1c ≤8%, low-density lipoprotein (LDL) cholesterol <100 mg/dL, blood pressure <130/80 mm Hg, not smoking, and aspirin prescription in patients ≥40 years. After adjusting for number of visits, age, sex, and insulin use, DMF-exposed patients showed less improvement in attaining "optimal care" (estimated difference-in-difference [DID] = -2.06 percentage points; P < .001), LDL cholesterol (DID = -2.30; P = .023), blood pressure (DID = -3.05; P < .001), and total cholesterol (DID = -0.47; P = .004) targets. Documented microalbumin tests, aspirin prescription, and eye and foot exams increased more. Thus, DMF use was associated with smaller gains in achieving evidence-based targets, but greater improvement in documented delivery of care. © 2013 by the American College of Medical Quality.

Competencies for optimal practice in integrated environments: examining attributes of a consensus interprofessional practice document from the licensed integrative health disciplines.

PubMed

Goldblatt, Elizabeth; Wiles, Michael; Schwartz, Jan; Weeks, John

2013-01-01

The Academic Consortium for Complementary and Alternative Health Care (ACCAHC) is committed to advancing human health through the advancement and integration of the complementary and alternative medicine (CAM) professions within the American healthcare system. This will involve the maturation and integration of the licensed CAM professions into conventional healthcare delivery, and in turn, it will involve the development of competency in integrative healthcare and interprofessional education within the CAM professions. In 2010, ACCAHC resolved to identify the competencies necessary for this transformation, and in the process, discovered a parallel process of competency development within conventional healthcare, the Interprofessional Education Collaborative (IPEC), representing the six major conventional healthcare professions. The ACCAHC competency document, its development, and its similarity to the IPEC document are discussed. The ACCAHC competency document identified two domains of competence that were not present in the IPEC document: evidence-informed practice and institutional healthcare practices. These two domains of competency are discussed with respect to their significance in both CAM and conventional healthcare practices. ACCAHC's goal is to foster collaboration among its member professions and with conventional healthcare professions, and to use these competency documents to improve and optimize healthcare delivery, practices, and outcomes in America. It is hoped that ACCAHC's competency document will catalyze interaction with IPEC leading to the adoption of a single shared competency document that will meet the needs of all healthcare providers and educators. © 2013 Elsevier Inc. All rights reserved.

Assessment of the Content, Design, and Dissemination of the Real Warriors Campaign

DTIC Science & Technology

2012-01-01

by law as indicated in a notice appearing later in this work. This electronic representation of RAND intellectual property is provided for non...commercial use only. Unauthorized posting of RAND electronic documents to a non-RAND website is prohibited. RAND electronic documents are protected under...copyright law. Permission is required from RAND to reproduce, or reuse in another form, any of our research documents for commercial use. For

Electron/proton spectrometer certification documentation analyses

NASA Technical Reports Server (NTRS)

Gleeson, P.

1972-01-01

A compilation of analyses generated during the development of the electron-proton spectrometer for the Skylab program is presented. The data documents the analyses required by the electron-proton spectrometer verification plan. The verification plan was generated to satisfy the ancillary hardware requirements of the Apollo Applications program. The certification of the spectrometer requires that various tests, inspections, and analyses be documented, approved, and accepted by reliability and quality control personnel of the spectrometer development program.

Design and implementation of an inpatient physician documentation system using off-the-shelf components.

PubMed

Cucina, Russell J; Bokser, Seth J; Carter, Jonathan T; McLaren, Kevin M; Blum, Michael S

2007-10-11

We report the development and implementation of an electronic inpatient physician documentation system using off-the-shelf components, rapidly and at low cost. Within 9 months of deployment, over half of physician notes were electronic, and within 20 months, paper physician notes were eliminated. Our results suggest institutions can prioritize conversion to inpatient electronic physician documentation without waiting for development of sophisticated software packages or large capital investments.

Implementation of standardized nomenclature in the electronic medical record.

PubMed

Klehr, Joan; Hafner, Jennifer; Spelz, Leah Mylrea; Steen, Sara; Weaver, Kathy

2009-01-01

To describe a customized electronic medical record documentation system which provides an electronic health record, Epic, which was implemented in December 2006 using standardized taxonomies for nursing documentation. Descriptive data is provided regarding the development, implementation, and evaluation processes for the electronic medical record system. Nurses used standardized nursing nomenclature including NANDA-I diagnoses, Nursing Interventions Classification, and Nursing Outcomes Classification in a measurable and user-friendly format using the care plan activity. Key factors in the success of the project included close collaboration among staff nurses and information technology staff, ongoing support and encouragement from the vice president/chief nursing officer, the ready availability of expert resources, and nursing ownership of the project. Use of this evidence-based documentation enhanced institutional leadership in clinical documentation.

Patient Perceptions of Treatment Delivery Platforms for Cognitive Behavioral Therapy for Insomnia.

PubMed

Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Laba, Tracey-Lea; Saini, Bandana

2017-03-21

Stepped care has given rise to the proliferation of abbreviated CBT-I programs and delivery formats. This includes interventions delivered by allied health professionals and those delivered electronically through the Internet. This article aims to explore patient perceptions between electronic and face-to-face (FTF) delivery platforms for (abbreviated) CBT-I. Patients with insomnia from specialist sleep or psychology clinics and those from the general community in Sydney, Australia. Semistructured interviews were conducted with patients with insomnia, guided by a schedule of questions and a choice task to explore patient perceptions of the different CBT-I treatment delivery platforms (e.g., perceived advantages and disadvantages or willingness to engage with either platform). Interviews were transcribed verbatim and analyzed using Framework Analysis. Participants also completed a battery of clinical mood and insomnia measures. Fifty-one interviews were conducted with patients with insomnia from specialist sleep or psychology clinics (n = 22) and the general community (n = 29). Synthesis of the qualitative data set revealed three themes pertinent to the patients' perspective toward electronic and FTF CBT-I delivery: Concepts of Efficacy, Concerns About Treatment, and Treatment on My Terms. Participants' choice to engage with either platform was also informed by diverse factors including perceived efficacy of treatment, personal commitments, lifestyle, and beliefs about sleep and insomnia. Clarifying patient treatment priorities and allaying potential concerns about engaging with an electronic treatment platform represent important steps for disseminating eCBT-I into mainstream practice.

Facilitators and barriers to implementing electronic referral and/or consultation systems: a qualitative study of 16 health organizations.

PubMed

Tuot, Delphine S; Leeds, Kiren; Murphy, Elizabeth J; Sarkar, Urmimala; Lyles, Courtney R; Mekonnen, Tekeshe; Chen, Alice H M

2015-12-19

Access to specialty care remains a challenge for primary care providers and patients. Implementation of electronic referral and/or consultation (eCR) systems provides an opportunity for innovations in the delivery of specialty care. We conducted key informant interviews to identify drivers, facilitators, barriers and evaluation metrics of diverse eCR systems to inform widespread implementation of this model of specialty care delivery. Interviews were conducted with leaders of 16 diverse health care delivery organizations between January 2013 and April 2014. A limited snowball sampling approach was used for recruitment. Content analysis was used to examine key informant interview transcripts. Electronic referral systems, which provide referral management and triage by specialists, were developed to enhance tracking and operational efficiency. Electronic consultation systems, which encourage bi-directional communication between primary care and specialist providers facilitating longitudinal virtual co-management, were developed to improve access to specialty expertise. Integrated eCR systems leverage both functionalities to enhance the delivery of coordinated, specialty care at the population level. Elements of successful eCR system implementation included executive and clinician leadership, established funding models for specialist clinician reimbursement, and a commitment to optimizing clinician workflows. eCR systems have great potential to streamline access to and enhance the coordination of specialty care delivery. While different eCR models help solve different organizational challenges, all require institutional investments for successful implementation, such as funding for program management, leadership and clinician incentives.

Using an electronic medical record to improve communication within a prenatal care network.

PubMed

Bernstein, Peter S; Farinelli, Christine; Merkatz, Irwin R

2005-03-01

In 2002, the Institute of Medicine called for the introduction of information technologies in health care settings to improve quality of care. We conducted a review of hospital charts of women who delivered before and after the implementation of an intranet-based computerized prenatal record in an inner-city practice. Our objective was to assess whether the use of this record improved communication among the outpatient office, the ultrasonography unit, and the labor floor. The charts of patients who delivered in August 2002 and August 2003 and received their prenatal care at the Comprehensive Family Care Center at Montefiore Medical Center were analyzed. Data collected included the presence of a copy of the prenatal record in the hospital chart, the date of the last documented prenatal visit, and documentation of any prenatal ultrasonograms performed. Forty-three charts in each group were available for review. The prenatal chart was absent in 16% of the charts of patients from August 2002 compared with only 2% in August 2003 charts (P < .05). Among charts with prenatal records available, the median length of time between the last documented prenatal visit and delivery was significantly longer for August 2002 patients compared with August 2003 patients (36 compared with 4 days, respectively, P < .001). All patients received prenatal ultrasonograms, but documentation of the ultrasonogram was missing from 16% of the August 2002 charts compared with none of the August 2003 charts (P = .01). The use of a paperless, hospital intranet-based prenatal chart significantly improves communication among providers.

Development and Pilot Testing of a Video-Assisted Informed Consent Process

PubMed Central

Sonne, Susan C.; Andrews, Jeannette O.; Gentilin, Stephanie M.; Oppenheimer, Stephanie; Obeid, Jihad; Brady, Kathleen; Wolf, Sharon; Davis, Randal; Magruder, Kathryn

2013-01-01

The informed consent process for research has come under scrutiny, as consent documents are increasingly long and difficult to understand. Innovations are needed to improve comprehension in order to make the consent process truly informed. We report on the development and pilot testing of video clips that could be used during the consent process to better explain research procedures to potential participants. Based on input from researchers and community partners, 15 videos of common research procedures/concepts were produced. The utility of the videos was then tested by embedding them in mock informed consent documents that were presented via an online electronic consent system designed for delivery via iPad. Three mock consents were developed, each containing five videos. All participants (n=61) read both a paper version and the video-assisted iPad version of the same mock consent and were randomized to which format they reviewed first. Participants were given a competency quiz that posed specific questions about the information in the consent after reviewing the first consent document to which they were exposed. Most participants (78.7%) preferred the video-assisted format compared to paper (12.9%). Nearly all (96.7%) reported that the videos improved their understanding of the procedures described in the consent document; however, comprehension of material did not significantly differ by consent format. Results suggest videos may be helpful in providing participants with information about study procedures in a way that is easy to understand. Additional testing of video consents for complex protocols and with subjects of lower literacy is warranted. PMID:23747986

Development and pilot testing of a video-assisted informed consent process.

PubMed

Sonne, Susan C; Andrews, Jeannette O; Gentilin, Stephanie M; Oppenheimer, Stephanie; Obeid, Jihad; Brady, Kathleen; Wolf, Sharon; Davis, Randal; Magruder, Kathryn

2013-09-01

The informed consent process for research has come under scrutiny, as consent documents are increasingly long and difficult to understand. Innovations are needed to improve comprehension in order to make the consent process truly informed. We report on the development and pilot testing of video clips that could be used during the consent process to better explain research procedures to potential participants. Based on input from researchers and community partners, 15 videos of common research procedures/concepts were produced. The utility of the videos was then tested by embedding them in mock-informed consent documents that were presented via an online electronic consent system designed for delivery via iPad. Three mock consents were developed, each containing five videos. All participants (n = 61) read both a paper version and the video-assisted iPad version of the same mock consent and were randomized to which format they reviewed first. Participants were given a competency quiz that posed specific questions about the information in the consent after reviewing the first consent document to which they were exposed. Most participants (78.7%) preferred the video-assisted format compared to paper (12.9%). Nearly all (96.7%) reported that the videos improved their understanding of the procedures described in the consent document; however, the comprehension of material did not significantly differ by consent format. Results suggest videos may be helpful in providing participants with information about study procedures in a way that is easy to understand. Additional testing of video consents for complex protocols and with subjects of lower literacy is warranted. Copyright © 2013 Elsevier Inc. All rights reserved.

78 FR 123 - Diablo Canyon, Independent Spent Fuel Storage Installation; License Amendment Request...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-02

... receipt of the document. The E-Filing system also distributes an email notice that provides access to the...: Rulemaking and Adjudications Staff; or (2) courier, express mail, or expedited delivery service to the Office... mail as of the time of deposit in the mail, or by courier, express mail, or expedited delivery service...

78 FR 119 - Consideration of Approval of Application Containing Sensitive Unclassified Non-Safeguards...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-02

... receipt of the document. The E-Filing system also distributes an email notice that provides access to the...: Rulemaking and Adjudications Staff; or (2) courier, express mail, or expedited delivery service to the Office... mail as of the time of deposit in the mail, or by courier, express mail, or expedited delivery service...

78 FR 3454 - Prairie Island, Independent Spent Fuel Storage Installation; Notice of Docketing of Amendment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-16

...-Filing system also distributes an email notice that provides access to the document to the NRC's Office... Adjudications Staff; or (2) courier, express mail, or expedited delivery service to the Office of the Secretary... time of deposit in the mail, or by courier, express mail, or expedited delivery service upon depositing...

Adolescent Health. Volume III: Crosscutting Issues in the Delivery of Health and Related Services.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Office of Technology Assessment.

This document, the third of three volumes in the U.S. Congress Office of Technology Assessment's "Adolescent Health" series, contains chapters 15 through 19, which address issues in the delivery of health and related services to adolescents. Chapter 15 reviews research on the shortcomings of the mainstream primary health care system with…

49 CFR 1548.7 - Approval, amendment, annual renewal, and withdrawal of approval of the security program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... behalf of it and other indirect air carriers that co-sign the proposal. (1) Within 30 calendar days after... accomplished by personal delivery, certified mail, or express courier. Documents served on an indirect air... personal delivery; (ii) If served by certified mail, the mailing date shown on the certificate of service...

Assessing usage patterns of electronic clinical documentation templates.

PubMed

Vawdrey, David K

2008-11-06

Many vendors of electronic medical records support structured and free-text entry of clinical documents using configurable templates. At a healthcare institution comprising two large academic medical centers, a documentation management data mart and a custom, Web-accessible business intelligence application were developed to track the availability and usage of electronic documentation templates. For each medical center, template availability and usage trends were measured from November 2007 through February 2008. By February 2008, approximately 65,000 electronic notes were authored per week on the two campuses. One site had 934 available templates, with 313 being used to author at least one note. The other site had 765 templates, of which 480 were used. The most commonly used template at both campuses was a free text note called "Miscellaneous Nursing Note," which accounted for 33.3% of total documents generated at one campus and 15.2% at the other.

A Systematic Process to Facilitate Evidence-Informed Decisionmaking Regarding Program Expansion. The RAND Toolkit, Volume 3

DTIC Science & Technology

2014-01-01

provided for non - commercial use only. Unauthorized posting of RAND electronic documents to a non -RAND website is prohibited. RAND electronic documents...documents to a non -RAND website is prohibited. RAND documents are protected under copyright law. Permission is given to duplicate this document for...the DoD-wide decisionmaking board to focus their review efforts on larger programs or those that function in multiple branches of service, as well as

Electronic Derivative Classifier/Reviewing Official

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

Harris, Joshua C; McDuffie, Gregory P; Light, Ken L

2017-02-17

The electronic Derivative Classifier, Reviewing Official (eDC/RO) is a web based document management and routing system that reduces security risks and increases workflow efficiencies. The system automates the upload, notification review request, and document status tracking of documents for classification review on a secure server. It supports a variety of document formats (i.e., pdf, doc, docx, xls, xlsx, xlsm, ppt, pptx, vsd, vsdx and txt), and allows for the dynamic placement of classification markings such as the classification level, category and caveats on the document, in addition to a document footer and digital signature.

Feasibility of a knowledge translation CME program: Courriels Cochrane.

PubMed

Pluye, Pierre; Grad, Roland; Granikov, Vera; Theriault, Guyléne; Frémont, Pierre; Burnand, Bernard; Mercer, Jay; Marlow, Bernard; Arroll, Bruce; Luconi, Francesca; Légaré, France; Labrecque, Michel; Ladouceur, Roger; Bouthillier, France; Sridhar, Soumya Bindiganavile; Moscovici, Jonathan

2012-01-01

Systematic literature reviews provide best evidence, but are underused by clinicians. Thus, integrating Cochrane reviews into continuing medical education (CME) is challenging. We designed a pilot CME program where summaries of Cochrane reviews (Courriels Cochrane) were disseminated by e-mail. Program participants automatically received CME credit for each Courriel Cochrane they rated. The feasibility of this program is reported (delivery, participation, and participant evaluation). We recruited French-speaking physicians through the Canadian Medical Association. Program delivery and participation were documented. Participants rated the informational value of Courriels Cochrane using the Information Assessment Method (IAM), which documented their reflective learning (relevance, cognitive impact, use for a patient, expected health benefits). IAM responses were aggregated and analyzed. The program was delivered as planned. Thirty Courriels Cochrane were delivered to 985 physicians, and 127 (12.9%) completed at least one IAM questionnaire. Out of 1109 Courriels Cochrane ratings, 973 (87.7%) conta-ined 1 or more types of positive cognitive impact, while 835 (75.3%) were clinically relevant. Participants reported the use of information for a patient and expected health benefits in 595 (53.7%) and 569 (51.3%) ratings, respectively. Program delivery required partnering with 5 organizations. Participants valued Courriels Cochrane. IAM ratings documented their reflective learning. The aggregation of IAM ratings documented 3 levels of CME outcomes: participation, learning, and performance. This evaluation study demonstrates the feasibility of the Courriels Cochrane as an approach to further disseminate Cochrane systematic literature reviews to clinicians and document self-reported knowledge translation associated with Cochrane reviews. Copyright © 2012 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

76 FR 77670 - Retail Commodity Transactions Under Commodity Exchange Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-14

... were characterized as spot sales in contract documents, but in which, in practice, customer positions... but were ``in form, spot sales for delivery within 48 hours.'' \\10\\ In so ruling, the court focused... documents, held them to be spot contracts outside of CFTC jurisdiction. The CFTC Reauthorization Act of 2008...

The Intended Curriculum in Co-operative Education in Ontario Secondary Schools: An Analysis of School District Documents.

ERIC Educational Resources Information Center

Hutchinson, Nancy L.; Munby, Hugh; Chin, Peter; Edwards, Karol Lyn; Steiner-Bell, Karin; Chapman, Christine; Ho, Katherine; de Espana, Wendy Mills

2001-01-01

Analysis of cooperative education policy documents from nine Ontario school districts indicated that statements about evaluation, remediation, equity, and teacher qualifications were inconsistent. Although the Ministry of Education and Training prescribes co-op for delivery of academic subjects. districts focus exclusively on career preparation…

10 CFR 50.4 - Written communications.

Code of Federal Regulations, 2011 CFR

2011-01-01

...: Document Control Desk, U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001; by hand delivery to... NRC's Web site at http://www.nrc.gov/site-help/e-submittals.html; by e-mail to [email protected] otherwise specified in paragraphs (b)(2) through (b)(7) of this section: to the NRC's Document Control Desk...

49 CFR 1104.6 - Timely filing required.

Code of Federal Regulations, 2010 CFR

2010-10-01

... offers next day delivery to Washington, DC. If the e-filing option is chosen (for those pleadings and documents that are appropriate for e-filing, as determined by reference to the information on the Board's Web site), then the e-filed pleading or document is timely filed if the e-filing process is completed...

Testing the Integrity of a Psychotherapy Protocol: Assessment of Adherence and Competence.

ERIC Educational Resources Information Center

Waltz, Jennifer; And Others

1993-01-01

Treatment manuals and protocols have made delivery of particular therapies purer and more consistent, initiating a demand that researchers not only use treatment manuals to improve purity of their therapy but document that their efforts to achieve purity have been successful. Strategies that have been used to document treatment integrity are…

Deep Space Systems Technology Program Future Deliveries

NASA Technical Reports Server (NTRS)

Salvo, Christopher G.; Keuneke, Matthew S.

2000-01-01

NASA is in a period of frequent launches of low cost deep space missions with challenging performance needs. The modest budgets of these missions make it impossible for each to develop its own technology, therefore, efficient and effective development and insertion of technology for these missions must be approached at a higher level than has been done in the past. The Deep Space Systems Technology Program (DSST), often referred to as X2000, has been formed to address this need. The program is divided into a series of "Deliveries" that develop and demonstrate a set of spacecraft system capabilities with broad applicability for use by multiple missions. The First Delivery Project, to be completed in 2001, will provide a one MRAD-tolerant flight computer, power switching electronics, efficient radioisotope power source, and a transponder with services at 8.4 GHz and 32 GHz bands. Plans call for a Second Delivery in late 2003 to enable complete deep space systems in the 10 to 50 kg class, and a Third Delivery built around Systems on a Chip (extreme levels of electronic and microsystems integration) around 2006. Formulation of Future Deliveries (past the First Delivery) is ongoing and includes plans for such developments as highly miniaturized digital/analog/power electronics, optical communications, multifunctional structures, miniature lightweight propulsion, advanced thermal control techniques, highly efficient radioisotope power sources, and a unified flight ground software architecture to support the needs of future highly intelligent space systems. All developments are targeted at broad applicability and reuse, and will be commercialized within the US.

Improving documentation of a beta-blocker quality measure through an anesthesia information management system and real-time notification of documentation errors.

PubMed

Nair, Bala G; Peterson, Gene N; Newman, Shu-Fang; Wu, Wei-Ying; Kolios-Morris, Vickie; Schwid, Howard A

2012-06-01

Continuation of perioperative beta-blockers for surgical patients who are receiving beta-blockers prior to arrival for surgery is an important quality measure (SCIP-Card-2). For this measure to be considered successful, name, date, and time of the perioperative beta-blocker must be documented. Alternately, if the beta-blocker is not given, the medical reason for not administering must be documented. Before the study was conducted, the institution lacked a highly reliable process to document the date and time of self-administration of beta-blockers prior to hospital admission. Because of this, compliance with the beta-blocker quality measure was poor (-65%). To improve this measure, the anesthesia care team was made responsible for documenting perioperative beta-blockade. Clear documentation guidelines were outlined, and an electronic Anesthesia Information Management System (AIMS) was configured to facilitate complete documentation of the beta-blocker quality measure. In addition, real-time electronic alerts were generated using Smart Anesthesia Messenger (SAM), an internally developed decision-support system, to notify users concerning incomplete beta-blocker documentation. Weekly compliance for perioperative beta-blocker documentation before the study was 65.8 +/- 16.6%, which served as the baseline value. When the anesthesia care team started documenting perioperative beta-blocker in AIMS, compliance was 60.5 +/- 8.6% (p = .677 as compared with baseline). Electronic alerts with SAM improved documentation compliance to 94.6 +/- 3.5% (p < .001 as compared with baseline). To achieve high compliance for the beta-blocker measure, it is essential to (1) clearly assign a medical team to perform beta-blocker documentation and (2) enhance features in the electronic medical systems to alert the user concerning incomplete documentation.

Exploring Vital Sign Data Quality in Electronic Health Records with Focus on Emergency Care Warning Scores.

PubMed

Skyttberg, Niclas; Chen, Rong; Blomqvist, Hans; Koch, Sabine

2017-08-30

Computerized clinical decision support and automation of warnings have been advocated to assist clinicians in detecting patients at risk of physiological instability. To provide reliable support such systems are dependent on high-quality vital sign data. Data quality depends on how, when and why the data is captured and/or documented. This study aims to describe the effects on data quality of vital signs by three different types of documentation practices in five Swedish emergency hospitals, and to assess data fitness for calculating warning and triage scores. The study also provides reference data on triage vital signs in Swedish emergency care. We extracted a dataset including vital signs, demographic and administrative data from emergency care visits (n=335027) at five Swedish emergency hospitals during 2013 using either completely paper-based, completely electronic or mixed documentation practices. Descriptive statistics were used to assess fitness for use in emergency care decision support systems aiming to calculate warning and triage scores, and data quality was described in three categories: currency, completeness and correctness. To estimate correctness, two further categories - plausibility and concordance - were used. The study showed an acceptable correctness of the registered vital signs irrespectively of the type of documentation practice. Completeness was high in sites where registrations were routinely entered into the Electronic Health Record (EHR). The currency was only acceptable in sites with a completely electronic documentation practice. Although vital signs that were recorded in completely electronic documentation practices showed plausible results regarding correctness, completeness and currency, the study concludes that vital signs documented in Swedish emergency care EHRs cannot generally be considered fit for use for calculation of triage and warning scores. Low completeness and currency were found if the documentation was not completely electronic.

Rate of Interfacial Electron Transfer through the 1,2,3-Triazole Linkage

PubMed Central

Devaraj, Neal K.; Decreau, Richard A.; Ebina, Wataru; Collman, James P.; Chidsey, Christopher E. D.

2012-01-01

The rate of electron transfer is measured to two ferrocene and one iron tetraphenylporphyrin redox species coupled through terminal acetylenes to azide-terminated thiol monolayers by the Cu(I)-catalyzed azide–alkyne cycloaddition (a Sharpless “click” reaction) to form the 1,2,3-triazole linkage. The high yield, chemoselectivity, convenience, and broad applicability of this triazole formation reaction make such a modular assembly strategy very attractive. Electron-transfer rate constants from greater than 60,000 to 1 s−1 are obtained by varying the length and conjugation of the electron-transfer bridge and by varying the surrounding diluent thiols in the monolayer. Triazole and the triazole carbonyl linkages provide similar electronic coupling for electron transfer as esters. The ability to vary the rate of electron transfer to many different redox species over many orders of magnitude by using modular coupling chemistry provides a convenient way to study and control the delivery of electrons to multielectron redox catalysts and similar interfacial systems that require controlled delivery of electrons. PMID:16898751

Benefits of an Electronic Consultation-Liaison Note System: Better Notes Faster

ERIC Educational Resources Information Center

Sola, Christopher L.; Bostwick, J. Michael; Sampson, Shirlene

2007-01-01

Objective: The authors determined the efficiency of electronic documentation in consultation-liaison psychiatry. METHOD: An electronic note system was customized for a psychiatric consultation note. Specific attention given to common diagnoses permitted rapid documentation. Results: Residents learned the system quickly. The standardized nature of…

Association of Medical Directors of Information Systems consensus on inpatient electronic health record documentation.

PubMed

Shoolin, J; Ozeran, L; Hamann, C; Bria, W

2013-01-01

In 2013, electronic documentation of clinical care stands at a crossroads. The benefits of creating digital notes are at risk of being overwhelmed by the inclusion of easily importable detail. Providers are the primary authors of encounters with patients. We must document clearly our understanding of patients and our communication with them and our colleagues. We want to document efficiently to meet without exceeding documentation guidelines. We copy and paste documentation, because it not only simplifies the documentation process generally, but also supports meeting coding and regulatory requirements specifically. Since the primary goal of our profession is to spend as much time as possible listening to, understanding and helping patients, clinicians need information technology to make electronic documentation easier, not harder. At the same time, there should be reasonable restrictions on the use of copy and paste to limit the growing challenge of 'note bloat'. We must find the right balance between ease of use and thoughtless documentation. The guiding principles in this document may be used to launch an interdisciplinary dialogue that promotes useful and necessary documentation that best facilitates efficient information capture and effective display.

Managing the life cycle of electronic clinical documents.

PubMed

Payne, Thomas H; Graham, Gail

2006-01-01

To develop a model of the life cycle of clinical documents from inception to use in a person's medical record, including workflow requirements from clinical practice, local policy, and regulation. We propose a model for the life cycle of clinical documents as a framework for research on documentation within electronic medical record (EMR) systems. Our proposed model includes three axes: the stages of the document, the roles of those involved with the document, and the actions those involved may take on the document at each stage. The model includes the rules to describe who (in what role) can perform what actions on the document, and at what stages they can perform them. Rules are derived from needs of clinicians, and requirements of hospital bylaws and regulators. Our model encompasses current practices for paper medical records and workflow in some EMR systems. Commercial EMR systems include methods for implementing document workflow rules. Workflow rules that are part of this model mirror functionality in the Department of Veterans Affairs (VA) EMR system where the Authorization/ Subscription Utility permits document life cycle rules to be written in English-like fashion. Creating a model of the life cycle of clinical documents serves as a framework for discussion of document workflow, how rules governing workflow can be implemented in EMR systems, and future research of electronic documentation.

Promoting International Energy Security. Volume 3: Sea-Lanes to Asia

DTIC Science & Technology

2012-01-01

commercial use only. Unauthorized posting of RAND electronic documents to a non-RAND website is prohibited. RAND electronic documents are protected under...copyright law. Permission is required from RAND to reproduce, or reuse in another form, any of our research documents for commercial use . For...trademark. © Copyright 2012 RAND Corporation Permission is given to duplicate this document for personal use only, as long as it is unaltered and

Xyce Parallel Electronic Simulator : reference guide, version 2.0.

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

Hoekstra, Robert John; Waters, Lon J.; Rankin, Eric Lamont

This document is a reference guide to the Xyce Parallel Electronic Simulator, and is a companion document to the Xyce Users' Guide. The focus of this document is (to the extent possible) exhaustively list device parameters, solver options, parser options, and other usage details of Xyce. This document is not intended to be a tutorial. Users who are new to circuit simulation are better served by the Xyce Users' Guide.

Xyce™ Parallel Electronic Simulator Reference Guide Version 6.8

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

Keiter, Eric R.; Aadithya, Karthik Venkatraman; Mei, Ting

This document is a reference guide to the Xyce Parallel Electronic Simulator, and is a companion document to the Xyce Users' Guide. The focus of this document is (to the extent possible) exhaustively list device parameters, solver options, parser options, and other usage details of Xyce . This document is not intended to be a tutorial. Users who are new to circuit simulation are better served by the Xyce Users' Guide.

7 CFR 246.12 - Food delivery systems.

Code of Federal Regulations, 2011 CFR

2011-01-01

... operational requirements for food delivery systems. In recognition of emergent electronic benefits transfer... incidence of a violation for which a pattern of incidences must be established in order to impose a sanction...

Waste Feed Delivery System Phase 1 Preliminary Reliability and Availability and Maintainability Analysis [SEC 1 and 2

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

CARLSON, A.B.

The document presents updated results of the preliminary reliability, availability, maintainability analysis performed for delivery of waste feed from tanks 241-AZ-101 and 241-AN-105 to British Nuclear Fuels Limited, inc. under the Tank Waste Remediation System Privatization Contract. The operational schedule delay risk is estimated and contributing factors are discussed.

Information retrieval system utilizing wavelet transform

DOEpatents

Brewster, Mary E.; Miller, Nancy E.

2000-01-01

A method for automatically partitioning an unstructured electronically formatted natural language document into its sub-topic structure. Specifically, the document is converted to an electronic signal and a wavelet transform is then performed on the signal. The resultant signal may then be used to graphically display and interact with the sub-topic structure of the document.

75 FR 75705 - Notice of Availability of the Models for Plant-Specific Adoption of Technical Specifications Task...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-06

..., Rockville, Maryland. NRC's Agencywide Documents Access and Management System (ADAMS): Publicly available documents created or received at the NRC are available electronically at the NRC's Electronic Reading Room... Specifications End States (BAW- 2441).'' TSTF-431, Revision 3, is available in the Agencywide Documents Access...

49 CFR 1104.1 - Address, identification, and electronic filing option.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 2 of 4” and so forth). (e) Persons filing pleadings and documents with the Board have the option of electronically filing (e-filing) certain types of pleadings and documents instead of filing paper copies. Details regarding the types of pleadings and documents eligible for e-filing, the procedures to be followed, and...

15 CFR 758.5 - Conformity of documents and unloading of items.

Code of Federal Regulations, 2011 CFR

2011-01-01

... and Shipper's Export Declaration (SED) or AES electronic equivalent. (2) Optional ports of unloading... ultimate destination or are included on the BIS license and SED or AES electronic equivalent. (ii... ports of unloading on the SED or AES electronic equivalent and other export control documents, so long...

Document Storage and Retrieval in the Electronic Office.

ERIC Educational Resources Information Center

Ashford, John

1985-01-01

Proposals are made for practical approaches to the design of electronic office systems to provide for the effective storage and retrieval of the documents that they generate. Problems of records management and requirements to be met by the designer of an electronic office system are highlighted. Nineteen references are cited. (EJS)

Documentation of and satisfaction with the service delivery process of electric powered scooters among adult users in different national contexts.

PubMed

Sund, Terje; Iwarsson, Susanne; Andersen, Mette C; Brandt, Åse

2013-03-01

The purpose of this study was to investigate how different service delivery systems for assistive devices were associated with the service delivery process (SDP) and user satisfaction in two national contexts when electric powered scooters were provided. The study had a follow-up design based on a consecutive inclusion of 50 Danish and 86 Norwegian adults as they were about to be provided a scooter. A study-specific structured questionnaire for documentation of the SDP was administered. The Satisfaction with Assistive Technology Services was used for documenting user satisfaction with the SDP. Besides descriptive statistics, regression analysis was used to identify contributors of variance and predictors of user satisfaction. The various steps of the SDP were carried out to a various degree. Significantly more total time was spent in the SDP in the Danish sample (p < 0.001). About 80% of the informants were satisfied/very satisfied with different aspects of the SDP. Time spent in the different steps was not associated with user satisfaction with the SDP. This study supports the assumption that structure of the service impacts on the SDP, but not that the process impacts on outcomes in terms of user satisfaction with the SDP. It may, however, be questioned whether this actually is an outcome.

The paperless labeling initiative: a proof-of-concept study.

PubMed

Ruchalski, Charles

2004-01-01

Traditional paper professional package inserts (PPIs) are used on a daily basis by a variety of healthcare providers to locate and disseminate drug information. Unfortunately, paper PPIs are sometimes not accessible to the healthcare provider, appear unreadable due to varied font sizes, and are often considered not to be user-friendly. In December 2000, the Food and Drug Administration proposed regulations that would revise the format of PPIs. To determine whether electronic delivery of PPI information is achievable in community pharmacy practice settings. Electronic PPIs are an alternative means of delivering this information. This 12-week proof-of-concept study evaluated the Health Information Designs/Thomson Healthcare and Etreby Computer Company for electronic delivery of PPIs in 6 chain and 4 independent community pharmacies, with 5 pharmacies evaluating each system. Participating pharmacists were asked 9 questions designed to determine the feasibility of implementing electronic PPI delivery, as well as pharmacist satisfaction with each system. Pharmacists deemed both systems to be accessible and user-friendly. Pharmacists from both groups felt that the electronic PPIs were challenging to read and that printing took too long. Future studies in a more diverse selection of dispensing sites, including pharmacies (community and hospital based), clinics, and physician practices, need to be performed to maximize the use of electronic PPIs.

Randomised trial comparing the recording ability of a novel, electronic emergency documentation system with the AHA paper cardiac arrest record.

PubMed

Grigg, Eliot; Palmer, Andrew; Grigg, Jeffrey; Oppenheimer, Peter; Wu, Tim; Roesler, Axel; Nair, Bala; Ross, Brian

2014-10-01

To evaluate the ability of an electronic system created at the University of Washington to accurately document prerecorded VF and pulseless electrical activity (PEA) cardiac arrest scenarios compared with the American Heart Association paper cardiac arrest record. 16 anaesthesiology residents were randomly assigned to view one of two prerecorded, simulated VF and PEA scenarios and asked to document the event with either the paper or electronic system. Each subject then repeated the process with the other video and documentation method. Five types of documentation errors were defined: (1) omission, (2) specification, (3) timing, (4) commission and (5) noise. The mean difference in errors between the paper and electronic methods was analysed using a single factor repeated measures ANOVA model. Compared with paper records, the electronic system omitted 6.3 fewer events (95% CI -10.1 to -2.5, p=0.003), which represents a 28% reduction in omission errors. Users recorded 2.9 fewer noise items (95% CI -5.3 to -0.6, p=0.003) when compared with paper, representing a 36% decrease in redundant or irrelevant information. The rate of timing (Δ=-3.2, 95% CI -9.3 to 3.0, p=0.286) and commission (Δ=-4.4, 95% CI -9.4 to 0.5, p=0.075) errors were similar between the electronic system and paper, while the rate of specification errors were about a third lower for the electronic system when compared with the paper record (Δ=-3.2, 95% CI -6.3 to -0.2, p=0.037). Compared with paper documentation, documentation with the electronic system captured 24% more critical information during a simulated medical emergency without loss in data quality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Development of an electronic medical report delivery system to 3G GSM mobile (cellular) phones for a medical imaging department.

PubMed

Lim, Eugene Y; Lee, Chiang; Cai, Weidong; Feng, Dagan; Fulham, Michael

2007-01-01

Medical practice is characterized by a high degree of heterogeneity in collaborative and cooperative patient care. Fast and effective communication between medical practitioners can improve patient care. In medical imaging, the fast delivery of medical reports to referring medical practitioners is a major component of cooperative patient care. Recently, mobile phones have been actively deployed in telemedicine applications. The mobile phone is an ideal medium to achieve faster delivery of reports to the referring medical practitioners. In this study, we developed an electronic medical report delivery system from a medical imaging department to the mobile phones of the referring doctors. The system extracts a text summary of medical report and a screen capture of diagnostic medical image in JPEG format, which are transmitted to 3G GSM mobile phones.

Guidance to employers on integrating e-cigarettes/electronic nicotine delivery systems into tobacco worksite policy.

PubMed

Whitsel, Laurie P; Benowitz, Neal; Bhatnagar, Aruni; Bullen, Chris; Goldstein, Fred; Matthias-Gray, Lena; Grossmeier, Jessica; Harris, John; Isaac, Fikry; Loeppke, Ron; Manley, Marc; Moseley, Karen; Niemiec, Ted; OʼBrien, Vince; Palma-Davis, LaVaughn; Pronk, Nico; Pshock, Jim; Stave, Gregg M; Terry, Paul

2015-03-01

In recent years, new products have entered the marketplace that complicate decisions about tobacco control policies and prevention in the workplace. These products, called electronic cigarettes (e-cigarettes) or electronic nicotine delivery systems, most often deliver nicotine as an aerosol for inhalation, without combustion of tobacco. This new mode of nicotine delivery raises several questions about the safety of the product for the user, the effects of secondhand exposure, how the public use of these products should be handled within tobacco-free and smoke-free air policies, and how their use affects tobacco cessation programs, wellness incentives, and other initiatives to prevent and control tobacco use. In this article, we provide a background on e-cigarettes and then outline key policy recommendations for employers on how the use of these new devices should be managed within worksite tobacco prevention programs and control policies.

47 CFR 1.1206 - Permit-but-disclose proceedings.

Code of Federal Regulations, 2012 CFR

2012-10-01

... document to be filed electronically contains metadata that is confidential or protected from disclosure by... metadata from the document before filing it electronically. (iii) Filing dates outside the Sunshine period...

47 CFR 1.1206 - Permit-but-disclose proceedings.

Code of Federal Regulations, 2011 CFR

2011-10-01

... technically possible. Where the document to be filed electronically contains metadata that is confidential or... filer may remove such metadata from the document before filing it electronically. (iii) Filing dates...

Improving delivery of health care to Aboriginal and Torres Strait Islander children.

PubMed

Attwood, Lucy; Rodrigues, Sarah; Winsor, Josephine; Warren, Shirley; Biviano, Lyn; Gunasekera, Hasantha

2015-05-01

To identify opportunities to improve health-care delivery for urban Aboriginal and Torres Strait Islander children requiring hospital admission and to determine their characteristics. We analysed all documentation of admissions of Aboriginal and/or Torres Strait Islander children to a tertiary paediatric hospital in 2010. We reviewed the medical records to determine whether the Aboriginal status of patients was known, whether Aboriginal and/or Torres Strait Islander children and their families were reviewed by Aboriginal staff during admission and whether basic health-care quality indicators were met, including documentation of anthropometry, ear examination findings, immunisation status and catch-up immunisation delivery. In 2010, 543 (2%) patients admitted to the institution were identified as Aboriginal and/or Torres Strait Islander: 140/538 (26.0%) were from the first decile (most disadvantaged) on Socio-Economic Indexes for Areas index. Of all admitted children, 148/543 (27.3%) were referred to Aboriginal health professionals during admission, more when length of stay was greater than 7 days (61% vs. 23%, P < 0.001). There was documentation of weight in 533/543 (98.2%), ear examinations in 64/543 (11.8%), immunisations being not up to date in 126/543 (23%), catch-up immunisation given in 7/126 (5.6%), Aboriginal and/or Torres Strait Islander status in 8/543 (1.5%) medical and 1/543 (0.2%) nursing discharge summaries. We have identified several opportunities to improve culturally appropriate health-care delivery for Aboriginal and Torres Strait Islander children admitted to hospital, including improved recognition of Aboriginal and/or Torres Strait Islander status of patients, improved access to Aboriginal health professionals and increased performance and documentation of basic anthropometry, ear examination and immunisation catch-up. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

An Official American Thoracic Society/European Respiratory Society Policy Statement: Enhancing Implementation, Use, and Delivery of Pulmonary Rehabilitation.

PubMed

Rochester, Carolyn L; Vogiatzis, Ioannis; Holland, Anne E; Lareau, Suzanne C; Marciniuk, Darcy D; Puhan, Milo A; Spruit, Martijn A; Masefield, Sarah; Casaburi, Richard; Clini, Enrico M; Crouch, Rebecca; Garcia-Aymerich, Judith; Garvey, Chris; Goldstein, Roger S; Hill, Kylie; Morgan, Michael; Nici, Linda; Pitta, Fabio; Ries, Andrew L; Singh, Sally J; Troosters, Thierry; Wijkstra, Peter J; Yawn, Barbara P; ZuWallack, Richard L

2015-12-01

Pulmonary rehabilitation (PR) has demonstrated physiological, symptom-reducing, psychosocial, and health economic benefits for patients with chronic respiratory diseases, yet it is underutilized worldwide. Insufficient funding, resources, and reimbursement; lack of healthcare professional, payer, and patient awareness and knowledge; and additional patient-related barriers all contribute to the gap between the knowledge of the science and benefits of PR and the actual delivery of PR services to suitable patients. The objectives of this document are to enhance implementation, use, and delivery of pulmonary rehabilitation to suitable individuals worldwide. Members of the American Thoracic Society (ATS) Pulmonary Rehabilitation Assembly and the European Respiratory Society (ERS) Rehabilitation and Chronic Care Group established a Task Force and writing committee to develop a policy statement on PR. The document was modified based on feedback from expert peer reviewers. After cycles of review and revisions, the statement was reviewed and formally approved by the Board of Directors of the ATS and the Science Council and Executive Committee of the ERS. This document articulates policy recommendations for advancing healthcare professional, payer, and patient awareness and knowledge of PR, increasing patient access to PR, and ensuring quality of PR programs. It also recommends areas of future research to establish evidence to support the development of an updated funding and reimbursement policy regarding PR. The ATS and ERS commit to undertake actions that will improve access to and delivery of PR services for suitable patients. They call on their members and other health professional societies, payers, patients, and patient advocacy groups to join in this commitment.

Human Research Program Requirements Document

NASA Technical Reports Server (NTRS)

Rieger, Gabe

2007-01-01

The purpose of this document is to define, document, and allocate the Human Research Program (HRP) requirements to the HRP Program elements. It establishes the flow-down of requirements from Exploration Systems Mission Directorate (ESMD) and Office of the Chief Health and Medical Officer (OCHMO) to the various Program Elements of the HRP to ensure that human research and technology countermeasure investments are made to insure the delivery of countermeasures and technologies that satisfy ESMD s and OCHMO's exploration mission requirements.

Human Research Program Requirements Document. Human Research Program Revision E

NASA Technical Reports Server (NTRS)

Vargas, Paul

2011-01-01

This document defines, documents, and allocates the Human Research Program (HRP) requirements to the HRP Program Elements. It also establishes the flow of requirements from the Human Exploration and Operations Mission Directorate (HEOMD) and the Office of the Chief Health and Medical Officer (OCHMO) down to the various HRP Program Elements to ensure that human research and technology countermeasure investments support the delivery of countermeasures and technologies that satisfy HEOMD's and OCHMO's exploration mission requirements.

Level-2 Milestone 6007: Sierra Early Delivery System Deployed to Secret Restricted Network

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

Bertsch, A. D.

This report documents the delivery and installation of Shark, a CORAL Sierra early delivery system deployed on the LLNL SRD network. Early ASC program users have run codes on the machine in support of application porting for the final Sierra system which will be deployed at LLNL in CY2018. In addition to the SRD resource, Shark, unclassified resources, Rzmanta and Ray, have been deployed on the LLNL Restricted Zone and Collaboration Zone networks in support of application readiness for the Sierra platform.

Xyce parallel electronic simulator reference guide, Version 6.0.1.

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

Keiter, Eric R; Mei, Ting; Russo, Thomas V.

2014-01-01

This document is a reference guide to the Xyce Parallel Electronic Simulator, and is a companion document to the Xyce Users Guide [1] . The focus of this document is (to the extent possible) exhaustively list device parameters, solver options, parser options, and other usage details of Xyce. This document is not intended to be a tutorial. Users who are new to circuit simulation are better served by the Xyce Users Guide [1] .

Xyce parallel electronic simulator reference guide, version 6.0.

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

Keiter, Eric R; Mei, Ting; Russo, Thomas V.

2013-08-01

This document is a reference guide to the Xyce Parallel Electronic Simulator, and is a companion document to the Xyce Users Guide [1] . The focus of this document is (to the extent possible) exhaustively list device parameters, solver options, parser options, and other usage details of Xyce. This document is not intended to be a tutorial. Users who are new to circuit simulation are better served by the Xyce Users Guide [1] .

47 CFR 1.1206 - Permit-but-disclose proceed-ings.

Code of Federal Regulations, 2013 CFR

2013-10-01

... technically possible. Where the document to be filed electronically contains metadata that is confidential or... filer may remove such metadata from the document before filing it electronically. (iii) Filing dates...

47 CFR 1.1206 - Permit-but-disclose proceed-ings.

Code of Federal Regulations, 2014 CFR

2014-10-01

... technically possible. Where the document to be filed electronically contains metadata that is confidential or... filer may remove such metadata from the document before filing it electronically. (iii) Filing dates...

Health information technology impact on productivity.

PubMed

Eastaugh, Steven R

2012-01-01

Managers work to achieve the greatest output for the least input effort, better balancing all factors of delivery to achieve the most with the smallest resource effort. Documentation of actual health information technology (HIT) cost savings has been elusive. Information technology and linear programming help to control hospital costs without harming service quality or staff morale. This study presents production function results from a study of hospital output during the period 2008-2011. The results suggest that productivity varies widely among the 58 hospitals as a function of staffing patterns, methods of organization, and the degree of reliance on information support systems. Financial incentives help to enhance productivity. Incentive pay for staff based on actual productivity gains is associated with improved productivity. HIT can enhance the marginal value product of nurses and staff, so that they concentrate their workday around patient care activities. The implementation of electronic health records (EHR) was associated with a 1.6 percent improvement in productivity.

RESEARCH ON ROBUST METHODS FOR EXTRACTING AND RECOGNIZING PHOTOGRAPHY MANAGEMENT ITEMS FROM VARIOUS IMAGE DATA Of CONSTRUCTION

NASA Astrophysics Data System (ADS)

Kitagawa, Etsuji; Tanaka, Shigenori; Abiko, Satoshi; Wakabayashi, Katsuma; Jiang, Wenyuan

Recently, an electronic delivery for various documents is carried out by Ministry of Land, Infrastructure, Transport and Tourism in construction fields. One of them is image data of construction photography that must be delivered with information of photography management items such as construction name or type of works, etc. However, there is a problem that a lot of cost is needed to treat contents of these items from characters printed and handwritten on blackboard into these image data. In this research, we develop the system which can treat contents of these items by extracting contents of these items from the image data of construction photography taken in various scenes with preprocessing the image, recognizing characters with OCR and correcting error with natural language process. And we confirm the effectiveness of the system, by experimenting in each function of system and in entire system.

NGNP Data Management and Analysis System Analysis and Web Delivery Capabilities

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

Cynthia D. Gentillon

2010-09-01

Projects for the Very High Temperature Reactor Technology Development Office provide data in support of Nuclear Regulatory Commission licensing of the very high temperature reactor. Fuel and materials to be used in the reactor are tested and characterized to quantify performance in high-temperature and high-fluence environments. In addition, thermal-hydraulic experiments are conducted to validate codes used to assess reactor safety. The Very High Temperature Reactor Technology Development Office has established the NGNP Data Management and Analysis System (NDMAS) at the Idaho National Laboratory to ensure that very high temperature reactor data are (1) qualified for use, (2) stored in amore » readily accessible electronic form, and (3) analyzed to extract useful results. This document focuses on the third NDMAS objective. It describes capabilities for displaying the data in meaningful ways and for data analysis to identify useful relationships among the measured quantities.« less

Advance Care Planning Documentation in Electronic Health Records: Current Challenges and Recommendations for Change.

PubMed

Lamas, Daniela; Panariello, Natalie; Henrich, Natalie; Hammes, Bernard; Hanson, Laura C; Meier, Diane E; Guinn, Nancy; Corrigan, Janet; Hubber, Sean; Luetke-Stahlman, Hannah; Block, Susan

2018-04-01

To develop a set of clinically relevant recommendations to improve the state of advance care planning (ACP) documentation in the electronic health record (EHR). Advance care planning (ACP) is a key process that supports goal-concordant care. For preferences to be honored, clinicians must be able to reliably record, find, and use ACP documentation. However, there are no standards to guide ACP documentation in the electronic health record (EHR). We interviewed 21 key informants to understand the strengths and weaknesses of EHR documentation systems for ACP and identify best practices. We analyzed these interviews using a qualitative content analysis approach and subsequently developed a preliminary set of recommendations. These recommendations were vetted and refined in a second round of input from a national panel of content experts. Informants identified six themes regarding current inadequacies in documentation and accessibility of ACP information and opportunities for improvement. We offer a set of concise, clinically relevant recommendations, informed by expert opinion, to improve the state of ACP documentation in the EHR.

Petition to Object to the Williams Four Corners, LLC - Sims Mesa Central Delivery Point natural gas processing plant and compressor station, Rio Arriba County, New Mexico, Title V Operating Permit

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Documenting the Emergence of Electronic Nicotine Delivery Systems as a Disruptive Technology in Nicotine and Tobacco Science

PubMed Central

Correa, John B.; Ariel, Idan; Menzie, Nicole S.; Brandon, Thomas H.

2016-01-01

Background The emergence of the electronic nicotine delivery systems (ENDS, or “e-cigarettes”) has resulted in nicotine and tobacco scientists committing increased resources to studying these products. Despite this surge of research on various topics related to e-cigarettes, it is important to characterize the evolving e-cigarette research landscape as a way to identify important future research directions. The purpose of this review was to broadly categorize published scholarly work on e-cigarettes using a structured, multi-level coding scheme. Methods A systematic literature search was conducted to collect articles on e-cigarettes that were published in peer-reviewed journals from 2006 through 2014. Studies were classified through 3 coding waves. Articles were first divided into research reports, literature reviews and opinions/editorials. Research reports were further categorized to determine the proportion of these studies using human participants. Finally, human studies were classified based on their methodologies: descriptive, predictive, explanatory, and intervention. Results Research reports (n = 224) and opinions/editorials (n = 248) were published at similar rates during this time period. All types of articles showed exponential rates of increase in more recent years. 76.3% of human research studies tended to be descriptive in nature, with very little research employing experimental (6.8%) or intervention-based methodologies (5.4%). Conclusions This review reinforces the idea that e-cigarettes are a disruptive technology exerting substantial influence on nicotine and tobacco science. This review also suggests that opinions on e-cigarettes may be outpacing our scientific understanding of these devices. Our findings highlight the need for more e-cigarette research involving experimental, intervention, and longitudinal designs. PMID:27816664

Cigarette Users’ Interest in Using or Switching to Electronic Nicotine Delivery Systems for Smokeless Tobacco for Harm Reduction, Cessation, or Novelty: A Cross-Sectional Survey of US Adults

PubMed Central

Haardoerfer, Regine; Escoffery, Cam; Zheng, Pinpin; Kegler, Michelle

2015-01-01

Introduction: We examined: (a) current (past 30-day) smokers’ interest in using or switching to electronic nicotine delivery systems (ENDS) or smokeless tobacco for various reasons; (b) correlates of interest in these products; and (c) subgroups of current smokers in relation to interest in these products. Methods: We conducted a cross-sectional survey assessing sociodemographics, tobacco use, interest in ENDS and smokeless tobacco among smokers, and knowledge about ENDS among 2,501US adults recruited through an online consumer panel. We oversampled tobacco users (36.7% current cigarette smokers), ethnic minorities, and southeastern US state residents. Results: On average, participants were more interested in ENDS than smokeless tobacco across all reasons provided. Additionally, they were less interested in either product because of their potential use in places prohibiting smoking or due to curiosity and more interested in reducing health risk or cigarette consumption or to aid in cessation. We documented high rates (27.9%) of misbeliefs about Food and Drug Administration approval of ENDS for cessation, particularly among current smokers (38.5%). Also, 27.2% of current smokers had talked with a health care provider about ENDS, with 18.0% reporting that their provider endorsed ENDS use for cessation. Furthermore, cluster analyses revealed 3 groups distinct in their interest in the products, sociodemographics, and smoking-related characteristics. Conclusions: This study highlights higher interest in ENDS versus smokeless tobacco and greater interest in both for harm reduction and cessation than due to novelty or smoking restrictions. Developing educational campaigns and informing practitioners about caveats around ENDS as cessation or harm reduction aids are critical. PMID:24951496

Documenting the emergence of electronic nicotine delivery systems as a disruptive technology in nicotine and tobacco science.

PubMed

Correa, John B; Ariel, Idan; Menzie, Nicole S; Brandon, Thomas H

2017-02-01

The emergence of electronic nicotine delivery systems (ENDS, or "e-cigarettes") has resulted in nicotine and tobacco scientists committing increased resources to studying these products. Despite this surge of research on various topics related to e-cigarettes, it is important to characterize the evolving e-cigarette research landscape as a way to identify important future research directions. The purpose of this review was to broadly categorize published scholarly work on e-cigarettes using a structured, multi-level coding scheme. A systematic literature search was conducted to collect articles on e-cigarettes that were published in peer-reviewed journals from 2006 through 2014. Studies were classified through 3 coding waves. Articles were first divided into research reports, literature reviews and opinions/editorials. Research reports were further categorized to determine the proportion of these studies using human participants. Finally, human studies were classified based on their methodologies: descriptive, predictive, explanatory, and intervention. Research reports (n=224) and opinions/editorials (n=248) were published at similar rates during this time period. All types of articles showed exponential rates of increase in more recent years. 76.4% of human research studies were descriptive in nature, with very little research employing experimental (6.8%) or intervention-based methodologies (5.4%). This review reinforces the idea that e-cigarettes are a disruptive technology exerting substantial influence on nicotine and tobacco science. This review also suggests that opinions on e-cigarettes may be outpacing our scientific understanding of these devices. Our findings highlight the need for more e-cigarette research involving experimental, intervention, and longitudinal designs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Lesson 5: Overview of CROMERR Requirements for Electronic Reporting

EPA Pesticide Factsheets

The purpose of the CROMERR requirements is to ensure that authorized programs that receive electronic documents in lieu of paper can rely on those documents for purposes of enforcement-related litigation.

Organizational learning in the implementation and adoption of national electronic health records: case studies of two hospitals participating in the National Programme for Information Technology in England.

PubMed

Takian, Amirhossein; Sheikh, Aziz; Barber, Nicholas

2014-09-01

To explore the role of organizational learning in enabling implementation and supporting adoption of electronic health record systems into two English hospitals. In the course of conducting our prospective and sociotechnical evaluation of the implementation and adoption of electronic health record into 12 "early adopter" hospitals across England, we identified two hospitals implementing virtually identical versions of the same "off-the-shelf" software (Millennium) within a comparable timeframe. We undertook a longitudinal qualitative case study-based analysis of these two hospitals (referred to hereafter as Alpha and Omega) and their implementation experiences. Data included the following: 63 in-depth interviews with various groups of internal and external stakeholders; 41-h on-site observation; and content analysis of 218 documents of various types. Analysis was both inductive and deductive, the latter being informed by the "sociotechnical changing" theoretical perspective. Although Alpha and Omega shared a number of contextual similarities, our evaluation revealed fundamental differences in visions of electronic health record and the implementation strategy between the hospitals, which resulted in distinct local consequences of electronic health record implementation and impacted adoption. Both hospitals did not, during our evaluation, see the hoped-for benefits to the organization as a result of the introduction of electronic health record, such as speeding-up tasks. Nonetheless, the Millennium software worked out to be easier to use at Omega. Interorganizational learning was at the heart of this difference. Despite the turbulent overall national "roll out" of electronic health record systems into the English hospitals, considerable opportunities for organizational learning were offered by sequential delivery of the electronic health record software into "early adopter" hospitals. We argue that understanding the process of organizational learning and its enabling factors has the potential to support efforts at implementing national electronic health record implementation endeavors. © The Author(s) 2013.

A Proposed Integration Environment for Enhanced User Interaction and Value-Adding of Electronic Documents: An Empirical Evaluation.

ERIC Educational Resources Information Center

Liew, Chern Li; Chennupati, K. R.; Foo, Schubert

2001-01-01

Explores the potential and impact of an innovative information environment in enhancing user activities in using electronic documents for various tasks, and to support the value-adding of these e-documents. Discusses the conceptual design and prototyping of a proposed environment, PROPIE. Presents an empirical and formative evaluation of the…

7 CFR 400.712 - Research and development reimbursement, maintenance reimbursement, and user fees.

Code of Federal Regulations, 2012 CFR

2012-01-01

.... Documentation of actual costs allowed under this section will be used to determine any reimbursement. (c) To be... requested, and all supporting documentation, must be submitted to FCIC by electronic method or by hard copy... supporting documentation, must be submitted to FCIC by electronic method or by hard copy and received by FCIC...

7 CFR 400.712 - Research and development reimbursement, maintenance reimbursement, and user fees.

Code of Federal Regulations, 2014 CFR

2014-01-01

.... Documentation of actual costs allowed under this section will be used to determine any reimbursement. (c) To be... requested, and all supporting documentation, must be submitted to FCIC by electronic method or by hard copy... supporting documentation, must be submitted to FCIC by electronic method or by hard copy and received by FCIC...

7 CFR 400.712 - Research and development reimbursement, maintenance reimbursement, and user fees.

Code of Federal Regulations, 2013 CFR

2013-01-01

.... Documentation of actual costs allowed under this section will be used to determine any reimbursement. (c) To be... requested, and all supporting documentation, must be submitted to FCIC by electronic method or by hard copy... supporting documentation, must be submitted to FCIC by electronic method or by hard copy and received by FCIC...

Information retrieval system utilizing wavelet transform

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

Brewster, M.E.; Miller, N.E.

A method is disclosed for automatically partitioning an unstructured electronically formatted natural language document into its sub-topic structure. Specifically, the document is converted to an electronic signal and a wavelet transform is then performed on the signal. The resultant signal may then be used to graphically display and interact with the sub-topic structure of the document.

76 FR 13121 - Electronic On-Board Recorders and Hours of Service Supporting Documents

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-10

... DEPARTMENT OF TRANSPORTATION Federal Motor Carrier Safety Administration 49 CFR Parts 385, 390, and 395 [Docket No. FMCSA-2010-0167] RIN 2126-AB20 Electronic On-Board Recorders and Hours of Service... comment period for the Electronic On-Board Recorder and Hours of Service Supporting Documents Notice of...

76 FR 61937 - Practice and Procedure: Rules of General Application, Safeguards, Antidumping and Countervailing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... System Web site at https://edis.usitc.gov . Failure to comply with the requirements of this chapter and... Electronic Document Information System (EDIS) already accepts electronic filing of certain documents, and..., regardless of whether the electronic docketing system is operational. The ITC TLA makes a similar comment...

78 FR 49280 - 30-Day Notice of Proposed Information Collection: Third-Party Documentation Facsimile Transmittal...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

... calling the toll-free Federal Relay Service at (800) 877-8339. This is not a toll- free number. Copies of... produces an electronic version of the document that will be matched with the electronic application....g., permitting electronic submission of responses. HUD encourages interested parties to submit...

Electronic Imaging in Admissions, Records & Financial Aid Offices.

ERIC Educational Resources Information Center

Perkins, Helen L.

Over the years, efforts have been made to work more efficiently with the ever increasing number of records and paper documents that cross workers' desks. Filing records on optical disk through electronic imaging is an alternative that many feel is the answer to successful document management. The pioneering efforts in electronic imaging in…

Advanced Electronics. Curriculum Development. Bulletin 1778.

ERIC Educational Resources Information Center

Eppler, Thomas

This document is a curriculum guide for a 180-hour course in advanced electronics for 11th and 12th grades that has four instructional units. The instructional units are orientation, discrete components, integrated circuits, and electronic systems. The document includes a course flow chart; a two-page section that describes the course, lists…

77 FR 35691 - Update to Electronic Common Technical Document Module 1

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-14

... Electronic Common Technical Document (eCTD) Module 1, which is used for electronic submission of... they are received with a limit of 350. SUPPLEMENTARY INFORMATION: The eCTD is an International... Research (CBER) have been receiving submissions in the eCTD format since 2003, and the eCTD has been the...

The effect of 3 torque delivery systems on gold screw preload at the gold cylinder-abutment screw joint.

PubMed

Tan, Keson B; Nicholls, Jack I

2002-01-01

This study measured the gold screw preload at the gold cylinder-abutment screw joint interface obtained by 3 torque delivery systems. Using a precalibrated, strain-gauged standard abutment as the load cell, 3 torque delivery systems tested were shown to have significant differences in gold screw preload when a gold cylinder was attached. Mean preloads measured were 291.2 N for hand torque drivers set at 10 Ncm, 340.3 N for electronic torque controllers at low setting/10 Ncm, 384.4 N for electronic torque controllers at high setting/10 Ncm; and 140.8 N for hand-tightening with a prosthetic slot screwdriver. Significant differences in screw preload were also found between operators using a hand torque driver. Hand-tightening delivered insufficient preload and cannot be recommended for final gold screw tightening. Different electronic torque controller units set at 10 Ncm induced mean gold screw preloads that ranged from 264.1 N to as high as 501.2 N. Electronic torque controllers should be regularly recalibrated to ensure optimal output.

Xyce parallel electronic simulator reference guide, version 6.1

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

Keiter, Eric R; Mei, Ting; Russo, Thomas V.

2014-03-01

This document is a reference guide to the Xyce Parallel Electronic Simulator, and is a companion document to the Xyce Users Guide [1] . The focus of this document is (to the extent possible) exhaustively list device parameters, solver options, parser options, and other usage details of Xyce. This document is not intended to be a tutorial. Users who are new to circuit simulation are better served by the Xyce Users Guide [1] .

Architecting for Sustainable Software Delivery

DTIC Science & Technology

2012-06-01

14 CrossTalk—May/June 2012 RAPID AND AGILE STABILITY Architecting for Sustainable Software Delivery Ronald J. Koontz , Boeing Robert L. Nord...Figure 2, and additional architecture documentation can be found in the work of Koontz [9, 10, 11]. Designing for extensibility promotes continued...Mapping of Practices to Agile and Architecture Criteria CrossTalk—May/June 2012 19 RAPID AND AGILE STABILITY ABOUT THE AUTHORS Ronald J. Koontz

Alternatives Generation and Analysis for Heat Removal from High Level Waste Tanks

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

WILLIS, W.L.

This document addresses the preferred combination of design and operational configurations to provide heat removal from high-level waste tanks during Phase 1 waste feed delivery to prevent the waste temperature from exceeding tank safety requirement limits. An interim decision for the preferred method to remove the heat from the high-level waste tanks during waste feed delivery operations is presented herein.

The Delivery and Content of Training for Adult Education Teachers and Volunteer Instructors. Study of ABE/ESL Instructor Training Approaches.

ERIC Educational Resources Information Center

Tibbetts, John; And Others

The delivery and content of training for teachers and volunteer instructors in adult basic education (ABE) and English as a Second Language (ESL) were documented in a study. Two sources of information were the research literature and extant data from states on training activities. Findings indicated that training for adult education teachers and…

Voyager electronic parts radiation program. Volume 2: Test requirements and procedures

NASA Technical Reports Server (NTRS)

Stanley, A. G.; Martin, K. E.; Price, W. E.

1978-01-01

Documents are presented outlining the conditions and requirements of the test program. The Appendixes are as follows: appendix A -- Electron Simulation Radiation Test Specification for Voyager Electronic Parts and Devices, appendix B -- Electronic Piece-Part Testing Program for Voyager, appendix C -- Test Procedure for Radiation Screening of Voyager Piece Parts, appendix D -- Boeing In Situ Test Fixture, and appendix E -- Irradiate - Anneal (IRAN) Screening Documents.

Nursing constraint models for electronic health records: a vision for domain knowledge governance.

PubMed

Hovenga, Evelyn; Garde, Sebastian; Heard, Sam

2005-12-01

Various forms of electronic health records (EHRs) are currently being introduced in several countries. Nurses are primary stakeholders and need to ensure that their information and knowledge needs are being met by such systems information sharing between health care providers to enable them to improve the quality and efficiency of health care service delivery for all subjects of care. The latest international EHR standards have adopted the openEHR approach of two-level modelling. The first level is a stable information model determining structure, while the second level consists of constraint models or 'archetypes' that reflect the specifications or clinician rules for how clinical information needs to be represented to enable unambiguous data sharing. The current state of play in terms of international health informatics standards development activities is providing the nursing profession with a unique opportunity and challenge. Much work has been undertaken internationally in the area of nursing terminologies and evidence-based practice. This paper argues that to make the most of these emerging technologies and EHRs we must now concentrate on developing a process to identify, document, implement, manage and govern our nursing domain knowledge as well as contribute to the development of relevant international standards. It is argued that one comprehensive nursing terminology, such as the ICNP or SNOMED CT is simply too complex and too difficult to maintain. As the openEHR archetype approach does not rely heavily on big standardised terminologies, it offers more flexibility during standardisation of clinical concepts and it ensures open, future-proof electronic health records. We conclude that it is highly desirable for the nursing profession to adopt this openEHR approach as a means of documenting and governing the nursing profession's domain knowledge. It is essential for the nursing profession to develop its domain knowledge constraint models (archetypes) collaboratively in an international context.

Using electronic document management systems to manage highway project files.

DOT National Transportation Integrated Search

2011-12-12

"WisDOTs Bureau of Technical Services is interested in learning about the practices of other state departments of : transportation in developing and implementing an electronic document management system to manage highway : project files"

76 FR 66311 - Draft Documents To Support Submission of an Electronic Common Technical Document; Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-26

.../DevelopmentApprovalProcess/FormsSubmissionRequirements/ElectronicSubmissions/ucm253101.htm , http://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/default.htm , or http...

The Importance of the Medical Record: A Critical Professional Responsibility.

PubMed

Ngo, Elizabeth; Patel, Nachiket; Chandrasekaran, Krishnaswamy; Tajik, A Jamil; Paterick, Timothy E

2016-01-01

Comprehensive, detailed documentation in the medical record is critical to patient care and to a physician when allegations of negligence arise. Physicians, therefore, would be prudent to have a clear understanding of this documentation. It is important to understand who is responsible for documentation, what is important to document, when to document, and how to document. Additionally, it should be understood who owns the medical record, the significance of the transition to the electronic medical record, problems and pitfalls when using the electronic medical record, and how the Health Information Technology for Economic and Clinical Health Act affects healthcare providers and health information technology.

Pharmaceutical liposomal drug delivery: a review of new delivery systems and a look at the regulatory landscape.

PubMed

Zylberberg, Claudia; Matosevic, Sandro

2016-11-01

Liposomes were the first nanoscale drug to be approved for clinical use in 1995. Since then, the technology has grown considerably, and pioneering recent work in liposome-based delivery systems has brought about remarkable developments with significant clinical implications. This includes long-circulating liposomes, stimuli-responsive liposomes, nebulized liposomes, elastic liposomes for topical, oral and transdermal delivery and covalent lipid-drug complexes for improved drug plasma membrane crossing and targeting to specific organelles. While the regulatory bodies' opinion on liposomes is well-documented, current guidance that address new delivery systems are not. This review describes, in depth, the current state-of-the-art of these new liposomal delivery systems and provides a critical overview of the current regulatory landscape surrounding commercialization efforts of higher-level complexity systems, the expected requirements and the hurdles faced by companies seeking to bring novel liposome-based systems for clinical use to market.

Acute dissociative reaction to spontaneous delivery in a case of total denial of pregnancy: Diagnostic and forensic aspects.

PubMed

Şar, Vedat; Aydın, Nazan; van der Hart, Onno; Steven Frankel, A; Şar, Meriç; Omay, Oğuz

2017-01-01

This article presents the history of a 21-year-old female college student with total denial of pregnancy who experienced an acute dissociative reaction during the spontaneous delivery at home without medical assistance where the newborn died immediately. Psychiatric examination, self-report questionnaires, legal documents, and witness reports have been reviewed in evaluation of the case. Evidence pointed to total denial of pregnancy, that is, until delivery. The diagnoses of an acute dissociative reaction to stress (remitted) and a subsequent PTSD were established in a follow-up examination conducted 7 months after the delivery. Notwithstanding the inherently dissociative nature of total denial of pregnancy, no other evidence has been found about pre-existing psychopathology. For causing the newborn's death, the patient faced charges for "aggravated murder," which were later on reduced into "involuntary manslaughter." Given the physical incapacity to perform voluntary acts due to the loss of control over her actions during the delivery, and the presence of an acute dissociative reaction to unexpected delivery, the legal case represents an intricate overlap between "insanity" and "incapacitation" defenses. The rather broad severity spectrum of acute dissociative conditions requires evaluation of the limits and conditions of appropriate legal defenses by mental health experts and lawyers. Denial of pregnancy as a source of potential stress has attracted little interest in psychiatric literature although solid research exists which documented that it is not infrequent. Arguments are presented to introduce this condition as a diagnostic category of female reproductive psychiatry with a more neutral label: "unperceived pregnancy."

eC3—A Modern Telecommunications Matrix for Cervical Cancer Prevention in Zambia

PubMed Central

Parham, Groesbeck P.; Mwanahamuntu, Mulindi H.; Pfaendler, Krista S.; Sahasrabuddhe, Vikrant V.; Myung, Daniel; Mkumba, Gracilia; Kapambwe, Sharon; Mwanza, Bianca; Chibwesha, Carla; Hicks, Michael L.; Stringer, Jeffrey S.A.

2013-01-01

Objectives Low physician density, undercapacitated laboratory infrastructures, and limited resources are major limitations to the development and implementation of widely accessible cervical cancer prevention programs in sub-Saharan Africa. Materials and Methods We developed a system operated by nonphysician health providers that used widely available and affordable communication technology to create locally adaptable and sustainable public sector cervical cancer prevention program in Zambia, one of the world’s poorest countries. Results Nurses were trained to perform visual inspection with acetic acid aided by digital cervicography using predefined criteria. Electronic digital images (cervigrams) were reviewed with patients, and distance consultation was sought as necessary. Same-visit cryotherapy or referral for further evaluation by a gynecologist was offered. The Zambian system of “electronic cervical cancer control” bypasses many of the historic barriers to the delivery of preventive health care to women in low-resource environments while facilitating monitoring, evaluation, and continued education of primary health care providers, patient education, and medical records documentation. Conclusions The electronic cervical cancer control system uses appropriate technology to bridge the gap between screening and diagnosis, thereby facilitating the conduct of “screen-and-treat” programs. The inherent flexibility of the system lends itself to the integration with future infrastructures using rapid molecular human papillomavirus–based screening approaches and wireless telemedicine communications. PMID:20592550

Electronic Cigarette Sales to Minors via the Internet

PubMed Central

Williams, Rebecca S.; Derrick, Jason; Ribisl, Kurt M.

2015-01-01

Importance Electronic cigarettes (e-cigarettes) entered the US market in 2007 and, with little regulatory oversight, grew into a $2-billion-a-year industry by 2013. The Centers for Disease Control and Prevention has reported a trend of increasing e-cigarette use among teens, with use rates doubling from 2011 to 2012. While several studies have documented that teens can and do buy cigarettes online, to our knowledge, no studies have yet examined age verification among Internet tobacco vendors selling e-cigarettes. Objective To estimate the extent to which minors can successfully purchase e-cigarettes online and assess compliance with North Carolina's 2013 e-cigarette age-verification law. Design, Setting, and Participants In this cross-sectional study conducted from February 2014 to June 2014, 11 nonsmoking minors aged 14 to 17 years made supervised e-cigarette purchase attempts from 98 Internet e-cigarette vendors. Purchase attempts were made at the University of North Carolina Internet Tobacco Vendors Study project offices using credit cards. Main Outcome and Measure Rate at which minors can successfully purchase e-cigarettes on the Internet. Results Minors successfully received deliveries of e-cigarettes from 76.5% of purchase attempts, with no attempts by delivery companies to verify their ages at delivery and 95% of delivered orders simply left at the door. All delivered packages came from shipping companies that, according to company policy or federal regulation, do not ship cigarettes to consumers. Of the total orders, 18 failed for reasons unrelated to age verification. Only 5 of the remaining 80 youth purchase attempts were rejected owing to age verification, resulting in a youth buy rate of 93.7%. None of the vendors complied with North Carolina's e-cigarette age-verification law. Conclusions and Relevance Minors are easily able to purchase e-cigarettes from the Internet because of an absence of age-verification measures used by Internet e-cigarette vendors. Federal law should require and enforce rigorous age verification for all e-cigarette sales as with the federal PACT (Prevent All Cigarette Trafficking) Act's requirements for age verification in Internet cigarette sales. PMID:25730697

Using an Educational Electronic Documentation System to Help Nursing Students Accurately Identify Nursing Diagnoses

ERIC Educational Resources Information Center

Pobocik, Tamara J.

2013-01-01

The use of technology and electronic medical records in healthcare has exponentially increased. This quantitative research project used a pretest/posttest design, and reviewed how an educational electronic documentation system helped nursing students to identify the accurate related to statement of the nursing diagnosis for the patient in the case…

Examining Evidence-Based Content Related to Hospital Acquired Pressure Ulcer Prevention in Paper and Electronic Health Records

ERIC Educational Resources Information Center

Jaekel, Camilla M.

2012-01-01

Although there have been great advancements in the Electronic Health Record (EHR), there is a dearth of rigorous research that examines the relationship between the use of electronic documentation to capture nursing process components and the impact of consistent documentation on patient outcomes (Daly, Buckwalter & Maas, 2002; Gugerty, 2006;…

E-submission Format for Sub-chronic and Chronic Studies

EPA Pesticide Factsheets

The purpose of this document is to suggest the format for final reports and to provide instructions for creation of Adobe PDF electronic submission documents for electronic submission of sub-chronic and chronic studies for pesticides.

Developing an Interface to Order and Document Health Education Videos in the Electronic Health Record.

PubMed

Wojcik, Lauren

2015-01-01

Transitioning to electronic health records (EHRs) provides an opportunity for health care systems to integrate educational content available on interactive patient systems (IPS) with the medical documentation system. This column discusses how one hospital simplified providers' workflow by making it easier to order educational videos and ensure that completed education is documented within the medical record. Integrating the EHR and IPS streamlined the provision of patient education, improved documentation, and supported the organization in meeting core requirements for Meaningful Use.

Alternative Strategies to Improve and Expand the Delivery of Vocational Education in Small, Rural, and/or Isolated Secondary Schools in Hawaii.

ERIC Educational Resources Information Center

Hawaii State Dept. of Education, Honolulu. Office of the Director for Vocational Education.

Intended for administrators of schools within the Hawaii Department of Education, this document provides descriptions of 34 alternative strategies implemented by small, rural, and/or isolated secondary schools across the nation to improve the quality of their vocational programs. Introductory materials discuss the document's purpose, the need for…

Telemedicine

MedlinePlus

... making health care delivery easier and more efficient. Electronic medical records are replacing paper charts. Digital devices ... 2016 More on this topic for: Parents Teens Electronic Health Records Talking to Your Child's Doctor How ...

Acute effects of using an electronic nicotine-delivery device (electronic cigarette) on myocardial function: comparison with the effects of regular cigarettes.

PubMed

Farsalinos, Konstantinos E; Tsiapras, Dimitris; Kyrzopoulos, Stamatis; Savvopoulou, Maria; Voudris, Vassilis

2014-06-23

Electronic cigarettes have been developed and marketed in recent years as smoking substitutes. However, no studies have evaluated their effects on the cardiovascular system. The purpose of this study was to examine the immediate effects of electronic cigarette use on left ventricular (LV) function, compared to the well-documented acute adverse effects of smoking. Echocardiographic examinations were performed in 36 healthy heavy smokers (SM, age 36 ± 5 years) before and after smoking 1 cigarette and in 40 electronic cigarette users (ECIG, age 35 ± 5 years) before and after using the device with "medium-strength" nicotine concentration (11 mg/ml) for 7 minutes. Mitral flow diastolic velocities (E, A), their ratio (E/A), deceleration time (DT), isovolumetric relaxation time (IVRT) and corrected-to-heart rate IVRT (IVRTc) were measured. Mitral annulus systolic (Sm), and diastolic (Em, Am) velocities were estimated. Myocardial performance index was calculated from Doppler flow (MPI) and tissue Doppler (MPIt). Longitudinal deformation measurements of global strain (GS), systolic (SRs) and diastolic (SRe, SRa) strain rate were also performed. Baseline measurements were similar in both groups. In SM, IVRT and IVRTc were prolonged, Em and SRe were decreased, and both MPI and MPIt were elevated after smoking. In ECIG, no differences were observed after device use. Comparing after-use measurements, ECIG had higher Em (P = 0.032) and SRe (P = 0.022), and lower IVRTc (P = 0.011), MPI (P = 0.001) and MPIt (P = 0.019). The observed differences were significant even after adjusting for changes in heart rate and blood pressure. Although acute smoking causes a delay in myocardial relaxation, electronic cigarette use has no immediate effects. Electronic cigarettes' role in tobacco harm reduction should be studied intensively in order to determine whether switching to electronic cigarette use may have long-term beneficial effects on smokers' health. Current Controlled Trials ISRCTN16974547.

Order Granting the Petition to Object to Williams Four Corners, LLC - Sims Mesa Central Delivery Point natural gas processing plant and compressor station, Rio Arriba County, New Mexico, Title V Operating Permit

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Electronic flight bag (EFB) : 2010 industry survey

DOT National Transportation Integrated Search

2010-09-01

This document provides an overview of Electronic Flight Bag (EFB) systems and capabilities, as of June 2010. This document updates and replaces the April 2007 EFB Industry Review (Yeh and Chandra, 2007). As with the previous industry survey, the focu...

Practice Bulletin No. 161 Summary: External Cephalic Version.

PubMed

2016-02-01

In the United States, there is a widespread belief that the overall cesarean delivery rate is higher than necessary. Efforts are being directed toward decreasing the number of these procedures, in part by encouraging physicians to make changes in their management practices. Because breech presentations are associated with a high rate of cesarean delivery, there is renewed interest in techniques such as external cephalic version (ECV) and vaginal breech delivery. The purpose of this document is to provide information about ECV by summarizing the relevant evidence presented in published studies and to make recommendations regarding its use in obstetric practice.

Practice Bulletin No. 161: External Cephalic Version.

PubMed

2016-02-01

In the United States, there is a widespread belief that the overall cesarean delivery rate is higher than necessary. Efforts are being directed toward decreasing the number of these procedures, in part by encouraging physicians to make changes in their management practices. Because breech presentations are associated with a high rate of cesarean delivery, there is renewed interest in techniques such as external cephalic version (ECV) and vaginal breech delivery. The purpose of this document is to provide information about ECV by summarizing the relevant evidence presented in published studies and to make recommendations regarding its use in obstetric practice.

Environmental Fate of Soil Applied Neonicotinoid Insecticides in an Irrigated Potato Agroecosystem

PubMed Central

Huseth, Anders S.; Groves, Russell L.

2014-01-01

Since 1995, neonicotinoid insecticides have been a critical component of arthropod management in potato, Solanum tuberosum L. Recent detections of neonicotinoids in groundwater have generated questions about the sources of these contaminants and the relative contribution from commodities in U.S. agriculture. Delivery of neonicotinoids to crops typically occurs as a seed or in-furrow treatment to manage early season insect herbivores. Applied in this way, these insecticides become systemically mobile in the plant and provide control of key pest species. An outcome of this project links these soil insecticide application strategies in crop plants with neonicotinoid contamination of water leaching from the application zone. In 2011 and 2012, our objectives were to document the temporal patterns of neonicotinoid leachate below the planting furrow following common insecticide delivery methods in potato. Leaching loss of thiamethoxam from potato was measured using pan lysimeters from three at-plant treatments and one foliar application treatment. Insecticide concentration in leachate was assessed for six consecutive months using liquid chromatography-tandem mass spectrometry. Findings from this study suggest leaching of neonicotinoids from potato may be greater following crop harvest in comparison to other times during the growing season. Furthermore, this study documented recycling of neonicotinoid insecticides from contaminated groundwater back onto the crop via high capacity irrigation wells. These results document interactions between cultivated potato, different neonicotinoid delivery methods, and the potential for subsurface water contamination via leaching. PMID:24823765

48 CFR 14.201-9 - Simplified contract format.

Code of Federal Regulations, 2011 CFR

2011-10-01

.... (6) Inspection and acceptance, quality assurance, and reliability requirements. (7) Place of delivery... particular acquisition. (d) List of documents and attachments. Include if necessary. (e) Representations and...

48 CFR 14.201-9 - Simplified contract format.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... (6) Inspection and acceptance, quality assurance, and reliability requirements. (7) Place of delivery... particular acquisition. (d) List of documents and attachments. Include if necessary. (e) Representations and...

Analysis of time series for postal shipments in Regional VII East Java Indonesia

NASA Astrophysics Data System (ADS)

Kusrini, DE; Ulama, B. S. S.; Aridinanti, L.

2018-03-01

The change of number delivery goods through PT. Pos Regional VII East Java Indonesia indicates that the trend of increasing and decreasing the delivery of documents and non-documents in PT. Pos Regional VII East Java Indonesia is strongly influenced by conditions outside of PT. Pos Regional VII East Java Indonesia so that the prediction the number of document and non-documents requires a model that can accommodate it. Based on the time series plot monthly data fluctuations occur from 2013-2016 then the model is done using ARIMA or seasonal ARIMA and selected the best model based on the smallest AIC value. The results of data analysis about the number of shipments on each product sent through the Sub-Regional Postal Office VII East Java indicates that there are 5 post offices of 26 post offices entering the territory. The largest number of shipments is available on the PPB (Paket Pos Biasa is regular package shipment/non-document ) and SKH (Surat Kilat Khusus is Special Express Mail/document) products. The time series model generated is largely a Random walk model meaning that the number of shipment in the future is influenced by random effects that are difficult to predict. Some are AR and MA models, except for Express shipment products with Malang post office destination which has seasonal ARIMA model on lag 6 and 12. This means that the number of items in the following month is affected by the number of items in the previous 6 months.

Nicotine blood levels and short-term smoking reduction with an electronic nicotine delivery system.

PubMed

Nides, Mitchell A; Leischow, Scott J; Bhatter, Meghna; Simmons, Michael

2014-03-01

To evaluate nicotine delivery from the NJOY® King Bold Electronic Nicotine Delivery System (ENDS) and its short-term potential for smoking reduction or cessation. One week of ad libitum use was followed by measurements of plasma nicotine, heart rate, and craving and withdrawal after 12 hours of nicotine abstinence in 25 adult smokers not interested in quitting. After 5 minutes of use, blood nicotine levels increased by a mean of 3.5 ng/mL (p < .001), heart rate increased, and craving was reduced by 55%. Cigarettes per day were reduced by 39% during the test week, and perceptions of use for reduction or cessation were positive. The NJOY® King Bold ENDS delivers nicotine and led to short-term smoking reduction.

U-10Mo Sample Preparation and Examination using Optical and Scanning Electron Microscopy

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

Prabhakaran, Ramprashad; Joshi, Vineet V.; Rhodes, Mark A.

2016-10-01

The purpose of this document is to provide guidelines to prepare specimens of uranium alloyed with 10 weight percent molybdenum (U-10Mo) for optical metallography and scanning electron microscopy. This document also provides instructions to set up an optical microscope and a scanning electron microscope to analyze U-10Mo specimens and to obtain the required information.

U-10Mo Sample Preparation and Examination using Optical and Scanning Electron Microscopy

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

Prabhakaran, Ramprashad; Joshi, Vineet V.; Rhodes, Mark A.

2016-03-30

The purpose of this document is to provide guidelines to prepare specimens of uranium alloyed with 10 weight percent molybdenum (U-10Mo) for optical metallography and scanning electron microscopy. This document also provides instructions to set up an optical microscope and a scanning electron microscope to analyze U-10Mo specimens and to obtain the required information.

Policy implementation in wheelchair service delivery in a rural South African setting.

PubMed

Visagie, Surona; Scheffler, Elsje; Schneider, Marguerite

2013-01-01

Wheelchairs allow users to realise basic human rights and improved quality of life. South African and international documents guide rehabilitation service delivery and thus the provision of wheelchairs. Evidence indicates that rehabilitation policy implementation gaps exist in rural South Africa. The aim of this article was to explore the extent to which wheelchair service delivery in a rural, remote area of South Africa was aligned with the South African National Guidelines on Provision of Assistive Devices, The United Nations Convention on the Rights of Persons with Disabilities and The World Health Organization Guidelines on Provision of Wheelchairs in Less-Resourced Settings. Qualitative methods were used. Data were collected through semi-structured interviews with 22 participants who were identified through purposive sampling. Content analysis of data was preformed around the construct of wheelchair service delivery. Study findings identified gaps between the guiding documents and wheelchair service delivery. Areas where gaps were identified included service aspects such as referral, assessment, prescription, user and provider training, follow up, maintenance and repair as well as management aspects such as staff support, budget and monitoring. Positive findings related to individual assessments, enthusiastic and caring staff and the provision of wheelchairs at no cost. The gaps in policy implementation can have a negative impact on users and the service provider. Inappropriate or no wheelchairs limit user function, participation and quality of life. In addition, an inappropriate wheelchair will have a shorter lifespan, requiring frequent repairs and replacements with cost implications for the service provider.

Emergency Medicine Resident Physicians’ Perceptions of Electronic Documentation and Workflow

PubMed Central

Neri, P.M.; Redden, L.; Poole, S.; Pozner, C.N.; Horsky, J.; Raja, A.S.; Poon, E.; Schiff, G.

2015-01-01

Summary Objective To understand emergency department (ED) physicians’ use of electronic documentation in order to identify usability and workflow considerations for the design of future ED information system (EDIS) physician documentation modules. Methods We invited emergency medicine resident physicians to participate in a mixed methods study using task analysis and qualitative interviews. Participants completed a simulated, standardized patient encounter in a medical simulation center while documenting in the test environment of a currently used EDIS. We recorded the time on task, type and sequence of tasks performed by the participants (including tasks performed in parallel). We then conducted semi-structured interviews with each participant. We analyzed these qualitative data using the constant comparative method to generate themes. Results Eight resident physicians participated. The simulation session averaged 17 minutes and participants spent 11 minutes on average on tasks that included electronic documentation. Participants performed tasks in parallel, such as history taking and electronic documentation. Five of the 8 participants performed a similar workflow sequence during the first part of the session while the remaining three used different workflows. Three themes characterize electronic documentation: (1) physicians report that location and timing of documentation varies based on patient acuity and workload, (2) physicians report a need for features that support improved efficiency; and (3) physicians like viewing available patient data but struggle with integration of the EDIS with other information sources. Conclusion We confirmed that physicians spend much of their time on documentation (65%) during an ED patient visit. Further, we found that resident physicians did not all use the same workflow and approach even when presented with an identical standardized patient scenario. Future EHR design should consider these varied workflows while trying to optimize efficiency, such as improving integration of clinical data. These findings should be tested quantitatively in a larger, representative study. PMID:25848411

Data from clinical notes: a perspective on the tension between structure and flexible documentation

PubMed Central

Denny, Joshua C; Xu, Hua; Lorenzi, Nancy; Stead, William W; Johnson, Kevin B

2011-01-01

Clinical documentation is central to patient care. The success of electronic health record system adoption may depend on how well such systems support clinical documentation. A major goal of integrating clinical documentation into electronic heath record systems is to generate reusable data. As a result, there has been an emphasis on deploying computer-based documentation systems that prioritize direct structured documentation. Research has demonstrated that healthcare providers value different factors when writing clinical notes, such as narrative expressivity, amenability to the existing workflow, and usability. The authors explore the tension between expressivity and structured clinical documentation, review methods for obtaining reusable data from clinical notes, and recommend that healthcare providers be able to choose how to document patient care based on workflow and note content needs. When reusable data are needed from notes, providers can use structured documentation or rely on post-hoc text processing to produce structured data, as appropriate. PMID:21233086

New Paradigms for Patient-Centered Outcomes Research in Electronic Medical Records: An Example of Detecting Urinary Incontinence Following Prostatectomy.

PubMed

Hernandez-Boussard, Tina; Tamang, Suzanne; Blayney, Douglas; Brooks, Jim; Shah, Nigam

2016-01-01

National initiatives to develop quality metrics emphasize the need to include patient-centered outcomes. Patient-centered outcomes are complex, require documentation of patient communications, and have not been routinely collected by healthcare providers. The widespread implementation of electronic medical records (EHR) offers opportunities to assess patient-centered outcomes within the routine healthcare delivery system. The objective of this study was to test the feasibility and accuracy of identifying patient centered outcomes within the EHR. Data from patients with localized prostate cancer undergoing prostatectomy were used to develop and test algorithms to accurately identify patient-centered outcomes in post-operative EHRs - we used urinary incontinence as the use case. Standard data mining techniques were used to extract and annotate free text and structured data to assess urinary incontinence recorded within the EHRs. A total 5,349 prostate cancer patients were identified in our EHR-system between 1998-2013. Among these EHRs, 30.3% had a text mention of urinary incontinence within 90 days post-operative compared to less than 1.0% with a structured data field for urinary incontinence (i.e. ICD-9 code). Our workflow had good precision and recall for urinary incontinence (positive predictive value: 0.73 and sensitivity: 0.84). Our data indicate that important patient-centered outcomes, such as urinary incontinence, are being captured in EHRs as free text and highlight the long-standing importance of accurate clinician documentation. Standard data mining algorithms can accurately and efficiently identify these outcomes in existing EHRs; the complete assessment of these outcomes is essential to move practice into the patient-centered realm of healthcare.

DEMONSTRATION BULLETIN: HIGH VOLTAGE ELECTRON BEAM TECHNOLOGY - HIGH VOLTAGE ENVIRONMENTAL APPLICATIONS, INC.

EPA Science Inventory

The high energy electron beam irradiation technology is a low temperature method for destroying complex mixtures of hazardous organic chemicals in solutions containing solids. The system consists of a computer-automated, portable electron beam accelerator and a delivery system. T...

Effectiveness of Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Methods in Medicaid-Supported Prenatal Care: Trial III

ERIC Educational Resources Information Center

Windsor, Richard; Woodby, Lesa; Miller, Thomas; Hardin, Michael

2011-01-01

This two-phase evaluation documented the delivery and effectiveness of evidence-based health education methods by regular staff to pregnant smokers. During Phase 1, a total of 436 Medicaid patients were screened and 416 (95%) gave consent: 334 nonsmokers and 102 smokers. This historical Comparison (C) group was assessed to document the "normal"…