Information system for diagnosis of respiratory system diseases

NASA Astrophysics Data System (ADS)

Abramov, G. V.; Korobova, L. A.; Ivashin, A. L.; Matytsina, I. A.

2018-05-01

An information system is for the diagnosis of patients with lung diseases. The main problem solved by this system is the definition of the parameters of cough fragments in the monitoring recordings using a voice recorder. The authors give the recognition criteria of recorded cough moments, audio records analysis. The results of the research are systematized. The cough recognition system can be used by the medical specialists to diagnose the condition of the patients and to monitor the process of their treatment.

New Advanced Technologies to Provide Decentralised and Secure Access to Medical Records: Case Studies in Oncology

PubMed Central

Quantin, Catherine; Coatrieux, Gouenou; Allaert, François André; Fassa, Maniane; Bourquard, Karima; Boire, Jean-Yves; de Vlieger, Paul; Maigne, Lydia; Breton, Vincent

2009-01-01

The main problem for health professionals and patients in accessing information is that this information is very often distributed over many medical records and locations. This problem is particularly acute in cancerology because patients may be treated for many years and undergo a variety of examinations. Recent advances in technology make it feasible to gain access to medical records anywhere and anytime, allowing the physician or the patient to gather information from an “ephemeral electronic patient record”. However, this easy access to data is accompanied by the requirement for improved security (confidentiality, traceability, integrity, ...) and this issue needs to be addressed. In this paper we propose and discuss a decentralised approach based on recent advances in information sharing and protection: Grid technologies and watermarking methodologies. The potential impact of these technologies for oncology is illustrated by the examples of two experimental cases: a cancer surveillance network and a radiotherapy treatment plan. It is expected that the proposed approach will constitute the basis of a future secure “google-like” access to medical records. PMID:19718446

Differences in Visual Attention between Those Who Correctly and Incorrectly Answer Physics Problems

ERIC Educational Resources Information Center

Madsen, Adrian M.; Larson, Adam M.; Loschky, Lester C.; Rebello, N. Sanjay

2012-01-01

This study investigated how visual attention differed between those who correctly versus incorrectly answered introductory physics problems. We recorded eye movements of 24 individuals on six different conceptual physics problems where the necessary information to solve the problem was contained in a diagram. The problems also contained areas…

An Auto-Scoring Mechanism for Evaluating Problem-Solving Ability in a Web-Based Learning Environment

ERIC Educational Resources Information Center

Chiou, Chuang-Kai; Hwang, Gwo-Jen; Tseng, Judy C. R.

2009-01-01

The rapid development of computer and network technologies has attracted researchers to investigate strategies for and the effects of applying information technologies in learning activities; simultaneously, learning environments have been developed to record the learning portfolios of students seeking web information for problem-solving. Although…

Radiology Reporting System Data Exchange With the Electronic Health Record System: A Case Study in Iran.

PubMed

Ahmadi, Maryam; Ghazisaeidi, Marjan; Bashiri, Azadeh

2015-03-18

In order to better designing of electronic health record system in Iran, integration of health information systems based on a common language must be done to interpret and exchange this information with this system is required. This study provides a conceptual model of radiology reporting system using unified modeling language. The proposed model can solve the problem of integration this information system with the electronic health record system. By using this model and design its service based, easily connect to electronic health record in Iran and facilitate transfer radiology report data. This is a cross-sectional study that was conducted in 2013. The study population was 22 experts that working at the Imaging Center in Imam Khomeini Hospital in Tehran and the sample was accorded with the community. Research tool was a questionnaire that prepared by the researcher to determine the information requirements. Content validity and test-retest method was used to measure validity and reliability of questioner respectively. Data analyzed with average index, using SPSS. Also Visual Paradigm software was used to design a conceptual model. Based on the requirements assessment of experts and related texts, administrative, demographic and clinical data and radiological examination results and if the anesthesia procedure performed, anesthesia data suggested as minimum data set for radiology report and based it class diagram designed. Also by identifying radiology reporting system process, use case was drawn. According to the application of radiology reports in electronic health record system for diagnosing and managing of clinical problem of the patient, with providing the conceptual Model for radiology reporting system; in order to systematically design it, the problem of data sharing between these systems and electronic health records system would eliminate.

Securing the communication of medical information using local biometric authentication and commercial wireless links.

PubMed

Ivanov, Vladimir I; Yu, Paul L; Baras, John S

2010-09-01

Medical information is extremely sensitive in nature - a compromise, such as eavesdropping or tampering by a malicious third party, may result in identity theft, incorrect diagnosis and treatment, and even death. Therefore, it is important to secure the transfer of medical information from the patient to the recording system. We consider a portable, wireless device transferring medical information to a remote server. We decompose this problem into two sub-problems and propose security solutions to each of them: (1) to secure the link between the patient and the portable device, and (2) to secure the link between the portable device and the network. Thus we push the limits of the network security to the edge by authenticating the user using their biometric information; authenticating the device to the network at the physical layer; and strengthening the security of the wireless link with a key exchange mechanism. The proposed authentication methods can be used for recording the readings of medical data in a central database and for accessing medical records in various settings.

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

PubMed Central

2011-01-01

Background Various countries are currently implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs, their overall adoption remains low and meets resistance from health care providers. This study aims to increase our understanding of health care providers' attitude towards the n-EPR, by investigating their perceptions of the benefits and problems of electronic information exchange in health care and the n-EPR in particular. Methods The study was conducted in three Dutch health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, interviews were conducted with 17 stakeholders working in these organisations. Relevant themes were deduced by means of thematic qualitative analysis. Results Health care providers perceived electronic information exchange to promote the efficiency and quality of care. The problems they perceived in electronic information exchange mainly concerned the confidentiality and safety of information exchange and the reliability and quality of patient data. Many problems perceived by health care providers did not specifically apply to the n-EPR, but to electronic information exchange in general. Conclusions The implementation of the Dutch n-EPR has mainly followed a top-down approach, thereby neglecting the fact that the perceptions and preferences of its users (health care providers) need to be addressed in order to achieve successful implementation. The results of this study provide valuable suggestions about how to promote health care providers' willingness to adopt electronic information exchange, which can be useful for other countries currently implementing an n-EPR. Apart from providing information about the benefits and usefulness of electronic information exchange, efforts should be focused on minimising the problems as perceived by health care providers. The safety and confidentiality of electronic information exchange can be improved by developing tools to evaluate the legitimacy of access to electronic records, by increasing health care providers' awareness of the need to be careful when using patient data, and by measures to limit access to sensitive patient data. Improving health care providers' recording behaviour is important to improve the reliability and quality of electronically exchanged patient data. PMID:21982395

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

PubMed

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

2011-10-07

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

Updates on information about free-living marine nematodes in Brazil: new records and comments on problems in taxonomic studies.

PubMed

Venekey, Virág

2017-10-17

New records of nematode species in Brazil, which appeared after or were not mentioned in the last review, are shown in this paper. All environments were considered, including the continental margin. In addition, all studies on marine nematodes in Brazil, including grey literature, ecological papers and book chapters, are listed. Furthermore, information on genera/species richness, dominant genera, and densities is also presented. A total of 11 orders, 72 families, 372 genera, and 450 species of nematodes were recorded in Brazilian marine environments by April 2017. Following problems are discussed: taxonomic lists available only in grey literature, use of outdated identification keys (leading to incorrect identifications), and identifications mostly to putative species or to the genus level.

Bringing science to medicine: an interview with Larry Weed, inventor of the problem-oriented medical record

PubMed Central

Wright, Adam; Sittig, Dean F; McGowan, Julie; Ash, Joan S; Weed, Lawrence L

2014-01-01

Larry Weed, MD is widely known as the father of the problem-oriented medical record and inventor of the now-ubiquitous SOAP (subjective/objective/assessment/plan) note, for developing an electronic health record system (Problem-Oriented Medical Information System, PROMIS), and for founding a company (since acquired), which developed problem-knowledge couplers. However, Dr Weed's vision for medicine goes far beyond software—over the course of his storied career, he has relentlessly sought to bring the scientific method to medical practice and, where necessary, to point out shortcomings in the system and advocate for change. In this oral history, Dr Weed describes, in his own words, the arcs of his long career and the work that remains to be done. PMID:24872343

An information system for epidemiology based on a computer-based medical record.

PubMed

Verdier, C; Flory, A

1994-12-01

A new way is presented to build an information system addressed to problems in epidemiology. Based on our analysis of current and future requirements, a system is proposed which allows for collection, organization and distribution of data within a computer network. In this application, two broad communities of users-physicians and epidemiologists-can be identified, each with their own perspectives and goals. The different requirements of each community lead us to a client-service centered architecture which provides the functionality requirements of the two groups. The resulting physician workstation provides help for recording and querying medical information about patients and from a pharmacological database. All information is classified and coded in order to be retrieved for pharmaco-economic studies. The service center receives information from physician workstations and permits organizations that are in charge of statistical studies to work with "real" data recorded during patient encounters. This leads to a new approach in epidemiology. Studies can be carried out with a more efficient data acquisition. For modelling the information system, we use an object-oriented approach. We have observed that the object-oriented representation, particularly its concepts of generalization, aggregation and encapsulation, are very usable for our problem.

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.

Data-driven approach for creating synthetic electronic medical records.

PubMed

Buczak, Anna L; Babin, Steven; Moniz, Linda

2010-10-14

New algorithms for disease outbreak detection are being developed to take advantage of full electronic medical records (EMRs) that contain a wealth of patient information. However, due to privacy concerns, even anonymized EMRs cannot be shared among researchers, resulting in great difficulty in comparing the effectiveness of these algorithms. To bridge the gap between novel bio-surveillance algorithms operating on full EMRs and the lack of non-identifiable EMR data, a method for generating complete and synthetic EMRs was developed. This paper describes a novel methodology for generating complete synthetic EMRs both for an outbreak illness of interest (tularemia) and for background records. The method developed has three major steps: 1) synthetic patient identity and basic information generation; 2) identification of care patterns that the synthetic patients would receive based on the information present in real EMR data for similar health problems; 3) adaptation of these care patterns to the synthetic patient population. We generated EMRs, including visit records, clinical activity, laboratory orders/results and radiology orders/results for 203 synthetic tularemia outbreak patients. Validation of the records by a medical expert revealed problems in 19% of the records; these were subsequently corrected. We also generated background EMRs for over 3000 patients in the 4-11 yr age group. Validation of those records by a medical expert revealed problems in fewer than 3% of these background patient EMRs and the errors were subsequently rectified. A data-driven method was developed for generating fully synthetic EMRs. The method is general and can be applied to any data set that has similar data elements (such as laboratory and radiology orders and results, clinical activity, prescription orders). The pilot synthetic outbreak records were for tularemia but our approach may be adapted to other infectious diseases. The pilot synthetic background records were in the 4-11 year old age group. The adaptations that must be made to the algorithms to produce synthetic background EMRs for other age groups are indicated.

[From planning to realization of an electronic patient record].

PubMed

Krämer, T; Rapp, R; Krämer, K L

1999-03-01

The high complex requirements on information and information flow in todays hospitals can only be accomplished by the use of modern Information Systems (IS). In order to achieve this, the Stiftung Orthopädische Universitätsklinik has carried out first the Project "Strategic Informations System Planning" in 1993. Then realizing the necessary infrastructure (network; client-server) from 1993 to 1997, and finally started the introduction of modern IS (SAP R/3 and IXOS-Archive) in the clinical area. One of the approved goal was the replacement of the paper medical record by an up-to-date electronical medical record. In this article the following three topics will be discussed: the difference between the up-to-date electronical medical record and the electronically archived finished cases, steps performed by our clinic to realize the up-to-date electronical medical record and the problems occurred during this process.

From planning to realisation of an electronic patient record.

PubMed

Krämer, T; Rapp, R; Krämer, K-L

1999-03-01

The high complex requirements on information and information flow in todays hospitals can only be accomplished by the use of modern Information Systems (IS). In order to achieve this, the Stiftung Orthopädische Universitätsklinik has carried out first the Project "Strategic Informations System Planning" in 1993. Then realizing the neccessary infrastructure (network; client-server) from 1993 to 1997, and finally started the introduction of modern IS (SAP R/3 and IXOS-Archive) in the clinical area. One of the approved goal was the replacement of the paper medical record by an up-to-date electronical medical record. In this article the following three topics will be discussed: the difference between the up-to-date electronical medical record and the electronically archived finished cases, steps performed by our clinic to realize the up-to-date electronical medical record and the problems occured during this process.

History of materials used for recording static and dynamic occlusal contact marks: a literature review

PubMed Central

Rahul, G R.; Poduval, Soorya T.; Shetty, Karunakar; Gupta, Bhawna; Rajora, Varun

2013-01-01

In the discipline of prosthetic dentistry it is important not only to examine the occlusion, but to be able to record, store, and transfer the information. Over the years many occlusion testing materials have been used. It has been suggested the clinical recording and transfer of information using waxes and other occlusion recording materials have disadvantages relating to inaccuracy and problems of manipulation. Therefore, there has been introduction of many new systems for recording occlusion contacts to overcome such problems. The correct physiological recovery of occlusion posses as much a challenge as ever for every dentist and technician. Even the smallest high spots measuring just a few microns can cause dysfunctions like temporo-mandibular pain. Occlusal proportions are being constantly changed with every procedure. Therefore, an understanding of the synergy of the teeth in static and dynamic occlusion forms the basis of good dentistry. The purpose of this review article is to give and overview of the various materials and methods that have been used to record occlusal contact marks. Key words:Occlusal contact marks, Occlusion indicators, Occlusion test materials, Occlusion recording materials. PMID:24455051

Electronic health record meets digital library: a new environment for achieving an old goal.

PubMed

Humphreys, B L

2000-01-01

Linking the electronic health record to the digital library is a Web-era reformulation of the long-standing informatics goal of seamless integration of automated clinical data and relevant knowledge-based information to support informed decisions. The spread of the Internet, the development of the World Wide Web, and converging format standards for electronic health data and digital publications make effective linking increasingly feasible. Some existing systems link electronic health data and knowledge-based information in limited settings or limited ways. Yet many challenging informatics research problems remain to be solved before flexible and seamless linking becomes a reality and before systems become capable of delivering the specific piece of information needed at the time and place a decision must be made. Connecting the electronic health record to the digital library also requires positive resolution of important policy issues, including health data privacy, government encouragement of high-speed communications, electronic intellectual property rights, and standards for health data and for digital libraries. Both the research problems and the policy issues should be important priorities for the field of medical informatics.

Electronic Health Record Meets Digital Library

PubMed Central

Humphreys, Betsy L.

2000-01-01

Linking the electronic health record to the digital library is a Web-era reformulation of the long-standing informatics goal of seamless integration of automated clinical data and relevant knowledge-based information to support informed decisions. The spread of the Internet, the development of the World Wide Web, and converging format standards for electronic health data and digital publications make effective linking increasingly feasible. Some existing systems link electronic health data and knowledge-based information in limited settings or limited ways. Yet many challenging informatics research problems remain to be solved before flexible and seamless linking becomes a reality and before systems become capable of delivering the specific piece of information needed at the time and place a decision must be made. Connecting the electronic health record to the digital library also requires positive resolution of important policy issues, including health data privacy, government envouragement of high-speed communications, electronic intellectual property rights, and standards for health data and for digital libraries. Both the research problems and the policy issues should be important priorities for the field of medical informatics. PMID:10984463

An Approach to Scoring Collaboration in Online Game Environments

ERIC Educational Resources Information Center

Scoular, Claire; Care, Esther; Awwal, Nafisa

2017-01-01

With technological advances, it is now possible to use games to capture information-rich behaviours that reveal processes by which players interact and solve problems. Recent problem-based games have been designed to assess and record detailed interactions between the problem solver and the game environment, and thereby capture salient solution…

77 FR 65245 - Privacy Act; System of Records: Visa Records, State-39

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-25

... appropriate, and the court has certified it needs such information in the interest of the ends of justice in a... user no longer needs access, the user's account is disabled. RETENTION AND DISPOSAL: These records will... to adjudicate visas. The system is also utilized for dealing with problems of a legal, enforcement...

Urban Alabama Physicians and the Electronic Medical Record: A Qualitative Study

ERIC Educational Resources Information Center

Tiggle, Michele

2012-01-01

The electronic medical record (EMR) is an information technology tool supporting the examination, treatment, and care of a patient. The EMR allows physicians to view a patient's record showing current medications, a history of visits from health care providers with notes from those visits, a problem list, a functional status assessment, a schedule…

Extracting Information from Electronic Medical Records to Identify the Obesity Status of a Patient Based on Comorbidities and Bodyweight Measures.

PubMed

Figueroa, Rosa L; Flores, Christopher A

2016-08-01

Obesity is a chronic disease with an increasing impact on the world's population. In this work, we present a method of identifying obesity automatically using text mining techniques and information related to body weight measures and obesity comorbidities. We used a dataset of 3015 de-identified medical records that contain labels for two classification problems. The first classification problem distinguishes between obesity, overweight, normal weight, and underweight. The second classification problem differentiates between obesity types: super obesity, morbid obesity, severe obesity and moderate obesity. We used a Bag of Words approach to represent the records together with unigram and bigram representations of the features. We implemented two approaches: a hierarchical method and a nonhierarchical one. We used Support Vector Machine and Naïve Bayes together with ten-fold cross validation to evaluate and compare performances. Our results indicate that the hierarchical approach does not work as well as the nonhierarchical one. In general, our results show that Support Vector Machine obtains better performances than Naïve Bayes for both classification problems. We also observed that bigram representation improves performance compared with unigram representation.

[Quality of information analysis on basic causes of neonatal deaths recorded in the Mortality Information System: a study in Maceió, Alagoas State, Brazil, 2001-2002].

PubMed

Pedrosa, Linda Délia C O; Sarinho, Silvia W; Ordonha, Manoelina R

2007-10-01

Analysis of the quality of information on basic causes of neonatal deaths in Brazil is crucially important, since it allows one to estimate how many deaths are avoidable and provide support for policies to decrease neonatal mortality. The current study aimed to evaluate the reliability and validity of the Mortality Information System (MIS) for discriminating between basic causes of neonatal deaths and defining percentages of reducible causes. The basic causes of early neonatal deaths in hospitals in Maceió, Alagoas State, were analyzed, and the causes recorded in medical records were compared to the MIS data in order to measure reliability and validity. The modified SEADE Foundation and Wigglesworth classifications were compared to analyze the capacity for reduction of neonatal mortality. Maternal causes predominated in the medical records, as compared to respiratory disorders on the death certificates and in the MIS. The percentage of avoidable deaths may be much higher than observed from the MIS, due to imprecision in completing death certificates. Based on the MIS, the greatest problems are in early diagnosis and treatment of neonatal causes. However, the results show that the most pressing problems relate to failures in prenatal care and lack of control of diseases.

IFLA General Conference, 1987. Division on Bibliographic Control. Bibliography and Round Table on A/V Media Section. Papers.

ERIC Educational Resources Information Center

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

The two papers in this section focus on the bibliographic control of sound recordings, primarily phonograph records. In the first, "The National Discography for the United Kingdom," Christopher Roads discusses the problem of lack of easily accessible and up-to-date information about the growing collection of new sound recordings as they…

Bringing science to medicine: an interview with Larry Weed, inventor of the problem-oriented medical record.

PubMed

Wright, Adam; Sittig, Dean F; McGowan, Julie; Ash, Joan S; Weed, Lawrence L

2014-01-01

Larry Weed, MD is widely known as the father of the problem-oriented medical record and inventor of the now-ubiquitous SOAP (subjective/objective/assessment/plan) note, for developing an electronic health record system (Problem-Oriented Medical Information System, PROMIS), and for founding a company (since acquired), which developed problem-knowledge couplers. However, Dr Weed's vision for medicine goes far beyond software--over the course of his storied career, he has relentlessly sought to bring the scientific method to medical practice and, where necessary, to point out shortcomings in the system and advocate for change. In this oral history, Dr Weed describes, in his own words, the arcs of his long career and the work that remains to be done. 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.

Linking guidelines to Electronic Health Record design for improved chronic disease management.

PubMed

Barretto, Sistine A; Warren, Jim; Goodchild, Andrew; Bird, Linda; Heard, Sam; Stumptner, Markus

2003-01-01

The promise of electronic decision support to promote evidence based practice remains elusive in the context of chronic disease management. We examine the problem of achieving a close relationship of Electronic Health Record (EHR) content to other components of a clinical information system (guidelines, decision support and workflow), particularly linking the decisions made by providers back to the guidelines. We use the openEHR architecture, which allows extension of a core Reference Model via Archetypes to refine the detailed information recording options for specific classes of encounter. We illustrate the use of openEHR for tracking the relationship of a series of clinical encounters to a guideline via a case study of guideline-compliant treatment of hypertension in diabetes. This case study shows the contribution guideline content can have on problem-specific EHR structure and demonstrates the potential for a constructive interaction of electronic decision support and the EHR.

Linking Guidelines to Electronic Health Record Design for Improved Chronic Disease Management

PubMed Central

Barretto, Sistine A.; Warren, Jim; Goodchild, Andrew; Bird, Linda; Heard, Sam; Stumptner, Markus

2003-01-01

The promise of electronic decision support to promote evidence based practice remains elusive in the context of chronic disease management. We examine the problem of achieving a close relationship of Electronic Health Record (EHR) content to other components of a clinical information system (guidelines, decision support and work-flow), particularly linking the decisions made by providers back to the guidelines. We use the openEHR architecture, which allows extension of a core Reference Model via Archetypes to refine the detailed information recording options for specific classes of encounter. We illustrate the use of openEHR for tracking the relationship of a series of clinical encounters to a guideline via a case study of guideline-compliant treatment of hypertension in diabetes. This case study shows the contribution guideline content can have on problem-specific EHR structure and demonstrates the potential for a constructive interaction of electronic decision support and the EHR. PMID:14728135

Do you know who's who in your EHR?

PubMed

Just, Beth Haenke; Proffitt, Karen

2009-08-01

Overlay and duplicate records pose a particularly insidious problem today for healthcare organizations--and pediatric hospitals in particular--that are introducing new information systems or upgrading their existing systems. Such erroneous records can be costly and time-consuming to identify and correct, and can lead to lost reimbursement and compromised quality of care. To address the problem, senior financial leaders need to recognize the critical importance of data integrity and take steps to ensure that the people and processes are in place to establish and maintain it.

A top-down approach for approximate data anonymisation

NASA Astrophysics Data System (ADS)

Li, JianQiang; Yang, Ji-Jiang; Zhao, Yu; Liu, Bo

2013-08-01

Data sharing in today's information society poses a threat to individual privacy and organisational confidentiality. k-anonymity is a widely adopted model to prevent the owner of a record being re-identified. By generalising and/or suppressing certain portions of the released dataset, it guarantees that no records can be uniquely distinguished from at least other k-1 records. A key requirement for the k-anonymity problem is to minimise the information loss resulting from data modifications. This article proposes a top-down approach to solve this problem. It first considers each record as a vertex and the similarity between two records as the edge weight to construct a complete weighted graph. Then, an edge cutting algorithm is designed to divide the complete graph into multiple trees/components. The Large Components with size bigger than 2k-1 are subsequently split to guarantee that each resulting component has the vertex number between k and 2k-1. Finally, the generalisation operation is applied on the vertices in each component (i.e. equivalence class) to make sure all the records inside have identical quasi-identifier values. We prove that the proposed approach has polynomial running time and theoretical performance guarantee O(k). The empirical experiments show that our approach results in substantial improvements over the baseline heuristic algorithms, as well as the bottom-up approach with the same approximate bound O(k). Comparing to the baseline bottom-up O(logk)-approximation algorithm, when the required k is smaller than 50, the adopted top-down strategy makes our approach achieve similar performance in terms of information loss while spending much less computing time. It demonstrates that our approach would be a best choice for the k-anonymity problem when both the data utility and runtime need to be considered, especially when k is set to certain value smaller than 50 and the record set is big enough to make the runtime have to be taken into account.

7 CFR 764.457 - Vendor requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Maintain and use a financial management information system to make financial decisions; (3) Understand and... budget; and (6) Use production records and other production information to identify problems, evaluate... general goal setting, risk management, and planning. (2) Financial management courses, covering all...

An early 19th-century Canadian surgical practice: the casebook of John Mackieson of Charlottetown, 1795–1885

PubMed Central

Shephard, David A.E.; Grogono, Basil J.S.

2002-01-01

A casebook written by Dr. John Mackieson (1795–1885), of Charlottetown, contains the records of 49 surgical cases he managed between 1826 and 1857. In view of the rarity of first-hand accounts of surgical practice in Canada in the mid-19th century, Mackieson’s case records are a significant source of information. These cases are discussed in order to delineate Mackieson’s approach to the surgical problems he faced in his general practice. His case records also illustrate some of the general problems that beset surgeons in that era. PMID:11939660

Problems of Maltreated Runaway Youth.

ERIC Educational Resources Information Center

Kurtz, P. David; And Others

1991-01-01

Shelter staff from 8 states completed Client Information Records on 2,019 runaways. Found significant differences in problems reported by physically abused and sexually abused runaways when compared to nonabused runaway peers. Runaways who were both physically and sexually maltreated were significantly more vulnerable and much worse off than those…

The quality of registration of clinical trials.

PubMed

Viergever, Roderik F; Ghersi, Davina

2011-02-24

Lack of transparency in clinical trial conduct, publication bias and selective reporting bias are still important problems in medical research. Through clinical trials registration, it should be possible to take steps towards resolving some of these problems. However, previous evaluations of registered records of clinical trials have shown that registered information is often incomplete and non-meaningful. If these studies are accurate, this negates the possible benefits of registration of clinical trials. A 5% sample of records of clinical trials that were registered between 17 June 2008 and 17 June 2009 was taken from the International Clinical Trials Registry Platform (ICTRP) database and assessed for the presence of contact information, the presence of intervention specifics in drug trials and the quality of primary and secondary outcome reporting. 731 records were included. More than half of the records were registered after recruitment of the first participant. The name of a contact person was available in 94.4% of records from non-industry funded trials and 53.7% of records from industry funded trials. Either an email address or a phone number was present in 76.5% of non-industry funded trial records and in 56.5% of industry funded trial records. Although a drug name or company serial number was almost always provided, other drug intervention specifics were often omitted from registration. Of 3643 reported outcomes, 34.9% were specific measures with a meaningful time frame. Clinical trials registration has the potential to contribute substantially to improving clinical trial transparency and reducing publication bias and selective reporting. These potential benefits are currently undermined by deficiencies in the provision of information in key areas of registered records.

The Quality of Registration of Clinical Trials

PubMed Central

Viergever, Roderik F.; Ghersi, Davina

2011-01-01

Background Lack of transparency in clinical trial conduct, publication bias and selective reporting bias are still important problems in medical research. Through clinical trials registration, it should be possible to take steps towards resolving some of these problems. However, previous evaluations of registered records of clinical trials have shown that registered information is often incomplete and non-meaningful. If these studies are accurate, this negates the possible benefits of registration of clinical trials. Methods and Findings A 5% sample of records of clinical trials that were registered between 17 June 2008 and 17 June 2009 was taken from the International Clinical Trials Registry Platform (ICTRP) database and assessed for the presence of contact information, the presence of intervention specifics in drug trials and the quality of primary and secondary outcome reporting. 731 records were included. More than half of the records were registered after recruitment of the first participant. The name of a contact person was available in 94.4% of records from non-industry funded trials and 53.7% of records from industry funded trials. Either an email address or a phone number was present in 76.5% of non-industry funded trial records and in 56.5% of industry funded trial records. Although a drug name or company serial number was almost always provided, other drug intervention specifics were often omitted from registration. Of 3643 reported outcomes, 34.9% were specific measures with a meaningful time frame. Conclusions Clinical trials registration has the potential to contribute substantially to improving clinical trial transparency and reducing publication bias and selective reporting. These potential benefits are currently undermined by deficiencies in the provision of information in key areas of registered records. PMID:21383991

Using medication list--problem list mismatches as markers of potential error.

PubMed Central

Carpenter, James D.; Gorman, Paul N.

2002-01-01

The goal of this project was to specify and develop an algorithm that will check for drug and problem list mismatches in an electronic medical record (EMR). The algorithm is based on the premise that a patient's problem list and medication list should agree, and a mismatch may indicate medication error. Successful development of this algorithm could mean detection of some errors, such as medication orders entered into a wrong patient record, or drug therapy omissions, that are not otherwise detected via automated means. Additionally, mismatches may identify opportunities to improve problem list integrity. To assess the concept's feasibility, this study compared medications listed in a pharmacy information system with findings in an online nursing adult admission assessment, serving as a proxy for the problem list. Where drug and problem list mismatches were discovered, examination of the patient record confirmed the mismatch, and identified any potential causes. Evaluation of the algorithm in diabetes treatment indicates that it successfully detects both potential medication error and opportunities to improve problem list completeness. This algorithm, once fully developed and deployed, could prove a valuable way to improve the patient problem list, and could decrease the risk of medication error. PMID:12463796

The place of SGML and HTML in building electronic patient records.

PubMed

Pitty, D; Gordon, C; Reeves, P; Capey, A; Vieyra, P; Rickards, T

1997-01-01

The authors are concerned that, although popular, SGML (Standard Generalized Markup Language) is only one approach to capturing, storing, viewing and exchanging healthcare information and does not provide a suitable paradigm for solving most of the problems associated with paper based patient record systems. Although a discussion of the relative merits of SGML, HTML (HyperText Markup Language) may be interesting, we feel such a discussion is avoiding the real issues associated with the most appropriate way to model, represent, and store electronic patient information in order to solve healthcare problems, and therefore the medical informatics community should firstly concern itself with these issues. The paper substantiates this viewpoint and concludes with some suggestions of how progress can be made.

Information Systems and Performance Measures in Schools.

ERIC Educational Resources Information Center

Coleman, James S.; Karweit, Nancy L.

Large school systems bring various administrative problems in handling scheduling, records, and avoiding making red tape casualties of students. The authors review a portion of the current use of computers to handle these problems and examine the range of activities for which computer processing could provide aid. Since automation always brings…

Measuring Children's Reading Development Using Leveled Texts.

ERIC Educational Resources Information Center

Paris, Scott G.

2002-01-01

Notes that the main problem with using Informal Reading Inventories (IRIs) for measuring reading growth is that running records and miscue analyses are gathered on variable levels of text that are appropriate for each child. Presents several possible solutions to the measurement problem beyond the simple profile descriptions usually reported from…

Processing medical data: a systematic review

PubMed Central

2013-01-01

Background Medical data recording is one of the basic clinical tools. Electronic Health Record (EHR) is important for data processing, communication, efficiency and effectiveness of patients’ information access, confidentiality, ethical and/or legal issues. Clinical record promote and support communication among service providers and hence upscale quality of healthcare. Qualities of records are reflections of the quality of care patients offered. Methods Qualitative analysis was undertaken for this systematic review. We reviewed 40 materials Published from 1999 to 2013. We searched these materials from databases including ovidMEDLINE and ovidEMBASE. Two reviewers independently screened materials on medical data recording, documentation and information processing and communication. Finally, all selected references were summarized, reconciled and compiled as one compatible document. Result Patients were dying and/or getting much suffering as the result of poor quality medical records. Electronic health record minimizes errors, saves unnecessary time, and money wasted on processing medical data. Conclusion Many countries have been complaining for incompleteness, inappropriateness and illegibility of records. Therefore creating awareness on the magnitude of the problem has paramount importance. Hence available correct patient information has lots of potential in reducing errors and support roles. PMID:24107106

Recording Information on Architectural Heritage Should Meet the Requirements for Conservation Digital Recording Practices at the Summer Palace

NASA Astrophysics Data System (ADS)

Zhang, L.; Cong, Y.; Wu, C.; Bai, C.; Wu, C.

2017-08-01

The recording of Architectural heritage information is the foundation of research, conservation, management, and the display of architectural heritage. In other words, the recording of architectural heritage information supports heritage research, conservation, management and architectural heritage display. What information do we record and collect and what technology do we use for information recording? How do we determine the level of accuracy required when recording architectural information? What method do we use for information recording? These questions should be addressed in relation to the nature of the particular heritage site and the specific conditions for the conservation work. In recent years, with the rapid development of information acquisition technology such as Close Range Photogrammetry, 3D Laser Scanning as well as high speed and high precision Aerial Photogrammetry, many Chinese universities, research institutes and heritage management bureaux have purchased considerable equipment for information recording. However, the lack of understanding of both the nature of architectural heritage and the purpose for which the information is being collected has led to several problems. For example: some institutions when recording architectural heritage information aim solely at high accuracy. Some consider that advanced measuring methods must automatically replace traditional measuring methods. Information collection becomes the purpose, rather than the means, of architectural heritage conservation. Addressing these issues, this paper briefly reviews the history of architectural heritage information recording at the Summer Palace (Yihe Yuan, first built in 1750), Beijing. Using the recording practices at the Summer Palace during the past ten years as examples, we illustrate our achievements and lessons in recording architectural heritage information with regard to the following aspects: (buildings') ideal status desired, (buildings') current status, structural distortion analysis, display, statue restoration and thematic research. Three points will be highlighted in our discussion: 1. Understanding of the heritage is more important than the particular technology used: Architectural heritage information collection and recording are based on an understanding of the value and nature of the architectural heritage. Understanding is the purpose, whereas information collection and recording are the means. 2. Demand determines technology: Collecting and recording architectural heritage information is to serve the needs of heritage research, conservation, management and display. These different needs determine the different technologies that we use. 3. Set the level of accuracy appropriately: For information recording, high accuracy is not the key criterion; rather an appropriate level of accuracy is key. There is considerable deviation between the nominal accuracy of any instrument and the accuracy of any particular measurement.

75 FR 45674 - Privacy Act of 1974, as Amended; System of Records Notices

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

... invasion of personal privacy by requiring Federal agencies to disseminate any record of identifiable personal information in a manner that assures that such action is for a necessary and lawful purpose, that... agency compliance with the FOIA. In this role, OGIS will capture and address systematic problems in FOIA...

Janice VanCleave's Rocks and Minerals: Mind-Boggling Experiments You Can Turn into Science Fair Projects.

ERIC Educational Resources Information Center

VanCleave, Janice

Science projects are a great way for students to learn more about science as they search for the answers to specific problems. This book offers guidance and provides ideas for students as they plan experiments, find and record information related to the problem, and organize data to find answers to the problem. The 20 topics in this book suggest…

CLARUS as a Cloud Security Framework: e-Health Use Case.

PubMed

Vidal, David; Iriso, Santiago; Mulero, Rafael

2017-01-01

Maintaining Passive Medical Health Records (PMHR) is an increasing cost and resource consumption problem. Moving to the cloud is the clearest solution to solve the problem as it offers a high amount of space and computation power. But the cloud is not safe enough when dealing with this kind of information because it can be easily accessed by attackers. The European Commission funded research project CLARUS contributes to protect healthcare-sensitive information in a secure way.

Linking attentional processes and conceptual problem solving: visual cues facilitate the automaticity of extracting relevant information from diagrams

PubMed Central

Rouinfar, Amy; Agra, Elise; Larson, Adam M.; Rebello, N. Sanjay; Loschky, Lester C.

2014-01-01

This study investigated links between visual attention processes and conceptual problem solving. This was done by overlaying visual cues on conceptual physics problem diagrams to direct participants’ attention to relevant areas to facilitate problem solving. Participants (N = 80) individually worked through four problem sets, each containing a diagram, while their eye movements were recorded. Each diagram contained regions that were relevant to solving the problem correctly and separate regions related to common incorrect responses. Problem sets contained an initial problem, six isomorphic training problems, and a transfer problem. The cued condition saw visual cues overlaid on the training problems. Participants’ verbal responses were used to determine their accuracy. This study produced two major findings. First, short duration visual cues which draw attention to solution-relevant information and aid in the organizing and integrating of it, facilitate both immediate problem solving and generalization of that ability to new problems. Thus, visual cues can facilitate re-representing a problem and overcoming impasse, enabling a correct solution. Importantly, these cueing effects on problem solving did not involve the solvers’ attention necessarily embodying the solution to the problem, but were instead caused by solvers attending to and integrating relevant information in the problems into a solution path. Second, this study demonstrates that when such cues are used across multiple problems, solvers can automatize the extraction of problem-relevant information extraction. These results suggest that low-level attentional selection processes provide a necessary gateway for relevant information to be used in problem solving, but are generally not sufficient for correct problem solving. Instead, factors that lead a solver to an impasse and to organize and integrate problem information also greatly facilitate arriving at correct solutions. PMID:25324804

Linking attentional processes and conceptual problem solving: visual cues facilitate the automaticity of extracting relevant information from diagrams.

PubMed

Rouinfar, Amy; Agra, Elise; Larson, Adam M; Rebello, N Sanjay; Loschky, Lester C

2014-01-01

This study investigated links between visual attention processes and conceptual problem solving. This was done by overlaying visual cues on conceptual physics problem diagrams to direct participants' attention to relevant areas to facilitate problem solving. Participants (N = 80) individually worked through four problem sets, each containing a diagram, while their eye movements were recorded. Each diagram contained regions that were relevant to solving the problem correctly and separate regions related to common incorrect responses. Problem sets contained an initial problem, six isomorphic training problems, and a transfer problem. The cued condition saw visual cues overlaid on the training problems. Participants' verbal responses were used to determine their accuracy. This study produced two major findings. First, short duration visual cues which draw attention to solution-relevant information and aid in the organizing and integrating of it, facilitate both immediate problem solving and generalization of that ability to new problems. Thus, visual cues can facilitate re-representing a problem and overcoming impasse, enabling a correct solution. Importantly, these cueing effects on problem solving did not involve the solvers' attention necessarily embodying the solution to the problem, but were instead caused by solvers attending to and integrating relevant information in the problems into a solution path. Second, this study demonstrates that when such cues are used across multiple problems, solvers can automatize the extraction of problem-relevant information extraction. These results suggest that low-level attentional selection processes provide a necessary gateway for relevant information to be used in problem solving, but are generally not sufficient for correct problem solving. Instead, factors that lead a solver to an impasse and to organize and integrate problem information also greatly facilitate arriving at correct solutions.

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

PubMed

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

2015-01-01

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

How secure is your information system? An investigation into actual healthcare worker password practices.

PubMed

Cazier, Joseph A; Medlin, B Dawn

2006-09-27

For most healthcare information systems, passwords are the first line of defense in keeping patient and administrative records private and secure. However, this defense is only as strong as the passwords employees chose to use. A weak or easily guessed password is like an open door to the medical records room, allowing unauthorized access to sensitive information. In this paper, we present the results of a study of actual healthcare workers' password practices. In general, the vast majority of these passwords have significant security problems on several dimensions. Implications for healthcare professionals are discussed.

How Secure Is Your Information System? An Investigation into Actual Healthcare Worker Password Practices

PubMed Central

Cazier, Joseph A; Medlin, B. Dawn

2006-01-01

For most healthcare information systems, passwords are the first line of defense in keeping patient and administrative records private and secure. However, this defense is only as strong as the passwords employees chose to use. A weak or easily guessed password is like an open door to the medical records room, allowing unauthorized access to sensitive information. In this paper, we present the results of a study of actual healthcare workers' password practices. In general, the vast majority of these passwords have significant security problems on several dimensions. Implications for healthcare professionals are discussed. PMID:18066366

A shared computer-based problem-oriented patient record for the primary care team.

PubMed

Linnarsson, R; Nordgren, K

1995-01-01

1. INTRODUCTION. A computer-based patient record (CPR) system, Swedestar, has been developed for use in primary health care. The principal aim of the system is to support continuous quality improvement through improved information handling, improved decision-making, and improved procedures for quality assurance. The Swedestar system has evolved during a ten-year period beginning in 1984. 2. SYSTEM DESIGN. The design philosophy is based on the following key factors: a shared, problem-oriented patient record; structured data entry based on an extensive controlled vocabulary; advanced search and query functions, where the query language has the most important role; integrated decision support for drug prescribing and care protocols and guidelines; integrated procedures for quality assurance. 3. A SHARED PROBLEM-ORIENTED PATIENT RECORD. The core of the CPR system is the problem-oriented patient record. All problems of one patient, recorded by different members of the care team, are displayed on the problem list. Starting from this list, a problem follow-up can be made, one problem at a time or for several problems simultaneously. Thus, it is possible to get an integrated view, across provider categories, of those problems of one patient that belong together. This shared problem-oriented patient record provides an important basis for the primary care team work. 4. INTEGRATED DECISION SUPPORT. The decision support of the system includes a drug prescribing module and a care protocol module. The drug prescribing module is integrated with the patient records and includes an on-line check of the patient's medication list for potential interactions and data-driven reminders concerning major drug problems. Care protocols have been developed for the most common chronic diseases, such as asthma, diabetes, and hypertension. The patient records can be automatically checked according to the care protocols. 5. PRACTICAL EXPERIENCE. The Swedestar system has been implemented in a primary care area with 30,000 inhabitants. It is being used by all the primary care team members: 15 general practitioners, 25 district nurses, and 10 physiotherapists. Several years of practical experience of the CPR system shows that it has a positive impact on quality of care on four levels: 1) improved clinical follow-up of individual patients; 2) facilitated follow-up of aggregated data such as practice activity analysis, annual reports, and clinical indicators; 3) automated medical audit; and 4) concurrent audit. Within that primary care area, quality of care has improved substantially in several aspects due to the use of the CPR system [1].

The Development from Effortful to Automatic Processing in Mathematical Cognition.

ERIC Educational Resources Information Center

Kaye, Daniel B.; And Others

This investigation capitalizes upon the information processing models that depend upon measurement of latency of response to a mathematical problem and the decomposition of reaction time (RT). Simple two term addition problems were presented with possible solutions for true-false verification, and accuracy and RT to response were recorded. Total…

Uncovering the problem-solving process: cued retrospective reporting versus concurrent and retrospective reporting.

PubMed

van Gog, Tamara; Paas, Fred; van Merriënboer, Jeroen J G; Witte, Puk

2005-12-01

This study investigated the amounts of problem-solving process information ("action," "why," "how," and "metacognitive") elicited by means of concurrent, retrospective, and cued retrospective reporting. In a within-participants design, 26 participants completed electrical circuit troubleshooting tasks under different reporting conditions. The method of cued retrospective reporting used the original computer-based task and a superimposed record of the participant's eye fixations and mouse-keyboard operations as a cue for retrospection. Cued retrospective reporting (with the exception of why information) and concurrent reporting (with the exception of metacognitive information) resulted in a higher number of codes on the different types of information than did retrospective reporting.

A prototype of a computerized patient record.

PubMed

Adelhard, K; Eckel, R; Hölzel, D; Tretter, W

1995-01-01

Computerized medical record systems (CPRS) should present user and problem oriented views of the patient file. Problem lists, clinical course, medication profiles and results of examinations have to be recorded in a computerized patient record. Patient review screens should give a synopsis of the patient data to inform whenever the patient record is opened. Several different types of data have to be stored in a patient record. Qualitative and quantitative measurements, narratives and images are such examples. Therefore, a CPR must also be able to handle these different data types. New methods and concepts appear frequently in medicine. Thus a CPRS must be flexible enough to cope with coming demands. We developed a prototype of a computer based patient record with a graphical user interface on a SUN workstation. The basis of the system are a dynamic data dictionary, an interpreter language and a large set of basic functions. This approach gives optimal flexibility to the system. A lot of different data types are already supported. Extensions are easily possible. There is also almost no limit concerning the number of medical concepts that can be handled by our prototype. Several applications were built on this platform. Some of them are presented to exemplify the patient and problem oriented handling of the CPR.

It's not as simple as it sounds: Problems and solutions in accessing and using administrative child welfare data for evaluating the impact of early childhood interventions☆

PubMed Central

Green, Beth L.; Ayoub, Catherine; Dym Bartlett, Jessica; Furrer, Carrie; Von Ende, Adam; Chazan-Cohen, Rachel; Klevens, Joanne; Nygren, Peggy

2015-01-01

In recent years, there has been increasing interest in using administrative data collected by state child welfare agencies as a source of information for research and evaluation. The challenges of obtaining access to and using these data, however, have not been well documented. This study describes the processes used to access child welfare records in six different states and the approach to combining and using the information gathered to evaluate the impact of the Early Head Start program on children's involvement with the child welfare system from birth through age eleven. We provide “lessons learned” for researchers who are attempting to use this information, including being prepared for long delays in access to information, the need for deep understanding of how child welfare agencies record and code information, and for considerable data management work for translating agency records into analysis-ready datasets. While accessing and using this information is not easy, and the data have a number of limitations, we suggest that the benefits can outweigh the challenges and that these records can be a useful source of information for policy-relevant child welfare research. PMID:26744551

Summary Time Oriented Record (STOR)—A Progress Report

PubMed Central

Simborg, Donald W.; Whiting-O'Keefe, Quinn E.

1981-01-01

A Summary Time Oriented Medical Record System (STOR) has been designed as a potential replacement for the medical record for use in ambulatory care. As described at the Fourth Annual Symposium, this system has unique characteristics aimed specifically for management of patients with chronic diseases. It is hypothesized that this record design will improve information flow to practitioners at the time of decision-making in ambulatory care, while at the same time reducing manual recording requirements by the practitioner. This system has now been implemented in three specialty clinics at the University of California, San Francisco Medical Center. Rigorous evaluation techniques using prospective randomized control studies are being used in its evaluation. The clinical information includes patient problems, diagnoses, therapies, and ancillary test results. It is implemented on an IBM 4331 computer using the RAMIS data base management system.

Multimedia Health Records: user-centered design approach for a multimedia uploading service.

PubMed

Plazzotta, Fernando; Mayan, John C; Storani, Fernando D; Ortiz, Juan M; Lopez, Gastón E; Gimenez, Gastón M; Luna, Daniel R

2015-01-01

Multimedia elements add value to text documents by transmitting information difficult to express in words. In healthcare, many professional and services keep this elements in their own repositories. This brings the problem of information fragmentation in different silos which hinder its access to other healthcare professionals. On the other hand patients have clinical data of their own in different formats generated in different healthcare organizations which is not accessible to professionals within our healthcare network. This paper describes the design, development and implementation processes of a service which allows media elements to be loaded in a patient clinical data repository (CDR) either through an electronic health record by professionals (EHR) or through a personal health record (PHR) by patients, in order to avoid fragmentation of the information.

Non-confidential 2002 IUR Company/Chemical Records

EPA Pesticide Factsheets

This file contains information reported to EPA under the 2002 Inventory Update Rule (IUR). The deadline for companies to report was December 31, 2002. This database includes all information received by EPA that did not have problems associated with the submission, including requests from companies to update or correct their earlier filings. Future updates to this information will be made available on this website.

Cloud Study Investigators: Using NASA's CERES S'COOL in Problem-Based Learning

ERIC Educational Resources Information Center

Moore, Susan; Popiolkowski, Gary

2011-01-01

1This article describes how, by incorporating NASA's Students' Cloud Observations On-Line (S'COOL) project into a problem-based learning (PBL) activity, middle school students are engaged in authentic scientific research where they observe and record information about clouds and contribute ground truth data to NASA's Clouds and the Earth's…

Automated Circulation Systems as a Source of Secondary Information.

ERIC Educational Resources Information Center

Chapin, Giny Ziegler

This report looks at the use of public library online circulation systems for the generation of in-house secondary information--such as statistical reports and mailing lists--and also considers problems in maintaining confidentiality of patron records when using online circulation systems. Based on a survey of the literature, general information…

77 FR 14565 - Information Collection Request Sent to the Office of Management and Budget (OMB) for Approval...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-12

... client evaluation helps refuge managers detect potential problems with guide services so that we can take... public record. Before including your address, phone number, email address, or other personal identifying information in your comment, you should be aware that your entire comment, including your personal identifying...

Assessing Information on the Internet: Toward Providing Library Services for Computer-Mediated Communication. A Final Report.

ERIC Educational Resources Information Center

Dillon, Martin; And Others

The Online Computer Library Center Internet Resource project focused on the nature of electronic textual information available through remote access using the Internet and the problems associated with creating machine-readable cataloging (MARC) records for these objects using current USMARC format for computer files and "Anglo-American…

Software engineering risk factors in the implementation of a small electronic medical record system: the problem of scalability.

PubMed

Chiang, Michael F; Starren, Justin B

2002-01-01

The successful implementation of clinical information systems is difficult. In examining the reasons and potential solutions for this problem, the medical informatics community may benefit from the lessons of a rich body of software engineering and management literature about the failure of software projects. Based on previous studies, we present a conceptual framework for understanding the risk factors associated with large-scale projects. However, the vast majority of existing literature is based on large, enterprise-wide systems, and it unclear whether those results may be scaled down and applied to smaller projects such as departmental medical information systems. To examine this issue, we discuss the case study of a delayed electronic medical record implementation project in a small specialty practice at Columbia-Presbyterian Medical Center. While the factors contributing to the delay of this small project share some attributes with those found in larger organizations, there are important differences. The significance of these differences for groups implementing small medical information systems is discussed.

Readability of Internet Information on Hearing: Systematic Literature Review.

PubMed

Laplante-Lévesque, Ariane; Thorén, Elisabet Sundewall

2015-09-01

This systematic literature review asks the following question: “ What is the readability of Internet information on hearing that people with hearing impairment and their significant others can access in the context of their hearing care?” Searches were completed in three databases: CINAHL, PubMed, and Scopus. Seventy-eight records were identified and systematically screened for eligibility: 8 records were included that contained data on the readability of Internet information on hearing that people with hear ing impairment and their significant others can access in the context of their hearing care. Records reported mean readability levels from 9 to over 14. In other words, people with hearing impairment and their significant others need 9 to 14 years of education to read and understand Internet information on hearing that they access in the context of their hearing care. The poor readability of Internet information on hearing has been well documented; it is time to focus on valid and sustainable initiatives that address this problem.

[Low concordance between primary care and hospital clinical information].

PubMed

Revilla-López, Concha; Calderón-Larrañaga, Amaia; Enríquez-Martín, Natalia; Prados-Torres, Alexandra

2016-04-01

To measure the diagnostic agreement between Primary Care (PC) and hospital information systems, in order to assess the usefulness of health care records for research purposes. Cross-sectional retrospective study integrating PC and hospital diagnostic information for the Aragon population admitted to hospital in 2010. 75.176 patients were analysed. Similarities, differences and the kappa index were calculated for each of the diagnoses recorded in both information systems. The studied diseases included COPD, diabetes, hypertension, cerebrovascular disease, ischaemic heart disease, asthma, epilepsy, and heart failure. Diagnostic concordance was higher in men and between 45 and 64 years. Diabetes was the condition showing the highest concordance (kappa index: 0.75), while asthma had the lowest values (kappa index: 0.34). The low concordance between the diagnostic information recorded in PC and in the hospital setting calls for urgent measures to ensure that healthcare professionals have a comprehensive picture of patient's health problems. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Securing recruitment and obtaining informed consent in minority ethnic groups in the UK.

PubMed

Lloyd, Cathy E; Johnson, Mark R D; Mughal, Shanaz; Sturt, Jackie A; Collins, Gary S; Roy, Tapash; Bibi, Rukhsana; Barnett, Anthony H

2008-03-30

Previous health research has often explicitly excluded individuals from minority ethnic backgrounds due to perceived cultural and communication difficulties, including studies where there might be language/literacy problems in obtaining informed consent. This study addressed these difficulties by developing audio-recorded methods of obtaining informed consent and recording data. This report outlines 1) our experiences with securing recruitment to a qualitative study investigating alternative methods of data collection, and 2) the development of a standardised process for obtaining informed consent from individuals from minority ethnic backgrounds whose main language does not have an agreed written form. Two researchers from South Asian backgrounds recruited adults with Type 2 diabetes whose main language was spoken and not written, to attend a series of focus groups. A screening tool was used at recruitment in order to assess literacy skills in potential participants. Informed consent was obtained using audio-recordings of the patient information and recording patients' verbal consent. Participants' perceptions of this method of obtaining consent were recorded. Recruitment rates were improved by using telephone compared to face-to-face methods. The screening tool was found to be acceptable by all potential participants. Audio-recorded methods of obtaining informed consent were easy to implement and accepted by all participants. Attrition rates differed according to ethnic group. Snowballing techniques only partly improved participation rates. Audio-recorded methods of obtaining informed consent are an acceptable alternative to written consent in study populations where literacy skills are variable. Further exploration of issues relating to attrition is required, and a range of methods may be necessary in order to maximise response and participation rates.

Archetype-based electronic health records: a literature review and evaluation of their applicability to health data interoperability and access.

PubMed

Wollersheim, Dennis; Sari, Anny; Rahayu, Wenny

Health Information Managers (HIMs) are responsible for overseeing health information. The change management necessary during the transition to electronic health records (EHR) is substantial, and ongoing. Archetype-based EHRs are a core health information system component which solve many of the problems that arise during this period of change. Archetypes are models of clinical content, and they have many beneficial properties. They are interoperable, both between settings and through time. They are more amenable to change than conventional paradigms, and their design is congruent with clinical practice. This paper is an overview of the current archetype literature relevant to Health Information Managers. The literature was sourced in the English language sections of ScienceDirect, IEEE Explore, Pubmed, Google Scholar, ACM Digital library and other databases on the usage of archetypes for electronic health record storage, looking at the current areas of archetype research, appropriate usage, and future research. We also used reference lists from the cited papers, papers referenced by the openEHR website, and the recommendations from experts in the area. Criteria for inclusion were (a) if studies covered archetype research and (b) were either studies of archetype use, archetype system design, or archetype effectiveness. The 47 papers included show a wide and increasing worldwide archetype usage, in a variety of medical domains. Most of the papers noted that archetypes are an appropriate solution for future-proof and interoperable medical data storage. We conclude that archetypes are a suitable solution for the complex problem of electronic health record storage and interoperability.

Secure Dynamic access control scheme of PHR in cloud computing.

PubMed

Chen, Tzer-Shyong; Liu, Chia-Hui; Chen, Tzer-Long; Chen, Chin-Sheng; Bau, Jian-Guo; Lin, Tzu-Ching

2012-12-01

With the development of information technology and medical technology, medical information has been developed from traditional paper records into electronic medical records, which have now been widely applied. The new-style medical information exchange system "personal health records (PHR)" is gradually developed. PHR is a kind of health records maintained and recorded by individuals. An ideal personal health record could integrate personal medical information from different sources and provide complete and correct personal health and medical summary through the Internet or portable media under the requirements of security and privacy. A lot of personal health records are being utilized. The patient-centered PHR information exchange system allows the public autonomously maintain and manage personal health records. Such management is convenient for storing, accessing, and sharing personal medical records. With the emergence of Cloud computing, PHR service has been transferred to storing data into Cloud servers that the resources could be flexibly utilized and the operation cost can be reduced. Nevertheless, patients would face privacy problem when storing PHR data into Cloud. Besides, it requires a secure protection scheme to encrypt the medical records of each patient for storing PHR into Cloud server. In the encryption process, it would be a challenge to achieve accurately accessing to medical records and corresponding to flexibility and efficiency. A new PHR access control scheme under Cloud computing environments is proposed in this study. With Lagrange interpolation polynomial to establish a secure and effective PHR information access scheme, it allows to accurately access to PHR with security and is suitable for enormous multi-users. Moreover, this scheme also dynamically supports multi-users in Cloud computing environments with personal privacy and offers legal authorities to access to PHR. From security and effectiveness analyses, the proposed PHR access scheme in Cloud computing environments is proven flexible and secure and could effectively correspond to real-time appending and deleting user access authorization and appending and revising PHR records.

Problem-oriented patient record model as a conceptual foundation for a multi-professional electronic patient record.

PubMed

De Clercq, Etienne

2008-09-01

It is widely accepted that the development of electronic patient records, or even of a common electronic patient record, is one possible way to improve cooperation and data communication between nurses and physicians. Yet, little has been done so far to develop a common conceptual model for both medical and nursing patient records, which is a first challenge that should be met to set up a common electronic patient record. In this paper, we describe a problem-oriented conceptual model and we show how it may suit both nursing and medical perspectives in a hospital setting. We started from existing nursing theory and from an initial model previously set up for primary care. In a hospital pilot site, a multi-disciplinary team refined this model using one large and complex clinical case (retrospective study) and nine ongoing cases (prospective study). An internal validation was performed through hospital-wide multi-professional interviews and through discussions around a graphical user interface prototype. To assess the consistency of the model, a computer engineer specified it. Finally, a Belgian expert working group performed an external assessment of the model. As a basis for a common patient record we propose a simple problem-oriented conceptual model with two levels of meta-information. The model is mapped with current nursing theories and it includes the following concepts: "health care element", "health approach", "health agent", "contact", "subcontact" and "service". These concepts, their interrelationships and some practical rules for using the model are illustrated in this paper. Our results are compatible with ongoing standardization work at the Belgian and European levels. Our conceptual model is potentially a foundation for a multi-professional electronic patient record that is problem-oriented and therefore patient-centred.

Implementing a regional oncology information system: approach and lessons learned.

PubMed

Evans, W K; Ashbury, F D; Hogue, G L; Smith, A; Pun, J

2014-10-01

Paper-based medical record systems are known to have major problems of inaccuracy, incomplete data, poor accessibility, and challenges to patient confidentiality. They are also an inefficient mechanism of record-sharing for interdisciplinary patient assessment and management, and represent a major problem for keeping current and monitoring quality control to facilitate improvement. To address those concerns, national, regional, and local health care authorities have increased the pressure on oncology practices to upgrade from paper-based systems to electronic health records. Here, we describe and discuss the challenges to implementing a region-wide oncology information system across four independent health care organizations, and we describe the lessons learned from the initial phases that are now being applied in subsequent activities of this complex project. The need for change must be shared across centres to increase buy-in, adoption, and implementation. It is essential to establish physician leadership, commitment, and engagement in the process. Work processes had to be revised to optimize use of the new system. Culture change must be included in the change management strategy. Furthermore, training and resource requirements must be thoroughly planned, implemented, monitored, and modified as required for effective adoption of new work processes and technology. Interfaces must be established with multiple existing electronic systems across the region to ensure appropriate patient flow. Periodic assessment of the existing project structure is necessary, and adjustments are often required to ensure that the project meets its objectives. The implementation of region-wide oncology information systems across different health practice locations has many challenges. Leadership is essential. A strong, collaborative information-sharing strategy across the region and with the supplier is essential to identify, discuss, and resolve implementation problems. A structure that supports project management and accountability contributes to success.

HEDEA: A Python Tool for Extracting and Analysing Semi-structured Information from Medical Records

PubMed Central

Aggarwal, Anshul; Garhwal, Sunita

2018-01-01

Objectives One of the most important functions for a medical practitioner while treating a patient is to study the patient's complete medical history by going through all records, from test results to doctor's notes. With the increasing use of technology in medicine, these records are mostly digital, alleviating the problem of looking through a stack of papers, which are easily misplaced, but some of these are in an unstructured form. Large parts of clinical reports are in written text form and are tedious to use directly without appropriate pre-processing. In medical research, such health records may be a good, convenient source of medical data; however, lack of structure means that the data is unfit for statistical evaluation. In this paper, we introduce a system to extract, store, retrieve, and analyse information from health records, with a focus on the Indian healthcare scene. Methods A Python-based tool, Healthcare Data Extraction and Analysis (HEDEA), has been designed to extract structured information from various medical records using a regular expression-based approach. Results The HEDEA system is working, covering a large set of formats, to extract and analyse health information. Conclusions This tool can be used to generate analysis report and charts using the central database. This information is only provided after prior approval has been received from the patient for medical research purposes. PMID:29770248

HEDEA: A Python Tool for Extracting and Analysing Semi-structured Information from Medical Records.

PubMed

Aggarwal, Anshul; Garhwal, Sunita; Kumar, Ajay

2018-04-01

One of the most important functions for a medical practitioner while treating a patient is to study the patient's complete medical history by going through all records, from test results to doctor's notes. With the increasing use of technology in medicine, these records are mostly digital, alleviating the problem of looking through a stack of papers, which are easily misplaced, but some of these are in an unstructured form. Large parts of clinical reports are in written text form and are tedious to use directly without appropriate pre-processing. In medical research, such health records may be a good, convenient source of medical data; however, lack of structure means that the data is unfit for statistical evaluation. In this paper, we introduce a system to extract, store, retrieve, and analyse information from health records, with a focus on the Indian healthcare scene. A Python-based tool, Healthcare Data Extraction and Analysis (HEDEA), has been designed to extract structured information from various medical records using a regular expression-based approach. The HEDEA system is working, covering a large set of formats, to extract and analyse health information. This tool can be used to generate analysis report and charts using the central database. This information is only provided after prior approval has been received from the patient for medical research purposes.

Using Oil and Gas Well Log Records to Understand Possible Connections Between Wastewater Injection Zones and Usable Groundwater Aquifers in California

NASA Astrophysics Data System (ADS)

Shimabukuro, D.; Haugen, E. A.; Battistella, C.; Treguboff, E. W.; Kale, J. M.

2015-12-01

Although the disposal of produced water in wastewater injection wells has been occurring in California for decades, it is not clear whether injected fluids may be migrating into usable groundwater aquifers. One problem is the poor characterization of federally-protected (<10,000 ppm TDS) water in the state. Another is the lack of publically-accessible information about the hydrological properties of confining strata adjacent to injection zones. In effort to better understand these two problems, we have begun studying the archived oil and gas well records collected by the California Division of Oil, Gas, and Geothermal Resources (DOGGR). These scanned records contain two useful sources of information. First, geophysical well logs, such those measuring resistivity and porosity, can be used to determine aquifer salinity. This allows a three-dimensional understanding of the distribution of protected groundwater. Second, driller's logs contain lithological descriptions at depth. These lithologies can be used to construct a three-dimensional texture model, which can then be used in a groundwater flow model. A large number of undergraduate researchers at CSU Sacramento and CSU Long Beach have been collecting information on well records in the Ventura Basin and the Southern San Joaquin Valley. Each well record is examined with basic metadata entered into an online database in an effort to identify appropriate geophysical well logs and driller's logs. High-quality driller's logs are coded and used to create three-dimensional framework models for each well field. The geophysical logs are digitized and will be used to determine aquifer salinity. In addition, we are using information from the DOGGR well records to investigate wellbore integrity, waste disposal and waterflood injection volumes, and the possibility of induced seismicity. This project is part of the broader effort of the California State Water Resources Control Board to implement Senate Bill 4.

Information on actual medication use and drug-related problems in older patients: questionnaire or interview?

PubMed

Willeboordse, Floor; Grundeken, Lucienne H; van den Eijkel, Lisanne P; Schellevis, François G; Elders, Petra J M; Hugtenburg, Jacqueline G

2016-04-01

Information on medication use and drug-related problems is important in the preparation of clinical medication reviews. Critical information can only be provided by patients themselves, but interviewing patients is time-consuming. Alternatively, patient information could be obtained with a questionnaire. In this study the agreement between patient information on medication use and drug-related problems in older patients obtained with a questionnaire was compared with information obtained during an interview. General practice in The Netherlands. A questionnaire was developed to obtain information on actual medication use and drug-related problems. Two patient groups ≥65 years were selected based on general practitioner electronic medical records in nine practices; I. polypharmacy and II. ≥1 predefined general geriatric problems. Eligible patients were asked to complete the questionnaire and were interviewed afterwards. Agreement on information on medication use and drug-related problems collected with the questionnaire and interview was calculated. Ninety-seven patients participated. Of all medications used, 87.6 % (95 % CI 84.7-90.5) was reported identically in the questionnaire and interview. Agreement for the complete medication list was found for 45.4 % (95 % CI 35.8-55.3) of the patients. On drug-related problem level, agreement between questionnaire and interview was 75 %. Agreement tended to be lower in vulnerable patients characterized by ≥4 chronic diseases, ≥10 medications used and low health literacy. Information from a questionnaire showed reasonable agreement compared with interviewing. The patients reported more medications and drug-related problems in the interview than the questionnaire. Taking the limitations into account, a questionnaire seems a suitable tool for medication reviews that may replace an interview for most patients.

Space Handbook

DTIC Science & Technology

1970-07-01

communications problem is confined to transfer between the vehicle and the surface and to recording the data in a form suitable for processing and analysis at a...information available for later analysis would be of greater significance. Thus, computers used to receive and record data may be used to perform preliminary...basic design of boosters and payloads to the reduction and analysis of the data after mission completion. Computers function to schedule experiments

Solar radiation data sources, applications, and network design

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

None

A prerequisite to considering solar energy projects is to determine the requirements for information about solar radiation to apply to possible projects. This report offers techniques to help the reader specify requirements in terms of solar radiation data and information currently available, describes the past and present programs to record and present information to be used for most requirements, presents courses of action to help the user meet his needs for information, lists sources of solar radiation data and presents the problems, costs, benefits and responsibilities of programs to acquire additional solar radiation data. Extensive background information is provided aboutmore » solar radiation data and its use. Specialized information about recording, collecting, processing, storing and disseminating solar radiation data is given. Several Appendices are included which provide reference material for special situations.« less

nStudy: A System for Researching Information Problem Solving

ERIC Educational Resources Information Center

Winne, Philip H.; Nesbit, John C.; Popowich, Fred

2017-01-01

A bottleneck in gathering big data about learning is instrumentation designed to record data about processes students use to learn and information on which those processes operate. The software system nStudy fills this gap. nStudy is an extension to the Chrome web browser plus a server side database for logged trace data plus peripheral modules…

Semantic extraction and processing of medical records for patient-oriented visual index

NASA Astrophysics Data System (ADS)

Zheng, Weilin; Dong, Wenjie; Chen, Xiangjiao; Zhang, Jianguo

2012-02-01

To have comprehensive and completed understanding healthcare status of a patient, doctors need to search patient medical records from different healthcare information systems, such as PACS, RIS, HIS, USIS, as a reference of diagnosis and treatment decisions for the patient. However, it is time-consuming and tedious to do these procedures. In order to solve this kind of problems, we developed a patient-oriented visual index system (VIS) to use the visual technology to show health status and to retrieve the patients' examination information stored in each system with a 3D human model. In this presentation, we present a new approach about how to extract the semantic and characteristic information from the medical record systems such as RIS/USIS to create the 3D Visual Index. This approach includes following steps: (1) Building a medical characteristic semantic knowledge base; (2) Developing natural language processing (NLP) engine to perform semantic analysis and logical judgment on text-based medical records; (3) Applying the knowledge base and NLP engine on medical records to extract medical characteristics (e.g., the positive focus information), and then mapping extracted information to related organ/parts of 3D human model to create the visual index. We performed the testing procedures on 559 samples of radiological reports which include 853 focuses, and achieved 828 focuses' information. The successful rate of focus extraction is about 97.1%.

[Conduct of survey four months after the start of EMR for home visits to promote cooperation between hospitals and clinics].

PubMed

Nakagawa, Yumiko; Sawada, Sachiko; Tomiyama, Takashi; Ueda, Yuki; Fujii, Kou; Takeshita, Kiyotaka; Kobayashi, Mitsuru; Isono, Osamu

2014-12-01

Electronic medical records(EMR)for home visits were introduced in October 2013 at our institution in order to ensure smooth cooperation between the hospital and clinic by sharing the details of a patient's medical record. A system was developed for remote desktop connections to the EMR terminal server(virtual server)with the use of an SSL-VPN. Mobile terminals and mobile printers were used. Four months after the start of this system, a survey was conducted for 41 home care professionals and other staff(physicians, nurses, and office staff). Home care staff indicated that they had problems with the system, including bad connections and operating conditions, and difficulties responding to problems when they arose. Other staff indicated that they were able to acquire patient information faster than with paper-based records. Future issues include improvements to the user-friendliness of the terminals and improved responses to problems when they occur.

SOCIAL PSYCHOLOGICAL RESEARCH IN DEVELOPING COUNTRIES,

DTIC Science & Technology

development. Part 3 is concerned with problems of education and the diffusion of knowledge , and Part 4 is a record of the discussions and working groups in which interaction was informal and the issues were explored in depth. (Author)

Recording and submitting specimen history data

USGS Publications Warehouse

Bodenstein, Barbara L.; Franson, J. Christian; Friend, Milton; Gibbs, Samantha E.J.; Wild, Margaret A.

2016-06-14

SummaryIn wildlife disease investigations, determining the history or background of a problem is the first significant step toward establishing a diagnosis and aiding agencies with management considerations. The diagnostic process and overall investigation is often greatly expedited by a chronological record accompanying specimens submitted for laboratory evaluation. Knowing where and when the outbreak is taking place, what the environmental conditions and species involved are, and clinical signs in sick animals, along with necropsy findings and diagnostic test results are important for understanding the natural history or epizootiology of disease outbreaks. It becomes increasingly difficult to retrospectively obtain all of the pertinent history as time passes. The most helpful information is that which is obtained at the time of the die-off event by perceptive field biologists and other observers. Significant events preceding morbidity and/or mortality also provide valuable information on which to base corrective actions. In this chapter, readers will find information regarding what type of information should be recorded, how it should be recorded and why it is relevant to a disease investigation. A thoughtful approach in providing as much information as possible surrounding the situation including about host species and the biotic and abiotic environment, greatly aids in determining the most likely causative agent(s).

Automated selection of relevant information for notification of incident cancer cases within a multisource cancer registry.

PubMed

Jouhet, V; Defossez, G; Ingrand, P

2013-01-01

The aim of this study was to develop and evaluate a selection algorithm of relevant records for the notification of incident cases of cancer on the basis of the individual data available in a multi-source information system. This work was conducted on data for the year 2008 in the general cancer registry of Poitou-Charentes region (France). The selection algorithm hierarchizes information according to its level of relevance for tumoral topography and tumoral morphology independently. The selected data are combined to form composite records. These records are then grouped in respect with the notification rules of the International Agency for Research on Cancer for multiple primary cancers. The evaluation, based on recall, precision and F-measure confronted cases validated manually by the registry's physicians with tumours notified with and without records selection. The analysis involved 12,346 tumours validated among 11,971 individuals. The data used were hospital discharge data (104,474 records), pathology data (21,851 records), healthcare insurance data (7508 records) and cancer care centre's data (686 records). The selection algorithm permitted performances improvement for notification of tumour topography (F-measure 0.926 with vs. 0.857 without selection) and tumour morphology (F-measure 0.805 with vs. 0.750 without selection). These results show that selection of information according to its origin is efficient in reducing noise generated by imprecise coding. Further research is needed for solving the semantic problems relating to the integration of heterogeneous data and the use of non-structured information.

Toward an integrated computerized patient record.

PubMed

Dole, T R; Luberti, A A

2000-04-01

Developing a comprehensive electronic medical record system to serve ambulatory care providers in a large health care enterprise requires significant time and resources. One approach to achieving this system is to devise a series of short-term, workable solutions until a complete system is designed and implemented. The initial solution introduced a basic (mini) medical record system that provided an automated problem/summary sheet and decentralization of ambulatory-based medical records. The next step was to partner with an information system vendor committed to continued development of the long-term system capable of supporting the health care organization well into the future.

[Problems in the transmission of information during within-hospital medical consultations and referrals].

PubMed

Montero Ruiz, E; Rebollar Merino, Á; Melgar Molero, V; Barbero Allende, J M; Culebras López, A; López Álvarez, J

2014-01-01

Within-hospital medical consultations and referrals (MCR) have many problems, among them are those related to the oral and written transmission of information. Our aim is to analyze problems in the transmission of information related to MCR, and possible differences between medical (MS) and surgical (SS) services. A prospective, observational study was conducted on the MCR requested to Internal Medicine Service over an 8 month period. The following variables were collected: age, sex, the requester, MCR type, type of admission, comorbidity, hospital stay and mortality, length of MCR, the number of physicians responsible for the patient requesting service during the MCR, MCR repeats, information on the request, available medical records, verbal contact, conflict between doctors, and medical information in the discharge summary. Of the total 215 MCR received, 66 (30.7%) were requested by MS, and 149 (69.3%) per SS. MCR duration was 3 days (standard deviation [SD] 4.8. The number of doctors responsible was 1.7 (SD 1.1), with, Repeats 43 (20%) and Urgent 14 (6.5%). Minimum information on the request, 6 (9.1%) MS and 21 (27.5%) SS. Low availability of medical record, 2 (3%) MS and 50 (33.6%) SS. No verbal contact, 33 (15.4%). Conflict between doctors 13 (6%). Information acceptably good in MCR urgent request 100% MS, and 80% SS. Two out of three MCR were without reference to the discharge report. There are significant losses in the transmission of information during the process of the MCR, which is higher in surgical than in medical departments. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

A method and knowledge base for automated inference of patient problems from structured data in an electronic medical record.

PubMed

Wright, Adam; Pang, Justine; Feblowitz, Joshua C; Maloney, Francine L; Wilcox, Allison R; Ramelson, Harley Z; Schneider, Louise I; Bates, David W

2011-01-01

Accurate knowledge of a patient's medical problems is critical for clinical decision making, quality measurement, research, billing and clinical decision support. Common structured sources of problem information include the patient problem list and billing data; however, these sources are often inaccurate or incomplete. To develop and validate methods of automatically inferring patient problems from clinical and billing data, and to provide a knowledge base for inferring problems. We identified 17 target conditions and designed and validated a set of rules for identifying patient problems based on medications, laboratory results, billing codes, and vital signs. A panel of physicians provided input on a preliminary set of rules. Based on this input, we tested candidate rules on a sample of 100,000 patient records to assess their performance compared to gold standard manual chart review. The physician panel selected a final rule for each condition, which was validated on an independent sample of 100,000 records to assess its accuracy. Seventeen rules were developed for inferring patient problems. Analysis using a validation set of 100,000 randomly selected patients showed high sensitivity (range: 62.8-100.0%) and positive predictive value (range: 79.8-99.6%) for most rules. Overall, the inference rules performed better than using either the problem list or billing data alone. We developed and validated a set of rules for inferring patient problems. These rules have a variety of applications, including clinical decision support, care improvement, augmentation of the problem list, and identification of patients for research cohorts.

[Information system in the cardio polyclinic].

PubMed

Mihajlović, Marina; Zivković, Marija

2014-03-01

The cardiologic polyclinic information system ensures effective management of business processes in the polyclinic. Medical nurse provides health care to a patient with the support of the information system, which enables recording the patient's identity, admission, participation fee charges, billing for the services provided, patients' orders for noninvasive diagnostic methods, and implementation of diagnostic methods. The nurse enters patient's personal information at every work station, updates the existing records, and has an opportunity to add notes and insights to the results of patient's diagnostic tests and doctors' opinions for patients in the polyclinic. Additionally, the nurse records the services and supplies provided, and these entries are used for billing and service charges. This information is accessible at every work station to authorized persons exclusively. The implementation of the information system enables medical nurses working at the reception desk and in nurses' consulting room to record administrative data and data related to diagnostic analysis at the moment and at the place they happen. A personal password is required to access these data. In this way, the patient admission recording is facilitated, and in case the patient needs to be contacted, communication with him/her is improved, and finally, writing reports and data analysis are simplified. Apart from the advantages, there also are problems such as inadequate staff education and insufficient reliability of the information infrastructure, which if overloaded, can slow down the system, and this is time consuming for both health workers and patients.

A practical guideline for identifying research intent with projects that collect private, identifiable health information.

PubMed

Amdur, Robert J; Speers, Marjorie A

2003-06-01

Radiation oncologists frequently engage in activities that involve the collection and analysis of data from medical records. Access to health information is an ethical issue because, if not done according to appropriate guidelines, it constitutes an invasion of privacy or breach in confidentiality. To protect patients for the social harm that may result from medical record review, our society has established laws and regulations that apply to projects that require medical record review. A major branch point in the guidelines for such projects is whether private information will be collected for research or nonresearch purposes. However, a problem with discussing privacy protection in terms of a research versus nonresearch model is that it is difficult to make this distinction for many kinds of projects. The purpose of this paper is to establish a practical guideline that can be used to decide if a project that involves analysis of private, identifiable medical information should be considered research from the regulatory standpoint.

Synthesis of an optoelectronic system for tracking (OEST) the information track of the optical record carrier based on the acceleration control principle

NASA Astrophysics Data System (ADS)

Zalogin, Stanislav M.; Zalogin, M. S.

1997-02-01

The problem for construction of control algorithm in OEST the information track of the optical record carrier the realization of which is based on the use of accelerations is considered. Such control algorithms render the designed system the properties of adaptability, feeble sensitivity to the system parameter change and the action of disturbing forces what gives known advantages to information carriers with such system under operation in hard climate conditions as well as at maladjustment, workpieces wear and change of friction in the system. In the paper are investigated dynamic characteristics of a closed OEST, it is shown, that the designed stable system with given quality indices is a high-precision one. The validated recommendations as to design of control algorithms parameters are confirmed by results of mathematical simulation of controlled processes. The proposed methods for OEST synthesis on the basis of the control acceleration principle can be recommended for the use at industrial production of optical information record carriers.

Selective attention to emotional pictures as a function of gambling motives in problem and nonproblem gamblers.

PubMed

Hudson, Amanda; Jacques, Sophie; Stewart, Sherry H

2013-12-01

Problem gambling may reflect a maladaptive means of fulfilling specific affect-regulation motives, such as enhancing positive affect or coping with negative affect. Research with clinical populations indicates that disorders with prominent affective symptoms are characterized by attentional biases for symptom-congruent information. Thus, we assessed whether problem gamblers with enhancement motives for gambling would demonstrate attentional biases for positive emotional information, relative to other types of emotional information, and problem gamblers with coping motives for gambling would demonstrate attentional biases for negative emotional information, compared with other types of emotional information. In addition, we expected motive-congruent biases to be stronger in problem gamblers than nonproblem gamblers. To test these hypotheses, problem and nonproblem gamblers received an emotional orienting task in which neutral, negative, and positive pictorial cues appeared to one side of the computer screen, followed by target words in cued or uncued locations. In a look-away condition, participants had to shift attention away from pictures to respond to predominantly uncued targets, whereas in a look-toward condition, they had to orient to pictures to categorize predominantly cued targets. The results revealed motive-congruent orienting biases and disengagement lags for emotional pictures in problem gamblers. The link between motives and affective biases was less apparent in nonproblem gamblers. Results suggest that attentional measures may provide a useful complement to the subjective methodologies that are typically employed in studying problem gamblers. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Ad-Hoc Queries over Document Collections - A Case Study

NASA Astrophysics Data System (ADS)

Löser, Alexander; Lutter, Steffen; Düssel, Patrick; Markl, Volker

We discuss the novel problem of supporting analytical business intelligence queries over web-based textual content, e.g., BI-style reports based on 100.000's of documents from an ad-hoc web search result. Neither conventional search engines nor conventional Business Intelligence and ETL tools address this problem, which lies at the intersection of their capabilities. "Google Squared" or our system GOOLAP.info, are examples of these kinds of systems. They execute information extraction methods over one or several document collections at query time and integrate extracted records into a common view or tabular structure. Frequent extraction and object resolution failures cause incomplete records which could not be joined into a record answering the query. Our focus is the identification of join-reordering heuristics maximizing the size of complete records answering a structured query. With respect to given costs for document extraction we propose two novel join-operations: The multi-way CJ-operator joins records from multiple relationships extracted from a single document. The two-way join-operator DJ ensures data density by removing incomplete records from results. In a preliminary case study we observe that our join-reordering heuristics positively impact result size, record density and lower execution costs.

The case against showing patients their records.

PubMed

Ross, A P

1986-03-01

The author, a British consultant surgeon, expresses his reservations about patients' having access to their medical records. The nature of communication between doctors may change if it is known that patients will see the material; potentially helpful yet tentative diagnoses may be excluded while other information is watered down. Physicians will have additional, perhaps burdensome, demands placed on them to explain the records--including parts written by deceased or otherwise unavailable doctors, medical students, or nonphysicians. Persons other than patients may see the records, further complicating the issue. Ross asserts that, while patients do have the right to see records, full access could be more harmful than beneficial to patients and could be fraught with problems for physicians.

Apollo experience report: Lunar module environmental control subsystem

NASA Technical Reports Server (NTRS)

Gillen, R. J.; Brady, J. C.; Collier, F.

1972-01-01

A functional description of the environmental control subsystem is presented. Development, tests, checkout, and flight experiences of the subsystem are discussed; and the design fabrication, and operational difficulties associated with the various components and subassemblies are recorded. Detailed information is related concerning design changes made to, and problems encountered with, the various elements of the subsystem, such as the thermal control water sublimator, the carbon dioxide sensing and control units, and the water section. The problems associated with water sterilization, water/glycol formulation, and materials compatibility are discussed. The corrective actions taken are described with the expection that this information may be of value for future subsystems. Although the main experiences described are problem oriented, the subsystem has generally performed satisfactorily in flight.

Past, present and future of spike sorting techniques

PubMed Central

Rey, Hernan Gonzalo; Pedreira, Carlos; Quian Quiroga, Rodrigo

2015-01-01

Spike sorting is a crucial step to extract information from extracellular recordings. With new recording opportunities provided by the development of new electrodes that allow monitoring hundreds of neurons simultaneously, the scenario for the new generation of algorithms is both exciting and challenging. However, this will require a new approach to the problem and the development of a common reference framework to quickly assess the performance of new algorithms. In this work, we review the basic concepts of spike sorting, including the requirements for different applications, together with the problems faced by presently available algorithms. We conclude by proposing a roadmap stressing the crucial points to be addressed to support the neuroscientific research of the near future. PMID:25931392

Search for biological specimens from midwestern parks: pitfalls and solutions

USGS Publications Warehouse

Bennett, J.P.

2001-01-01

This paper describes the results of searches of herbarium and museum collections and databases for records of vertebrate and vascular plant specimens that had been collected in 15 midwestern National Park System units. The records of these specimens were previously unknown to the National Park Service (NPS). In the course of our searches, numerous obstacles were encountered that prevented us from fully completing our task. These ranged from difficulties with the way databases are structured, to poor record-keeping, to incomplete or incorrect information on the actual location of specimens within collections. Despite these problems, we are convinced that the information to be gained from such searches in invaluable, and we believe that our experience, and the recommendations we offer, may well prove instructive to others undertaking this kind of work.

A method and knowledge base for automated inference of patient problems from structured data in an electronic medical record

PubMed Central

Pang, Justine; Feblowitz, Joshua C; Maloney, Francine L; Wilcox, Allison R; Ramelson, Harley Z; Schneider, Louise I; Bates, David W

2011-01-01

Background Accurate knowledge of a patient's medical problems is critical for clinical decision making, quality measurement, research, billing and clinical decision support. Common structured sources of problem information include the patient problem list and billing data; however, these sources are often inaccurate or incomplete. Objective To develop and validate methods of automatically inferring patient problems from clinical and billing data, and to provide a knowledge base for inferring problems. Study design and methods We identified 17 target conditions and designed and validated a set of rules for identifying patient problems based on medications, laboratory results, billing codes, and vital signs. A panel of physicians provided input on a preliminary set of rules. Based on this input, we tested candidate rules on a sample of 100 000 patient records to assess their performance compared to gold standard manual chart review. The physician panel selected a final rule for each condition, which was validated on an independent sample of 100 000 records to assess its accuracy. Results Seventeen rules were developed for inferring patient problems. Analysis using a validation set of 100 000 randomly selected patients showed high sensitivity (range: 62.8–100.0%) and positive predictive value (range: 79.8–99.6%) for most rules. Overall, the inference rules performed better than using either the problem list or billing data alone. Conclusion We developed and validated a set of rules for inferring patient problems. These rules have a variety of applications, including clinical decision support, care improvement, augmentation of the problem list, and identification of patients for research cohorts. PMID:21613643

Use of IDEF modeling to develop an information management system for drug and alcohol outpatient treatment clinics

NASA Astrophysics Data System (ADS)

Hoffman, Kenneth J.

1995-10-01

Few information systems create a standardized clinical patient record in which there are discrete and concise observations of patient problems and their resolution. Clinical notes usually are narratives which don't support an aggregate and systematic outcome analysis. Many programs collect information on diagnosis and coded procedures but are not focused on patient problems. Integrated definition (IDEF) methodology has been accepted by the Department of Defense as part of the Corporate Information Management Initiative and serves as the foundation that establishes a need for automation. We used IDEF modeling to describe present and idealized patient care activities. A logical IDEF data model was created to support those activities. The modeling process allows for accurate cost estimates based upon performed activities, efficient collection of relevant information, and outputs which allow real- time assessments of process and outcomes. This model forms the foundation for a prototype automated clinical information system (ACIS).

[Disagreement between physicians' medication records and information given by patients].

PubMed

Rabøl, Rasmus; Arrøe, Gry Rosenkjaer; Folke, Fredrik; Madsen, Kristian Rørbaek; Langergaard, Michael Thøger; Larsen, Annette Højmann; Budek, Tommy; Andersen, Jens Rikardt

2006-03-27

A survey was conducted to evaluate the level of disagreement between the drug records of family doctors and information provided by patients at the time of hospitalisation. One hundred patients acutely admitted to a hospital department of medicine were consecutively included if the patient ingested more than two non-OTC drugs. A second drug interview was performed shortly after admission, and the patient's current medication was recorded. If no written medical record from the referring family doctor was available at the time of admission, the doctor was contacted by phone for supplementary information. Discrepancies between the information given by the patient and the medical records of family doctors were recorded. The results were analysed blindly by two of the authors (one senior and one junior doctor) to determine if the discrepancies were clinically relevant for the patient. We found at least one clinically relevant and potentially dangerous discrepancy in the medical records of 40% (95% CI 30%-50%) of the patients. In all, discrepancies were found in the drug lists of 63% of the patients. The patients with discrepancies were similar in age, sex, way of hospitalization and number of drugs ingested, compared to those without discrepancies. Afterwards the family doctors were invited to a meeting in which these problems were evaluated. We conclude that there is an urgent need for improvement in the communication between the primary and secondary health care sectors concerning medication being prescribed for patients with chronic diseases. The large number of discrepancies in the drug records of patients in this study is discouraging.

Nursing Student Experiences Regarding Safe Use of Electronic Health Records: A Pilot Study of the Safety and Assurance Factors for EHR Resilience Guides.

PubMed

Whitt, Karen J; Eden, Lacey; Merrill, Katreena Collette; Hughes, Mckenna

2017-01-01

Previous research has linked improper electronic health record configuration and use with adverse patient events. In response to this problem, the US Office of the National Coordinator for Health Information Technology developed the Safety and Assurance Factors for EHR Resilience guides to evaluate electronic health records for optimal use and safety features. During the course of their education, nursing students are exposed to a variety of clinical practice settings and electronic health records. This descriptive study evaluated 108 undergraduate and 51 graduate nursing students' ratings of electronic health record features and safe practices, as well as what they learned from utilizing the computerized provider order entry and clinician communication Safety and Assurance Factors for EHR Resilience guide checklists. More than 80% of the undergraduate and 70% of the graduate students reported that they experienced user problems with electronic health records in the past. More than 50% of the students felt that electronic health records contribute to adverse patient outcomes. Students reported that many of the features assessed were not fully implemented in their electronic health record. These findings highlight areas where electronic health records can be improved to optimize patient safety. The majority of students reported that utilizing the Safety and Assurance Factors for EHR Resilience guides increased their understanding of electronic health record features.

When holography meets coherent diffraction imaging.

PubMed

Latychevskaia, Tatiana; Longchamp, Jean-Nicolas; Fink, Hans-Werner

2012-12-17

The phase problem is inherent to crystallographic, astronomical and optical imaging where only the intensity of the scattered signal is detected and the phase information is lost and must somehow be recovered to reconstruct the object's structure. Modern imaging techniques at the molecular scale rely on utilizing novel coherent light sources like X-ray free electron lasers for the ultimate goal of visualizing such objects as individual biomolecules rather than crystals. Here, unlike in the case of crystals where structures can be solved by model building and phase refinement, the phase distribution of the wave scattered by an individual molecule must directly be recovered. There are two well-known solutions to the phase problem: holography and coherent diffraction imaging (CDI). Both techniques have their pros and cons. In holography, the reconstruction of the scattered complex-valued object wave is directly provided by a well-defined reference wave that must cover the entire detector area which often is an experimental challenge. CDI provides the highest possible, only wavelength limited, resolution, but the phase recovery is an iterative process which requires some pre-defined information about the object and whose outcome is not always uniquely-defined. Moreover, the diffraction patterns must be recorded under oversampling conditions, a pre-requisite to be able to solve the phase problem. Here, we report how holography and CDI can be merged into one superior technique: holographic coherent diffraction imaging (HCDI). An inline hologram can be recorded by employing a modified CDI experimental scheme. We demonstrate that the amplitude of the Fourier transform of an inline hologram is related to the complex-valued visibility, thus providing information on both, the amplitude and the phase of the scattered wave in the plane of the diffraction pattern. With the phase information available, the condition of oversampling the diffraction patterns can be relaxed, and the phase problem can be solved in a fast and unambiguous manner. We demonstrate the reconstruction of various diffraction patterns of objects recorded with visible light as well as with low-energy electrons. Although we have demonstrated our HCDI method using laser light and low-energy electrons, it can also be applied to any other coherent radiation such as X-rays or high-energy electrons.

Knowledge management for the protection of information in electronic medical records.

PubMed

Lea, Nathan; Hailes, Stephen; Austin, Tony; Kalra, Dipak

2008-01-01

This paper describes foundational work investigating the protection requirements of sensitive medical information, which is being stored more routinely in repository systems for electronic medical records. These systems have increasingly powerful sharing capabilities at the point of clinical care, in medical research and for clinical and managerial audit. The potential for sharing raises concerns about the protection of individual patient privacy and challenges the duty of confidentiality by which medical practitioners are ethically and legally bound. By analysing the protection requirements and discussing the need to apply policy-based controls to discrete items of medical information in a record, this paper suggests that this is a problem for which existing privacy management solutions are not sufficient or appropriate to the protection requirements. It proposes that a knowledge management approach is required and it introduces a new framework based on the knowledge management techniques now being used to manage electronic medical record data. The background, existing work in this area, initial investigation methods, results to date and discussion are presented, and the paper is concluded with the authors' comments on the ramifications of the work.

Improving life sciences information retrieval using semantic web technology.

PubMed

Quan, Dennis

2007-05-01

The ability to retrieve relevant information is at the heart of every aspect of research and development in the life sciences industry. Information is often distributed across multiple systems and recorded in a way that makes it difficult to piece together the complete picture. Differences in data formats, naming schemes and network protocols amongst information sources, both public and private, must be overcome, and user interfaces not only need to be able to tap into these diverse information sources but must also assist users in filtering out extraneous information and highlighting the key relationships hidden within an aggregated set of information. The Semantic Web community has made great strides in proposing solutions to these problems, and many efforts are underway to apply Semantic Web techniques to the problem of information retrieval in the life sciences space. This article gives an overview of the principles underlying a Semantic Web-enabled information retrieval system: creating a unified abstraction for knowledge using the RDF semantic network model; designing semantic lenses that extract contextually relevant subsets of information; and assembling semantic lenses into powerful information displays. Furthermore, concrete examples of how these principles can be applied to life science problems including a scenario involving a drug discovery dashboard prototype called BioDash are provided.

MEDRIS: The Problem Oriented Electronic Medical Record in Medical Education

PubMed Central

Rifat, Sami F.; Robert, Shanthi; Trace, David; Prakash, Sanjeev; Naeymi-Rad, Frank; Barnett, David; Pannicia, Gregory; Hammergren, David; Carmony, Lowell; Evens, Martha

1990-01-01

MEDRIS (The Medical Record Interface System) is an object oriented HyperCard interface designed to help physicians enter patient information as comfortably and naturally as possible. It can function as a stand alone system producing its own reports or serve as an interface to a medical expert system (e.g., MEDAS). MEDRIS plays an important role in the clinical education of medical students at the Chicago Medical School. MEDRIS portrays an intuitive, graphically oriented system that will provide a learning environment for the problem oriented medical record (POMR) that forms the basis of the structure of the history and physical exam. The enthusiasm shown by the medical students for this project has garnered support for including MEDRIS in the curriculum of the Introduction to Clinical Medicine course this semester. MEDRIS, developed using HyperCard, can be used as a tool not only for teaching POMR and physical diagnosis, but also computer literacy.

A Real Time Interface Between a Computerized Physician Order Entry System and the Computerized ICU Medication Administration Record

PubMed Central

Chen, Jeannie; Shabot, M. Michael; LoBue, Mark

2003-01-01

Prior attempts to interface ICU Clinical Information Systems (CIS) to Pharmacy systems have been less than successful. The major problem is that in ICUs, medications frequently have to be administered and charted in the CIS Medication Administration Record (MAR) before pharmacists can enter them into the Pharmacy system. When the Pharmacy system belatedly sends medication orders to the CIS MAR, this may create duplicate entries for medications that ICU nurses have had to enter manually to chart doses actually given. The authors have implemented a real time interface between a Computerized Physician Order Entry (CPOE) system and a CIS operating in ten ICUs that solves this problem. The interface transfers new medication orders including order details and alerts directly to the CIS Medication Administration Record (MAR), where they are immediately available for nurse charting. PMID:14728315

Improved hybrid information filtering based on limited time window

NASA Astrophysics Data System (ADS)

Song, Wen-Jun; Guo, Qiang; Liu, Jian-Guo

2014-12-01

Adopting the entire collecting information of users, the hybrid information filtering of heat conduction and mass diffusion (HHM) (Zhou et al., 2010) was successfully proposed to solve the apparent diversity-accuracy dilemma. Since the recent behaviors are more effective to capture the users' potential interests, we present an improved hybrid information filtering of adopting the partial recent information. We expand the time window to generate a series of training sets, each of which is treated as known information to predict the future links proven by the testing set. The experimental results on one benchmark dataset Netflix indicate that by only using approximately 31% recent rating records, the accuracy could be improved by an average of 4.22% and the diversity could be improved by 13.74%. In addition, the performance on the dataset MovieLens could be preserved by considering approximately 60% recent records. Furthermore, we find that the improved algorithm is effective to solve the cold-start problem. This work could improve the information filtering performance and shorten the computational time.

Role of Information in Consumer Selection of Health Plans

PubMed Central

Sainfort, François; Booske, Bridget C.

1996-01-01

Considerable efforts are underway in the public and private sectors to increase the amount of information available to consumers when making health plan choices. The objective of this study was to examine the role of information in consumer health plan decisionmaking. A computer system was developed which provides different plan descriptions with the option of accessing varying types and levels of information. The system tracked the information search processes and recorded the hypothetical plan choices of 202 subjects. Results are reported showing the relationship between information and problem perception, preference structure, choice of plan, and attitude towards the decision. PMID:10165036

The Shock and Vibration Digest. Volume 18, Number 4

DTIC Science & Technology

1986-04-01

determined by this procedure decreases though this equation includes several standard with the square toot of the numbers of records problems, for...earthquake design for nuclear 86-781 power plants in the FRG are recorded in the Vibratos of Nudear Fuel Assemblies: A Simpli- L German nuclear safety...Publications and Printing Pol- icy Committee. SVIC NOTES MANY THANKS"’-’ .e " ., On behalf of the Shock and Vibration Information Center, I wish to

Negative ratings play a positive role in information filtering

NASA Astrophysics Data System (ADS)

Zeng, Wei; Zhu, Yu-Xiao; Lü, Linyuan; Zhou, Tao

2011-11-01

The explosive growth of information asks for advanced information filtering techniques to solve the so-called information overload problem. A promising way is the recommender system which analyzes the historical records of users’ activities and accordingly provides personalized recommendations. Most recommender systems can be represented by user-object bipartite networks where users can evaluate and vote for objects, and ratings such as “dislike” and “I hate it” are treated straightforwardly as negative factors or are completely ignored in traditional approaches. Applying a local diffusion algorithm on three benchmark data sets, MovieLens, Netflix and Amazon, our study arrives at a very surprising result, namely the negative ratings may play a positive role especially for very sparse data sets. In-depth analysis at the microscopic level indicates that the negative ratings from less active users to less popular objects could probably have positive impacts on the recommendations, while the ones connecting active users and popular objects mostly should be treated negatively. We finally outline the significant relevance of our results to the two long-term challenges in information filtering: the sparsity problem and the cold-start problem.

Fire! What One College Did when Fire Struck--Twice.

ERIC Educational Resources Information Center

Renner, Tom

1980-01-01

A large fire in a main administration building at Hope College (Michigan) destroyed many records, though not all. The crisis plan used to disseminate information about the fire and its results is described and both the problems and positive results are reviewed. (MSE)

My Family Health Portrait, A tool from the Surgeon General | NIH MedlinePlus the Magazine

MedlinePlus

... is it important to know my family medical history? Your family medical history is a record of health information about you and three generations of close relatives. Family history can be an important risk factor for problems ...

Realization of a universal patient identifier for electronic medical records through biometric technology.

PubMed

Leonard, D C; Pons, Alexander P; Asfour, Shihab S

2009-07-01

The technology exists for the migration of healthcare data from its archaic paper-based system to an electronic one, and, once in digital form, to be transported anywhere in the world in a matter of seconds. The advent of universally accessible healthcare data has benefited all participants, but one of the outstanding problems that must be addressed is how the creation of a standardized nationwide electronic healthcare record system in the United States would uniquely identify and match a composite of an individual's recorded healthcare information to an identified individual patients out of approximately 300 million people to a 1:1 match. To date, a few solutions to this problem have been proposed that are limited in their effectiveness. We propose the use of biometric technology within our fingerprint, iris, retina scan, and DNA (FIRD) framework, which is a multiphase system whose primary phase is a multilayer consisting of these four types of biometric identifiers: 1) fingerprint; 2) iris; 3) retina scan; and 4) DNA. In addition, it also consists of additional phases of integration, consolidation, and data discrepancy functions to solve the unique association of a patient to their medical data distinctively. This would allow a patient to have real-time access to all of their recorded healthcare information electronically whenever it is necessary, securely with minimal effort, greater effectiveness, and ease.

Epidemiological profile of snake-bite cases from Haryana: A five year (2011-2015) retrospective study.

PubMed

Bhargava, Saurabh; Kaur, Ramanjeet; Singh, Rajvinder

2018-02-01

Varieties of venomous snakes inhabit in the world which accidentally take thousands of human lives every year. This severe medical emergency constantly persuades national and international health agencies to look at efficient epidemiological profiling of snake-bite cases for the proper management of this sympathetic problem. Establishing the accurate database of snake-bite in humans from different localities of India may perhaps lack certainty due to few inevitable reasons such as consideration of this problem as less emergent problem in disparity to pesticide poisoning, difficulty in the accessibility to rural and tribal areas where chances of snake-bite remain ceiling, lack of inspiring models of snake-bite management training, reduced reporting system, and pitiable maintenance of hospital data in India. Therefore, the present modest study was carried out to explore valuable information regarding snake-bite problem in Haryana. Factual data on snake-bite incidences happened from 2011 to 2015 were collected from government hospitals and medical institutes of Haryana. This retrospective study disclosed a few characteristic points related to the frequency of snake-bite cases, gender involved, anti-snake venom (ASV) treatment, and numbers of deaths with snake-bite. Records revealed a total of 6555 cases of snake-bite including 130 deaths reported in Haryana during the study period. A significant variation in the occurrence of snake-bite cases was also recorded in different areas of Haryana. There was a huge database of recorded snake-bite cases from government medical institute but district wise survey disclosed the maximum number of snake-bite incidences, especially amongst males from Panchkula. The present study has provided a more updated and comprehensive record of snake-bite from Haryana during 2011-2015. A huge burden of snake-bite amongst human was found in Haryana; hence, the findings of this study purposely enlighten people about the size of this problem in the selected region. However, this study also remained limited due to lack of information on a few important parameters and availability of homogeneous data. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Efficient Privacy-Aware Record Integration.

PubMed

Kuzu, Mehmet; Kantarcioglu, Murat; Inan, Ali; Bertino, Elisa; Durham, Elizabeth; Malin, Bradley

2013-01-01

The integration of information dispersed among multiple repositories is a crucial step for accurate data analysis in various domains. In support of this goal, it is critical to devise procedures for identifying similar records across distinct data sources. At the same time, to adhere to privacy regulations and policies, such procedures should protect the confidentiality of the individuals to whom the information corresponds. Various private record linkage (PRL) protocols have been proposed to achieve this goal, involving secure multi-party computation (SMC) and similarity preserving data transformation techniques. SMC methods provide secure and accurate solutions to the PRL problem, but are prohibitively expensive in practice, mainly due to excessive computational requirements. Data transformation techniques offer more practical solutions, but incur the cost of information leakage and false matches. In this paper, we introduce a novel model for practical PRL, which 1) affords controlled and limited information leakage, 2) avoids false matches resulting from data transformation. Initially, we partition the data sources into blocks to eliminate comparisons for records that are unlikely to match. Then, to identify matches, we apply an efficient SMC technique between the candidate record pairs. To enable efficiency and privacy, our model leaks a controlled amount of obfuscated data prior to the secure computations. Applied obfuscation relies on differential privacy which provides strong privacy guarantees against adversaries with arbitrary background knowledge. In addition, we illustrate the practical nature of our approach through an empirical analysis with data derived from public voter records.

The Future of Healthcare Informatics: It Is Not What You Think

PubMed Central

2012-01-01

Electronic health records (EHRs) offer many valuable benefits for patient safety, but it becomes apparent that the effective application of healthcare informatics creates problems and unintended consequences. One problem that seems particularly challenging is integration. Painfully missing are low-cost, easy to implement, plug-and-play, nonintrusive integration solutions—healthcare's “killer app.” Why is this? We must stop confusing application integration with information integration. Our goal must be to communicate data (ie, integrate information), not to integrate application functionality via complex and expensive application program interfaces (APIs). Communicating data simply requires a loosely coupled flow of data, as occurs today via email. In contrast, integration is a chief information officer's nightmare. Integrating applications, when we just wanted a bit of information, is akin to killing a gnat with a brick. PMID:24278826

Increasing patient engagement: patients' responses to viewing problem lists online.

PubMed

Wright, A; Feblowitz, J; Maloney, F L; Henkin, S; Ramelson, H; Feltman, J; Bates, D W

2014-01-01

To characterize the opinions, emotions, and actions taken by patients who viewed their electronic problem list via an online personal health record (PHR). An online survey of patients who viewed their problem lists, as maintained by their healthcare provider, in a web-based PHR linked to an electronic health record for the first time. A total 3,649 patients completed the survey, yielding a response rate of 42.1%. Patient attitudes towards the problem list function were positive overall, with 90.4% rating it at least somewhat useful and 86.7% reporting they would probably or definitely use it again. Nearly half (45.6%) of patients identified at least one major or minor problem missing from their list. After viewing the list, 56.1% of patients reported taking at least one action in response, with 32.4% of patients reporting that they researched a condition on the Internet, 18.3% reported that they contacted their healthcare provider and 16.7% reported changing or planning to change a health behavior (patients could report multiple actions). 64.7% of patients reported feeling at least somewhat happy while viewing their problem list, though others reported feeling sad (30.4%), worried (35.7%) or scared (23.8%) (patients could report multiple emotions). A smaller number of patients reported feeling angry (16.6%) or ashamed (14.3%). Patients who experienced an emotional response were more likely to take action. Overall, patients found the ability to view their problem lists very useful and took action in response to the information. However, some had negative emotions. More research is needed into optimal strategies for supporting patients receiving this information.

A problem-oriented approach to journal selection for hospital libraries.

PubMed Central

Delman, B S

1982-01-01

This paper describes a problem-oriented approach to journal selection (PAJS), including general methodology, theoretical terms, and a brief description of results when the system was applied in three different hospitals. The PAJS system relates the objective information which the MEDLARS data base offers about the universe of biomedical literature to objective, problem-oriented information supplied by the hospital's medical records. The results were manipulated quantitatively to determine (1) the relevance of various journals to each of the hospital's defined significant information problems and (2) the overall utility of each journal to the institution as a whole. The utility information was plotted on a graph to identify the collection of journal titles which would be most useful to the given hospital. Attempts made to verify certain aspects of the whole process are also described. The results suggest that the methodology is generally able to provide an effective library response. The system optimizes resources vis-a-vis information and can be used for both budget allocation and justification. It offers an algorithm to which operations researchers can apply any one of a variety of mathematical programming methods. Although originally intended for librarians in the community hospital environment, the PAJS system is generalizable and has application potential in a variety of special library settings. PMID:6758893

No privacy for all? Serious failings in the HHS medical records regulations.

PubMed

Sobel, Richard

2002-01-01

The Bush administration surprised many by the approval without major revisions of the Clinton administration's HHS medical records regulations, despite heavy lobbying from the health industry. Though these "privacy rules" are supposed to protect patient confidentiality, what has gone unmentioned are the regulations' major lapses that breach informed consent and confidentiality. Recently issued "clarifications" of the regulations reveal that they do not prevent unconsented access to sensitive medical information by marketers, health plans, health care clearinghouses, and law enforcement. These problems with the regulations constitute a serious breach of patient privacy, endangering the doctor-patient relationship and potentially driving up health care costs, and need to be addressed.

Privacy and Access Control for IHE-Based Systems

NASA Astrophysics Data System (ADS)

Katt, Basel; Breu, Ruth; Hafner, Micahel; Schabetsberger, Thomas; Mair, Richard; Wozak, Florian

Electronic Health Record (EHR) is the heart element of any e-health system, which aims at improving the quality and efficiency of healthcare through the use of information and communication technologies. The sensitivity of the data contained in the health record poses a great challenge to security. In this paper we propose a security architecture for EHR systems that are conform with IHE profiles. In this architecture we are tackling the problems of access control and privacy. Furthermore, a prototypical implementation of the proposed model is presented.

Ensuring Healthy Babies in Upstate New York: Pressing Problems, Promising Strategies. Hearing before the Select Committee on Children, Youth, and Families. House of Representatives, One Hundred First Congress, Second Session (Syracuse, New York, July 16, 1990).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Children, Youth, and Families.

Following opening remarks by presiding committee member Matthew F. McHugh, this hearing record begins with a fact sheet inserted into the record which provides information on the following issues: infant mortality in the U.S. and in upstate New York; the inadequacy, unavailablity, or unaffordability of prenatal care; other obstacles to care…

Electronic Health Record in Italy and Personal Data Protection.

PubMed

Bologna, Silvio; Bellavista, Alessandro; Corso, Pietro Paolo; Zangara, Gianluca

2016-06-01

The present article deals with the Italian Electronic Health Record (hereinafter EHR), recently introduced by Act 221/2012, with a specific focus on personal data protection. Privacy issues--e.g., informed consent, data processing, patients' rights and minors' will--are discussed within the framework of recent e-Health legislation, national Data Protection Code, the related Data Protection Authority pronouncements and EU law. The paper is aimed at discussing the problems arising from a complex, fragmentary and sometimes uncertain legal framework on e-Health.

Diffused holographic information storage and retrieval using photorefractive optical materials

NASA Astrophysics Data System (ADS)

McMillen, Deanna Kay

Holography offers a tremendous opportunity for dense information storage, theoretically one bit per cubic wavelength of material volume, with rapid retrieval, of up to thousands of pages of information simultaneously. However, many factors prevent the theoretical storage limit from being reached, including dynamic range problems and imperfections in recording materials. This research explores new ways of moving closer to practical holographic information storage and retrieval by altering the recording materials, in this case, photorefractive crystals, and by increasing the current storage capacity while improving the information retrieved. As an experimental example of the techniques developed, the information retrieved is the correlation peak from an optical recognition architecture, but the materials and methods developed are applicable to many other holographic information storage systems. Optical correlators can potentially solve any signal or image recognition problem. Military surveillance, fingerprint identification for law enforcement or employee identification, and video games are but a few examples of applications. A major obstacle keeping optical correlators from being universally accepted is the lack of a high quality, thick (high capacity) holographic recording material that operates with red or infrared wavelengths which are available from inexpensive diode lasers. This research addresses the problems from two positions: find a better material for use with diode lasers, and reduce the requirements placed on the material while maintaining an efficient and effective system. This research found that the solutions are new dopants introduced into photorefractive lithium niobate to improve wavelength sensitivities and the use of a novel inexpensive diffuser that reduces the dynamic range and optical element quality requirements (which reduces the cost) while improving performance. A uniquely doped set of 12 lithium niobate crystals was specified and procured for this research. Transmission spectra and diffraction efficiencies were measured for each of the crystals using wavelengths in the visible spectrum. The diffraction efficiency was increased by as much as two orders of magnitude by using a new dopant combination. A new optical diffuser was designed, modeled, fabricated, and tested as a means of improving storage capacity for angularly multiplexed holograms in photorefractive crystals. The diffuser reduced the dynamic range requirement by over three orders of magnitude, increased the storage capacity by more than 400%, and dramatically improved the correlation signals.

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.

Agent Architecture for Aviation Data Integration System

NASA Technical Reports Server (NTRS)

Kulkarni, Deepak; Wang, Yao; Windrem, May; Patel, Hemil; Wei, Mei

2004-01-01

This paper describes the proposed agent-based architecture of the Aviation Data Integration System (ADIS). ADIS is a software system that provides integrated heterogeneous data to support aviation problem-solving activities. Examples of aviation problem-solving activities include engineering troubleshooting, incident and accident investigation, routine flight operations monitoring, safety assessment, maintenance procedure debugging, and training assessment. A wide variety of information is typically referenced when engaging in these activities. Some of this information includes flight recorder data, Automatic Terminal Information Service (ATIS) reports, Jeppesen charts, weather data, air traffic control information, safety reports, and runway visual range data. Such wide-ranging information cannot be found in any single unified information source. Therefore, this information must be actively collected, assembled, and presented in a manner that supports the users problem-solving activities. This information integration task is non-trivial and presents a variety of technical challenges. ADIS has been developed to do this task and it permits integration of weather, RVR, radar data, and Jeppesen charts with flight data. ADIS has been implemented and used by several airlines FOQA teams. The initial feedback from airlines is that such a system is very useful in FOQA analysis. Based on the feedback from the initial deployment, we are developing a new version of the system that would make further progress in achieving following goals of our project.

The Unknown Variable: Identifying Learning Disabilities with Pupil Behavior Rating Scales.

ERIC Educational Resources Information Center

Winzer, Margret; Malarczyk, Barbara

Difficulties in identifying learning disabilities (LD) are examined, and special problems presented by hearing impaired children with LD are considered. The value of rating scales as a quick instrument for obtaining, measuring, recording and communicating information is emphasized. Adaptations of the Pupil Rating Scale for hearing impaired…

Studying Abroad: The Fundacion Gran Mariscal de Ayacucho.

ERIC Educational Resources Information Center

Mauch, James E.

The Fundacion Gran Mariscal de Ayacucho, a large Venezuelan scholarship program that sends students to study in the United States and other countries, is discussed. Information on program objectives, issues, and problems was obtained from work with students at the University of Pittsburgh, the literature, program records, and interviews with…

Computers Can Soothe Transfer Articulation.

ERIC Educational Resources Information Center

Mazman, Samuel

In order to solve the problem of students enrolling in courses not directly articulated with an ultimate goal, West Shore Community College (WSCC) developed a program using articulation data, master student records, and fee statements. The objectives of the program were to: (1) communicate information about the transferability of courses at the…

How immigrant workers experience workplace problems: a qualitative study.

PubMed

de Castro, Arnold B; Fujishiro, Kaori; Sweitzer, Erica; Oliva, Jose

2006-01-01

In this qualitative study, the authors describe work organization factors, problems workers encounter on the job, consequences of these problems, and actions taken to deal with them. Study participants were immigrant workers seeking assistance at the Chicago Interfaith Workers' Rights Center. Using a grounded theory approach, the investigators coded narratives from 455 records describing workers' problems. Emerged sequences of events were then integrated into a model. Data show that workers' rights are systematically violated and problems are rooted in how jobs are designed and managed. Work organization factors are associated with occupational injury/illness, job loss, and worker actions. Employer responses included indifference and various forms of retaliation. This model provides insight into the work-related troubles immigrants face and informs hypothesis generation and action initiatives.

Environmental/Biomedical Terminology Index

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

Huffstetler, J.K.; Dailey, N.S.; Rickert, L.W.

1976-12-01

The Information Center Complex (ICC), a centrally administered group of information centers, provides information support to environmental and biomedical research groups and others within and outside Oak Ridge National Laboratory. In-house data base building and development of specialized document collections are important elements of the ongoing activities of these centers. ICC groups must be concerned with language which will adequately classify and insure retrievability of document records. Language control problems are compounded when the complexity of modern scientific problem solving demands an interdisciplinary approach. Although there are several word lists, indexes, and thesauri specific to various scientific disciplines usually groupedmore » as Environmental Sciences, no single generally recognized authority can be used as a guide to the terminology of all environmental science. If biomedical terminology for the description of research on environmental effects is also needed, the problem becomes even more complex. The building of a word list which can be used as a general guide to the environmental/biomedical sciences has been a continuing activity of the Information Center Complex. This activity resulted in the publication of the Environmental Biomedical Terminology Index (EBTI).« less

Image restoration, uncertainty, and information.

PubMed

Yu, F T

1969-01-01

Some of the physical interpretations about image restoration are discussed. From the theory of information the unrealizability of an inverse filter can be explained by degradation of information, which is due to distortion on the recorded image. The image restoration is a time and space problem, which can be recognized from the theory of relativity (the problem of image restoration is related to Heisenberg's uncertainty principle in quantum mechanics). A detailed discussion of the relationship between information and energy is given. Two general results may be stated: (1) the restoration of the image from the distorted signal is possible only if it satisfies the detectability condition. However, the restored image, at the best, can only approach to the maximum allowable time criterion. (2) The restoration of an image by superimposing the distorted signal (due to smearing) is a physically unrealizable method. However, this restoration procedure may be achieved by the expenditure of an infinite amount of energy.

Semantic Relations for Problem-Oriented Medical Records

PubMed Central

Uzuner, Ozlem; Mailoa, Jonathan; Ryan, Russell; Sibanda, Tawanda

2010-01-01

Summary Objective We describe semantic relation (SR) classification on medical discharge summaries. We focus on relations targeted to the creation of problem-oriented records. Thus, we define relations that involve the medical problems of patients. Methods and Materials We represent patients’ medical problems with their diseases and symptoms. We study the relations of patients’ problems with each other and with concepts that are identified as tests and treatments. We present an SR classifier that studies a corpus of patient records one sentence at a time. For all pairs of concepts that appear in a sentence, this SR classifier determines the relations between them. In doing so, the SR classifier takes advantage of surface, lexical, and syntactic features and uses these features as input to a support vector machine. We apply our SR classifier to two sets of medical discharge summaries, one obtained from the Beth Israel-Deaconess Medical Center (BIDMC), Boston, MA and the other from Partners Healthcare, Boston, MA. Results On the BIDMC corpus, our SR classifier achieves micro-averaged F-measures that range from 74% to 95% on the various relation types. On the Partners corpus, the micro-averaged F-measures on the various relation types range from 68% to 91%. Our experiments show that lexical features (in particular, tokens that occur between candidate concepts, which we refer to as inter-concept tokens) are very informative for relation classification in medical discharge summaries. Using only the inter-concept tokens in the corpus, our SR classifier can recognize 84% of the relations in the BIDMC corpus and 72% of the relations in the Partners corpus. Conclusion These results are promising for semantic indexing of medical records. They imply that we can take advantage of lexical patterns in discharge summaries for relation classification at a sentence level. PMID:20646918

A research strategy for the dynamic study of students' concepts and problem solving strategies using science software

NASA Astrophysics Data System (ADS)

Krajcik, Joseph S.; Simmons, Patricia E.; Lunetta, Vincent N.

Microcomputers and appropriate software have the potential to help students learn. They can also serve as appropriate media for investigating how students learn. In this article we describe a research strategy examining learning and behavior when students interacted with microcomputers and software. Results from two preliminary studies illustrate the strategy.A major feature of the strategy included recording students interacting with microcomputer software interfaced with a VCR. The VCR recorded the video output from a microcomputer and students' verbal commentary via microphone input. This technique allowed students' comments about their observations, perceptions, predictions, explanations, and decisions to be recorded simultaneously with their computer input and the display on the microcomputer monitor.The research strategy described can provide important information about cognitive and affective behaviors of students engaged in using instructional software. Research studies utilizing this strategy can enhance our understanding of how students develop and employ important concepts and scientific relationships, how students develop problem-solving skills and solve problems, and how they interact with instructional software. Results of such studies have important implications for teaching and for the design of instructional software.

[Informal employment, unemployment and underemployment: a matter of public health].

PubMed

García-Ubaque, Juan C; Riaño-Casallas, Martha I; Benavides-Piracón, John A

2012-06-01

Unemployment and underemployment are problems that have been studied from the economy and politics points of view. Although public health has taken an approach to this problem, it has been mainly disciplinary, since it has focused on the health effects of the unemployed and underemployed but it has failed to propose alternatives from the public policy to solve this problem. The purpose of this essay is to examine the unemployment as an economic, social and health problem of the population. According to records of diagnosis, we review this situation (which requires different strategies at various levels) including different groups involved and their organizations, the State, companies, trade unions and employers unions, not just people unemployed and underemployed.

Past, present and future of spike sorting techniques.

PubMed

Rey, Hernan Gonzalo; Pedreira, Carlos; Quian Quiroga, Rodrigo

2015-10-01

Spike sorting is a crucial step to extract information from extracellular recordings. With new recording opportunities provided by the development of new electrodes that allow monitoring hundreds of neurons simultaneously, the scenario for the new generation of algorithms is both exciting and challenging. However, this will require a new approach to the problem and the development of a common reference framework to quickly assess the performance of new algorithms. In this work, we review the basic concepts of spike sorting, including the requirements for different applications, together with the problems faced by presently available algorithms. We conclude by proposing a roadmap stressing the crucial points to be addressed to support the neuroscientific research of the near future. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Social science and linguistic text analysis of nurses' records: a systematic review and critique.

PubMed

Buus, Niels; Hamilton, Bridget Elizabeth

2016-03-01

The two aims of the paper were to systematically review and critique social science and linguistic text analyses of nursing records in order to inform future research in this emerging area of research. Systematic searches in reference databases and in citation indexes identified 12 articles that included analyses of the social and linguistic features of records and recording. Two reviewers extracted data using established criteria for the evaluation of qualitative research papers. A common characteristic of nursing records was the economical use of language with local meanings that conveyed little information to the uninitiated reader. Records were dominated by technocratic-medical discourse focused on patients' bodies, and they depicted only very limited aspects of nursing practice. Nurses made moral evaluations in their categorisation of patients, which reflected detailed surveillance of patients' disturbing behaviour. The text analysis methods were rarely transparent in the articles, which could suggest research quality problems. For most articles, the significance of the findings was substantiated more by theoretical readings of the institutional settings than by the analysis of textual data. More probing empirical research of nurses' records and a wider range of theoretical perspectives has the potential to expose the situated meanings of nursing work in healthcare organisations. © 2015 John Wiley & Sons Ltd.

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.

Measuring Actual eHealth Literacy Among Patients With Rheumatic Diseases: a Qualitative Analysis of Problems Encountered Using Health 1.0 and Health 2.0 Applications

PubMed Central

Drossaert, Constance HC; de Heus, Miriam; Taal, Erik; van de Laar, Mart AFJ

2013-01-01

Background The Internet offers diverse opportunities for disease management, through information websites (Health 1.0) and interactive applications such as peer support forums, online consults, and insight into electronic medical records (Health 2.0). However, various skills are required to benefit from Health 1.0 and Health 2.0 applications for one’s own health, known as eHealth literacy. Objective To study the eHealth literacy of patients with rheumatic diseases and the types of problems they encounter when using the Internet in relation to their disease. Methods In two studies, patients were asked about their current disease-related Internet use and their eHealth literacy was observed during performance tests. In study 1, 15 patients (aged 39-74) performed 6 information-retrieval tasks on the Internet (Health 1.0). In study 2, 16 patients (aged 24-72) performed 3 Health 2.0 tasks on a hospital-based online Web portal and 2 Health 2.0 tasks on interactive websites. Participants were asked to think aloud while performing the assignments, and screen activities were recorded. Types and frequency of problems were identified by 2 independent researchers and coded into categories using inductive analysis. Results Almost all patients in our studies had searched the Internet for information about rheumatic diseases in the past. Fewer patients had used Health 2.0 applications, but many were nevertheless enthusiastic about the possibilities from Health 2.0 applications after finishing the assignments. However, nearly all participants experienced difficulties, and a substantial number of participants were not able to complete all of the assignments. Encountered problems could be divided into 6 sequential categories: (1) operating the computer and Internet browser, (2) navigating and orientating on the Web, (3) utilizing search strategies, (4) evaluating relevance and reliability, (5) adding content to the Web, and (6) protecting and respecting privacy. Most severe difficulties occurred in levels 3 and 4—in formulating a search query, evaluating the source of the information, and in scanning a website for relevant information. Conclusions Many patients have insufficient skills to properly use Health 1.0 and Health 2.0. Formulating proper search strategies and evaluating the found information caused problems among the majority of patients. Concerning Health 2.0, use and awareness of these applications is low and patients should be guided in the use of them. Our findings may contribute to the awareness of patients’ eHealth literacy problems among health professionals, and stress the importance of usability guidelines in Web design. PMID:23399720

Use of patients' mobile phones to store and share personal health information: results of a questionnaire survey.

PubMed

Tawara, Satoru; Yonemochi, Yasuhiro; Kosaka, Takayuki; Kouzaki, Yanosuke; Takita, Tomohiro; Tsuruta, Toshihisa

2013-01-01

To explore the opinions of outpatients concerning a new communication method: the self-management of assessed personal problems in health information records (SAPPHIRE) using patients' mobile phones to store and share medical content (medical SAPPHIRE, or m-SAPPHIRE). A cross-sectional questionnaire survey. Patients Outpatients who visited us from March 1 to May 30, 2012, were asked to complete a questionnaire survey regarding SAPPHIRE and m-SAPPHIRE. The m-SAPPHIRE data consisted of a problem list, height, weight, waist size and active medication list. Ten questions were asked regarding the usefulness of m-SAPPHIRE, the sharing of m-SAPPHIRE and the use of mobile phones to store m-SAPPHIRE data. One hundred and ninety-three patients (male/female, 79/114; mean age, 57±21 years) were registered: 95.9% answered that m-SAPPHIRE would be useful, 98% agreed to manage their personal health records by themselves, and 95.8%, 93.8%, and 92.8% of the patients responded that they would allow m-SAPPHIRE information to be shared with family members, medical workers, and health care providers, respectively. Of the patients, 75.1% responded that they owned a mobile phone, and 43.5% answered that they could enter m-SAPPHIRE information into a mobile phone by themselves, while 27.5% responded that they could do so with someone's help. Patients believe that m-SAPPHIRE would be useful for retrieving their health records during emergency situations or for sharing with family members and medical and health care providers. SAPPHIRE using mobile phones could be an inexpensive and legal method for sharing medical data.

NetWall distributed firewall in the use of campus network

NASA Astrophysics Data System (ADS)

He, Junhua; Zhang, Pengshuai

2011-10-01

Internet provides a modern means of education but also non-mainstream consciousness and poor dissemination of information opens the door, network and moral issues have become prominent, poor dissemination of information and network spread rumors and negative effects of new problems, ideological and political education in schools had a huge impact, poses a severe challenge. This paper presents a distributed firewall will NetWall deployed in a campus network solution. The characteristics of the campus network, using technology to filter out bad information on the means of control, of sensitive information related to the record, establish a complete information security management platform for the campus network.

Utility-preserving transaction data anonymization with low information loss.

PubMed

Loukides, Grigorios; Gkoulalas-Divanis, Aris

2012-08-01

Transaction data record various information about individuals, including their purchases and diagnoses, and are increasingly published to support large-scale and low-cost studies in domains such as marketing and medicine. However, the dissemination of transaction data may lead to privacy breaches, as it allows an attacker to link an individual's record to their identity. Approaches that anonymize data by eliminating certain values in an individual's record or by replacing them with more general values have been proposed recently, but they often produce data of limited usefulness. This is because these approaches adopt value transformation strategies that do not guarantee data utility in intended applications and objective measures that may lead to excessive data distortion. In this paper, we propose a novel approach for anonymizing data in a way that satisfies data publishers' utility requirements and incurs low information loss. To achieve this, we introduce an accurate information loss measure and an effective anonymization algorithm that explores a large part of the problem space. An extensive experimental study, using click-stream and medical data, demonstrates that our approach permits many times more accurate query answering than the state-of-the-art methods, while it is comparable to them in terms of efficiency.

Utility-preserving transaction data anonymization with low information loss

PubMed Central

Loukides, Grigorios; Gkoulalas-Divanis, Aris

2012-01-01

Transaction data record various information about individuals, including their purchases and diagnoses, and are increasingly published to support large-scale and low-cost studies in domains such as marketing and medicine. However, the dissemination of transaction data may lead to privacy breaches, as it allows an attacker to link an individual’s record to their identity. Approaches that anonymize data by eliminating certain values in an individual’s record or by replacing them with more general values have been proposed recently, but they often produce data of limited usefulness. This is because these approaches adopt value transformation strategies that do not guarantee data utility in intended applications and objective measures that may lead to excessive data distortion. In this paper, we propose a novel approach for anonymizing data in a way that satisfies data publishers’ utility requirements and incurs low information loss. To achieve this, we introduce an accurate information loss measure and an effective anonymization algorithm that explores a large part of the problem space. An extensive experimental study, using click-stream and medical data, demonstrates that our approach permits many times more accurate query answering than the state-of-the-art methods, while it is comparable to them in terms of efficiency. PMID:22563145

MATERNAL AGE AND BIRTH ORDER CORRELATIONS. PROBLEMS OF DISTINGUISHING MUTATIONAL FROM ENVIRONMENTAL COMPONENTS,

DTIC Science & Technology

The associations of maternal age and birth order differences with differences in the risks of various diseases in the offspring have been studied for...affected individuals. Parental age and birth order information, where missing, was derived by computer ’linkages’ of these records with the birth

Effects of a Training Package to Improve the Accuracy of Descriptive Analysis Data Recording

ERIC Educational Resources Information Center

Mayer, Kimberly L.; DiGennaro Reed, Florence D.

2013-01-01

Functional behavior assessment is an important precursor to developing interventions to address a problem behavior. Descriptive analysis, a type of functional behavior assessment, is effective in informing intervention design only if the gathered data accurately capture relevant events and behaviors. We investigated a training procedure to improve…

A Learning Research Informed Design and Evaluation of a Web-Enhanced Object Oriented Programming Seminar

ERIC Educational Resources Information Center

Georgantaki, Stavroula C.; Retalis, Symeon D.

2007-01-01

"Object-Oriented Programming" subject is included in the ACM Curriculum Guidelines for Undergraduate and Graduate Degree Programs in Computer Science as well as in Curriculum for K-12 Computer Science. In a few research studies learning problems and difficulties have been recorded, and therefore, specific pedagogical guidelines and…

Alaska Natives & the Land.

ERIC Educational Resources Information Center

Arnold, Robert D.; And Others

Pursuant to the Native land claims within Alaska, this compilation of background data and interpretive materials relevant to a fair resolution of the Alaska Native problem seeks to record data and information on the Native peoples; the land and resources of Alaska and their uses by the people in the past and present; land ownership; and future…

Anabat bat detection system: description and maintenance manual.

Treesearch

Douglas W. Waldren

2000-01-01

Anabat bat detection systems record ultrasonic bat calls on cassette tape by using a sophisticated ultrasonic microphone and cassette tape interface. This paper describes equipment setup and some maintenance issues. The layout and function of display panels are presented with special emphasis on how to use this information to troubleshoot equipment problems. The...

75 FR 18857 - Privacy Act of 1974; Department of Homeland Security Citizenship and Immigration Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-13

... processing of information and to aid the Ombudsman in assisting individuals and employers in making systemic... individuals and employers problems allowing the Ombudsman to make systemic recommendations to USCIS. The... prosecuting a violation or enforcing or implementing a law, rule, regulation, or order, where a record, either...

Identification of cloud fields by the nonparametric algorithm of pattern recognition from normalized video data recorded with the AVHRR instrument

NASA Astrophysics Data System (ADS)

Protasov, Konstantin T.; Pushkareva, Tatyana Y.; Artamonov, Evgeny S.

2002-02-01

The problem of cloud field recognition from the NOAA satellite data is urgent for solving not only meteorological problems but also for resource-ecological monitoring of the Earth's underlying surface associated with the detection of thunderstorm clouds, estimation of the liquid water content of clouds and the moisture of the soil, the degree of fire hazard, etc. To solve these problems, we used the AVHRR/NOAA video data that regularly displayed the situation in the territory. The complexity and extremely nonstationary character of problems to be solved call for the use of information of all spectral channels, mathematical apparatus of testing statistical hypotheses, and methods of pattern recognition and identification of the informative parameters. For a class of detection and pattern recognition problems, the average risk functional is a natural criterion for the quality and the information content of the synthesized decision rules. In this case, to solve efficiently the problem of identifying cloud field types, the informative parameters must be determined by minimization of this functional. Since the conditional probability density functions, representing mathematical models of stochastic patterns, are unknown, the problem of nonparametric reconstruction of distributions from the leaning samples arises. To this end, we used nonparametric estimates of distributions with the modified Epanechnikov kernel. The unknown parameters of these distributions were determined by minimization of the risk functional, which for the learning sample was substituted by the empirical risk. After the conditional probability density functions had been reconstructed for the examined hypotheses, a cloudiness type was identified using the Bayes decision rule.

Evaluation of a BCMA’s Electronic Medication Administration Record

PubMed Central

Staggers, Nancy; Iribarren, Sarah; Guo, Jia-Wen; Weir, Charlene

2015-01-01

Barcode medication administration (BCMA) systems can reduce medication errors, but sociotechnical issues are quite common. Although crucial to nurses’ work, few usability evaluations are available for electronic medication administration record screens (eMARs). The purpose of this research was to identify current usability problems in the VA’s eMAR/BCMA system and explore how these might impact nurses’ situation awareness. Three expert evaluators used 10 tasks/elements, heuristic evaluation techniques and explored potential impacts using a situation awareness perspective. The results yielded 99 usability problems categorized into 440 heuristic violations with the largest volume in the category of Match with the Real World. Fifteen usability issues were rated as catastrophic with the Administer/Chart medications task having the most. Situational awareness was impacted at all levels, especially at Level 2, Comprehension. Usability problems point to important areas for improvement because these issues have the potential to impact nurses’ situation awareness, “at a glance” information, nurse productivity and patient safety. PMID:25601936

[Perinatal Information System. Incorporation latency and impact on perinatal clinical registry].

PubMed

Simini, F; Fernández, A; Sosa, C; Díaz Rossello, J L

2001-10-01

The Perinatal Information System (SIP) is a clinical record, local management and quality assurance software standard in Latin America and the Caribbean. The time to implement SIP in a Maternity Hospital is evaluated as well as the effect of statistics on perinatal health indicators in subsequent years. In the sample of 20 Maternity Hospitals (5 Countries, 40% Private and 60% Public) 85% had a reliable information system by the third year of use of SIP. 15% of hospitals still had problems at that time that were already clear during the second year, a time corrective measures can still be taken. The evaluation of the impact of yearly reports shows that 58% of recommendations were fulfilled, specially those regarding the complete filling-in of clinical records (62%) and to a lesser extent variables that reflect clinical practices and organization of services (52%). The conclusion is that Maternity Hospitals in Latin America and the Caribbean have the capacity to adopt a complex tool of computerized clinical records for quality assurance of perinatal care and monitoring of health indicators.

Single-intensity-recording optical encryption technique based on phase retrieval algorithm and QR code

NASA Astrophysics Data System (ADS)

Wang, Zhi-peng; Zhang, Shuai; Liu, Hong-zhao; Qin, Yi

2014-12-01

Based on phase retrieval algorithm and QR code, a new optical encryption technology that only needs to record one intensity distribution is proposed. In this encryption process, firstly, the QR code is generated from the information to be encrypted; and then the generated QR code is placed in the input plane of 4-f system to have a double random phase encryption. For only one intensity distribution in the output plane is recorded as the ciphertext, the encryption process is greatly simplified. In the decryption process, the corresponding QR code is retrieved using phase retrieval algorithm. A priori information about QR code is used as support constraint in the input plane, which helps solve the stagnation problem. The original information can be recovered without distortion by scanning the QR code. The encryption process can be implemented either optically or digitally, and the decryption process uses digital method. In addition, the security of the proposed optical encryption technology is analyzed. Theoretical analysis and computer simulations show that this optical encryption system is invulnerable to various attacks, and suitable for harsh transmission conditions.

Understanding health care providers' reluctance to adopt a national electronic patient record: an empirical and legal analysis.

PubMed

Zwaanswijk, M; Ploem, M C; Wiesman, F J; Verheij, R A; Friele, R D; Gevers, J K M

2013-03-01

Several countries are implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs on the efficiency, continuity, safety and quality of care, their overall adoption remains low and meets resistance from involved parties. The implementation of the Dutch n-EPR also raised considerable controversy, which eventually caused the Dutch government to stop its contribution to the national infrastructure. To explain Dutch health care providers' reluctance in adopting the n-EPR, we investigated their perceptions of problems associated with the n-EPR and their legal position regarding then-EPR. We hereby aim to provide suggestions about approaches that could promote successful implementation. The study consisted of two parts. The empirical part of the study was conducted in three health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, 17 stakeholders working in these organisations were interviewed to investigate health care providers' perceptions of problems associated with the n-EPR. In the legal part of the study, legal documents were analysed to study health care providers' legal position regarding the n-EPR and any associated problems. The respondents expressed concerns about the confidentiality and safety of information exchange and the reliability and quality of patient data in the n-EPR, and indicated that their liability in case of medical errors was not sufficiently clear. The perceived problems could partly be attributed to legal uncertainties. It is recommended to start the implementation of an n-EPR in limited geographical areas. This will allow health care providers to experience benefits of electronic information exchange before being asked to participate in information exchange at a larger scale. The problems that health care providers perceive in the n-EPR should be minimised. Legislation underlying the n-EPR should provide sufficient clarity about health care professionals' responsibilities and liabilities.

Avoiding (or fixing) problems with lawyers and courts.

PubMed

Reid, William H

2013-03-01

Clinicians who do work for attorneys and courts sometimes encounter problems in defining their roles, with access to records or litigants, with unexpected changes or additions to their tasks, or with being compensated for their work. Understanding the context of the forensic consultation and the processes commonly employed by lawyers and the judiciary can prevent many problems. Be cautious about "informal" requests from attorneys, particularly if they involve your own patients. Maintain solid business practices and make sure your role, relationship, and financial agreement with the person or entity retaining you are clear, ethical, and well documented before you begin work on a case.

Protection method for an optical information carrier

NASA Astrophysics Data System (ADS)

Pitsyuga, Vitaly V.; Kolesnikov, Michael Y.; Kosyak, Igor V.

1997-02-01

Now information protection on personal carriers (for example, cards) from an unauthorized access (UA) is a very important problem in connection with wide introduction of proper automatic systems for information processing in different spheres of human activity. These are financial, medical and information services, an access to restricted units and so on. There is proposed to use physical parameters of the special coating part (so-called restricted zone) to information protection on optical carriers (laser cards). There is formed restricted zone on the surface of the recording coating of a laser card. The unique information about every laser card to creating a protective passport from UA is obtained by readout of defects parameters.

Video coding for next-generation surveillance systems

NASA Astrophysics Data System (ADS)

Klasen, Lena M.; Fahlander, Olov

1997-02-01

Video is used as recording media in surveillance system and also more frequently by the Swedish Police Force. Methods for analyzing video using an image processing system have recently been introduced at the Swedish National Laboratory of Forensic Science, and new methods are in focus in a research project at Linkoping University, Image Coding Group. The accuracy of the result of those forensic investigations often depends on the quality of the video recordings, and one of the major problems when analyzing videos from crime scenes is the poor quality of the recordings. Enhancing poor image quality might add manipulative or subjective effects and does not seem to be the right way of getting reliable analysis results. The surveillance system in use today is mainly based on video techniques, VHS or S-VHS, and the weakest link is the video cassette recorder, (VCR). Multiplexers for selecting one of many camera outputs for recording is another problem as it often filters the video signal, and recording is limited to only one of the available cameras connected to the VCR. A way to get around the problem of poor recording is to simultaneously record all camera outputs digitally. It is also very important to build such a system bearing in mind that image processing analysis methods becomes more important as a complement to the human eye. Using one or more cameras gives a large amount of data, and the need for data compression is more than obvious. Crime scenes often involve persons or moving objects, and the available coding techniques are more or less useful. Our goal is to propose a possible system, being the best compromise with respect to what needs to be recorded, movements in the recorded scene, loss of information and resolution etc., to secure the efficient recording of the crime and enable forensic analysis. The preventative effective of having a well functioning surveillance system and well established image analysis methods is not to be neglected. Aspects of this next generation of digital surveillance systems are discussed in this paper.

[Problem areas and examples of best practice in intersectoral medication treatment--a literature review].

PubMed

Mehrmann, Lena; Ollenschläger, Günter

2014-01-01

Transitions between the outpatient and inpatient sector are a critical phase in medication treatment. This article provides an overview of published problem areas and examples of best practice in the intersectoral medication treatment. Data with regard to related problem areas and examples of best practice was collected in August 2011 by a systematic literature research. The relevant literature was identified using the following databases and search engines: MEDLINE, The Cochrane Library, EMBASE, Google, and Google Scholar. Additionally, a hand search was done on the websites of SpringerLink and Thieme Connect. The initial search yielded a total of 4,409 records which were further selected in two screening steps and analysed according to their relevance. Of the remaining 63 records, 3 exclusively described problem areas, 11 of them examples of best practice, and 49 provided information on both problem areas and examples of best practice with regard to intersectoral medication treatment. Among other things, problem areas include varying legal regulations in inpatient and outpatient medication treatment, drug therapy interruptions after hospital discharge, or deficits in communication and continuity of care. Examples of best practice are projects, programmes, initiatives, recommendations, and points to consider with respect to medication reconciliation, pharmaceutical support, or transitions of care. Problem areas as well as examples of best practice are mainly focused on the transition from inpatient to outpatient care. Copyright © 2013. Published by Elsevier GmbH.

Development and Validation of the Diabetes Adolescent Problem Solving Questionnaire

PubMed Central

Mulvaney, Shelagh A.; Jaser, Sarah S.; Rothman, Russell L.; Russell, William; Pittel, Eric J.; Lybarger, Cindy; Wallston, Kenneth A.

2014-01-01

Objective Problem solving is a critical diabetes self-management skill. Because of a lack of clinically feasible measures, our aim was to develop and validate a self-report self-management problem solving questionnaire for adolescents with type 1 diabetes (T1D). Methods A multidisciplinary team of diabetes experts generated questionnaire items that addressed diabetes self-management problem solving. Iterative feedback from parents and adolescents resulted in 27 items. Adolescents from two studies (N=156) aged 13–17 were recruited through a pediatric diabetes clinic and completed measures through an online survey. Glycemic control was measured by HbA1c recorded in the medical record. Results Empirical elimination of items using Principal Components Analyses resulted in a 13-item unidimensional measure, the Diabetes Adolescent Problem Solving Questionnaire (DAPSQ) that explained 57% of the variance. The DAPSQ demonstrated internal consistency (Cronbach’s alpha = 0.92) and was correlated with diabetes self-management (r=0.53, p<.001), self-efficacy (r=0.54, p<.001), and glycemic control (r= −0.24, p<.01). Conclusion The DAPSQ is a brief instrument for assessment of diabetes self-management problem solving in youth with T1D associated with better self-management behaviors and glycemic control. Practice Implications The DAPSQ is a clinically feasible self-report measure that can provide valuable information regarding level of self-management problem solving and guide patient education. PMID:25063715

Development and validation of the diabetes adolescent problem solving questionnaire.

PubMed

Mulvaney, Shelagh A; Jaser, Sarah S; Rothman, Russell L; Russell, William E; Pittel, Eric J; Lybarger, Cindy; Wallston, Kenneth A

2014-10-01

Problem solving is a critical diabetes self-management skill. Because of a lack of clinically feasible measures, our aim was to develop and validate a self-report self-management problem solving questionnaire for adolescents with type 1 diabetes (T1D). A multidisciplinary team of diabetes experts generated questionnaire items that addressed diabetes self-management problem solving. Iterative feedback from parents and adolescents resulted in 27 items. Adolescents from two studies (N=156) aged 13-17 were recruited through a pediatric diabetes clinic and completed measures through an online survey. Glycemic control was measured by HbA1c recorded in the medical record. Empirical elimination of items using principal components analyses resulted in a 13-item unidimensional measure, the diabetes adolescent problem solving questionnaire (DAPSQ) that explained 56% of the variance. The DAPSQ demonstrated internal consistency (Cronbach's alpha=0.92) and was correlated with diabetes self-management (r=0.53, p<.001), self-efficacy (r=0.54, p<.001), and glycemic control (r=-0.24, p<.01). The DAPSQ is a brief instrument for assessment of diabetes self-management problem solving in youth with T1D and is associated with better self-management behaviors and glycemic control. The DAPSQ is a clinically feasible self-report measure that can provide valuable information regarding level of self-management problem solving and guide patient education. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Self-reported difficulty in conceiving as a measure of infertility.

PubMed

Dick, M-L B; Bain, C J; Purdie, D M; Siskind, V; Molloy, D; Green, A C

2003-12-01

This study aimed to explore the meaning and potential use of women's self-reported difficulties in conceiving as a measure of infertility in epidemiological studies, and to compare women's stated reasons for infertility with information in their medical records. Data were available from a population-based case-control study of ovarian cancer involving 1638 women. The sensitivity and specificity of women's self-reported infertility were calculated against their estimated fertility status based on detailed reproductive histories. Self-reported reasons for infertility were compared with diagnoses documented in women's medical records. The sensitivity of women's self-reported difficulty in conceiving was 66 and 69% respectively when compared with calendar-derived and self-reported times taken trying to conceive; its specificity was 95%. Forty-one (23%) of the 179 women for whom medical records were available had their self-reported fertility problem confirmed. Self-reported infertility causes could be compared with diagnoses in medical records for only 22 of these women. Self-reported difficulty conceiving is a useful measure of infertility for quantifying the burden of fertility problems experienced in the community. Validation of reasons for infertility is unlikely to be feasible through examination of medical records. Improved education of the public regarding the availability and success rates of infertility treatments is proposed.

The Human Communication Research Centre dialogue database.

PubMed

Anderson, A H; Garrod, S C; Clark, A; Boyle, E; Mullin, J

1992-10-01

The HCRC dialogue database consists of over 700 transcribed and coded dialogues from pairs of speakers aged from seven to fourteen. The speakers are recorded while tackling co-operative problem-solving tasks and the same pairs of speakers are recorded over two years tackling 10 different versions of our two tasks. In addition there are over 200 dialogues recorded between pairs of undergraduate speakers engaged on versions of the same tasks. Access to the database, and to its accompanying custom-built search software, is available electronically over the JANET system by contacting liz@psy.glasgow.ac.uk, from whom further information about the database and a user's guide to the database can be obtained.

A unique problem of muscle adaptation from weightlessness: The deceleration deficiency

NASA Technical Reports Server (NTRS)

Stauber, William T.

1989-01-01

Decelerator problems of the knee are emphasized since the lower leg musculature is known to atrophy in response to weightlessness. However, other important decelerator functions are served by the shoulder muscles, in particular the rotator cuff muscles. Problems in these muscles often result in tears and dislocations as seen in baseball pitchers. It is noteworthy that at least one device currently exists that can measure concentric and eccentric muscle loading including a submaximal simulated free weight exercise (i.e., force-controlled) and simultaneously record integrated EMG analysis appropriate for assessment of all muscle functional activities. Studies should be undertaken to provide information as to the performance of maximal and submaximal exercise in space travelers to define potential problems and provide rationale for prevention.

A survey to identify the clinical coding and classification systems currently in use across Europe.

PubMed

de Lusignan, S; Minmagh, C; Kennedy, J; Zeimet, M; Bommezijn, H; Bryant, J

2001-01-01

This is a survey to identify what clinical coding systems are currently in use across the European Union, and the states seeking membership to it. We sought to identify what systems are currently used and to what extent they were subject to local adaptation. Clinical coding should facilitate identifying key medical events in a computerised medical record, and aggregating information across groups of records. The emerging new driver is as the enabler of the life-long computerised medical record. A prerequisite for this level of functionality is the transfer of information between different computer systems. This transfer can be facilitated either by working on the interoperability problems between disparate systems or by harmonising the underlying data. This paper examines the extent to which the latter has occurred across Europe. Literature and Internet search. Requests for information via electronic mail to pan-European mailing lists of health informatics professionals. Coding systems are now a de facto part of health information systems across Europe. There are relatively few coding systems in existence across Europe. ICD9 and ICD 10, ICPC and Read were the most established. However the local adaptation of these classification systems either on a by country or by computer software manufacturer basis; significantly reduces the ability for the meaning coded with patients computer records to be easily transferred from one medical record system to another. There is no longer any debate as to whether a coding or classification system should be used. Convergence of different classifications systems should be encouraged. Countries and computer manufacturers within the EU should be encouraged to stop making local modifications to coding and classification systems, as this practice risks significantly slowing progress towards easy transfer of records between computer systems.

Electronic medical records for otolaryngology office-based practice.

PubMed

Chernobilsky, Boris; Boruk, Marina

2008-02-01

Pressure is mounting on physicians to adopt electronic medical records. The field of health information technology is evolving rapidly with innovations and policies often outpacing science. We sought to review research and discussions about electronic medical records from the past year to keep abreast of these changes. Original scientific research, especially from otolaryngologists, is lacking in this field. Adoption rates are slowly increasing, but more of the burden is shouldered by physicians despite policy efforts and the clear benefits to third-party payers. Scientific research from the past year suggests lack of improvements and even decreasing quality of healthcare with electronic medical record adoption in the ambulatory care setting. The increasing prevalence and standardization of electronic medical record systems results in a new set of problems including rising costs, audits, difficulties in transition and public concerns about security of information. As major players in healthcare continue to push for adoption, increased effort must be made to demonstrate actual improvements in patient care in the ambulatory care setting. More scientific studies are needed to demonstrate what features of electronic medical records actually improve patient care. Otolaryngologists should help each other by disseminating research about improvement in patient outcomes with their systems since current adoption and outcomes policies do not apply to specialists.

Robust selectivity to two-object images in human visual cortex

PubMed Central

Agam, Yigal; Liu, Hesheng; Papanastassiou, Alexander; Buia, Calin; Golby, Alexandra J.; Madsen, Joseph R.; Kreiman, Gabriel

2010-01-01

SUMMARY We can recognize objects in a fraction of a second in spite of the presence of other objects [1–3]. The responses in macaque areas V4 and inferior temporal cortex [4–15] to a neuron’s preferred stimuli are typically suppressed by the addition of a second object within the receptive field (see however [16, 17]). How can this suppression be reconciled with rapid visual recognition in complex scenes? One option is that certain “special categories” are unaffected by other objects [18] but this leaves the problem unsolved for other categories. Another possibility is that serial attentional shifts help ameliorate the problem of distractor objects [19–21]. Yet, psychophysical studies [1–3], scalp recordings [1] and neurophysiological recordings [14, 16, 22–24], suggest that the initial sweep of visual processing contains a significant amount of information. We recorded intracranial field potentials in human visual cortex during presentation of flashes of two-object images. Visual selectivity from temporal cortex during the initial ~200 ms was largely robust to the presence of other objects. We could train linear decoders on the responses to isolated objects and decode information in two-object images. These observations are compatible with parallel, hierarchical and feed-forward theories of rapid visual recognition [25] and may provide a neural substrate to begin to unravel rapid recognition in natural scenes. PMID:20417105

Speech watermarking: an approach for the forensic analysis of digital telephonic recordings.

PubMed

Faundez-Zanuy, Marcos; Lucena-Molina, Jose J; Hagmüller, Martin

2010-07-01

In this article, the authors discuss the problem of forensic authentication of digital audio recordings. Although forensic audio has been addressed in several articles, the existing approaches are focused on analog magnetic recordings, which are less prevalent because of the large amount of digital recorders available on the market (optical, solid state, hard disks, etc.). An approach based on digital signal processing that consists of spread spectrum techniques for speech watermarking is presented. This approach presents the advantage that the authentication is based on the signal itself rather than the recording format. Thus, it is valid for usual recording devices in police-controlled telephone intercepts. In addition, our proposal allows for the introduction of relevant information such as the recording date and time and all the relevant data (this is not always possible with classical systems). Our experimental results reveal that the speech watermarking procedure does not interfere in a significant way with the posterior forensic speaker identification.

Searching for Significance in Unstructured Data: Text Mining with Leximancer

ERIC Educational Resources Information Center

Thomas, David A.

2014-01-01

Scholars in many knowledge domains rely on sophisticated information technologies to search for and retrieve records and publications pertinent to their research interests. But what is a scholar to do when a search identifies hundreds of documents, any of which might be vital or irrelevant to his or her work? The problem is further complicated by…

County Community Development Studies. No. 2: Extensions Library on Tape, Sarasota County.

ERIC Educational Resources Information Center

Rozar, Luther L.; And Others

A study was conducted in Sarasota County, Florida, to determine the feasibility of implementing a County Extension Service library on telecassette tape that could be dialed by phone callers. The system would allow office callers access to two-to-three-minute tape recordings containing information on many common problems. A survey instrument…

Small Craft Advisory!: Cardboard Boat Challenges Students' Research, Design and Construction Skills

ERIC Educational Resources Information Center

Griffis, Kurt; Brand, Lance; Shackelford, Ray

2006-01-01

Throughout history, people have moved themselves and cargo across water in boats and other types of vessels. Most vessels are developed using a technological design process, which typically involves problem solving and a series of steps. The designer documents each step to provide an accurate record of accomplishments and information to guide…

Effects of increased nurses' workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province.

PubMed

Shihundla, Rhulani C; Lebese, Rachel T; Maputle, Maria S

2016-05-13

Recording of information on multiple documents increases professional nurses' responsibilities and workload during working hours. There are multiple registers and books at Primary Health Care (PHC) facilities in which a patient's information is to be recorded for different services during a visit to a health professional. Antenatal patients coming for the first visit must be recorded in the following documents: tick register; Prevention of Mother-ToChild Transmission (PMTCT) register; consent form for HIV and AIDS testing; HIV Counselling and Testing (HCT) register (if tested positive for HIV and AIDS then this must be recorded in the Antiretroviral Therapy (ART) wellness register); ART file with an accompanying single file, completion of which is time-consuming; tuberculosis (TB) suspects register; blood specimen register; maternity case record book and Basic Antenatal Care (BANC) checklist. Nurses forget to record information in some documents which leads to the omission of important data. Omitting information might lead to mismanagement of patients. Some of the documents have incomplete and inaccurate information. As PHC facilities in Vhembe District render twenty four hour services through a call system, the same nurses are expected to resume duty at 07:00 the following morning. They are expected to work effectively and when tired a nurse may record illegible information which may cause problems when the document is retrieved by the next person for continuity of care. The objective of this study was to investigate and describe the effects of increased nurses' workload on quality documentation of patient information at PHC facilities in Vhembe District, Limpopo Province. The study was conducted in Vhembe District, Limpopo Province, where the effects of increased nurses' workload on quality documentation of information is currently experienced. The research design was explorative, descriptive and contextual in nature. The population consisted of all nurses who work at PHC facilities in Vhembe District. Purposive sampling was used to select nurses and three professional nurses were sampled from each PHC facility. An in-depth face-to-face interview was used to collect data using an interview guide. PHC facilities encountered several effects due to increased nurses' workload where incomplete patient information is documented. Unavailability of patient information was observed, whilst some documented information was found to be illegible, inaccurate and incomplete. Documentation of information at PHC facilities is an evidence of effective communication amongst professional nurses. There should always be active follow-up and mentoring of the nurses' documentation to ensure that information is accurately and fully documented in their respective facilities. Nurses find it difficult to cope with the increased workload associated with documenting patient information on the multiple records that are utilized at PHC facilities, leading to incomplete information. The number of nurses at facilities should be increased to reduce the increased workload.

Children with dyslexia show a reduced processing benefit from bimodal speech information compared to their typically developing peers.

PubMed

Schaadt, Gesa; van der Meer, Elke; Pannekamp, Ann; Oberecker, Regine; Männel, Claudia

2018-01-17

During information processing, individuals benefit from bimodally presented input, as has been demonstrated for speech perception (i.e., printed letters and speech sounds) or the perception of emotional expressions (i.e., facial expression and voice tuning). While typically developing individuals show this bimodal benefit, school children with dyslexia do not. Currently, it is unknown whether the bimodal processing deficit in dyslexia also occurs for visual-auditory speech processing that is independent of reading and spelling acquisition (i.e., no letter-sound knowledge is required). Here, we tested school children with and without spelling problems on their bimodal perception of video-recorded mouth movements pronouncing syllables. We analyzed the event-related potential Mismatch Response (MMR) to visual-auditory speech information and compared this response to the MMR to monomodal speech information (i.e., auditory-only, visual-only). We found a reduced MMR with later onset to visual-auditory speech information in children with spelling problems compared to children without spelling problems. Moreover, when comparing bimodal and monomodal speech perception, we found that children without spelling problems showed significantly larger responses in the visual-auditory experiment compared to the visual-only response, whereas children with spelling problems did not. Our results suggest that children with dyslexia exhibit general difficulties in bimodal speech perception independently of letter-speech sound knowledge, as apparent in altered bimodal speech perception and lacking benefit from bimodal information. This general deficit in children with dyslexia may underlie the previously reported reduced bimodal benefit for letter-speech sound combinations and similar findings in emotion perception. Copyright © 2018 Elsevier Ltd. All rights reserved.

Computer security: a necessary element of integrated information systems.

PubMed Central

Butzen, F; Furler, F

1986-01-01

The Matheson Report sees the medical library as playing a key role in a network of interlocking information bases that will extend from central repositories of medical information to each physician's personal records. It appears, however, that the role of security in this vision has not been fully delineated. This paper discusses problems in maintaining the security of confidential medical information, the state of the applicable law, and techniques for security (with special emphasis on the UNIX operating system). It is argued that the absence of security threatens any plan to build an information network, as there will be resistance to any system that may give intruders access to confidential data. PMID:3742113

Medical record management systems: criticisms and new perspectives.

PubMed

Frénot, S; Laforest, F

1999-06-01

The first generation of computerized medical records stored the data as text, but these records did not bring any improvement in information manipulation. The use of a relational database management system (DBMS) has largely solved this problem as it allows for data requests by using SQL. However, this requires data structuring which is not very appropriate to medicine. Moreover, the use of templates and icon user interfaces has introduced a deviation from the paper-based record (still existing). The arrival of hypertext user interfaces has proven to be of interest to fill the gap between the paper-based medical record and its electronic version. We think that further improvement can be accomplished by using a fully document-based system. We present the architecture, advantages and disadvantages of classical DBMS-based and Web/DBMS-based solutions. We also present a document-based solution and explain its advantages, which include communication, security, flexibility and genericity.

One positive impact of health care reform to physicians: the computer-based patient record.

PubMed

England, S P

1993-11-01

The health care industry is an information-dependent business that will require a new generation of health information systems if successful health care reform is to occur. We critically need integrated clinical management information systems to support the physician and related clinicians at the direct care level, which in turn will have linkages with secondary users of health information such as health payors, regulators, and researchers. The economic dependence of health care industry on the CPR cannot be underestimated, says Jeffrey Ritter. He sees the U.S. health industry as about to enter a bold new age where our records are electronic, our computers are interconnected, and our money is nothing but pulses running across the telephone lines. Hence the United States is now in an age of electronic commerce. Clinical systems reform must begin with the community-based patient chart, which is located in the physician's office, the hospital, and other related health care provider offices. A community-based CPR and CPR system that integrates all providers within a managed care network is the most logical step since all health information begins with the creation of a patient record. Once a community-based CPR system is in place, the physician and his or her clinical associates will have a common patient record upon which all direct providers have access to input and record patient information. Once a community-level CPR system is in place with a community provider network, each physician will have available health information and data processing capability that will finally provide real savings in professional time and effort. Lost patient charts will no longer be a problem. Data input and storage of health information would occur electronically via transcripted text, voice, and document imaging. All electronic clinical information, voice, and graphics could be recalled at any time and transmitted to any terminal location within the health provider network. Hence, health system re-engineering must begin and be developed where health information is initially created--in the physician's office or clinic.

Site-occupancy distribution modeling to correct population-trend estimates derived from opportunistic observations

USGS Publications Warehouse

Kery, M.; Royle, J. Andrew; Schmid, Hans; Schaub, M.; Volet, B.; Hafliger, G.; Zbinden, N.

2010-01-01

Species' assessments must frequently be derived from opportunistic observations made by volunteers (i.e., citizen scientists). Interpretation of the resulting data to estimate population trends is plagued with problems, including teasing apart genuine population trends from variations in observation effort. We devised a way to correct for annual variation in effort when estimating trends in occupancy (species distribution) from faunal or floral databases of opportunistic observations. First, for all surveyed sites, detection histories (i.e., strings of detection-nondetection records) are generated. Within-season replicate surveys provide information on the detectability of an occupied site. Detectability directly represents observation effort; hence, estimating detectablity means correcting for observation effort. Second, site-occupancy models are applied directly to the detection-history data set (i.e., without aggregation by site and year) to estimate detectability and species distribution (occupancy, i.e., the true proportion of sites where a species occurs). Site-occupancy models also provide unbiased estimators of components of distributional change (i.e., colonization and extinction rates). We illustrate our method with data from a large citizen-science project in Switzerland in which field ornithologists record opportunistic observations. We analyzed data collected on four species: the widespread Kingfisher (Alcedo atthis. ) and Sparrowhawk (Accipiter nisus. ) and the scarce Rock Thrush (Monticola saxatilis. ) and Wallcreeper (Tichodroma muraria. ). Our method requires that all observed species are recorded. Detectability was <1 and varied over the years. Simulations suggested some robustness, but we advocate recording complete species lists (checklists), rather than recording individual records of single species. The representation of observation effort with its effect on detectability provides a solution to the problem of differences in effort encountered when extracting trend information from haphazard observations. We expect our method is widely applicable for global biodiversity monitoring and modeling of species distributions. ?? 2010 Society for Conservation Biology.

Recording and reading of information on optical disks

NASA Astrophysics Data System (ADS)

Bouwhuis, G.; Braat, J. J. M.

In the storage of information, related to video programs, in a spiral track on a disk, difficulties arise because the bandwidth for video is much greater than for audio signals. An attractive solution was found in optical storage. The optical noncontact method is free of wear, and allows for fast random access. Initial problems regarding a suitable light source could be overcome with the aid of appropriate laser devices. The basic concepts of optical storage on disks are treated insofar as they are relevant for the optical arrangement. A general description is provided of a video, a digital audio, and a data storage system. Scanning spot microscopy for recording and reading of optical disks is discussed, giving attention to recording of the signal, the readout of optical disks, the readout of digitally encoded signals, and cross talk. Tracking systems are also considered, taking into account the generation of error signals for radial tracking and the generation of focus error signals.

Life Course Trajectories of Labour Market Participation among Young Adults Who Experienced Severe Alcohol-Related Health Outcomes: A Retrospective Cohort Study.

PubMed

Paljärvi, Tapio; Martikainen, Pekka; Pensola, Tiina; Leinonen, Taina; Herttua, Kimmo; Mäkelä, Pia

2015-01-01

Long-term employment trajectories of young problem drinkers are poorly understood. We constructed retrospective labour market participation histories at ages 18-34 of 64 342 persons born in 1969-1982. Beginning from the year of each subject's 18th birthday, we extracted information from the records of Statistics Finland on educational attainment, main type of economic activity, months in employment, and months in unemployment for a minimum of seven years (range 7-16 years). We used information on the timing of alcohol-related hospitalizations and deaths in the same period to define problem drinkers with early onset limited course, early onset persistent course, and late onset problem drinking. Early onset limited course problem drinkers improved their employment considerably by age, whereas early onset persistent problem drinkers experienced a constant decline in their employment by age. From the age of 18 to 34, early onset persistent problem drinkers were in employment merely 12% of the time, in comparison with 39% among the early onset limited course problem drinkers, and 58% among the general population. These results indicate that young adults who were retrospectively defined as having early onset persistent course problem drinking were extensively marginalized from the labour market early on during their life course, and that their employment trajectory was significantly worse compared to other problem drinkers.

Factors influencing recording of drug misuse in primary care: a qualitative study of GPs in England.

PubMed

Davies-Kershaw, Hilary; Petersen, Irene; Nazareth, Irwin; Stevenson, Fiona

2018-04-01

Drug misuse is a serious public health problem. Evidence from previous epidemiological studies show that GPs are recording drug misuse in electronic patient records (EPR). However, although the recording trends are similar to national surveys, recording rates are much lower. To explore the factors that influence GPs to record drug misuse in the EPR, and to gain a clearer understanding of the gap between the amount of drug misuse recorded in primary care and that in national surveys and other studies. A semi-structured qualitative interview study of GPs working in general practices across England. Purposive sampling was employed to recruit 12 GPs, both with and without a special interest in drug misuse, from across England. Semi-structured face-to-face interviews were conducted to consider whether and why GPs record drug misuse, which methods GPs use for recording, GPs' actions if a patient asks for the information not to be recorded, and GPs' actions if they think a patient misuses drugs but does not disclose the information. Resulting data were analysed using a combination of inductive and deductive thematic analysis. The complexity of asking about drug misuse preceded GPs' decision to record. They described how the context of the general practice protocols, interaction between GP and patient, and the questioning process affected whether, how, and in which circumstances they asked about drug use. This led to GPs making a clinical decision on whether, who, and how to record in the EPR. When making decisions about whether or not to record drug misuse, GPs face complex choices. Aside from their own views, they reported feelings of pressure from the general practice environment in which they worked and their clinical commissioning group, as well as government policies. © British Journal of General Practice 2018.

GP trainees' in-consultation information-seeking: associations with human, paper and electronic sources.

PubMed

Magin, Parker; Morgan, Simon; Wearne, Susan; Tapley, Amanda; Henderson, Kim; Oldmeadow, Chris; Ball, Jean; Scott, John; Spike, Neil; McArthur, Lawrie; van Driel, Mieke

2015-10-01

Answering clinical questions arising from patient care can improve that care and offers an opportunity for adult learning. It is also a vital component in practising evidence-based medicine. GPs' sources of in-consultation information can be human or non-human (either hard copy or electronic). To establish the prevalence and associations of GP trainees' in-consultation information-seeking, and to establish the prevalence of use of different sources of information (human, hard copy and electronic) and the associations of choosing particular sources. A cross-sectional analysis of data (2010-13) from an ongoing cohort study of Australian GP trainees' consultations. Once each 6-month training term, trainees record detailed data of 60 consecutive consultations. The primary outcome was whether the trainee sought in-consultation information for a problem/diagnosis. Secondary outcomes were whether information-seeking was from a human (GP, other specialist or other health professional) or from a non-human source (electronic or hard copy), and whether a non-human source was electronic or hard copy. Six hundred forty-five trainees (response rate 94.3%) contributed data for 84,723 consultations including 131,583 problems/diagnoses. In-consultation information was sought for 15.4% (95% confidence interval=15.3-15.6) of problems/diagnoses. Sources were: GP in 6.9% of problems/diagnoses, other specialists 0.9%, other health professionals 0.6%, electronic sources 6.5% and hard-copy sources 1.5%. Associations of information-seeking included younger patient age, trainee full-time status and earlier training stage, longer consultation duration, referring the patient, organizing follow-up and generating learning goals. Associations of choosing human information sources (over non-human sources) were similar, but also included the trainee's training organization. Associations of electronic rather than hard-copy information-seeking included the trainee being younger, the training organization and information-seeking for management rather than diagnosis. Trainee information-seeking is mainly from GP colleagues and electronic sources. Human information-sources are preferentially sought for more complex problems, even by these early-career GPs who have trained in the 'internet era'. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A preliminary study on travel health issues of medical students undertaking electives.

PubMed

Goldsmid, John M; Bettiol, Silvana S; Sharples, Nadine

2003-01-01

With the inclusion of elective programs, often overseas, in many medical courses, it was decided that a preliminary retrospective analysis of health problems associated with these programs in medical students from the University of Tasmania would be desirable. A questionnaire covering general travel health issues was distributed to all medical students in the University of Tasmania, on return from their elective. They were asked to complete the questionnaire and return it on an anonymous and voluntary basis. In addition, student elective submissions were consulted for information relating to their chosen destination. Results of the study indicate that general practitioners were the most common source of pretravel advice for Tasmanian medical students. Overall, 64% of students experienced some sort of health problem of which travelers' diarrhea was the most common. Most problems were mild and self-limiting, but a number of serious infections were recorded, including acute leptospirosis, paratyphoid, and Staphylococcus aureus cellulitis. Of particular concern were the reports of assault and sexual harassment recorded by several students. Elective programs are an important part of many medical courses. With the widespread destinations chosen by students, it is important that they be given adequate pretravel health advice. Most of the health problems encountered by students from the University of Tasmania were mild, but exposure to serious infections was recorded. It is thus imperative that students take out travel health insurance and that they are counseled on how to avoid dangerous situations while abroad.

A web-based referral system for neurosurgery--a solution to our problems?

PubMed

Choo, Melissa C; Thennakon, Shyamica; Shapey, Jonathan; Tolias, Christos M

2011-06-01

Accurate handover is very important in the running of all modern neurosurgical units. Referrals are notoriously difficult to track and review due to poor quality of written paper-based recorded information for handover (illegibility, incomplete paper trail, repetition of information and loss of patients). We have recently introduced a web-based referral system to three of our referring hospitals. To review the experience of a tertiary neurosurgical unit in using the UK's first real time online referral system and to discuss its strengths and weaknesses in comparison to the currently used written paper-based referral system. A retrospective analysis of all paper-based referrals made to our unit in March 2009, compared to 14 months' referrals through the web system. Patterns of information recorded in both systems were investigated and advantages and disadvantages of each identified. One hundred ninety-six patients were referred using the online system, 483 using the traditional method. Significant problems of illegibility and missing information were identified with the paper-based referrals. In comparison, 100% documentation was achieved with the online referral system. Only 63% penetrance in the best performing trust was found using the online system, with significant delays in responding to referrals. Traditional written paper-based referrals do not provide an acceptable level of documentation. We present our experience and difficulties implementing a web-based system to address this. Although our data are unable to show improved patient care, we believe the potential benefits of a fully integrated system may offer a solution.

The Quality of Registration of Clinical Trials: Still a Problem

PubMed Central

Viergever, Roderik F.; Karam, Ghassan; Reis, Andreas; Ghersi, Davina

2014-01-01

Introduction The benefits of clinical trials registration include improved transparency on clinical trials for healthcare workers and patients, increased accountability of trialists, the potential to address publication bias and selective reporting, and possibilities for research collaboration and prioritization. However, poor quality of information in registered records of trials has been found to undermine these benefits in the past. Trialists' increasing experience with trial registration and recent developments in registration systems may have positively affected data quality. This study was conducted to investigate whether the quality of registration has improved. Methods We repeated a study from 2009, using the same methods and the same research team. A random sample of 400 records of clinical trials that were registered between 01/01/2012 and 01/01/2013 was taken from the International Clinical Trials Registry Platform (ICTRP) and assessed for the quality of information on 1) contact details, 2) interventions and 3) primary outcomes. Results were compared to the equivalent assessments from our previous study. Results There was a small and not statistically significant increase from 81.0% to 85.5% in the percentage of records that provided a name of a contact person. There was a significant increase from 68.7% to 74.9% in the number of records that provided either an email address or a telephone number. There was a significant increase from 44.2% to 51.9% in the number of intervention arms that were complete in registering intervention specifics. There was a significant increase from 38.2% to 57.6% in the number of primary outcomes that were specific measures with a meaningful timeframe. Approximately half of all trials continued to be retrospectively registered. Discussion There have been small but significant improvements in the quality of registration since 2009. Important problems with quality remain and continue to constitute an impediment to the meaningful utilization of registered trial information. PMID:24427293

Reasons for hospital admissions among youth and young adults with cerebral palsy.

PubMed

Young, Nancy L; McCormick, Anna M; Gilbert, Tom; Ayling-Campos, Anne; Burke, Tricia; Fehlings, Darcy; Wedge, John

2011-01-01

To identify the most common reasons for acute care hospital admissions among youth (age range, 13-17.9y) and young adults (age range, 23-32.9y) with cerebral palsy (CP). We completed a secondary analysis of data from the Canadian Institute for Health Information (CIHI) to determine the most frequently observed reasons for admissions and the associated lengths of stay (LOS). Participants were identified from 6 children's treatment centers in Ontario, Canada. Health records data from youth with CP (n=587) and young adults with CP (n=477) contributed to this study. Not applicable. The most common reasons for hospital admission, relative frequencies of admissions for each reason, and mean LOS were reported. The analysis of CIHI records identified epilepsy and pneumonia as the top 2 reasons for admissions in both age groups. Both age groups were commonly admitted because of infections other than pneumonia and urinary tract infections (UTIs), gastrointestinal (GI) problems such as malabsorption, and mental illness. The reasons that were unique to youth included orthopedic and joint-related issues, other respiratory problems, and scoliosis. In young adults, mental illness was the third most common reason for admission, followed by lower GI or constipation problems, malnutrition or dehydration, upper GI problems, fractures, and UTIs. This article provides important clinical information that can be used in the training of physicians and health care providers, and to guide future planning of ambulatory care services to support the clinical management of persons with CP over their lifespan. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Relevance of the electronic computer to hospital medical records*

PubMed Central

Mitchell, J. H.

1969-01-01

During the past 30 years an “information explosion” has completely changed patterns of illness. Unit files of individual patients have become so large that they are increasingly difficult both to store physically and to assimilate mentally. We have reached a communications barriers which poses a major threat to the efficient practice of clinical medicine. At the same time a new kind of machine, the electronic digital computer, which was invented only 26 years ago, has already come to dominate large areas of military, scientific, commercial, and industrial activity. Its supremacy rests on its ability to perform any data procedure automatically and incredibly quickly. Computers are being employed in clinical medicine in hospitals for various purposes. They can act as arithmetic calculators, they can process and analyse output from recording devices, and they can make possible the automation of various machine systems. However, in the field of case records their role is much less well defined, for here the organization of data as a preliminary to computer input is the real stumbling-block. Data banks of retrospective selected clinical information have been in operation in some centres for a number of years. Attempts are now being made to design computerized “total information systems” to replace conventional paper records, and the possibility of automated diagnosis is being seriously discussed. In my view, however, the medical profession is in danger of being dazzled by optimistic claims about the usefulness of computers in case record processing. The solution to the present problems of record storage and handling is very simple, and does not involve computerization. PMID:4898564

Enhancing the routine health information system in rural southern Tanzania: successes, challenges and lessons learned.

PubMed

Maokola, W; Willey, B A; Shirima, K; Chemba, M; Armstrong Schellenberg, J R M; Mshinda, H; Alonso, P; Tanner, M; Schellenberg, D

2011-06-01

To describe and evaluate the use of handheld computers for the management of Health Management Information System data. Electronic data capture took place in 11 sentinel health centres in rural southern Tanzania. Information from children attending the outpatient department (OPD) and the Expanded Program on Immunization vaccination clinic was captured by trained local school-leavers, supported by monthly supervision visits. Clinical data included malaria blood slides and haemoglobin colour scale results. Quality of captured data was assessed using double data entry. Malaria blood slide results from health centre laboratories were compared to those from the study's quality control laboratory. The system took 5 months to implement, and few staffings or logistical problems were encountered. Over the following 12 months (April 2006-March 2007), 7056 attendances were recorded in 9880 infants aged 2-11 months, 50% with clinical malaria. Monthly supervision visits highlighted incomplete recording of information between OPD and laboratory records, where on average 40% of laboratory visits were missing the record of their corresponding OPD visit. Quality of microscopy from health facility laboratories was lower overall than that from the quality assurance laboratory. Electronic capture of HMIS data was rapidly and successfully implemented in this resource-poor setting. Electronic capture alone did not resolve issues of data completeness, accuracy and reliability, which are essential for management, monitoring and evaluation; suggestions to monitor and improve data quality are made. © 2011 Blackwell Publishing Ltd.

Step-By-Step Instructions for Retina Recordings with Perforated Multi Electrode Arrays

PubMed Central

Idrees, Saad; Mutter, Marion; Benkner, Boris; Münch, Thomas A.

2014-01-01

Multi-electrode arrays are a state-of-the-art tool in electrophysiology, also in retina research. The output cells of the retina, the retinal ganglion cells, form a monolayer in many species and are well accessible due to their proximity to the inner retinal surface. This structure has allowed the use of multi-electrode arrays for high-throughput, parallel recordings of retinal responses to presented visual stimuli, and has led to significant new insights into retinal organization and function. However, using conventional arrays where electrodes are embedded into a glass or ceramic plate can be associated with three main problems: (1) low signal-to-noise ratio due to poor contact between electrodes and tissue, especially in the case of strongly curved retinas from small animals, e.g. rodents; (2) insufficient oxygen and nutrient supply to cells located on the bottom of the recording chamber; and (3) displacement of the tissue during recordings. Perforated multi-electrode arrays (pMEAs) have been found to alleviate all three issues in brain slice recordings. Over the last years, we have been using such perforated arrays to study light evoked activity in the retinas of various species including mouse, pig, and human. In this article, we provide detailed step-by-step instructions for the use of perforated MEAs to record visual responses from the retina, including spike recordings from retinal ganglion cells and in vitro electroretinograms (ERG). In addition, we provide in-depth technical and methodological troubleshooting information, and show example recordings of good quality as well as examples for the various problems which might be encountered. While our description is based on the specific equipment we use in our own lab, it may also prove useful when establishing retinal MEA recordings with other equipment. PMID:25165854

[Security specifications for electronic medical records on the Internet].

PubMed

Mocanu, Mihai; Mocanu, Carmen

2007-01-01

The extension for the Web applications of the Electronic Medical Record seems both interesting and promising. Correlated with the expansion of Internet in our country, it allows the interconnection of physicians of different specialties and their collaboration for better treatment of patients. In this respect, the ophthalmologic medical applications consider the increased possibilities for monitoring chronic ocular diseases and for the identification of some elements for early diagnosis and risk factors supervision. We emphasize in this survey some possible solutions to the problems of interconnecting medical information systems to the Internet: the achievement of interoperability within medical organizations through the use of open standards, the automated input and processing for ocular imaging, the use of data reduction techniques in order to increase the speed of image retrieval in large databases, and, last but not least, the resolution of security and confidentiality problems in medical databases.

Effects of an Informational Brochure, Lottery-Based Financial Incentive, and Public Posting on Absenteeism of Direct-Care Human Services Employees

ERIC Educational Resources Information Center

Luiselli, James K.; DiGennaro Reed, Florence D.; Christian, Walter P.; Markowski, Andrea; Rue, Hanna C.; St. Amand, CarrieAnne; Ryan, Chad J.

2009-01-01

Chronic absenteeism is a problem encountered by many human services organizations. Large-scale intervention projects to reduce staff absences have incorporated applied behavior analysis methods but there are few studies in the extant literature. In the present study, the authors record staff absenteeism at a specialized school for students with…

Healthcare provider attitudes towards the problem list in an electronic health record: a mixed-methods qualitative study

PubMed Central

2012-01-01

Background The problem list is a key part of the electronic health record (EHR) that allows practitioners to see a patient’s diagnoses and health issues. Yet, as the content of the problem list largely represents the subjective decisions of those who edit it, patients’ problem lists are often unreliable when shared across practitioners. The lack of standards for how the problem list is compiled in the EHR limits its effectiveness in improving patient care, particularly as a resource for clinical decision support and population management tools. The purpose of this study is to discover practitioner opinions towards the problem list and the logic behind their decisions during clinical situations. Materials and methods An observational cross-sectional study was conducted at two major Boston teaching hospitals. Practitioners’ opinions about the problem list were collected through both in-person interviews and an online questionnaire. Questions were framed using vignettes of clinical scenarios asking practitioners about their preferred actions towards the problem list. Results These data confirmed prior research that practitioners differ in their opinions over managing the problem list, but in most responses to a questionnaire, there was a common approach among the relative majority of respondents. Further, basic demographic characteristics of providers (age, medical experience, etc.) did not appear to strongly affect attitudes towards the problem list. Conclusion The results supported the premise that policies and EHR tools are needed to bring about a common approach. Further, the findings helped identify what issues might benefit the most from a defined policy and the level of restriction a problem list policy should place on the addition of different types of information. PMID:23140312

Informed consent: what does it mean?

PubMed Central

Kirby, M D

1983-01-01

The editorial in the September 1982 issue of this journal and many articles before and since have addressed the problem of informed consent. Is it possible? Is it a useful concept? Is there anything new to be said about it? In this article the basic rationale of the rule (patient autonomy) is explained and the extent of the rule explored. Various exceptions have been offered by the law and an attempt is made to catalogue the chief of these. A number of specially vulnerable groups are then identified, the most important, and vexed, being children. How can informed consent be secured in the case of young patients? Finally, a few problems are mentioned in an attempt to get this subject back to reality. The appeal to the principle primum non nocere may be medical paternalism in disguise. Informed consent is the competing principle that reminds us of the primacy of human autonomy. A pointer is given to the future: even the use of sound recordings to explain medical procedures and to activate informed consent so that it may become a reality and not just a lawyer's myth, should be considered. PMID:6876100

A WWW-based information system on resistance of bacteria to antibiotics.

PubMed

Schindler, J; Schindler, Z; Schindler, J

1998-01-01

The information system on resistance of bacteria to antibiotics (WARN--World Antibiotic Resistance Network) is implemented as a WWW server at Charles University in Prague (http:/(/)www.warn.cas.cz). Its main goal is to give information about problems of antibiotic resistance of bacteria and to process data on isolated strains. The WARN web-site contains six main topics. Four of them form the core of the system: Topics of Interest bring information on selected timely topics in antibiotic resistance--pneumococci, staphylococci, beta-lactamases, glycopeptide--and aminoglycoside resistance. Global Monitor brings references and reports on resistance in the world as well as recommended method of surveillance. The topic Data contains raw data on strains in particular countries and hospitals. Data can be viewed in their original form as a list of records (strains) or processed to provide statistics about the resistance rates in the selected country or hospital respectively. The topic Search allows one to search for one or several terms in the whole document. Counts of accessed pages show, that there is a standing demand for information about the serious problems of antibiotic therapy of infectious diseases.

A content analysis of parents' written communication of needs and expectations for emergency care of their children.

PubMed

Hoppa, Eric Christopher; Porter, Stephen C

2011-06-01

We investigated the potential value of information shared by parents on a written form designed to capture needs and expectations for care to an emergency department (ED) system that values patient-centeredness. We conducted a retrospective content analysis of parent-completed written forms collected during an improvement project focused on parent-provider communication in a pediatric ED. The primary outcome was potential value of the completed forms to a patient-centered ED system, defined as a form that was legible, included observations that mapped to medical problems, and included reasonable parental requests. We analyzed variation in potential value and other form attributes across a priori-defined visit type and acuity. Visit type was validated by a separate, blinded medical record review. A random stratified sample of 1008 forms was established from 6937 parent-completed forms collected during the 6-month improvement project; 995 of 1008 forms had matching medical records; 922 (92.7%) of 995 forms demonstrated potential value; 990 (99.5%) of 995 forms were legible; 948 (95.3%) of 995 forms included observations that mapped to a medical problem, and 599 (93.3%) of 642 forms contained reasonable parental requests. There was good agreement between the form and medical record for visit type (κ = 0.62). The potential value of forms did not vary significantly across visit type (88.2%-92.8%) or acuity (88.9%-93.4%). Information shared by parents on written forms designed to capture needs and expectations provides potential value to a patient-centered ED system. The high level of informational value is consistent across patient type and acuity level.

IMASIS computer-based medical record project: dealing with the human factor.

PubMed

Martín-Baranera, M; Planas, I; Palau, J; Sanz, F

1995-01-01

The Institut Municipal d'Assistència Sanitària (IMAS) is a health care organization in Barcelona, comprising two general hospitals, a psychiatric hospital, a surgical clinic, a geriatric center, some primary care clinics, and a research institute. Since 1984, IMAS has been engaged in creating a multicenter integrated hospital information system (IMASIS). Currently, IMASIS offers the possibility to manage administrative data, laboratory results, pathology and cytology reports, radiology reports, and pharmacy inpatient orders; it also shares this information on-line among IMAS centers. IMASIS users may also work with a word processor, a spreadsheet, a database, or a statistical package and have access to MEDLINE. A second phase of IMASIS development began in December 1993 focused on clinical information management. The goal was to move towards an integrated multimedia medical record [1]. As a first step, the implementation experiences of the most advanced hospital information systems around the world were studied. Some of these experiences detected behavioral, cultural, and organizational factors [2] as the main sources of delay, or even failure, in HIS projects. A preliminary analysis to define such factors, assess their potential impact, and introduce adequate measures to deal with them seemed unavoidable before structuring of the project. In our approach to physician attitudes analysis, two survey techniques were applied. First, every hospital service head was contacted to schedule an interview, with either a service representative or a group of staff physicians and residents. The aim was to provide detailed information about project objectives and collect personal opinions, problems encountered in the current HIS, and specific needs of every medical and surgical specialty (including imaging needs). Every service head was asked to distribute a questionnaire among all clinicians, which assessed frequency of use of IMASIS current applications, user's satisfaction level, problems to be solved in utilization of the system, errors detected in the systems' database, and the personal interest in participating in the IMASIS project. The questionnaire was also intended to be a tool to monitor IMASIS evolution. Our study showed that medical staff had a lack of information about the current HIS, leading to a poor utilization of some system options. Another major characteristic, related to the above, was the feeling that the project would negatively affect the organization of work at the hospitals. A computer-based medical record was feared to degrade physician-patient relationship, introduce supplementary administrative burden in clinicians day-to-day work, unnecessarily slow history taking, and imply too-rigid patterns of work. The most frequent problems in using the current system could be classified into two groups: problems related to lack of agility and consistency in user interface design, and those derived from lack of a common patient identification number. Duplication of medical records was the most frequent error detected by physicians. Analysis of physicians' attitudes towards IMASIS revealed a lack of confidence globally. This was probably the consequence of two current features: a lack of complete information about IMASIS possibilities and problems faced when using the system. To deal with such factors, three types of measures have been planned. First, an effort is to be done to ensure that every physician is able to adequately use the current system and understands long-term benefits of the project. This task will be better accomplished by personal interaction between clinicians and a physician from the Informatics Department than through formal teaching of IMASIS. Secondly, a protocol for evaluating the HIS is being developed and will be systematically applied to detect both database errors and systemUs design pitfalls. Finally, the IMASIS project has to find a convenient point for starting, to offer short-term re

On necessity and sufficiency in counseling and psychotherapy (revisited).

PubMed

Lazarus, Arnold A

2007-09-01

It seems to me that Carl Rogers (see record 2007-14639-002) was far too ambitious in trying to specify general conditions of necessity and sufficiency that would be relevant to the entire spectrum of problems and the diverse expectancies and personalities of the people who seek our help. Rogers' position and orientation almost totally overlook the array of problems under the rubric of "response deficits" that stem from misinformation and missing information and call for active correction, training, and retraining. Rogers also paid scant attention to problems with significant biological determinants. Nevertheless, as exemplified by his seminal 1957 article and many other articles and books, Rogers made major contributions within the domain of the therapeutic alliance. Today, the scientific emphasis looks at accountability, the need to establish various treatments of choice, and the need to understand their presumed mechanisms. Treatment efficacy and generalizability across different methodologies are now considered key issues. The efficacy narrowing and clinically self-limiting consequences of adhering to one particular school of thought are now self-evident to most. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Rebuilding and the private cloud of the hospital information system by the virtualization technology.

PubMed

Yamashita, Yoshinori; Ogaito, Tatoku

2013-01-01

In our hospital, we managed an electronic health record system and many section subsystems as a hospital information system. By the expansion of these information systems, a system becomes complicated, and maintenance and operative cost increased. Furthermore, the environment that is available to medical information is demanded anywhere anytime by expansion of the computerization. However, the expansion of the information use becomes necessary for the expansion such as the personal protection of information for security. We became rebuilding and the private cloud of the hospital information system by the virtualization technology to solve such a problem. As a result, we were able to perform a decrease in number of the servers which constituted a system, a decrease in network traffic, reduction of the operative cost.

Privacy and policy for genetic research.

PubMed

DeCew, Judith Wagner

2004-01-01

I begin with a discussion of the value of privacy and what we lose without it. I then turn to the difficulties of preserving privacy for genetic information and other medical records in the face of advanced information technology. I suggest three alternative public policy approaches to the problem of protecting individual privacy and also preserving databases for genetic research: (1) governmental guidelines and centralized databases, (2) corporate self-regulation, and (3) my hybrid approach. None of these are unproblematic; I discuss strengths and drawbacks of each, emphasizing the importance of protecting the privacy of sensitive medical and genetic information as well as letting information technology flourish to aid patient care, public health and scientific research.

[Book review] Stevenson, H.M. & Anderson, B.H. 1994. The Birdlife of Florida

USGS Publications Warehouse

Kushlan, J.A.

1996-01-01

The book consists of species accounts of each species including, where information is available, such topics as overall distribution, Florida status, relative abundance, migration, haunts and habits, adverse factors, problems of identification, variation, references and a distribution map symbolically showing seasonal distribution records by county. The book also has an addendum of records in 1993-1994 and an extensive bibliography. Any faunistic treatment of Florida or study of the status of any Florida species will need to use the text as a starting point, although not necessarily an ending point. Those concerned with having the most solidly verified species list would be best advised to continue to use Robertson and Woolfenden's Annotated List and its successors. But for a compendium of information on the birds of this fascinating peninsula, one could do no better.

A National Medical Information System for Senegal: Architecture and Services.

PubMed

Camara, Gaoussou; Diallo, Al Hassim; Lo, Moussa; Tendeng, Jacques-Noël; Lo, Seynabou

2016-01-01

In Senegal, great amounts of data are daily generated by medical activities such as consultation, hospitalization, blood test, x-ray, birth, death, etc. These data are still recorded in register, printed images, audios and movies which are manually processed. However, some medical organizations have their own software for non-standardized patient record management, appointment, wages, etc. without any possibility of sharing these data or communicating with other medical structures. This leads to lots of limitations in reusing or sharing these data because of their possible structural and semantic heterogeneity. To overcome these problems we have proposed a National Medical Information System for Senegal (SIMENS). As an integrated platform, SIMENS provides an EHR system that supports healthcare activities, a mobile version and a web portal. The SIMENS architecture proposes also a data and application integration services for supporting interoperability and decision making.

Completeness of patient records in community pharmacies post-discharge after in-patient medication reconciliation: a before-after study.

PubMed

Karapinar-Çarkıt, Fatma; van Breukelen, Ben R L; Borgsteede, Sander D; Janssen, Marjo J A; Egberts, Antoine C G; van den Bemt, Patricia M L A

2014-08-01

Transfer of discharge medication related information to community pharmacies could improve continuity of care. This requires for community pharmacies to accurately update their patient records when new information is transferred. An instruction manual that specifies how to document information regarding medication changes and clinical information (i.e. allergies/contraindications) could support community pharmacies. To explore the effect of instruction manuals sent to community pharmacies on completeness of their patient records. A before-after study was performed (July 2009-August 2010) in the St Lucas Andreas Hospital, a general teaching hospital in Amsterdam, The Netherlands. Patients discharged from the cardiology and respiratory ward were included consecutively. The intervention consisted of a training session for community pharmacies regarding documentation problems and faxing an instruction manual to community pharmacies specifying how to document discharge information in their information system. Usual care consisted of faxing a discharge medication overview to community pharmacies without additional instructions. Two weeks after discharge the medication records of community pharmacies were collected by fax. These were compared with the initial discharge overviews regarding completeness of medication changes (i.e. explicit explanation that medication had been changed) and clinical information documentation. MAIN OUTCOME MEASURE OUTCOMES: were the number and percentage of completely documented medication changes (either needing to be dispensed or not) and clinical information items. The sample size was calculated at 107 patients per measurement period. Multivariable logistic regression was used for analysis. Two hundred and eighteen patients (112 before-106 after) were included. Completeness of medication changes documentation increased marginally after the intervention (46.6 vs 56.3 %, adjusted Odds Ratio 1.4 [95 % confidence interval 1.07-1.83]). Documentation increased when medication was actually dispensed by the community pharmacy. No significant improvements were seen for allergy and contraindication documentation. The intervention is insufficient to increase the completeness of documentation by community pharmacies as marginal improvements were achieved. Future studies should evaluate whether electronic infrastructures may help in achieving updated medication records to improve continuity of pharmaceutical care.

Ethical problems experienced by oncology nurses.

PubMed

da Luz, Kely Regina; Vargas, Mara Ambrosina de Oliveira; Schmidtt, Pablo Henrique; Barlem, Edison Luiz Devos; Tomaschewski-Barlem, Jamila Geri; da Rosa, Luciana Martins

2015-01-01

To know the ethical problems experienced by oncology nurses. Descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. For the effective confrontation of the ethical problems experienced by oncology nurses to occur, it is important to invest in the training of these professionals, preparing them in an ethical and human way to act as lawyers of the patient with cancer, in a context of dilemmas related mainly to the possibility of finitude.

Novel approaches to reducing uncertainty in regional climate predictions (Invited)

NASA Astrophysics Data System (ADS)

Ammann, C. M.

2009-12-01

Regional planning in preparation for future climate changes is rapidly gaining importance. However, compared to the global mean projections, correctly anticipating regional climate is often much more difficult, particularly with regard to hydrologic changes. The reason for the high, inherent uncertainty in location specific forecasts arises on one hand from the superposition of large internal variability in the atmosphere-ocean system on the more gradual changes. On the other hand, this problem is confounded by the fact that regional climate records are often short and therefore offer little guidance as to how an underlying trend can be identified within the noise. The use of indirect climate information (proxy records) from a host of natural archives has made significant progress recently. Based on an extended record, process studies can help reveal the regional response to changes in large scale climate that likely have to be expected. But in order to come up with robust, season and parameter specific (temperature versus moisture) climate reconstructions, comprehensive data compilations are needed that integrate proxy records of different characteristics, temporal representations, and different systematic and sampling uncertainties. Based on understanding of physical processes, and making explicit use of that knowledge, new dynamical and statistical techniques in paleoclimatology are being developed and explored. In addition to improved estimates of the past climate, the cascade of uncertainties is directly taken into account so that errors can more comprehensively be assessed. A brief overview of the problems and its potential implications for regional planning is followed by an application that demonstrates how collaboration between paleoclimatologists, climate modelers and statisticians can advance our understanding of the climate system and how agencies, businesses and individuals might be able to make better informed decisions in preparation for future climate.

Robust QRS peak detection by multimodal information fusion of ECG and blood pressure signals.

PubMed

Ding, Quan; Bai, Yong; Erol, Yusuf Bugra; Salas-Boni, Rebeca; Zhang, Xiaorong; Hu, Xiao

2016-11-01

QRS peak detection is a challenging problem when ECG signal is corrupted. However, additional physiological signals may also provide information about the QRS position. In this study, we focus on a unique benchmark provided by PhysioNet/Computing in Cardiology Challenge 2014 and Physiological Measurement focus issue: robust detection of heart beats in multimodal data, which aimed to explore robust methods for QRS detection in multimodal physiological signals. A dataset of 200 training and 210 testing records are used, where the testing records are hidden for evaluating the performance only. An information fusion framework for robust QRS detection is proposed by leveraging existing ECG and ABP analysis tools and combining heart beats derived from different sources. Results show that our approach achieves an overall accuracy of 90.94% and 88.66% on the training and testing datasets, respectively. Furthermore, we observe expected performance at each step of the proposed approach, as an evidence of the effectiveness of our approach. Discussion on the limitations of our approach is also provided.

A Compositional Relevance Model for Adaptive Information Retrieval

NASA Technical Reports Server (NTRS)

Mathe, Nathalie; Chen, James; Lu, Henry, Jr. (Technical Monitor)

1994-01-01

There is a growing need for rapid and effective access to information in large electronic documentation systems. Access can be facilitated if information relevant in the current problem solving context can be automatically supplied to the user. This includes information relevant to particular user profiles, tasks being performed, and problems being solved. However most of this knowledge on contextual relevance is not found within the contents of documents, and current hypermedia tools do not provide any easy mechanism to let users add this knowledge to their documents. We propose a compositional relevance network to automatically acquire the context in which previous information was found relevant. The model records information on the relevance of references based on user feedback for specific queries and contexts. It also generalizes such information to derive relevant references for similar queries and contexts. This model lets users filter information by context of relevance, build personalized views of documents over time, and share their views with other users. It also applies to any type of multimedia information. Compared to other approaches, it is less costly and doesn't require any a priori statistical computation, nor an extended training period. It is currently being implemented into the Computer Integrated Documentation system which enables integration of various technical documents in a hypertext framework.

The advantages and barriers in the implementation of a substance dependence treatment information system (SDTIS).

PubMed

Ajami, Sima; Mellat-Karkevandi, Zahra

2015-11-01

Addiction is a phenomenon that causes structural changes in different systems of society. Studies show for planning of addiction prevention and treatment, it is necessary to create an information management system. Substance dependence information systems refer to systems which collect, analyse and report data related to substance dependence information. The aim of this study was to identify advantages and barriers to implement Substance Dependence Treatment Information System (SDTIS). This study was a narrative review. Our review divided into three phases: literature collection, assessing, and selection. We employed the following keywords and their combinations in different areas of articles. In this study, 22 of collected articles and reports were selected based on their relevancy. We found many advantages for a substance dependence treatment information system such as recording sufficient, complete and accurate information and easy and timely access to them and monitoring and enhancing the quality of care received by patients. But we may face some concerns for implementing this information system like taking time and funds from client services, being expensive or even problems regarding the quality of data contained in these information systems. There are some important problems in the way of implementing. In order to overcome these issues, we need to raise community awareness.

The advantages and barriers in the implementation of a substance dependence treatment information system (SDTIS)

PubMed Central

Ajami, Sima; Mellat-Karkevandi, Zahra

2015-01-01

Addiction is a phenomenon that causes structural changes in different systems of society. Studies show for planning of addiction prevention and treatment, it is necessary to create an information management system. Substance dependence information systems refer to systems which collect, analyse and report data related to substance dependence information. The aim of this study was to identify advantages and barriers to implement Substance Dependence Treatment Information System (SDTIS). This study was a narrative review. Our review divided into three phases: literature collection, assessing, and selection. We employed the following keywords and their combinations in different areas of articles. In this study, 22 of collected articles and reports were selected based on their relevancy. We found many advantages for a substance dependence treatment information system such as recording sufficient, complete and accurate information and easy and timely access to them and monitoring and enhancing the quality of care received by patients. But we may face some concerns for implementing this information system like taking time and funds from client services, being expensive or even problems regarding the quality of data contained in these information systems. There are some important problems in the way of implementing. In order to overcome these issues, we need to raise community awareness. PMID:26941816

Electronic hand-drafting and picture management system.

PubMed

Yang, Tsung-Han; Ku, Cheng-Yuan; Yen, David C; Hsieh, Wen-Huai

2012-08-01

The Department of Health of Executive Yuan in Taiwan (R.O.C.) is implementing a five-stage project entitled Electronic Medical Record (EMR) converting all health records from written to electronic form. Traditionally, physicians record patients' symptoms, related examinations, and suggested treatments on paper medical records. Currently when implementing the EMR, all text files and image files in the Hospital Information System (HIS) and Picture Archiving and Communication Systems (PACS) are kept separate. The current medical system environment is unable to combine text files, hand-drafted files, and photographs in the same system, so it is difficult to support physicians with the recording of medical data. Furthermore, in surgical and other related departments, physicians need immediate access to medical records in order to understand the details of a patient's condition. In order to address these problems, the Department of Health has implemented an EMR project, with the primary goal of building an electronic hand-drafting and picture management system (HDP system) that can be used by medical personnel to record medical information in a convenient way. This system can simultaneously edit text files, hand-drafted files, and image files and then integrate these data into Portable Document Format (PDF) files. In addition, the output is designed to fit a variety of formats in order to meet various laws and regulations. By combining the HDP system with HIS and PACS, the applicability can be enhanced to fit various scenarios and can assist the medical industry in moving into the final phase of EMR.

Why Patient Matching Is a Challenge: Research on Master Patient Index (MPI) Data Discrepancies in Key Identifying Fields

PubMed Central

Just, Beth Haenke; Marc, David; Munns, Megan; Sandefer, Ryan

2016-01-01

Patient identification matching problems are a major contributor to data integrity issues within electronic health records. These issues impede the improvement of healthcare quality through health information exchange and care coordination, and contribute to deaths resulting from medical errors. Despite best practices in the area of patient access and medical record management to avoid duplicating patient records, duplicate records continue to be a significant problem in healthcare. This study examined the underlying causes of duplicate records using a multisite data set of 398,939 patient records with confirmed duplicates and analyzed multiple reasons for data discrepancies between those record matches. The field that had the greatest proportion of mismatches (nondefault values) was the middle name, accounting for 58.30 percent of mismatches. The Social Security number was the second most frequent mismatch, occurring in 53.54 percent of the duplicate pairs. The majority of the mismatches in the name fields were the result of misspellings (53.14 percent in first name and 33.62 percent in last name) or swapped last name/first name, first name/middle name, or last name/middle name pairs. The use of more sophisticated technologies is critical to improving patient matching. However, no amount of advanced technology or increased data capture will completely eliminate human errors. Thus, the establishment of policies and procedures (such as standard naming conventions or search routines) for front-end and back-end staff to follow is foundational for the overall data integrity process. Training staff on standard policies and procedures will result in fewer duplicates created on the front end and more accurate duplicate record matching and merging on the back end. Furthermore, monitoring, analyzing trends, and identifying errors that occur are proactive ways to identify data integrity issues. PMID:27134610

Longitudinal Analysis of New Information Types in Clinical Notes

PubMed Central

Zhang, Rui; Pakhomov, Serguei; Melton, Genevieve B.

2014-01-01

It is increasingly recognized that redundant information in clinical notes within electronic health record (EHR) systems is ubiquitous, significant, and may negatively impact the secondary use of these notes for research and patient care. We investigated several automated methods to identify redundant versus relevant new information in clinical reports. These methods may provide a valuable approach to extract clinically pertinent information and further improve the accuracy of clinical information extraction systems. In this study, we used UMLS semantic types to extract several types of new information, including problems, medications, and laboratory information. Automatically identified new information highly correlated with manual reference standard annotations. Methods to identify different types of new information can potentially help to build up more robust information extraction systems for clinical researchers as well as aid clinicians and researchers in navigating clinical notes more effectively and quickly identify information pertaining to changes in health states. PMID:25717418

Explanations and information-giving: clinician strategies used in talking to parents of preterm infants.

PubMed

Redshaw, M E; Harvey, M E

2016-02-11

The study is part of a larger research programme on neonatal brain imaging in the trial element of which parents were randomised to receive prognostic information based upon either magnetic resonance imaging (MRI) or ultrasound findings (ePrime study). The aim of this study was to investigate the strategies used by clinicians in communicating with parents following imaging at term age of the brain of preterm infants born before 33 weeks gestation, focusing on explanations and information-giving about prognosis  Audio recordings of discussions between parents and clinicians were made following MRI and ultrasound assessment. Parents were given the scan result and the baby's predicted prognosis. A framework was developed based on preliminary analysis of the recordings and findings of other studies of information-giving in healthcare. Communication of scan results by the clinicians was further explored in qualitative analysis with 36 recordings using NVivo 10 and the specifically developed framework. Emerging themes and associated sub-themes were identified. The ways in which clinicians gave information and helped parents to understand were identified. Within the over-arching theme of clinician strategies a wide range of approaches were used to facilitate parental understanding. These included orienting, checking on previously acquired information, using analogies, explaining terminology, pacing the information, confirming understanding, inviting clarification, answering parents' questions and recapping at intervals. Ultimately four key themes were identified: 'Framing the information-giving', 'What we are looking at', 'Presenting the numbers and explaining the risk' and 'Appreciating the position of parents'. The interviews represent a multifaceted situation in which there is a tension between the need to explain and inform and the inherent complexity of neurological development, potential problems following preterm birth and the technology used to investigate and monitor these.

Utilization of Dental General Anaesthesia for Children

PubMed Central

Karim, Zarina Abdul; Musa, Normaizura; Noor, Siti Noor Fazliah Mohd

2008-01-01

Dental treatment under general anaesthesia may be needed for some children and adolescents due to medical or behaviour problem. The objective of the study is to identify the type of treatment that has been carried out under GA in Hospital Universiti Sains Malaysia (HUSM). A retrospective record review study from hospital records of dental patients (under 18 years old) receiving dental treatment under GA from 2003 until 2007 were retrieved from the database. Information such as the reason for GA, and the type of treatment provided was recorded in data sheet. The data were analyzed using SPSS 12.0.1 for Windows. It was checked and verified for errors. A total of 349 cases were treated of which 43.6% had medical problems. Patients were mostly diagnosed to have rampant caries (77.1%) and some of them have behavioural problems (34.4%). Treatment pattern in deciduous dentition revealed more extraction (97.8%) as compared to restoration (75.7%) whereas in permanent dentition more restoration was done (24.3%) as compared to extraction (2.2%). Majority of the restorations were done using Glass Ionomer Cements (47.5%). Biopsy (4.3%) contributed mainly to the surgery (24.1%) done during GA. General anesthesia is necessary when dental disease is interfering with health and general well-being of patient and it can facilitated dental treatment allowing dentists to benefit from improved treatment conditions and provide a higher quality of care. PMID:22570587

Life Course Trajectories of Labour Market Participation among Young Adults Who Experienced Severe Alcohol-Related Health Outcomes: A Retrospective Cohort Study

PubMed Central

Paljärvi, Tapio; Martikainen, Pekka; Pensola, Tiina; Leinonen, Taina; Herttua, Kimmo; Mäkelä, Pia

2015-01-01

Background Long-term employment trajectories of young problem drinkers are poorly understood. Methods We constructed retrospective labour market participation histories at ages 18–34 of 64 342 persons born in 1969–1982. Beginning from the year of each subject’s 18th birthday, we extracted information from the records of Statistics Finland on educational attainment, main type of economic activity, months in employment, and months in unemployment for a minimum of seven years (range 7–16 years). We used information on the timing of alcohol-related hospitalizations and deaths in the same period to define problem drinkers with early onset limited course, early onset persistent course, and late onset problem drinking. Results Early onset limited course problem drinkers improved their employment considerably by age, whereas early onset persistent problem drinkers experienced a constant decline in their employment by age. From the age of 18 to 34, early onset persistent problem drinkers were in employment merely 12% of the time, in comparison with 39% among the early onset limited course problem drinkers, and 58% among the general population. Conclusions These results indicate that young adults who were retrospectively defined as having early onset persistent course problem drinking were extensively marginalized from the labour market early on during their life course, and that their employment trajectory was significantly worse compared to other problem drinkers. PMID:25938764

Legal issues of the electronic dental record: security and confidentiality.

PubMed

Szekely, D G; Milam, S; Khademi, J A

1996-01-01

Computer-based, electronic dental record keeping involves complex issues of patient privacy and the dental practitioner's ethical duty of confidentiality. Federal and state law is responding to the new legal issues presented by computer technology. Authenticating the electronic record in terms of ensuring its reliability and accuracy is essential in order to protect its admissibility as evidence in legal actions. Security systems must be carefully planned to limit access and provide for back-up and storage of dental records. Carefully planned security systems protect the patient from disclosure without the patient's consent and also protect the practitioner from the liability that would arise from such disclosure. Human errors account for the majority of data security problems. Personnel security is assured through pre-employment screening, employment contracts, policies, and staff education. Contracts for health information systems should include provisions for indemnification and ensure the confidentiality of the system by the vendor.

To Get Rid of a Difficult Employee, a College May Hush Up Problems in a Professor's Past.

ERIC Educational Resources Information Center

Leatherman, Courtney

1996-01-01

The common practice of keeping negative information about a faculty member quiet if he agrees to resign quietly is criticized by some who find it unethical or illegal. They feel employers should disclose full employment records. Others warn that colleges may invade the privacy of a professor or defame him by passing on unsubstantiated charges to a…

[Management of Personal Information in Clinical Laboratory Medicine:--Chairmen's Introductory Remarks].

PubMed

Yoshida, Hiroshi; Shimetani, Naoto

2014-11-01

The Japanese Society of Laboratory Medicine has been running its own Medical Safety Committee, and holding a symposium on medical safety during the annual meeting. The medical world is filled with a considerable amount of personal information, including genetic information, the ultimate personal information. We, as medical staff, have to manage such personal information not only in times of peace but also during disasters or emergency situations. In Japan, the Act on the Protection of Personal Information is currently being implemented, but a number of problems remain. Human beings have entered the information technology era, including electrical medical record systems, which is useful for research and education besides medical practice. This is why personal information must be more effectively protected from leakage, misconception, and abuse. We should create a sound system to manage personal information, with the spirit of protecting patient information that originated from the Oath of Hippocrates.

Testing a Nursing-Specific Model of Electronic Patient Record documentation with regard to information completeness, comprehensiveness and consistency.

PubMed

von Krogh, Gunn; Nåden, Dagfinn; Aasland, Olaf Gjerløw

2012-10-01

To present the results from the test site application of the documentation model KPO (quality assurance, problem solving and caring) designed to impact the quality of nursing information in electronic patient record (EPR). The KPO model was developed by means of consensus group and clinical testing. Four documentation arenas and eight content categories, nursing terminologies and a decision-support system were designed to impact the completeness, comprehensiveness and consistency of nursing information. The testing was performed in a pre-test/post-test time series design, three times at a one-year interval. Content analysis of nursing documentation was accomplished through the identification, interpretation and coding of information units. Data from the pre-test and post-test 2 were subjected to statistical analyses. To estimate the differences, paired t-tests were used. At post-test 2, the information is found to be more complete, comprehensive and consistent than at pre-test. The findings indicate that documentation arenas combining work flow and content categories deduced from theories on nursing practice can influence the quality of nursing information. The KPO model can be used as guide when shifting from paper-based to electronic-based nursing documentation with the aim of obtaining complete, comprehensive and consistent nursing information. © 2012 Blackwell Publishing Ltd.

The Pocket Psychiatrist: Tools to enhance psychiatry education in family medicine.

PubMed

Bass, Deanna; Brandenburg, Dana; Danner, Christine

2015-01-01

Primary care is the setting where the majority of patients seek assistance for their mental health problems. To assist family medicine residents in providing effective care to patients for mental health problems during residency and after graduation, it is essential they receive training in the assessment, diagnosis, and treatment of common mental health conditions. While there is some limited education time with a psychiatrist in our department, residents need tools and resources that provide education during their continuity clinics even when the psychiatrist is not available. Information on two tools that were developed is provided. These tools include teaching residents a brief method for conducting a psychiatric interview as well as a means to access evidence-based information on diagnosis and treatment of mental health conditions through templates available within our electronic medical record. © The Author(s) 2015.

Tools for Protecting the Privacy of Specific Individuals in Video

NASA Astrophysics Data System (ADS)

Chen, Datong; Chang, Yi; Yan, Rong; Yang, Jie

2007-12-01

This paper presents a system for protecting the privacy of specific individuals in video recordings. We address the following two problems: automatic people identification with limited labeled data, and human body obscuring with preserved structure and motion information. In order to address the first problem, we propose a new discriminative learning algorithm to improve people identification accuracy using limited training data labeled from the original video and imperfect pairwise constraints labeled from face obscured video data. We employ a robust face detection and tracking algorithm to obscure human faces in the video. Our experiments in a nursing home environment show that the system can obtain a high accuracy of people identification using limited labeled data and noisy pairwise constraints. The study result indicates that human subjects can perform reasonably well in labeling pairwise constraints with the face masked data. For the second problem, we propose a novel method of body obscuring, which removes the appearance information of the people while preserving rich structure and motion information. The proposed approach provides a way to minimize the risk of exposing the identities of the protected people while maximizing the use of the captured data for activity/behavior analysis.

The computerized OMAHA system in microsoft office excel.

PubMed

Lai, Xiaobin; Wong, Frances K Y; Zhang, Peiqiang; Leung, Carenx W Y; Lee, Lai H; Wong, Jessica S Y; Lo, Yim F; Ching, Shirley S Y

2014-01-01

The OMAHA System was adopted as the documentation system in an interventional study. To systematically record client care and facilitate data analysis, two Office Excel files were developed. The first Excel file (File A) was designed to record problems, care procedure, and outcomes for individual clients according to the OMAHA System. It was used by the intervention nurses in the study. The second Excel file (File B) was the summary of all clients that had been automatically extracted from File A. Data in File B can be analyzed directly in Excel or imported in PASW for further analysis. Both files have four parts to record basic information and the three parts of the OMAHA System. The computerized OMAHA System simplified the documentation procedure and facilitated the management and analysis of data.

Perceived Barriers and Enablers of Help-Seeking for Substance Use Problems During Adolescence.

PubMed

Berridge, Bonita J; McCann, Terence V; Cheetham, Ali; Lubman, Dan I

2018-01-01

Receiving professional help early can reduce long-term harms associated with substance use. However, little is known about the factors that influence help-seeking for substance use problems during early-mid adolescence, prior to the emergence of disorder. Given that beliefs regarding help-seeking are likely to develop early, understanding adolescent views of help-seeking during this period is likely to provide important information for prevention and intervention efforts. The current study identifies perceptions that would facilitate or prevent adolescents from seeking support for substance use problems from formal and informal help sources. Thirty-four 12- to 16-year-olds from two schools in Melbourne, Victoria, Australia, were recruited. A qualitative interpretative design was used, incorporating semistructured, audio-recorded interviews. Three overlapping themes that reflected barriers or enablers to help-seeking were identified: approachability, confidentiality and trustworthiness, and expertise. Help-seeking was facilitated when adolescents believed that the help source would be supportive and understanding, would keep information confidential, and had expertise in the alcohol and drug field. Conversely, adolescents were reluctant to seek help from sources they believed would be judgmental, lacked expertise, or would inform their parents. These findings highlight perceptions that may influence help-seeking for alcohol and drug problems during adolescence. Further research is needed to determine if help-seeking can be facilitated by improving parents' and peers' knowledge and promoting health professionals' expertise in working with young people's alcohol and drug issues.

Technology Implementation and Workarounds in the Nursing Home

PubMed Central

Vogelsmeier, Amy A.; Halbesleben, Jonathon R.B.; Scott-Cawiezell, Jill R.

2008-01-01

Objective This study sought to explore the relationship of workarounds related to the implementation of an electronic medication administration record and medication safety practices in five Midwestern nursing homes. Design As a part of a larger study, this qualitative evaluation was conducted to identify workarounds associated with the implementation of an electronic medication administration record. Data were collected using multimethods including direct observation, process mapping, key informant interviews, and review of field notes from medication safety team meetings. Measurements Open and axial coding techniques were used to identify and categorize types of workarounds in relation to work flow blocks. Results Workarounds presented in two distinct patterns, those related to work flow blocks introduced by technology and those related to organizational processes not reengineered to effectively integrate with the technology. Workarounds such as safety alert overrides and shortcuts to documentation resulted from first-order problem solving of immediate blocks. Nursing home staff as individuals frequently used first-order problem solving instead of the more sophisticated second-order problem solving approach used by the medication safety team. Conclusion This study provides important practical examples of how nursing home staff work around work flow blocks encountered during the implementation of technology. Understanding these workarounds as a means of first-order problem solving is an important consideration to understanding risk to medication safety. PMID:17947626

Tactical reconnaissance recorder alternatives

NASA Astrophysics Data System (ADS)

Klang, Mark R.

1997-11-01

The actual collection of data, such as digital imagery, using the multitude of sensors available today and in the near future, requires a high data rate digital recorder. The amount of memory, data rates, environmental factors and affordability are important issues when selecting the type of recording system. This paper will discuss two types of systems, tape and solid state. Emphasis will be placed on operational factors and specific mission profiles that are associated with a tactical reconnaissance mission. The current and projected costs of the digital tape recorder and soli state recorder will be examined. The logistics of moving the data from the aircraft to a Ground Exploitation System will be discussed. Once the data is collected it needs to be stored in non-volatile memory with easy access. One of the major problems encountered during Desert Storm was the inability to locate and retrieve reconnaissance images. A data base that can store terabytes of data and have the ability to recall this information from off-site locations should be a requirement for a Desert Storm scenario.

Using Benford's law to investigate Natural Hazard dataset homogeneity.

PubMed

Joannes-Boyau, Renaud; Bodin, Thomas; Scheffers, Anja; Sambridge, Malcolm; May, Simon Matthias

2015-07-09

Working with a large temporal dataset spanning several decades often represents a challenging task, especially when the record is heterogeneous and incomplete. The use of statistical laws could potentially overcome these problems. Here we apply Benford's Law (also called the "First-Digit Law") to the traveled distances of tropical cyclones since 1842. The record of tropical cyclones has been extensively impacted by improvements in detection capabilities over the past decades. We have found that, while the first-digit distribution for the entire record follows Benford's Law prediction, specific changes such as satellite detection have had serious impacts on the dataset. The least-square misfit measure is used as a proxy to observe temporal variations, allowing us to assess data quality and homogeneity over the entire record, and at the same time over specific periods. Such information is crucial when running climatic models and Benford's Law could potentially be used to overcome and correct for data heterogeneity and/or to select the most appropriate part of the record for detailed studies.

Pixelated camouflage patterns from the perspective of hyperspectral imaging

NASA Astrophysics Data System (ADS)

Racek, František; Jobánek, Adam; Baláž, Teodor; Krejčí, Jaroslav

2016-10-01

Pixelated camouflage patterns fulfill the role of both principles the matching and the disrupting that are exploited for blending the target into the background. It means that pixelated pattern should respect natural background in spectral and spatial characteristics embodied in micro and macro patterns. The HS imaging plays the similar, however the reverse role in the field of reconnaissance systems. The HS camera fundamentally records and extracts both the spectral and spatial information belonging to the recorded scenery. Therefore, the article deals with problems of hyperspectral (HS) imaging and subsequent processing of HS images of pixelated camouflage patterns which are among others characterized by their specific spatial frequency heterogeneity.

A lack of vision: evidence for poor communication of visual problems and support needs in education statements/plans for children with SEN.

PubMed

Little, J-A; Saunders, K J

2015-02-01

Visual dysfunction is more common in children with neurological impairments and previous studies have recommended such children receive visual and refractive assessment. In the UK, children with neurological impairment often have educational statementing for Special Educational Needs (SEN) and the statement should detail all health care and support needs to ensure the child's needs are met during school life. This study examined the representation of visual information in statements of SEN and compared this to orthoptic visual information from school visual assessments for children in a special school in Northern Ireland, UK. The parents of 115 school children in a special school were informed about the study via written information. Participation involved parents permitting the researchers to access their child's SEN educational statement and orthoptic clinical records. Statement information was accessed for 28 participants aged between four and 19 years; 25 contained visual information. Two participants were identified in their statements as having a certification of visual impairment. An additional 10 children had visual acuity ≥ 0.3 logMAR. This visual deficit was not reported in statements in eight out of these 12 cases (67%). 11 participants had significant refractive error and wore spectacles, but only five (45%) had this requirement recorded in their statement. Overall, 10 participants (55%) had either reduced visual acuity or significant refractive error which was not recorded in their statement. Despite additional visual needs being common, and described in clinical records, the majority of those with reduced vision and/or spectacle requirements did not have this information included in their statement. If visual limitations are not recognized by educational services, the child's needs may not be met during school life. More comprehensive eye care services, embedded with stakeholder communication and links to education are necessary to improve understanding of vision for children with neurological impairments. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Smart cards--the key to trustworthy health information systems.

PubMed Central

Neame, R.

1997-01-01

Some 20 years after they were first developed, "smart cards" are set to play a crucial part in healthcare systems. Last year about a billion were supplied, mainly for use in the financial sector, but their special features make them of particular strategic importance for the health sector, where they offer a ready made solution to some key problems of security and confidentiality. This article outlines what smart cards are and why they are so important in managing health information. I discuss some of the unique features of smart cards that are of special importance in the development of secure and trustworthy health information systems. Smart cards would enable individuals' identities to be authenticated and communications to be secured and would provide the mechanisms for implementing strong security, differential access to data, and definitive audit trails. Patient cards can also with complete security carry personal details, data on current health problems and medications, emergency care data, and pointers to where medical records for the patient can be found. Provider cards can in addition carry authorisations and information on computer set up. PMID:9055719

[Problem based learning from the perspective of tutors].

PubMed

Navarro Hernández, Nancy; Illesca P, Mónica; Cabezas G, Mirtha

2009-02-01

Problem based learning is a student centered learning technique that develops deductive, constructive and reasoning capacities among the students. Teachers must adapt to this paradigm of constructing rather than transmitting knowledge. To interpret the importance of tutors in problem based learning during a module of Health research and management given to medical, nursing, physical therapy, midwifery, technology and nutrition students. Eight teachers that participated in a module using problem based learning accepted to participate in an in depth interview. The qualitative analysis of the textual information recorded, was performed using the ATLAS software. We identified 662 meaning units, grouped in 29 descriptive categories, with eight emerging meta categories. The sequential and cross-generated qualitative analysis generated four domains: competence among students, competence of teachers, student-centered learning and evaluation process. Multiprofessional problem based learning contributes to the development of generic competences among future health professionals, such as multidisciplinary work, critical capacity and social skills. Teachers must shelter the students in the context of their problems and social situation.

Marital hostility and child sleep problems: direct and indirect associations via hostile parenting.

PubMed

Rhoades, Kimberly A; Leve, Leslie D; Harold, Gordon T; Mannering, Anne M; Neiderhiser, Jenae M; Shaw, Daniel S; Natsuaki, Misaki N; Reiss, David

2012-08-01

The current study examined two family process predictors of parent-reported child sleep problems at 4.5 years in an adoption sample: marital hostility and hostile parenting. Participants were 361 linked triads of birth parents, adoptive parents, and adopted children. We examined direct and indirect pathways from marital hostility to child sleep problems via hostile parenting. Mothers' marital hostility at 9 months was associated with child sleep problems at 4.5 years. Fathers' marital hostility at 9 months evidenced an indirect effect on child sleep problems at 4.5 years via fathers' hostile parenting at 27 months. Findings were significant even after controlling for genetic influences on child sleep (i.e., birth parent internalizing disorders). The findings suggest targets for prevention and intervention programs that are potentially modifiable (e.g., hostile parenting, marital hostility), and inform theory by demonstrating that relations among marital hostility, hostile parenting, and child sleep problems are significant after accounting for genetic influences. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Model-free data analysis for source separation based on Non-Negative Matrix Factorization and k-means clustering (NMFk)

NASA Astrophysics Data System (ADS)

Vesselinov, V. V.; Alexandrov, B.

2014-12-01

The identification of the physical sources causing spatial and temporal fluctuations of state variables such as river stage levels and aquifer hydraulic heads is challenging. The fluctuations can be caused by variations in natural and anthropogenic sources such as precipitation events, infiltration, groundwater pumping, barometric pressures, etc. The source identification and separation can be crucial for conceptualization of the hydrological conditions and characterization of system properties. If the original signals that cause the observed state-variable transients can be successfully "unmixed", decoupled physics models may then be applied to analyze the propagation of each signal independently. We propose a new model-free inverse analysis of transient data based on Non-negative Matrix Factorization (NMF) method for Blind Source Separation (BSS) coupled with k-means clustering algorithm, which we call NMFk. NMFk is capable of identifying a set of unique sources from a set of experimentally measured mixed signals, without any information about the sources, their transients, and the physical mechanisms and properties controlling the signal propagation through the system. A classical BSS conundrum is the so-called "cocktail-party" problem where several microphones are recording the sounds in a ballroom (music, conversations, noise, etc.). Each of the microphones is recording a mixture of the sounds. The goal of BSS is to "unmix'" and reconstruct the original sounds from the microphone records. Similarly to the "cocktail-party" problem, our model-freee analysis only requires information about state-variable transients at a number of observation points, m, where m > r, and r is the number of unknown unique sources causing the observed fluctuations. We apply the analysis on a dataset from the Los Alamos National Laboratory (LANL) site. We identify and estimate the impact and sources are barometric pressure and water-supply pumping effects. We also estimate the location of the water-supply pumping wells based on the available data. The possible applications of the NMFk algorithm are not limited to hydrology problems; NMFk can be applied to any problem where temporal system behavior is observed at multiple locations and an unknown number of physical sources are causing these fluctuations.

Locating relevant patient information in electronic health record data using representations of clinical concepts and database structures.

PubMed

Pan, Xuequn; Cimino, James J

2014-01-01

Clinicians and clinical researchers often seek information in electronic health records (EHRs) that are relevant to some concept of interest, such as a disease or finding. The heterogeneous nature of EHRs can complicate retrieval, risking incomplete results. We frame this problem as the presence of two gaps: 1) a gap between clinical concepts and their representations in EHR data and 2) a gap between data representations and their locations within EHR data structures. We bridge these gaps with a knowledge structure that comprises relationships among clinical concepts (including concepts of interest and concepts that may be instantiated in EHR data) and relationships between clinical concepts and the database structures. We make use of available knowledge resources to develop a reproducible, scalable process for creating a knowledge base that can support automated query expansion from a clinical concept to all relevant EHR data.

1. On note taking.

PubMed

Plaut, Alfred B J

2005-02-01

In this paper the author explores the theoretical and technical issues relating to taking notes of analytic sessions, using an introspective approach. The paper discusses the lack of a consistent approach to note taking amongst analysts and sets out to demonstrate that systematic note taking can be helpful to the analyst. The author describes his discovery that an initial phase where as much data was recorded as possible did not prove to be reliably helpful in clinical work and initially actively interfered with recall in subsequent sessions. The impact of the nature of the analytic session itself and the focus of the analyst's interest on recall is discussed. The author then describes how he modified his note taking technique to classify information from sessions into four categories which enabled the analyst to select which information to record in notes. The characteristics of memory and its constructive nature are discussed in relation to the problems that arise in making accurate notes of analytic sessions.

Surveillance of occupational noise exposures using OSHA's Integrated Management Information System.

PubMed

Middendorf, Paul J

2004-11-01

Exposure to noise has long been known to cause hearing loss, and is an ubiquitous problem in workplaces. Occupational noise exposures for industries stored in the Occupational Safety and Health Administration's (OSHA) Integrated Management Information System (IMIS) can be used to identify temporal and industrial trends of noise exposure to anticipate changes in rates of hearing loss. The noise records in OSHA's IMIS database for 1979-1999 were extracted by major industry division and measurement criteria. The noise exposures were summarized by year, industry, and employment size. The majority of records are from Manufacturing and Services. Exposures in Manufacturing and Services have decreased during the period, except that PEL exposures measured by federal enforcement increased from 1995 to 1999. Noise exposures in manufacturing have been reduced since the late 1970s, except those documented by federal enforcement. Noise exposure data outside manufacturing is not well represented in IMIS. Copyright 2004 Wiley-Liss, Inc.

Mishaps with Oxygen in NASA Operations

NASA Technical Reports Server (NTRS)

Ordin, Paul M.

1971-01-01

Data from a substantial number of oxygen mishaps obtained from NASA and contractor records are presented. Information from several Air Force records, concerning oxygen accidents involving aircraft operations, are also included. Descriptions of the mishaps and their causes, for both liquid and gaseous oxygen in ground test facilities and space vehicle systems, are given. A number of safety regulations aimed at reducing the accident probability is discussed. The problems related to material compatibility and materials testing are considered, and the limited information on factors affecting the ignition of materials in oxygen is presented. In addition, details are given of several of the accident/incidents listed in order to define the combination of conditions causing the mishap. In addition to propellant system mishaps, accident/incidents which occurred in space and ground system structures were included, as well as those in electrical systems, ground support facilities, ordnance, and related operations.

Graphical correlation of gaging-station records

USGS Publications Warehouse

Searcy, James K.

1960-01-01

A gaging-station record is a sample of the rate of flow of a stream at a given site. This sample can be used to estimate the magnitude and distribution of future flows if the record is long enough to be representative of the long-term flow of the stream. The reliability of a short-term record for estimating future flow characteristics can be improved through correlation with a long-term record. Correlation can be either numerical or graphical, but graphical correlation of gaging-station records has several advantages. The graphical correlation method is described in a step-by-step procedure with an illustrative problem of simple correlation, illustrative problems of three examples of multiple correlation--removing seasonal effect--and two examples of correlation of one record with two other records. Except in the problem on removal of seasonal effect, the same group of stations is used in the illustrative problems. The purpose of the problems is to illustrate the method--not to show the improvement that can result from multiple correlation as compared with simple correlation. Hydrologic factors determine whether a usable relation exists between gaging-station records. Statistics is only a tool for evaluating and using an existing relation, and the investigator must be guided by a knowledge of hydrology.

Subaru FATS (fault tracking system)

NASA Astrophysics Data System (ADS)

Winegar, Tom W.; Noumaru, Junichi

2000-07-01

The Subaru Telescope requires a fault tracking system to record the problems and questions that staff experience during their work, and the solutions provided by technical experts to these problems and questions. The system records each fault and routes it to a pre-selected 'solution-provider' for each type of fault. The solution provider analyzes the fault and writes a solution that is routed back to the fault reporter and recorded in a 'knowledge-base' for future reference. The specifications of our fault tracking system were unique. (1) Dual language capacity -- Our staff speak both English and Japanese. Our contractors speak Japanese. (2) Heterogeneous computers -- Our computer workstations are a mixture of SPARCstations, Macintosh and Windows computers. (3) Integration with prime contractors -- Mitsubishi and Fujitsu are primary contractors in the construction of the telescope. In many cases, our 'experts' are our contractors. (4) Operator scheduling -- Our operators spend 50% of their work-month operating the telescope, the other 50% is spent working day shift at the base facility in Hilo, or day shift at the summit. We plan for 8 operators, with a frequent rotation. We need to keep all operators informed on the current status of all faults, no matter the operator's location.

Physicians in nonprimary care and small practices and those age 55 and older lag in adopting electronic health record systems.

PubMed

Decker, Sandra L; Jamoom, Eric W; Sisk, Jane E

2012-05-01

By 2011 more than half of all office-based physicians were using electronic health record systems, but only about one-third of those physicians had systems with basic features such as the abilities to record information on patient demographics, view laboratory and imaging results, maintain problem lists, compile clinical notes, or manage computerized prescription ordering. Basic features are considered important to realize the potential of these systems to improve health care. We found that although trends in adoption of electronic health record systems across geographic regions converged from 2002 through 2011, adoption continued to lag for non-primary care specialists, physicians age fifty-five and older, and physicians in small (1-2 providers) and physician-owned practices. Federal policies are specifically aimed at encouraging primary care providers and small practices to achieve widespread use of electronic health records. To achieve their nationwide adoption, federal policies may also have to focus on encouraging adoption among non-primary care specialists, as well as addressing persistent gaps in the use of electronic record systems by practice size, physician age, and ownership status.

Information recovery from high-speed silver halide emulsions containing CRT traces after exposure to nuclear gamma radiation

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

Dittmore, C. H.

1974-03-01

A data recovery problem often occurs in nuclear tests when photographic film used to record CRT traces is unavoidably exposed fo gamma rays before it can be retrieved for developing. Studies made to improve recovery of the CRT data from such film are described. Best results were obtained with a procedure involving reversal processing, silver intensification, dye-coupling development, and duplication. (auth)

Navy Occupational Health Information Management System (NOHIMS). Users’ Reference Manual. COSTAR (Computer-Stored Ambulatory Record System). Operators Guide

DTIC Science & Technology

1987-05-01

AUDIOGRAM DAY Of WEEK MJIL-TIME-DAY HOURS SINCE ENT PROBLEM AT TIME OF TESI do,~iiII. r___1 ISON WEDHURSA LAST~ N II-o 2YE LIii. I2 MON T-URS I E...POS ’REI...such as CHEMISTRY, HEMATOLOGY, MICROBIOLOGY , RADIOLOGY, and MISCELLANEOUS. The date is displayed in the same format as previously described. The

Design and Evaluation of a Real-Time Video Conferencing Environment for Support Teaching: An Attempt to Promote Equality of K-12 Education in China

ERIC Educational Resources Information Center

Xiong, Caiping; Ge, Jun; Wang, Qiyun; Wang, Xuejun

2017-01-01

Imbalanced allocation of teacher resources is a major factor causing inequality in K-12 education in China. Traditional ways to solve this problem, such as on-site support teaching and recorded lectures of quality teachers, have posed many defects. It is suggested that information and communication technology should be employed to deal with the…

Extracting Low-Frequency Information from Time Attenuation in Elastic Waveform Inversion

NASA Astrophysics Data System (ADS)

Guo, Xuebao; Liu, Hong; Shi, Ying; Wang, Weihong

2017-03-01

Low-frequency information is crucial for recovering background velocity, but the lack of low-frequency information in field data makes inversion impractical without accurate initial models. Laplace-Fourier domain waveform inversion can recover a smooth model from real data without low-frequency information, which can be used for subsequent inversion as an ideal starting model. In general, it also starts with low frequencies and includes higher frequencies at later inversion stages, while the difference is that its ultralow frequency information comes from the Laplace-Fourier domain. Meanwhile, a direct implementation of the Laplace-transformed wavefield using frequency domain inversion is also very convenient. However, because broad frequency bands are often used in the pure time domain waveform inversion, it is difficult to extract the wavefields dominated by low frequencies in this case. In this paper, low-frequency components are constructed by introducing time attenuation into the recorded residuals, and the rest of the method is identical to the traditional time domain inversion. Time windowing and frequency filtering are also applied to mitigate the ambiguity of the inverse problem. Therefore, we can start at low frequencies and to move to higher frequencies. The experiment shows that the proposed method can achieve a good inversion result in the presence of a linear initial model and records without low-frequency information.

Acceptability of a personally controlled health record in a community-based setting: implications for policy and design.

PubMed

Weitzman, Elissa R; Kaci, Liljana; Mandl, Kenneth D

2009-04-29

Consumer-centered health information systems that address problems related to fragmented health records and disengaged and disempowered patients are needed, as are information systems that support public health monitoring and research. Personally controlled health records (PCHRs) represent one response to these needs. PCHRs are a special class of personal health records (PHRs) distinguished by the extent to which users control record access and contents. Recently launched PCHR platforms include Google Health, Microsoft's HealthVault, and the Dossia platform, based on Indivo. To understand the acceptability, early impacts, policy, and design requirements of PCHRs in a community-based setting. Observational and narrative data relating to acceptability, adoption, and use of a personally controlled health record were collected and analyzed within a formative evaluation of a PCHR demonstration. Subjects were affiliates of a managed care organization run by an urban university in the northeastern United States. Data were collected using focus groups, semi-structured individual interviews, and content review of email communications. Subjects included: n = 20 administrators, clinicians, and institutional stakeholders who participated in pre-deployment group or individual interviews; n = 52 community members who participated in usability testing and/or pre-deployment piloting; and n = 250 subjects who participated in the full demonstration of which n = 81 initiated email communications to troubleshoot problems or provide feedback. All data were formatted as narrative text and coded thematically by two independent analysts using a shared rubric of a priori defined major codes. Sub-themes were identified by analysts using an iterative inductive process. Themes were reviewed within and across research activities (ie, focus group, usability testing, email content review) and triangulated to identify patterns. Low levels of familiarity with PCHRs were found as were high expectations for capabilities of nascent systems. Perceived value for PCHRs was highest around abilities to co-locate, view, update, and share health information with providers. Expectations were lowest for opportunities to participate in research. Early adopters perceived that PCHR benefits outweighed perceived risks, including those related to inadvertent or intentional information disclosure. Barriers and facilitators at institutional, interpersonal, and individual levels were identified. Endorsement of a dynamic platform model PCHR was evidenced by preferences for embedded searching, linking, and messaging capabilities in PCHRs; by high expectations for within-system tailored communications; and by expectation of linkages between self-report and clinical data. Low levels of awareness/preparedness and high expectations for PCHRs exist as a potentially problematic pairing. Educational and technical assistance for lay users and providers are critical to meet challenges related to: access to PCHRs, especially among older cohorts; workflow demands and resistance to change among providers; inadequate health and technology literacy; clarification of boundaries and responsibility for ensuring accuracy and integrity of health information across distributed data systems; and understanding confidentiality and privacy risks. Continued demonstration and evaluation of PCHRs is essential to advancing their use.

Youth Top Problems: using idiographic, consumer-guided assessment to identify treatment needs and to track change during psychotherapy.

PubMed

Weisz, John R; Chorpita, Bruce F; Frye, Alice; Ng, Mei Yi; Lau, Nancy; Bearman, Sarah Kate; Ugueto, Ana M; Langer, David A; Hoagwood, Kimberly E

2011-06-01

To complement standardized measurement of symptoms, we developed and tested an efficient strategy for identifying (before treatment) and repeatedly assessing (during treatment) the problems identified as most important by caregivers and youths in psychotherapy. A total of 178 outpatient-referred youths, 7-13 years of age, and their caregivers separately identified the 3 problems of greatest concern to them at pretreatment and then rated the severity of those problems weekly during treatment. The Top Problems measure thus formed was evaluated for (a) whether it added to the information obtained through empirically derived standardized measures (e.g., the Child Behavior Checklist [CBCL; Achenbach & Rescorla, 2001] and the Youth Self-Report [YSR; Achenbach & Rescorla, 2001]) and (b) whether it met conventional psychometric standards. The problems identified were significant and clinically relevant; most matched CBCL/YSR items while adding specificity. The top problems also complemented the information yield of the CBCL/YSR; for example, for 41% of caregivers and 79% of youths, the identified top problems did not correspond to any items of any narrowband scales in the clinical range. Evidence on test-retest reliability, convergent and discriminant validity, sensitivity to change, slope reliability, and the association of Top Problems slopes with standardized measure slopes supported the psychometric strength of the measure. The Top Problems measure appears to be a psychometrically sound, client-guided approach that complements empirically derived standardized assessment; the approach can help focus attention and treatment planning on the problems that youths and caregivers consider most important and can generate evidence on trajectories of change in those problems during treatment. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

A case of collegial communication and a patient who does not pay.

PubMed

Peltier, Bruce; Rosenblum, Alvin; Bebeau, Muriel J; Koerber, Anne

2011-01-01

Four individuals who teach ethics in dental schools comment on a case in which negative financial information is revealed by one dentist when transferring records of a potential patient to another dentist. All commentators find varying degrees of ethical problem with disclosing such information. Professional codes discourage this practice. All commentators stress the importance of the potential new dentist developing a relationship based on professional standards, with the greatest emphasis placed on the patient's health needs. Several of the commentators discuss positive ways of conducting a patient interview, including specific useful language.

Release 0.0: clinical information technology in the real world.

PubMed

Kleinke, J D

1998-01-01

The industrialization of medical care delivery, compelled by fifteen years of reimbursement reform, has given rise to a commercial health information technology (HIT) industry. Well financed by Wall Street, the HIT industry offers a variety of ready-made solutions designed to transform a health care organization's raw data resources into useful clinical information. Many of the resulting clinical decision-support products are encumbered by numerous insurmountable intellectual and technical problems and, as a consequence, meet with cultural resistance from physicians. The long-awaited but costly implementation of electronic medical records (EMRs) will make these pioneering but flawed efforts obsolete, if EMR development successfully exploits recent technological breakthroughs and the ongoing consolidation of health care organizations.

Collaborative Information Retrieval Method among Personal Repositories

NASA Astrophysics Data System (ADS)

Kamei, Koji; Yukawa, Takashi; Yoshida, Sen; Kuwabara, Kazuhiro

In this paper, we describe a collaborative information retrieval method among personal repositorie and an implementation of the method on a personal agent framework. We propose a framework for personal agents that aims to enable the sharing and exchange of information resources that are distributed unevenly among individuals. The kernel of a personal agent framework is an RDF(resource description framework)-based information repository for storing, retrieving and manipulating privately collected information, such as documents the user read and/or wrote, email he/she exchanged, web pages he/she browsed, etc. The repository also collects annotations to information resources that describe relationships among information resources and records of interaction between the user and information resources. Since the information resources in a personal repository and their structure are personalized, information retrieval from other users' is an important application of the personal agent. A vector space model with a personalized concept-base is employed as an information retrieval mechanism in a personal repository. Since a personalized concept-base is constructed from information resources in a personal repository, it reflects its user's knowledge and interests. On the other hand, it leads to another problem while querying other users' personal repositories; that is, simply transferring query requests does not provide desirable results. To solve this problem, we propose a query equalization scheme based on a relevance feedback method for collaborative information retrieval between personalized concept-bases. In this paper, we describe an implementation of the collaborative information retrieval method and its user interface on the personal agent framework.

Assessing the efficacy of the electronic patient record system EDeR: implementation study—study protocol

PubMed Central

Job, Oliver; Bachmann, Lucas M; Schmid, Martin K; Thiel, Michael A; Ivic, Sandra

2013-01-01

Introduction Despite many innovations in information technology, many clinics still rely on paper-based medical records. Critics, however, claim that they are hard to read, because of illegible handwriting, and uncomfortable to use. Moreover, a chronological overview is not always easily possible, content can be destroyed or get lost. There is an overall opinion that electronic medical records (EMRs) should solve these problems and improve physicians’ efficiency, patients’ safety and reduce the overall costs in practice. However, to date, the evidence supporting this view is sparse. Methods and analysis In this protocol, we describe a study exploring differences in speed and accuracy when searching clinical information using the paper-based patient record or the Elektronische DateneRfassung (EDeR). Designed as a randomised vignette study, we hypothesise that the EDeR increases efficiency, that is, reduces time on reading the patient history and looking for relevant examination results, helps finding mistakes and missing information quicker and more reliably. In exploratory analyses, we aim at exploring factors associated with a higher performance. Ethics and dissemination The ethics committee of the Canton Lucerne, Switzerland, approved this study. We presume that the implementation of the EMR software EDeR will have a positive impact on the efficiency of the doctors, which will result in an increase of consultations per day. We believe that the results of our study will provide a valid basis to quantify the added value of an EMR system in an ophthalmological environment. PMID:23578684

Marketing E-Commerce by Social media using Product Recommendations and user Embedding

NASA Astrophysics Data System (ADS)

Ramalingam, V. V.; Pandian, A.; Masilamani, Kirthiga

2018-04-01

MarketingE-CommercebySodal media is the best way to improve marketing and business widely.The major issues faced with E-commerce and Social media interfacing is cold- start cross-site problem. The cold-start problem occurs at a situation when user is not having the history of purchase records.For the user who does not have a history of purchase records, we have introduced a method of finding the users’ interested product without knowing any of the demographic information of the user. The product is recommended on basesof visits i.e., the item which is most likely to be visited by the users occur in the hit list. This product is rated at the top position for the users to purchase. The e-commerce with social media sites uses the strategy of user embedding and product recommendations. The product recommendations are achieved by incorporating LatentDirichlet Allocation(LDA), Re Ranking and Collaborative Filtering algorithms. The proposed framework can enhance the recommendation system by embedding products and users. This shows the potential of solving cold-start cross-site problem across the e-commerce and social media sites and enhances the marketing strategy.

Termination Proofs for String Rewriting Systems via Inverse Match-Bounds

NASA Technical Reports Server (NTRS)

Butler, Ricky (Technical Monitor); Geser, Alfons; Hofbauer, Dieter; Waldmann, Johannes

2004-01-01

Annotating a letter by a number, one can record information about its history during a reduction. A string rewriting system is called match-bounded if there is a global upper bound to these numbers. In earlier papers we established match-boundedness as a strong sufficient criterion for both termination and preservation of regular languages. We show now that the string rewriting system whose inverse (left and right hand sides exchanged) is match-bounded, also have exceptional properties, but slightly different ones. Inverse match-bounded systems effectively preserve context-free languages; their sets of normalized strings and their sets of immortal strings are effectively regular. These sets of strings can be used to decide the normalization, the termination and the uniform termination problems of inverse match-bounded systems. We also show that the termination problem is decidable in linear time, and that a certain strong reachability problem is deciable, thus solving two open problems of McNaughton's.

Usability and Safety in Electronic Medical Records Interface Design: A Review of Recent Literature and Guideline Formulation.

PubMed

Zahabi, Maryam; Kaber, David B; Swangnetr, Manida

2015-08-01

The objectives of this study were to (a) review electronic medical record (EMR) and related electronic health record (EHR) interface usability issues, (b) review how EMRs have been evaluated with safety analysis techniques along with any hazard recognition, and (c) formulate design guidelines and a concept for enhanced EMR interfaces with a focus on diagnosis and documentation processes. A major impact of information technology in health care has been the introduction of EMRs. Although numerous studies indicate use of EMRs to increase health care quality, there remain concerns with usability issues and safety. A literature search was conducted using Compendex, PubMed, CINAHL, and Web of Science databases to find EMR research published since 2000. Inclusion criteria included relevant English-language papers with subsets of keywords and any studies (manually) identified with a focus on EMR usability. Fifty studies met the inclusion criteria. Results revealed EMR and EHR usability problems to include violations of natural dialog, control consistency, effective use of language, effective information presentation, and customization principles as well as a lack of error prevention, minimization of cognitive load, and feedback. Studies focusing on EMR system safety made no objective assessments and applied only inductive reasoning methods for hazard recognition. On the basis of the identified usability problems and structure of safety analysis techniques, we provide EMR design guidelines and a design concept focused on the diagnosis process and documentation. The design guidelines and new interface concept can be used for prototyping and testing enhanced EMRs. © 2015, Human Factors and Ergonomics Society.

Specialty Task Force: A Strategic Component to Electronic Health Record (EHR) Optimization.

PubMed

Romero, Mary Rachel; Staub, Allison

2016-01-01

Post-implementation stage comes after an electronic health record (EHR) deployment. Analyst and end users deal with the reality that some of the concepts and designs initially planned and created may not be complementary to the workflow; creating anxiety, dissatisfaction, and failure with early adoption of system. Problems encountered during deployment are numerous and can vary from simple to complex. Redundant ticket submission creates backlog for Information Technology personnel resulting in delays in resolving concerns with EHR system. The process of optimization allows for evaluation of system and reassessment of users' needs. A solid and well executed optimization infrastructure can help minimize unexpected end-user disruptions and help tailor the system to meet regulatory agency goals and practice standards. A well device plan to resolve problems during post implementation is necessary for cost containment and to streamline communication efforts. Creating a specialty specific collaborative task force is efficacious and expedites resolution of users' concerns through a more structured process.

Reconceptualizing perceptual load as a rate problem: The role of time in the allocation of selective attention.

PubMed

Li, Zhi; Xin, Keyun; Li, Wei; Li, Yanzhe

2018-04-30

In the literature about allocation of selective attention, a widely studied question is when will attention be allocated to information that is clearly irrelevant to the task at hand. The present study, by using convergent evidence, demonstrated that there is a trade-off between quantity of information present in a display and the time allowed to process it. Specifically, whether or not there is interference from irrelevant distractors depends not only on the amount of information present, but also on the amount of time allowed to process that information. When processing time is calibrated to the amount of information present, irrelevant distractors can be selectively ignored successfully. These results suggest that the perceptual load in the load theory of selective attention (i.e., Lavie, 2005) should be thought about as a dynamic rate problem rather than a static capacity limitation. The authors thus propose that rather than conceiving of perceptual load as a quantity of information, they should consider it as a quantity of information per unit of time. In other words, it is the relationship between the quantity of information in the task and the time for processing the information that determines the allocation of selective attention. Thus, the present findings extended load theory, allowing it to explain findings that were previously considered as counter evidence of load theory. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Definition, structure, content, use and impacts of electronic health records: a review of the research literature.

PubMed

Häyrinen, Kristiina; Saranto, Kaija; Nykänen, Pirkko

2008-05-01

This paper reviews the research literature on electronic health record (EHR) systems. The aim is to find out (1) how electronic health records are defined, (2) how the structure of these records is described, (3) in what contexts EHRs are used, (4) who has access to EHRs, (5) which data components of the EHRs are used and studied, (6) what is the purpose of research in this field, (7) what methods of data collection have been used in the studies reviewed and (8) what are the results of these studies. A systematic review was carried out of the research dealing with the content of EHRs. A literature search was conducted on four electronic databases: Pubmed/Medline, Cinalh, Eval and Cochrane. The concept of EHR comprised a wide range of information systems, from files compiled in single departments to longitudinal collections of patient data. Only very few papers offered descriptions of the structure of EHRs or the terminologies used. EHRs were used in primary, secondary and tertiary care. Data were recorded in EHRs by different groups of health care professionals. Secretarial staff also recorded data from dictation or nurses' or physicians' manual notes. Some information was also recorded by patients themselves; this information is validated by physicians. It is important that the needs and requirements of different users are taken into account in the future development of information systems. Several data components were documented in EHRs: daily charting, medication administration, physical assessment, admission nursing note, nursing care plan, referral, present complaint (e.g. symptoms), past medical history, life style, physical examination, diagnoses, tests, procedures, treatment, medication, discharge, history, diaries, problems, findings and immunization. In the future it will be necessary to incorporate different kinds of standardized instruments, electronic interviews and nursing documentation systems in EHR systems. The aspects of information quality most often explored in the studies reviewed were the completeness and accuracy of different data components. It has been shown in several studies that the use of an information system was conducive to more complete and accurate documentation by health care professionals. The quality of information is particularly important in patient care, but EHRs also provide important information for secondary purposes, such as health policy planning. Studies focusing on the content of EHRs are needed, especially studies of nursing documentation or patient self-documentation. One future research area is to compare the documentation of different health care professionals with the core information about EHRs which has been determined in national health projects. The challenge for ongoing national health record projects around the world is to take into account all the different types of EHRs and the needs and requirements of different health care professionals and consumers in the development of EHRs. A further challenge is the use of international terminologies in order to achieve semantic interoperability.

Noise Reduction with Microphone Arrays for Speaker Identification

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

Cohen, Z

Reducing acoustic noise in audio recordings is an ongoing problem that plagues many applications. This noise is hard to reduce because of interfering sources and non-stationary behavior of the overall background noise. Many single channel noise reduction algorithms exist but are limited in that the more the noise is reduced; the more the signal of interest is distorted due to the fact that the signal and noise overlap in frequency. Specifically acoustic background noise causes problems in the area of speaker identification. Recording a speaker in the presence of acoustic noise ultimately limits the performance and confidence of speaker identificationmore » algorithms. In situations where it is impossible to control the environment where the speech sample is taken, noise reduction filtering algorithms need to be developed to clean the recorded speech of background noise. Because single channel noise reduction algorithms would distort the speech signal, the overall challenge of this project was to see if spatial information provided by microphone arrays could be exploited to aid in speaker identification. The goals are: (1) Test the feasibility of using microphone arrays to reduce background noise in speech recordings; (2) Characterize and compare different multichannel noise reduction algorithms; (3) Provide recommendations for using these multichannel algorithms; and (4) Ultimately answer the question - Can the use of microphone arrays aid in speaker identification?« less

JSD: Parallel Job Accounting on the IBM SP2

NASA Technical Reports Server (NTRS)

Saphir, William; Jones, James Patton; Walter, Howard (Technical Monitor)

1995-01-01

The IBM SP2 is one of the most promising parallel computers for scientific supercomputing - it is fast and usually reliable. One of its biggest problems is a lack of robust and comprehensive system software. Among other things, this software allows a collection of Unix processes to be treated as a single parallel application. It does not, however, provide accounting for parallel jobs other than what is provided by AIX for the individual process components. Without parallel job accounting, it is not possible to monitor system use, measure the effectiveness of system administration strategies, or identify system bottlenecks. To address this problem, we have written jsd, a daemon that collects accounting data for parallel jobs. jsd records information in a format that is easily machine- and human-readable, allowing us to extract the most important accounting information with very little effort. jsd also notifies system administrators in certain cases of system failure.

A knowledge-based, concept-oriented view generation system for clinical data.

PubMed

Zeng, Q; Cimino, J J

2001-04-01

Information overload is a well-known problem for clinicians who must review large amounts of data in patient records. Concept-oriented views, which organize patient data around clinical concepts such as diagnostic strategies and therapeutic goals, may offer a solution to the problem of information overload. However, although concept-oriented views are desirable, they are difficult to create and maintain. We have developed a general-purpose, knowledge-based approach to the generation of concept-oriented views and have developed a system to test our approach. The system creates concept-oriented views through automated identification of relevant patient data. The knowledge in the system is represented by both a semantic network and rules. The key relevant data identification function is accomplished by a rule-based traversal of the semantic network. This paper focuses on the design and implementation of the system; an evaluation of the system is reported separately.

Electronic medical archives: a different approach to applying re-signing mechanisms to digital signatures.

PubMed

Chen, Tzer-Long; Lin, Frank Y S

2011-08-01

Electronic medical records can be defined as a digital format of the traditionally paper-based anamneses, which contains the history of a patient such as his somewhat illness, current health problems, and his chronic treatments. An electronic anamnesis is meant to make the patient's health information more conveniently accessible and transferable between different medical institutions and also easier to be kept quite a long time. Because of such transferability and accessibility of electronic anamneses, we can use less resource than before on storing the patients' medical information. This also means that medical care providers could save more funds on record-keeping and access a patient's medical background directly since shown on the computer screen more quickly and easily. Overall, the service quality has seemingly improved greatly. However, the usage of electronic anamneses involves in some concerned issues such as its related law declaration, and the security of the patient's confidential information. Because of these concerns, a secure medical networking scheme is taking into consideration. Nowadays, the administrators at the medical institutions are facing more challenges on monitoring computers and network systems, because of dramatic advances in this field. For instance, a trusted third party is authorized to access some medical records for a certain period of time. In regard to the security purpose, all the electronic medical records are embedded with both of the public-key infrastructure (PKI) cryptography and the digital signature technique so as to ensure the records well-protected. Since the signatures will be invalid due to the revocation or time expiration, the security of records under this premise would turn into vulnerable. Hence, we propose a re-signing scheme, whose purpose is to make a going-expired digital signature been resigned in time, in keeping with the premise of not conflicting with the laws, morals, and privacy while maintaining the security of the electronic medical records.

Facilitating the ethical use of health data for the benefit of society: electronic health records, consent and the duty of easy rescue

PubMed Central

Porsdam Mann, Sebastian; Sahakian, Barbara J.

2016-01-01

Advances in data science allow for sophisticated analysis of increasingly large datasets. In the medical context, large volumes of data collected for healthcare purposes are contained in electronic health records (EHRs). The real-life character and sheer amount of data contained in them make EHRs an attractive resource for public health and biomedical research. However, medical records contain sensitive information that could be misused by third parties. Medical confidentiality and respect for patients' privacy and autonomy protect patient data, barring access to health records unless consent is given by the data subject. This creates a situation in which much of the beneficial records-based research is prevented from being used or is seriously undermined, because the refusal of consent by some patients introduces a systematic deviation, known as selection bias, from a representative sample of the general population, thus distorting research findings. Although research exemptions for the requirement of informed consent exist, they are rarely used in practice due to concerns over liability and a general culture of caution. In this paper, we argue that the problem of research access to sensitive data can be understood as a tension between the medical duties of confidentiality and beneficence. We attempt to show that the requirement of informed consent is not appropriate for all kinds of records-based research by distinguishing studies involving minimal risk from those that feature moderate or greater risks. We argue that the duty of easy rescue—the principle that persons should benefit others when this can be done at no or minimal risk to themselves—grounds the removal of consent requirements for minimally risky records-based research. Drawing on this discussion, we propose a risk-adapted framework for the facilitation of ethical uses of health data for the benefit of society. This article is part of the themed issue ‘The ethical impact of data science’. PMID:28336803

Facilitating the ethical use of health data for the benefit of society: electronic health records, consent and the duty of easy rescue.

PubMed

Porsdam Mann, Sebastian; Savulescu, Julian; Sahakian, Barbara J

2016-12-28

Advances in data science allow for sophisticated analysis of increasingly large datasets. In the medical context, large volumes of data collected for healthcare purposes are contained in electronic health records (EHRs). The real-life character and sheer amount of data contained in them make EHRs an attractive resource for public health and biomedical research. However, medical records contain sensitive information that could be misused by third parties. Medical confidentiality and respect for patients' privacy and autonomy protect patient data, barring access to health records unless consent is given by the data subject. This creates a situation in which much of the beneficial records-based research is prevented from being used or is seriously undermined, because the refusal of consent by some patients introduces a systematic deviation, known as selection bias, from a representative sample of the general population, thus distorting research findings. Although research exemptions for the requirement of informed consent exist, they are rarely used in practice due to concerns over liability and a general culture of caution. In this paper, we argue that the problem of research access to sensitive data can be understood as a tension between the medical duties of confidentiality and beneficence. We attempt to show that the requirement of informed consent is not appropriate for all kinds of records-based research by distinguishing studies involving minimal risk from those that feature moderate or greater risks. We argue that the duty of easy rescue-the principle that persons should benefit others when this can be done at no or minimal risk to themselves-grounds the removal of consent requirements for minimally risky records-based research. Drawing on this discussion, we propose a risk-adapted framework for the facilitation of ethical uses of health data for the benefit of society.This article is part of the themed issue 'The ethical impact of data science'. © 2015 The Authors.

Syphilis in pregnancy and congenital syphilis in Amazonas State, Brazil: an evaluation using database linkage.

PubMed

Soeiro, Claudia Marques de Oliveira; Miranda, Angélica Espinosa; Saraceni, Valeria; Santos, Marcelo Cordeiro dos; Talhari, Sinesio; Ferreira, Luiz Carlos de Lima

2014-04-01

This study analyzes notification of syphilis in pregnancy and congenital syphilis in Amazo- nas State, Brazil, from 2007 to 2009 and verifies underreporting in databases in the National Information System on Diseases of Notification (SINAN) and the occurrence of perinatal deaths associated with congenital syphilis and not reported in the Mortality Information System (SIM). This was a cross-sectional study with probabilistic record linkage between the SINAN and SIM. There were 666 reports of syphilis in pregnant women, including 224 in 2007 (3.8/1,000), 244(4.5/1,000) in 2008, and 198(4.0/1,000) in 2009. The study found 486 cases of congenital syphilis, of which 153 in 2007 (2.1/1,000), 193 in 2008 (2.6/1,000), and 140 in 2009 (2.0/1,000). After linkage of the SINAN databases, 237 pregnant women (35.6%) had cases of congenital syphilis reported. The SIM recorded 4,905 perinatal deaths, of which 57.8% were stillbirths. Probabilistic record linkage between SIM and SINAN-Congenital Syphilis yielded 13 matched records. The use of SINAN and SIM may not reflect the total magnitude of syphilis, but provide the basis for monitoring and analyzing this health problem, with a view towards planning and management.

Measuring the frequency of functional gastrointestinal disorders in rural Crete: a need for improving primary care physicians' diagnostic skills.

PubMed

Lionis, Christos; Olsen-Faresjo, Ashild; Anastasiou, Foteini; Wallander, Mari-Ann; Johansson, Saga; Faresjo, Tomas

2005-01-01

Studies of the frequency and aetiology of functional gastrointestinal disorders in the general population have received increasing interest over the past few years; the field seems to be neglected in Southern Europe. The aim of this study was to report on the frequency of functional dyspepsia (FD), irritable bowel syndrome (IBS) and gastroenteritis within the primary care setting, to provide some information on the extent to which the recorded diagnoses in the physicians' notes fulfil existing diagnostic criteria. A retrospective study was used, where all new cases of these diseases at five primary health care centres in three rural and two semi-rural areas of Crete were identified by scrutinizing medical records from 280,000 consecutive visits during a 4 year period. The occurrence rate per 1000 person-years were calculated for the three conditions. We also checked the extent to which the Talley's criteria for FD and Rome II diagnostic criteria for IBS were followed. Gastroenteritis was revealed to be a quite frequent health problem among the rural population on Crete, while the occurrence rates for other problems, such as dyspepsia and IBS, were found to be lower than expected. IBS was over-represented among women compared with men, OR 2.04 (CI 1.39-3.00). In many cases a diagnosis of FD, IBS or gastroenteritis was evident to the research team on the basis of findings recorded in the notes, but the diagnosis was not recorded by the clinician at the time of consultation. This study yielded two key messages: the first that gastroenteritis is still a frequent health problem, and the second that primary care physicians in rural Crete seem to fail in adequately diagnosing FD and IBS and need further training.

Use of an electronic problem list by primary care providers and specialists.

PubMed

Wright, Adam; Feblowitz, Joshua; Maloney, Francine L; Henkin, Stanislav; Bates, David W

2012-08-01

Accurate patient problem lists are valuable tools for improving the quality of care, enabling clinical decision support, and facilitating research and quality measurement. However, problem lists are frequently inaccurate and out-of-date and use varies widely across providers. Our goal was to assess provider use of an electronic problem list and identify differences in usage between medical specialties. Chart review of a random sample of 100,000 patients who had received care in the past two years at a Boston-based academic medical center. Counts were collected of all notes and problems added for each patient from 1/1/2002 to 4/30/2010. For each entry, the recording provider and the clinic in which the entry was recorded was collected. We used the Healthcare Provider Taxonomy Code Set to categorize each clinic by specialty. We analyzed the problem list use across specialties, controlling for note volume as a proxy for visits. A total of 2,264,051 notes and 158,105 problems were recorded in the electronic medical record for this population during the study period. Primary care providers added 82.3% of all problems, despite writing only 40.4% of all notes. Of all patients, 49.1% had an assigned primary care provider (PCP) affiliated with the hospital; patients with a PCP had an average of 4.7 documented problems compared to 1.5 problems for patients without a PCP. Primary care providers were responsible for the majority of problem documentation; surgical and medical specialists and subspecialists recorded a disproportionately small number of problems on the problem list.

Stroke survivors' views and experiences on impact of visual impairment.

PubMed

Rowe, Fiona J

2017-09-01

We sought to determine stroke survivors' views on impact of stroke-related visual impairment to quality of life. Stroke survivors with visual impairment, more than 1 year post stroke onset, were recruited. Semistructured biographical narrative interviews were audio-recorded and transcribed verbatim. A thematic approach to analysis of the qualitative data was adopted. Transcripts were systematically coded using NVivo10 software. Thirty-five stroke survivors were interviewed across the UK: 16 females, 19 males; aged 20-75 years at stroke onset. Five qualitative themes emerged: "Formal care," "Symptoms and self," "Adaptations," "Daily life," and "Information." Where visual problems existed, they were often not immediately recognized as part of the stroke syndrome and attributed to other causes such as migraine. Many participants did not receive early vision assessment or treatment for their visual problems. Visual problems included visual field loss, double vision, and perceptual problems. Impact of visual problems included loss in confidence, being a burden to others, increased collisions/accidents, and fear of falling. They made many self-identified adaptations to compensate for visual problems: magnifiers, large print, increased lighting, use of white sticks. There was a consistent lack of support and provision of information about visual problems. Poststroke visual impairment causes considerable impact to daily life which could be substantially improved by simple measures including early formal visual assessment, management and advice on adaptive strategies and self-management options. Improved education about poststroke visual impairment for the public and clinicians could aid earlier diagnosis of visual impairments.

Organ Procurement Organizations and the Electronic Health Record.

PubMed

Howard, R J; Cochran, L D; Cornell, D L

2015-10-01

The adoption of electronic health records (EHRs) has adversely affected the ability of organ procurement organizations (OPOs) to perform their federally mandated function of honoring the donation decisions of families and donors who have signed the registry. The difficulties gaining access to potential donor medical record has meant that assessment, evaluation, and management of brain dead organ donors has become much more difficult. Delays can occur that can lead to potential recipients not receiving life-saving organs. For over 40 years, OPO personnel have had ready access to paper medical records. But the widespread adoption of EHRs has greatly limited the ability of OPO coordinators to readily gain access to patient medical records and to manage brain dead donors. Proposed solutions include the following: (1) hospitals could provide limited access to OPO personnel so that they could see only the potential donor's medical record; (2) OPOs could join with other transplant organizations to inform regulators of the problem; and (3) hospital organizations could be approached to work with Center for Medicare and Medicaid Services (CMS) to revise the Hospital Conditions of Participation to require OPOs be given access to donor medical records. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

Ethical problems experienced by oncology nurses1

PubMed Central

da Luz, Kely Regina; Vargas, Mara Ambrosina de Oliveira; Schmidtt, Pablo Henrique; Barlem, Edison Luiz Devos; Tomaschewski-Barlem, Jamila Geri; da Rosa, Luciana Martins

2015-01-01

Objective: to know the ethical problems experienced by oncology nurses. Method: descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Results: two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. Conclusion: for the effective confrontation of the ethical problems experienced by oncology nurses to occur, it is important to invest in the training of these professionals, preparing them in an ethical and human way to act as lawyers of the patient with cancer, in a context of dilemmas related mainly to the possibility of finitude. PMID:26626012

Introduction to cognitive processes of expert pilots.

PubMed

Adams, R J; Ericsson, A E

2000-10-01

This report addresses the historical problem that a very high percentage of accidents have been classified as involving "pilot error." Through extensive research since 1977, the Federal Aviation Administration determined that the predominant underlying cause of these types of accidents involved decisional problems or cognitive information processing. To attack these problems, Aeronautical Decision Making (ADM) training materials were developed and tested for ten years. Since the publication of the ADM training manuals in 1987, significant reductions in human performance error (HPE) accidents have been documented both in the U.S. and world wide. However, shortcomings have been observed in the use of these materials for recurrency training and in their relevance to more experienced pilots. The following discussion defines the differences between expert and novice decision makers from a cognitive information processing perspective, correlates the development of expert pilot cognitive processes with training and experience, and reviews accident scenarios which exemplify those processes. This introductory material is a necessary prerequisite to an understanding of how to formulate expert pilot decision making training innovations; and, to continue the record of improved safety through ADM training.

Agreement between questionnaire and medical records on some health and socioeconomic problems among poisoning cases

PubMed Central

Fathelrahman, Ahmed I

2009-01-01

Background The main objective of the present study was to evaluate the agreement between questionnaire and medical records on some health and socioeconomic problems among poisoning cases. Methods Cross-sectional sample of 100 poisoning cases consecutively admitted to the Hospital Pulau Pinang, Malaysia during the period from September 2003 to February 2004 were studied. Data on health and socioeconomic problems were collected both by self-administered questionnaire and from medical records. Agreement between the two sets of data was assessed by calculating the concordance rate, Kappa (k) and PABAK. McNemar statistic was used to test differences between categories. Results Data collected by questionnaire and medical records showed excellent agreement on the "marital status"; good agreements on "chronic illness", "psychiatric illness", and "previous history of poisoning"; and fair agreements on "at least one health problem", and "boy-girl friends problem". PABAK values suggest better agreements' measures. Conclusion There were excellent to good agreements between questionnaire and medical records on the marital status and most of the health problems and fair to poor agreements on the majority of socioeconomic problems. The implications of those findings were discussed. PMID:19751526

WITHDRAWN: Nursing record systems: effects on nursing practice and healthcare outcomes.

PubMed

Urquhart, Christine; Currell, Rosemary; Grant, Maria J; Hardiker, Nicholas R

2018-05-15

A nursing record system is the record of care that was planned or given to individual patients and clients by qualified nurses or other caregivers under the direction of a qualified nurse. Nursing record systems may be an effective way of influencing nurse practice. To assess the effects of nursing record systems on nursing practice and patient outcomes. For the original version of this review in 2000, and updates in 2003 and 2008, we searched: the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register; MEDLINE, EMBASE, CINAHL, BNI, ISI Web of Knowledge, and ASLIB Index of Theses. We also handsearched: Computers, Informatics, Nursing (Computers in Nursing); Information Technology in Nursing; and the Journal of Nursing Administration. For this update, searches can be considered complete until the end of 2007. We checked reference lists of retrieved articles and other related reviews. Randomised controlled trials (RCTs), controlled before and after studies, and interrupted time series comparing one kind of nursing record system with another in hospital, community or primary care settings. The participants were qualified nurses, students or healthcare assistants working under the direction of a qualified nurse, and patients receiving care recorded or planned using nursing record systems. Two review authors (in two pairs) independently assessed trial quality and extracted data. We included nine trials (eight RCTs, one controlled before and after study) involving 1846 people. The studies that evaluated nursing record systems focusing on relatively discrete and focused problems, for example effective pain management in children, empowering pregnant women and parents, reducing loss of notes, reducing time spent on data entry of test results, reducing transcription errors, and reducing the number of pieces of paper in a record, all demonstrated some degree of success in achieving the desired results. Studies of nursing care planning systems and total nurse records demonstrated uncertain or equivocal results. We found some limited evidence of effects on practice attributable to changes in record systems. It is clear from the literature that it is possible to set up the randomised trials or other quasi-experimental designs needed to produce evidence for practice. Qualitative nursing research to explore the relationship between practice and information use could be used as a precursor to the design and testing of nursing information systems.

Big Data, Big Problems: Incorporating Mission, Values, and Culture in Provider Affiliations.

PubMed

Shaha, Steven H; Sayeed, Zain; Anoushiravani, Afshin A; El-Othmani, Mouhanad M; Saleh, Khaled J

2016-10-01

This article explores how integration of data from clinical registries and electronic health records produces a quality impact within orthopedic practices. Data are differentiated from information, and several types of data that are collected and used in orthopedic outcome measurement are defined. Furthermore, the concept of comparative effectiveness and its impact on orthopedic clinical research are assessed. This article places emphasis on how the concept of big data produces health care challenges balanced with benefits that may be faced by patients and orthopedic surgeons. Finally, essential characteristics of an electronic health record that interlinks musculoskeletal care and big data initiatives are reviewed. Copyright © 2016 Elsevier Inc. All rights reserved.

Correlates of specific childhood feeding problems.

PubMed

Field, D; Garland, M; Williams, K

2003-01-01

The correlates of specific childhood feeding problems are described to further examine possible predisposing factors for feeding problems. We report our experience with 349 participants evaluated by an interdisciplinary feeding team. A review of records was conducted and each participant was identified as having one or more of five functionally defined feeding problems: food refusal, food selectivity by type, food selectivity by texture, oral motor delays, or dysphagia. The prevalence of predisposing factors for these feeding problems was examined. Predisposing factors included developmental disabilities, gastrointestinal problems, cardiopulmonary problems, neurological problems, renal disease and anatomical anomalies. The frequencies of predisposing factors varied by feeding problem. Differences were found in the prevalence of the five feeding problems among children with three different developmental disabilities: autism, Down syndrome and cerebral palsy. Gastro-oesophageal reflux was the most prevalent condition found among all children in the sample and was the factor most often associated with food refusal. Neurological conditions and anatomical anomalies were highly associated with skill deficits, such as oral motor delays and dysphagia. Specific medical conditions and developmental disabilities are often associated with certain feeding problems. Information concerning predisposing factors of feeding problems can help providers employ appropriate primary, secondary and tertiary prevention measures to decrease the frequency or severity of some feeding problems.

A relational database in neurosurgery.

PubMed

Sicurello, F; Marchetti, M R; Cazzaniga, P

1995-01-01

This paper describes teh automatic procedure for a clinical record management in a Neurosurgery ward. The automated record allows the storage, querying and effective management of clinical data. This is useful during the patient stay and also for data processing and analysis aiming at clinical research and statistical studies. The clinical record is problem-oriented. It contains a minimum data set regarding every patient and a data set which is defined by a classification nomenclature (using an inner protocol). The main parts of the clinical record are the following tables: PERSONAL DATA: contains the fields relating to personal and admission data of the patient. The compilation of some fields is compulsory because they serve as input for the automated discharge letter. This table is used as an identifier for patient retrieval. composed of five different tables according to the kind of data. They are: familiar anamnesis, physiological anamnesis, past and next pathology anamnesis, and trauma anamnesis. GENERAL OBJECTIVITY: contains the general physical information of a patient. The field hold default values, which quickens the compilation and assures the recording of normal values. NEUROLOGICAL EXAMINATION: contains information about the neurological status of the patient. Also in this table, ther are default values in the fields. COMA: contains standardized ata and classifications. The multiple choices are automated and driven and belong to homogeneous classes. SURGICAL OPERATIONS: the information recording is made defining the general kind of operation and then defining the peculiar kind of operation. INSTRUMENTAL EXAMINATIONS: some examination results are recorded in a free structure, while other ones (TAC, etc.) follow codified structure. In order to identify a pathology by means of TAC, it is enough to record three values corresponding to three variables. THis classification fully describes a lot of neurosurgical pathologies. DISCHARGE: contains conclusions, therapies, result, and hospital course. Medical language is closer to the natural one and presents some abiguities. In order to solve this problem, a classification nomenclature was used for diagnosis definition. DISCHARGE LETTER: the document given to the patient when he is discharged. It extracts data from the previously described modules and contains standard headings. The information stored int he database is structured (e.g., diagnosis, name, surname, etc.) and access to this data takes place when the user wants to search the database, using particular queries where the identifying data of a patient is put as conditions for the research (SELECT age, name WHERE diagnosis="TRAUMA"). Logical operators and relational algebra of the relational DBMS allows more complex queries ((diagnosis="TRAUMA" AND age="19") OR sex="M"). The queries are deterministic, because data management uses a classification nomenclature. Data retrieval takes place through a matching, and the DBMS answers directly to the queries. The information retrieval speed depends upon the kind of system that is used; in our case retrieval time is low because the accesses to disk are few even for big databases. In medicine, clinical records can have a hierarchical structure and/or a relational one. Nevertheless, the hierarchical model presents a disadvantage: it is not very flexible because it is linked to a pre-defined structure; as a matter of fact, the definition of path is established in the beginning and not during the execution. Thus, a better representation of the system at a logical level requries a relational DBMS which exploits the relationships between entities in a vertical and horizontal way. That is why the developers adopted a mixed strategy which exploits the advantages of both models and which is provided by M Technology with SQL language (M/SQL). For the future, it is important to have at one's disposal multimedia technologies, which integrate different kinds of information (alp

Worldwide Buoy Technology Survey. Volume 2. Appendix B. Buoy Records. Book 2. Germany - USA

DTIC Science & Technology

1991-02-01

arrangement and effectiveness of the complete system could not be addressed in detail within the constraints of this project. In an overall evaluation of...the SRA system , such considerations should also be addressed. The USCG’s Waterway Analysis and Management System (WAMS) is considering this matter as...project. The task includes the screening of worldwide engineering and technical information on buoy systems , approaches to problem solving (particularly

Automated Quality of Care Evaluation Support System (AQCESS): AQCESS Functional Description

DTIC Science & Technology

1985-12-04

to greater awareness of and increased expec- tations from the health care field. During the oast several years , incidents of improper or questionable...great deal of time and effort must be spent by OA personnel culling from a large volume of paper the salient information about what problems each...center around manual, labor- and paper -intensive reviews of medical records, hospital incident reports, committee actions and follow-ups, recurring

Arctic Alaska and Icebreaking: An Assessment of Future Requirements for the United States Coast Guard.

DTIC Science & Technology

1981-03-01

Extraction in the Arctic," Polar Record, v. 19, January 1978. 96. Mohl, Bertel, " Marine Mammals and Noise ," Canadian Arctic Resources Committee...unnatural sound can adversely affect wildlife. Research indicates that marine mammals rely exclusively on auditory sensations for long range...seriously disrupt the lives of a variety of marine mammal species (Ref. 961. The problem is exacerbated by a lack of reliable information. It is

The effective use of newspaper information in corporations (2) Centered around corporate and managemant information

NASA Astrophysics Data System (ADS)

Kamio, Tatsuo

A newspaper article is a fragmentary record of fact. For information activities in corporations it is fundamental to gather newspaper articles related to the object thema as many as possible, integrate them, analyze them, and then, create new intelligence based on them. Here in databases become effective measures. It seems essential to construct searching strategy with high recall of necessary information and understand the databases in detail when we use newspaper article databases. The cases that newspaper databases are useful for business are represented by (1) research and analysis for problem solving, (2) gathering of knowledge, and confirmation of the facts, and (3) constant observation of facts without missing any change in there. Particularly for case (1) various methods are tried for analyzing the tendency.

A security architecture for interconnecting health information systems.

PubMed

Gritzalis, Dimitris; Lambrinoudakis, Costas

2004-03-31

Several hereditary and other chronic diseases necessitate continuous and complicated health care procedures, typically offered in different, often distant, health care units. Inevitably, the medical records of patients suffering from such diseases become complex, grow in size very fast and are scattered all over the units involved in the care process, hindering communication of information between health care professionals. Web-based electronic medical records have been recently proposed as the solution to the above problem, facilitating the interconnection of the health care units in the sense that health care professionals can now access the complete medical record of the patient, even if it is distributed in several remote units. However, by allowing users to access information from virtually anywhere, the universe of ineligible people who may attempt to harm the system is dramatically expanded, thus severely complicating the design and implementation of a secure environment. This paper presents a security architecture that has been mainly designed for providing authentication and authorization services in web-based distributed systems. The architecture has been based on a role-based access scheme and on the implementation of an intelligent security agent per site (i.e. health care unit). This intelligent security agent: (a). authenticates the users, local or remote, that can access the local resources; (b). assigns, through temporary certificates, access privileges to the authenticated users in accordance to their role; and (c). communicates to other sites (through the respective security agents) information about the local users that may need to access information stored in other sites, as well as about local resources that can be accessed remotely.

Employee problems and their consequences in the technology industry: evidence from surveys and counseling records.

PubMed

Wang, Ching-Wen; Lin, Po-Chang; Sha, Chyuan

2014-06-01

To support employees' work and health, organizations should help employees cope with common problems. Previous studies have focused primarily on work-related problems across multiple industries rather than on evaluating industry-specific issues. Here, two approaches identified common work and non-work employee problems in the technology industry with the strongest correlations with psychosomatic health and life satisfaction. Study 1 used questionnaires to identify the problems that were perceived as the most frequent by lower-level employees (N = 355) working in the technology industry. Study 2 evaluated employees' coping behaviors by analyzing (with permission) counseling records collected from an employee assistance service company (N = 276). Employees reported a variety of problems; work problems were the only problems (of the top 5 problems) reported in both studies. Several problems emerged in the counseling records (e.g., legal issues, career development, family and marriage problems, and emotional problems) but not in the surveys. Future research should apply these observations to develop scales for measuring employee stressors.

Report of the Tape Recorder Action Plan Committee, 21 March 1972

NASA Technical Reports Server (NTRS)

1972-01-01

A NASA/AF Tape Recorder Action Plan Committee was formed in January 1972 to investigate tape recorder problems and to recommend an action plan to NASA management. The committee collected data on tape recorder failure history, pinpointed problem areas, discussed needed technical and management changes, and proposed an action plan for the recommended approaches.

[Recommendations for overcoming interface problems in medical rehabilitation of federal pension funds and statutory health insurance].

PubMed

Pohontsch, N; Träder, J-M; Scherer, M; Deck, R

2013-10-01

Interface problems in medical rehabilitation are a consequence of problems with communication and cooperation, lack of information and transparency. Different stakeholders are trying to solve these problems since many years or decades respectively. Following a series of deficit-oriented studies we tried to develop recommendations for possible solutions of important interface problems together with affected people based on a qualitative analysis of main problem areas. 10 separate group discussions with rehabilitation patients, general practitioners and specialists in private practices, representatives of the federal pension fund and statutory health insurance as well as clinicians from rehabilitation clinics and 3 mixed group discussions (all before mentioned groups excluding rehabilitation patients) were conducted. These group discussions served to prepare a semidiurnal final conference. All meetings were recorded and content analyzed or summarized in protocols respectively. Results are recommendations on strategies to reduce interface problems in medical rehabilitation. Those are: development of a rehabilitation-information-website for insurees and general practitioners and specialists in private practices; changes in forms, applications, notifications; advanced training for general practitioners and specialists in private practices und support in detecting rehabilitation need. Due to divided structures of care provision and increasing specialization, overcoming interface problems is one of the main challenges in the provision of medical rehabilitation. It can be met if different stakeholder approach each other without prejudices, share instead of demarcate competencies and are willing to strike new paths. Our recommendations represent the first step to reaching this goal. © Georg Thieme Verlag KG Stuttgart · New York.

The completeness of medication histories in hospital medical records of patients admitted to general internal medicine wards

PubMed Central

Lau, Hong Sang; Florax, Christa; Porsius, Arijan J; de Boer, Anthonius

2000-01-01

Aims Accurate recording of medication histories in hospital medical records (HMR) is important when patients are admitted to the hospital. Lack of registration of drugs can lead to unintended discontinuation of drugs and failure to detect drug related problems. We investigated the comprehensiveness of medication histories in HMR with regard to prescription drugs by comparing the registration of drugs in HMR with computerized pharmacy records obtained from the community pharmacy. Methods Patients admitted to the general ward of two acute care hospitals were included in the study after obtaining informed consent. We conducted an interview on drugs used just prior to hospitalization and extracted the medication history from the HMR. Pharmacy records were collected from the community pharmacists over a 1 year period before the admission. Drugs in the pharmacy records were defined as possibly used (PU-drugs) when they were dispensed before the admission date and had a theoretical enddate of 7 days before the admission date or later. If any PU-drug was not recorded in the HMR, we asked the patient whether they were using that drug or not. Results Data were obtained from 304 patients who had an average age of 71 (range 40–92) years. The total number of drugs according to the HMR was 1239, 43 of which were not used. When compared with the pharmacy records we found an extra 518 drugs that were not recorded in the HMR but were possibly in use. After verification with the patients, 410 of these were indeed in use bringing the total number of drugs in use to 1606. The type of drugs in use but not recorded in the HMR covered a broad spectrum and included many drugs considered to be important such as cardiovascular drugs (n = 67) and NSAIDs (n = 31). The percentages of patients with 0, 1, 2, 3, 4, 5–11 drugs not recorded in the HMR were 39, 28, 16, 8, 3.6 and 5.5, respectively. Of the 1606 drugs in use according to information from all sources, only 38 (2.4%) were not retrievable in the pharmacy records when the complete year prior to hospitalization was evaluated. Conclusions The medication history in the hospital medical record is often incomplete, as 25% of the prescription drugs in use is not recorded and 61% of all patients has one of more drugs not registered. Pharmacy records from the community pharmacist can be used to obtain more complete information on the medication history of patients admitted to the hospital. PMID:10848724

Improving quality: bridging the health sector divide.

PubMed

Pringle, Mike

2003-12-01

All too often, quality assurance looks at just one small part of the complex system that is health care. However, evidently each individual patient has one set of experiences and outcomes, often involving a range of health professionals in a number of settings across multiple sectors. In order to solve the problems of this complexity, we need to establish high-quality electronic recording in each of the settings. In the UK, primary care has been leading the way in adopting information technology and can now use databases for individual clinical care, for quality assurance using significant event and conventional auditing, and for research. Before we can understand and quality-assure the whole health care system, we need electronic patient records in all settings and good communication to build a summary electronic health record for each patient. Such an electronic health record will be under the control of the patient concerned, will be shared with the explicit consent of the patient, and will form the vehicle for quality assurance across all sectors of the health service.

Quality of Health Management Information System for Maternal & Child Health Care in Haryana State, India

PubMed Central

Sharma, Atul; Rana, Saroj Kumar; Prinja, Shankar; Kumar, Rajesh

2016-01-01

Background Despite increasing importance being laid on use of routine data for decision making in India, it has frequently been reported to be riddled with problems. Evidence suggests lack of quality in the health management information system (HMIS), however there is no robust analysis to assess the extent of its inaccuracy. We aim to bridge this gap in evidence by assessing the extent of completeness and quality of HMIS in Haryana state of India. Methods Data on utilization of key maternal and child health (MCH) services were collected using a cross-sectional household survey from 4807 women in 209 Sub-Centre (SC) areas across all 21 districts of Haryana state. Information for same services was also recorded from HMIS records maintained by auxiliary nurse midwives (ANMs) at SCs to check under- or over-recording (Level 1 discordance). Data on utilisation of MCH services from SC ANM records, for a subset of the total women covered in the household survey, were also collected and compared with monthly reports submitted by ANMs to assess over-reporting while report preparation (Level 2 discordance) to paint the complete picture for quality and completeness of routine HMIS. Results Completeness of ANM records for various MCH services ranged from 73% for DPT1 vaccination dates to 94.6% for dates of delivery. Average completeness level for information recorded in HMIS was 88.5%. Extent of Level 1 discordance for iron-folic acid (IFA) supplementation, 3 or more ante-natal care (ANC) visits and 2 Tetanus toxoid (TT) injections was 41%, 16% and 2% respectively. In 48.2% cases, respondents from community as well as HMIS records reported at least one post-natal care (PNC) home visit by ANM. Extent of Level 2 discordance ranged from 1.6% to 6%. These figures were highest for number of women who completed IFA supplementation, contraceptive intra-uterine device insertion and provision of 2nd TT injection during ANC. Conclusions HMIS records for MCH services at sub-centre level in Haryana state were satisfactory in terms of completeness. However, there were significant differences in terms of reported and evaluated coverage of MCH services. Quality of HMIS needs to be improved in order to make it relevant for public health program planning and research. PMID:26872353

Detecting oscillatory patterns and time lags from proxy records with non-uniform sampling: Some pitfalls and possible solutions

NASA Astrophysics Data System (ADS)

Donner, Reik

2013-04-01

Time series analysis offers a rich toolbox for deciphering information from high-resolution geological and geomorphological archives and linking the thus obtained results to distinct climate and environmental processes. Specifically, on various time-scales from inter-annual to multi-millenial, underlying driving forces exhibit more or less periodic oscillations, the detection of which in proxy records often allows linking them to specific mechanisms by which the corresponding drivers may have affected the archive under study. A persistent problem in geomorphology is that available records do not present a clear signal of the variability of environmental conditions, but exhibit considerable uncertainties of both the measured proxy variables and the associated age model. Particularly, time-scale uncertainty as well as the heterogeneity of sampling in the time domain are source of severe conceptual problems that may lead to false conclusions about the presence or absence of oscillatory patterns and their mutual phasing in different archives. In my presentation, I will discuss how one can cope with non-uniformly sampled proxy records to detect and quantify oscillatory patterns in one or more data sets. For this purpose, correlation analysis is reformulated using kernel estimates which are found superior to classical estimators based on interpolation or Fourier transform techniques. In order to characterize non-stationary or noisy periodicities and their relative phasing between different records, an extension of continuous wavelet transform is utilized. The performance of both methods is illustrated for different case studies. An extension to explicitly considering time-scale uncertainties by means of Bayesian techniques is briefly outlined.

Advanced instrumentation: Technology database enhancement, volume 4, appendix G

NASA Technical Reports Server (NTRS)

1991-01-01

The purpose of this task was to add to the McDonnell Douglas Space Systems Company's Sensors Database, including providing additional information on the instruments and sensors applicable to physical/chemical Environmental Control and Life Support System (P/C ECLSS) or Closed Ecological Life Support System (CELSS) which were not previously included. The Sensors Database was reviewed in order to determine the types of data required, define the data categories, and develop an understanding of the data record structure. An assessment of the MDSSC Sensors Database identified limitations and problems in the database. Guidelines and solutions were developed to address these limitations and problems in order that the requirements of the task could be fulfilled.

Problems and Processes in Medical Encounters: The CASES method of dialogue analysis

PubMed Central

Laws, M. Barton; Taubin, Tatiana; Bezreh, Tanya; Lee, Yoojin; Beach, Mary Catherine; Wilson, Ira B.

2013-01-01

Objective To develop methods to reliably capture structural and dynamic temporal features of clinical interactions. Methods Observational study of 50 audio-recorded routine outpatient visits to HIV specialty clinics, using innovative analytic methods. The Comprehensive Analysis of the Structure of Encounters System (CASES) uses transcripts coded for speech acts, then imposes larger-scale structural elements: threads – the problems or issues addressed; and processes within threads –basic tasks of clinical care labeled Presentation, Information, Resolution (decision making) and Engagement (interpersonal exchange). Threads are also coded for the nature of resolution. Results 61% of utterances are in presentation processes. Provider verbal dominance is greatest in information and resolution processes, which also contain a high proportion of provider directives. About half of threads result in no action or decision. Information flows predominantly from patient to provider in presentation processes, and from provider to patient in information processes. Engagement is rare. Conclusions In this data, resolution is provider centered; more time for patient participation in resolution, or interpersonal engagement, would have to come from presentation. Practice Implications Awareness of the use of time in clinical encounters, and the interaction processes associated with various tasks, may help make clinical communication more efficient and effective. PMID:23391684

Problems and processes in medical encounters: the cases method of dialogue analysis.

PubMed

Laws, M Barton; Taubin, Tatiana; Bezreh, Tanya; Lee, Yoojin; Beach, Mary Catherine; Wilson, Ira B

2013-05-01

To develop methods to reliably capture structural and dynamic temporal features of clinical interactions. Observational study of 50 audio-recorded routine outpatient visits to HIV specialty clinics, using innovative analytic methods. The comprehensive analysis of the structure of encounters system (CASES) uses transcripts coded for speech acts, then imposes larger-scale structural elements: threads--the problems or issues addressed; and processes within threads--basic tasks of clinical care labeled presentation, information, resolution (decision making) and Engagement (interpersonal exchange). Threads are also coded for the nature of resolution. 61% of utterances are in presentation processes. Provider verbal dominance is greatest in information and resolution processes, which also contain a high proportion of provider directives. About half of threads result in no action or decision. Information flows predominantly from patient to provider in presentation processes, and from provider to patient in information processes. Engagement is rare. In this data, resolution is provider centered; more time for patient participation in resolution, or interpersonal engagement, would have to come from presentation. Awareness of the use of time in clinical encounters, and the interaction processes associated with various tasks, may help make clinical communication more efficient and effective. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Development of the workflow kine systems for support on KAIZEN.

PubMed

Mizuno, Yuki; Ito, Toshihiko; Yoshikawa, Toru; Yomogida, Satoshi; Morio, Koji; Sakai, Kazuhiro

2012-01-01

In this paper, we introduce the new workflow line system consisted of the location and image recording, which led to the acquisition of workflow information and the analysis display. From the results of workflow line investigation, we considered the anticipated effects and the problems on KAIZEN. Workflow line information included the location information and action contents information. These technologies suggest the viewpoints to help improvement, for example, exclusion of useless movement, the redesign of layout and the review of work procedure. Manufacturing factory, it was clear that there was much movement from the standard operation place and accumulation residence time. The following was shown as a result of this investigation, to be concrete, the efficient layout was suggested by this system. In the case of the hospital, similarly, it is pointed out that the workflow has the problem of layout and setup operations based on the effective movement pattern of the experts. This system could adapt to routine work, including as well as non-routine work. By the development of this system which can fit and adapt to industrial diversification, more effective "visual management" (visualization of work) is expected in the future.

Use of satellite telecommunications for telemedicine

NASA Technical Reports Server (NTRS)

Tamkovich, Gennady

1991-01-01

The use of space telecommunications facilities in the interests of medicine should establish a reliable and timely connection between the specialists involved and access for each of them to information sources the need. Since a certain global-scale program should be implemented for this goal to be achieved, one of the top-priority tasks is to determine appropriate orbital facilities for telecommunications as well as appropriate areas and countries for them, outlining the territories where portable data receive/transport records can be placed and stations that are cheap and simple enough to operate can be stored. Eventually the satellite telecommunications system should encourage health workers to unite in a world community on the basis of a regular and efficient information exchange with the goal of protecting the health of man and the peace of Earth. This goal could only be achieved by gradually removing differences in the domain of medical education and information in different regions over the globe, by providing a possibility of rapid and coordinated access to the information on medical problems of interest on the global scale, as well as by coordinating the discussion and solution of all problems associated with the development and progress of the satellite communications system.

Construction of a virtual EPR and automated contextual linkage to multiple sources of support information on the Oxford Clinical Intranet.

PubMed

Kay, J D; Nurse, D

1999-01-01

We have used internet-standard tools to provide access for clinicians to the components of the electronic patient record held on multiple remote disparate systems. Through the same interface we have provided access to multiple knowledgebases, some written locally and others published elsewhere. We have developed linkage between these two types of information which removes the need for the user to drill down into each knowledgebase to search for relevant information. This approach may help in the implementation of evidence-based practice. The major problems appear to be semantic rather than technological. The intranet was developed at low cost and is now in routine use. This approach appears to be transferable across systems and organisations.

An updated look at document security: from initiation to storage or shredder.

PubMed

McConnell, Charles R

2014-01-01

In these days of close attention to security of information handled electronically, there is often a tendency to overlook the security of hard-copy documents. Document security can involve many areas of business, but the health care department manager's concerns are primarily for patient records and employee documentation. Document security is closely related to growing concerns for individual privacy; guidelines are furnished for protecting employee privacy by separating retention practices for business information from personal information. Sensitive documentation requires rules and procedures for processing, retaining, accessing, storing, and eventually destroying. Also, documents that are missing or incomplete at times present unique problems for the organization. The department manager is provided with some simple rules for safeguarding employee and patient documentation.

Operational problems of Haniwa net as a form of social capital: interdependence between human networks of physicians and information networks.

PubMed

Maeda, Minoru; Araki, Sanae; Suzuki, Muneou; Umemoto, Katsuhiro; Kai, Yukiko; Araki, Kenji

2012-10-01

In August 2009, Miyazaki Health and Welfare Network (Haniwa Net, hereafter referred to as "the Net"), centrally led by University of Miyazaki Hospital (UMH), adopted a center hospital-based system offering a unilateral linkage that enables the viewing of UMH's medical records through a web-based browser (electronic medical records (EMR)). By the end of December 2010, the network had developed into a system of 79 collaborating physicians from within the prefecture. Beginning in August 2010, physicians in 12 medical institutions were visited and asked to speak freely on the operational issues concerning the Net. Recordings and written accounts were coded using the text analysis software MAXQDA 10 to understand the actual state of operations. Analysis of calculations of Kendall's rank correlation confirmed that the interdependency between human networks and information networks is significant. At the same time, while the negative opinions concerning the functions of the Net were somewhat conspicuous, the results showed a correlation between requests and proposals for operational improvements of the Net, clearly indicating the need for a more user-friendly system and a better viewer.

MCORES: a system for noun phrase coreference resolution for clinical records.

PubMed

Bodnari, Andreea; Szolovits, Peter; Uzuner, Özlem

2012-01-01

Narratives of electronic medical records contain information that can be useful for clinical practice and multi-purpose research. This information needs to be put into a structured form before it can be used by automated systems. Coreference resolution is a step in the transformation of narratives into a structured form. This study presents a medical coreference resolution system (MCORES) for noun phrases in four frequently used clinical semantic categories: persons, problems, treatments, and tests. MCORES treats coreference resolution as a binary classification task. Given a pair of concepts from a semantic category, it determines coreferent pairs and clusters them into chains. MCORES uses an enhanced set of lexical, syntactic, and semantic features. Some MCORES features measure the distance between various representations of the concepts in a pair and can be asymmetric. MCORES was compared with an in-house baseline that uses only single-perspective 'token overlap' and 'number agreement' features. MCORES was shown to outperform the baseline; its enhanced features contribute significantly to performance. In addition to the baseline, MCORES was compared against two available third-party, open-domain systems, RECONCILE(ACL09) and the Beautiful Anaphora Resolution Toolkit (BART). MCORES was shown to outperform both of these systems on clinical records.

Using exceedance probabilities to detect anomalies in routinely recorded animal health data, with particular reference to foot-and-mouth disease in Viet Nam.

PubMed

Richards, K K; Hazelton, M L; Stevenson, M A; Lockhart, C Y; Pinto, J; Nguyen, L

2014-10-01

The widespread availability of computer hardware and software for recording and storing disease event information means that, in theory, we have the necessary information to carry out detailed analyses of factors influencing the spatial distribution of disease in animal populations. However, the reliability of such analyses depends on data quality, with anomalous records having the potential to introduce significant bias and lead to inappropriate decision making. In this paper we promote the use of exceedance probabilities as a tool for detecting anomalies when applying hierarchical spatio-temporal models to animal health data. We illustrate this methodology through a case study data on outbreaks of foot-and-mouth disease (FMD) in Viet Nam for the period 2006-2008. A flexible binomial logistic regression was employed to model the number of FMD infected communes within each province of the country. Standard analyses of the residuals from this model failed to identify problems, but exceedance probabilities identified provinces in which the number of reported FMD outbreaks was unexpectedly low. This finding is interesting given that these provinces are on major cattle movement pathways through Viet Nam. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Technical Evaluation of Wireless Connectivity from Patient Monitors to an Anesthesia Information Management System During Intensive Care Unit Surgery.

PubMed

Simpao, Allan F; Galvez, Jorge A; England, W Randall; Wartman, Elicia C; Scott, James H; Hamid, Michael M; Rehman, Mohamed A; Epstein, Richard H

2016-02-01

Surgical procedures performed at the bedside in the neonatal intensive care unit (NICU) at The Children's Hospital of Philadelphia were documented using paper anesthesia records in contrast to the operating rooms, where an anesthesia information management system (AIMS) was used for all cases. This was largely because of logistical problems related to connecting cables between the bedside monitors and our portable AIMS workstations. We implemented an AIMS for documentation in the NICU using wireless adapters to transmit data from bedside monitoring equipment to a portable AIMS workstation. Testing of the wireless AIMS during simulation in the presence of an electrosurgical generator showed no evidence of interference with data transmission. Thirty NICU surgical procedures were documented via the wireless AIMS. Two wireless cases exhibited brief periods of data loss; one case had an extended data gap because of adapter power failure. In comparison, in a control group of 30 surgical cases in which wired connections were used, there were no data gaps. The wireless AIMS provided a simple, unobtrusive, portable alternative to paper records for documenting anesthesia records during NICU bedside procedures.

Anthropic Correction of Information Estimates and Its Application to Neural Coding

PubMed Central

Gastpar, Michael C.; Gill, Patrick R.; Huth, Alexander G.; Theunissen, Frédéric E.

2015-01-01

Information theory has been used as an organizing principle in neuroscience for several decades. Estimates of the mutual information (MI) between signals acquired in neurophysiological experiments are believed to yield insights into the structure of the underlying information processing architectures. With the pervasive availability of recordings from many neurons, several information and redundancy measures have been proposed in the recent literature. A typical scenario is that only a small number of stimuli can be tested, while ample response data may be available for each of the tested stimuli. The resulting asymmetric information estimation problem is considered. It is shown that the direct plug-in information estimate has a negative bias. An anthropic correction is introduced that has a positive bias. These two complementary estimators and their combinations are natural candidates for information estimation in neuroscience. Tail and variance bounds are given for both estimates. The proposed information estimates are applied to the analysis of neural discrimination and redundancy in the avian auditory system. PMID:26900172

Anthropic Correction of Information Estimates and Its Application to Neural Coding.

PubMed

Gastpar, Michael C; Gill, Patrick R; Huth, Alexander G; Theunissen, Frédéric E

2010-02-01

Information theory has been used as an organizing principle in neuroscience for several decades. Estimates of the mutual information (MI) between signals acquired in neurophysiological experiments are believed to yield insights into the structure of the underlying information processing architectures. With the pervasive availability of recordings from many neurons, several information and redundancy measures have been proposed in the recent literature. A typical scenario is that only a small number of stimuli can be tested, while ample response data may be available for each of the tested stimuli. The resulting asymmetric information estimation problem is considered. It is shown that the direct plug-in information estimate has a negative bias. An anthropic correction is introduced that has a positive bias. These two complementary estimators and their combinations are natural candidates for information estimation in neuroscience. Tail and variance bounds are given for both estimates. The proposed information estimates are applied to the analysis of neural discrimination and redundancy in the avian auditory system.

The challenge of electronic health records (EHRs) design and implementation: responses of health workers to drawing a 'big and rich picture' of a future EHR programme using animated tools.

PubMed

Jenkings, K Neil; Wilson, Robert G

2007-01-01

To investigate the use of animation tools to aid visualisation of problems for discussion within focus groups, in the context of healthcare workers discussing electronic health records (EHRs). Ten healthcare staff focus groups, held in a range of organisational contexts. Each focus group was in four stages: baseline discussion, animator presentation, post-animator discussion and questionnaire. Audio recordings of the focus groups were transcribed and coded and the emergent analytic themes analysed for issues relating to EHR design and implementation. The data allowed a comparison of baseline and post-animator discussion. The animator facilitated discussion about EHR issues and these were thematically coded as: Workload; Sharing Information; Access to Information; Record Content; Confidentiality; Patient Consent; and Implementation. We illustrate that use of the animator in focus groups is one means to raise understanding about a proposed EHR development. The animator provided a visual 'probe' to support a more proactive and discursive localised approach to end-user concerns, which could be part of an effective stakeholder engagement and communication strategy crucial in any EHR or health informatics implementation programme. The results of the focus groups were to raise salient issues and concerns, many of which anticipated those that have emerged in the current NHS Connecting for Health Care Records programme in England. Potentially, animator-type technologies may facilitate the user ownership which other forms of dissemination appear to be failing to achieve.

Particle sizing in rocket motor studies utilizing hologram image processing

NASA Technical Reports Server (NTRS)

Netzer, David; Powers, John

1987-01-01

A technique of obtaining particle size information from holograms of combustion products is described. The holograms are obtained with a pulsed ruby laser through windows in a combustion chamber. The reconstruction is done with a krypton laser with the real image being viewed through a microscope. The particle size information is measured with a Quantimet 720 image processing system which can discriminate various features and perform measurements of the portions of interest in the image. Various problems that arise in the technique are discussed, especially those that are a consequence of the speckle due to the diffuse illumination used in the recording process.

Use abstracted patient-specific features to assist an information-theoretic measurement to assess similarity between medical cases

PubMed Central

Cao, Hui; Melton, Genevieve B.; Markatou, Marianthi; Hripcsak, George

2008-01-01

Inter-case similarity metrics can potentially help find similar cases from a case base for evidence-based practice. While several methods to measure similarity between cases have been proposed, developing an effective means for measuring patient case similarity remains a challenging problem. We were interested in examining how abstracting could potentially assist computing case similarity. In this study, abstracted patient-specific features from medical records were used to improve an existing information-theoretic measurement. The developed metric, using a combination of abstracted disease, finding, procedure and medication features, achieved a correlation between 0.6012 and 0.6940 to experts. PMID:18487093

Ship localization in Santa Barbara Channel using machine learning classifiers.

PubMed

Niu, Haiqiang; Ozanich, Emma; Gerstoft, Peter

2017-11-01

Machine learning classifiers are shown to outperform conventional matched field processing for a deep water (600 m depth) ocean acoustic-based ship range estimation problem in the Santa Barbara Channel Experiment when limited environmental information is known. Recordings of three different ships of opportunity on a vertical array were used as training and test data for the feed-forward neural network and support vector machine classifiers, demonstrating the feasibility of machine learning methods to locate unseen sources. The classifiers perform well up to 10 km range whereas the conventional matched field processing fails at about 4 km range without accurate environmental information.

GCS programmer's manual

NASA Technical Reports Server (NTRS)

Lowman, Douglas S.; Withers, B. Edward; Shagnea, Anita M.; Dent, Leslie A.; Hayhurst, Kelly J.

1990-01-01

A variety of instructions to be used in the development of implementations of software for the Guidance and Control Software (GCS) project is described. This document fulfills the Radio Technical Commission for Aeronautics RTCA/DO-178A guidelines, 'Software Considerations in Airborne Systems and Equipment Certification' requirements for document No. 4, which specifies the information necessary for understanding and programming the host computer, and document No. 12, which specifies the software design and implementation standards that are applicable to the software development and testing process. Information on the following subjects is contained: activity recording, communication protocol, coding standards, change management, error handling, design standards, problem reporting, module testing logs, documentation formats, accuracy requirements, and programmer responsibilities.

What does industry need in the way of meteorology for air pollution problems

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

Crow, L.W.

1978-01-01

A discussion covers information which should be supplied to the consulting meteorologist; typical requests made by industrial concerns of various consultants; feeding meteorological data to models; the use of meteorological information in developing prevention of significant deterioration requirements; sources of error, e.g., assuming that digital values have a higher validity than the original analog records; the need for industrial concerns to develop sets of site-specific data; and the greater liability of air flow and stability frequencies estimated by professional meteorologists than transposed historical data from the nearest airport station for use as model input to make preliminary planning decisions.

Multiplexed Holographic Data Storage in Bacteriorhodopsin

NASA Technical Reports Server (NTRS)

Mehrl, David J.; Krile, Thomas F.

1997-01-01

High density optical data storage, driven by the information revolution, remains at the forefront of current research areas. Much of the current research has focused on photorefractive materials (SBN and LiNbO3) and polymers, despite various problems with expense, durability, response time and retention periods. Photon echo techniques, though promising, are questionable due to the need for cryogenic conditions. Bacteriorhodopsin (BR) films are an attractive alternative recording medium. Great strides have been made in refining BR, and materials with storage lifetimes as long as 100 days have recently become available. The ability to deposit this robust polycrystalline material as high quality optical films suggests the use of BR as a recording medium for commercial optical disks. Our own recent research has demonstrated the suitability of BR films for real time spatial filtering and holography. We propose to fully investigate the feasibility of performing holographic mass data storage in BR. Important aspects of the problem to be investigated include various data multiplexing techniques (e.g. angle- amplitude- and phase-encoded multiplexing, and in particular shift-multiplexing), multilayer recording techniques, SLM selection and data readout using crossed polarizers for noise rejection. Systems evaluations of storage parameters, including access times, memory refresh constraints, erasure, signal-to-noise ratios and bit error rates, will be included in our investigations.

From troglodytes to information managers: information management and technology needs to achieve the primary care NHS modernization agenda--the views of three GPs.

PubMed

Rooney, I; Hornby, S

2000-09-01

In response to the information management and technology changes proposed by the Government's NHS modernization initiative this article examines the issues that GPs feel to be of major significance to their work. Although information and communications technology is widely used in general practice there is no one agreed standard system. The level of technology and the manner in which it is used is also diverse throughout the profession, as are the attitudes that exist amongst GPs regarding the value of information management and technology, and the benefits efficient information management offers to them and to their patients. The views of three local GPs from practices with varying levels of information technology were obtained through semi-structured interviews and the findings developed in the light of current discussions in the published literature. The GPs chosen reflect the disparity within general practice and, perhaps, other units of the NHS in the use and understanding of information management. The main conclusions were that there is ambivalence and scepticism about what NHSnet currently has to offer; that local electronic records benefit patient care, but when networked more widely problems of confidentiality and security result. Practitioners were also mindful of the financial costs of changes and concerned, given the impact of PCGs and clinical governance, as to who will be responsible for ensuring a common level of electronic records, IT provision, and financial and technological support.

The Computer: An Effective Research Assistant

PubMed Central

Gancher, Wendy

1984-01-01

The development of software packages such as data management systems and statistical packages has made it possible to process large amounts of research data. Data management systems make the organization and manipulation of such data easier. Floppy disks ease the problem of storing and retrieving records. Patient information can be kept confidential by limiting access to computer passwords linked with research files, or by using floppy disks. These attributes make the microcomputer essential to modern primary care research. PMID:21279042

Privacy-preserving heterogeneous health data sharing.

PubMed

Mohammed, Noman; Jiang, Xiaoqian; Chen, Rui; Fung, Benjamin C M; Ohno-Machado, Lucila

2013-05-01

Privacy-preserving data publishing addresses the problem of disclosing sensitive data when mining for useful information. Among existing privacy models, ε-differential privacy provides one of the strongest privacy guarantees and makes no assumptions about an adversary's background knowledge. All existing solutions that ensure ε-differential privacy handle the problem of disclosing relational and set-valued data in a privacy-preserving manner separately. In this paper, we propose an algorithm that considers both relational and set-valued data in differentially private disclosure of healthcare data. The proposed approach makes a simple yet fundamental switch in differentially private algorithm design: instead of listing all possible records (ie, a contingency table) for noise addition, records are generalized before noise addition. The algorithm first generalizes the raw data in a probabilistic way, and then adds noise to guarantee ε-differential privacy. We showed that the disclosed data could be used effectively to build a decision tree induction classifier. Experimental results demonstrated that the proposed algorithm is scalable and performs better than existing solutions for classification analysis. The resulting utility may degrade when the output domain size is very large, making it potentially inappropriate to generate synthetic data for large health databases. Unlike existing techniques, the proposed algorithm allows the disclosure of health data containing both relational and set-valued data in a differentially private manner, and can retain essential information for discriminative analysis.

Privacy-preserving heterogeneous health data sharing

PubMed Central

Mohammed, Noman; Jiang, Xiaoqian; Chen, Rui; Fung, Benjamin C M; Ohno-Machado, Lucila

2013-01-01

Objective Privacy-preserving data publishing addresses the problem of disclosing sensitive data when mining for useful information. Among existing privacy models, ε-differential privacy provides one of the strongest privacy guarantees and makes no assumptions about an adversary's background knowledge. All existing solutions that ensure ε-differential privacy handle the problem of disclosing relational and set-valued data in a privacy-preserving manner separately. In this paper, we propose an algorithm that considers both relational and set-valued data in differentially private disclosure of healthcare data. Methods The proposed approach makes a simple yet fundamental switch in differentially private algorithm design: instead of listing all possible records (ie, a contingency table) for noise addition, records are generalized before noise addition. The algorithm first generalizes the raw data in a probabilistic way, and then adds noise to guarantee ε-differential privacy. Results We showed that the disclosed data could be used effectively to build a decision tree induction classifier. Experimental results demonstrated that the proposed algorithm is scalable and performs better than existing solutions for classification analysis. Limitation The resulting utility may degrade when the output domain size is very large, making it potentially inappropriate to generate synthetic data for large health databases. Conclusions Unlike existing techniques, the proposed algorithm allows the disclosure of health data containing both relational and set-valued data in a differentially private manner, and can retain essential information for discriminative analysis. PMID:23242630

Comparison of recent S-wave indicating methods

NASA Astrophysics Data System (ADS)

Hubicka, Katarzyna; Sokolowski, Jakub

2018-01-01

Seismic event consists of surface waves and body waves. Due to the fact that the body waves are faster (P-waves) and more energetic (S-waves) in literature the problem of their analysis is taken more often. The most universal information that is received from the recorded wave is its moment of arrival. When this information is obtained from at least four seismometers in different locations, the epicentre of the particular event can be estimated [1]. Since the recorded body waves may overlap in signal, the problem of wave onset moment is considered more often for faster P-wave than S-wave. This however does not mean that the issue of S-wave arrival time is not taken at all. As the process of manual picking is time-consuming, methods of automatic detection are recommended (these however may be less accurate). In this paper four recently developed methods estimating S-wave arrival are compared: the method operating on empirical mode decomposition and Teager-Kaiser operator [2], the modification of STA/LTA algorithm [3], the method using a nearest neighbour-based approach [4] and the algorithm operating on characteristic of signals' second moments. The methods will be also compared to wellknown algorithm based on the autoregressive model [5]. The algorithms will be tested in terms of their S-wave arrival identification accuracy on real data originating from International Research Institutions for Seismology (IRIS) database.

A comparison of substance dependence treatment information system in America, England, and Iran.

PubMed

Ajami, Sima; Mellat-Karkevandi, Zahra; Saghaeiannejad-Isfahani, Sakineh; Salehi, Mehrdad; Jahanbakhsh, Maryam

2014-01-01

Addiction, as a social problem, is a phenomenon that causes structural changes in cultural, social, political, and economic system in society. Prevention of this problem means decrease of risk factors and increase of protective factors; and recognition of these factors is possible with the help of update, accurate, and complete information in information systems. The aim of this study was to compare substance dependence treatment information system (SDTIS) in America, England, and Iran. This research was an applied and comparison-descriptive study, in which SDTIS was compared in America, England, and Iran. These countries were chosen based on available information on the Internet and also on the development of these countries in the health information management field. Information resources included library resources, electronic resources, and expert people (Health Information Management, Medical Records Education, Psychologist, Psychiatrist, and Medical Informatics). The data collection tool was the data raw form, whose reliability was proved by expert people. Findings were analyzed by theory and descriptive method. America and England had the SDTIS. Their systems had special characteristics such as goals, scope, special method for collecting, processing, reporting, quality and validity control, and confidentiality principles. However, there was no such system in Iran and the present situation in Iran has many differences with similar situations in the studied countries. Presence of an information system in the substance dependence treatment field helps to prevent, control, and treat addicted people. Hence, we try to submit a suitable model for implementing this system.

Personal health records: mobile biosensors and smartphones for developing countries.

PubMed

Simon, Sternly K; Seldon, H Lee

2012-01-01

A target of telehealth is to maintain or improve the health of people outside the normal healthcare infrastructure. A modern paradigm in healthcare, and one which fits perfectly with telehealth, is "person self-monitoring", and this fits with the concept of "personal health record" (PHR). One factor in maintaining health is to monitor physiological parameters; this is of course especially important in people with chronic maladies such as diabetes or heart disease. Parameters to be monitored include blood pressure, pulse rate, temperature, weight, blood glucose, oxygen saturation, electrocardiogram (ECG), etc. So one task within telehealth would be to help monitor an individual's physiological parameters outside of healthcare institutions and store the results in a PHR in a way which is available, comprehensible and beneficial to the individual concerned and to healthcare providers. To date many approaches to this problem have been fragmented - emphasizing only part of the problem - or proprietary and not freely verifiable. We describe a framework to approach this task; it emphasizes the implementation of standards for data acquisition, storage and transmission in order to maximize the compatibility among disparate components, e.g. various PHR systems. Data from mobile biosensors is collected on a smartphone using the IEEE 11073 standard where possible; the data can be stored in a PHR on the phone (using standard formats) or can be converted in real-time into more useful information in the PHR, which is based on the International Classification for Primary Care (ICPC2e). The phone PHR data or information can be uploaded to a central online PHR using either the Wi-Fi or GSM transmission protocol together with the Continuity of Care Record message format (CCR, ASTM E2369).

36 CFR 1239.20 - When will NARA undertake an inspection?

Code of Federal Regulations, 2010 CFR

2010-07-01

... management problems involving high risk to significant records. Problems may be identified through a risk... ADMINISTRATION RECORDS MANAGEMENT PROGRAM ASSISTANCE AND INSPECTIONS Inspections § 1239.20 When will NARA...) have failed to mitigate situations where there is a high risk of loss of significant records, or when...

Storage, Preservation, and Recovery of Magnetic Recording Tape

NASA Technical Reports Server (NTRS)

Cuddihy, Edward F.

1994-01-01

During the 1970's, a commercial magnetic recording tape fabricated with magnetic oxide particles, and with oxide and backcoat binders made from polyester urethane was being used for spacecraft tape recorders, and which would periodically manifest operational problems such as layer-to-layer adhesion, stick-slip, and shedding of sticky organic materials. These problems were generally associated with periods of high humidity. An experimental study identified that these problems resulted from hydrolysis of the polyester urethane binders.

Mental health problems of undocumented migrants in the Netherlands: A qualitative exploration of recognition, recording, and treatment by general practitioners.

PubMed

Teunissen, Erik; Van Bavel, Eric; Van Den Driessen Mareeuw, Francine; Macfarlane, Anne; Van Weel-Baumgarten, Evelyn; Van Den Muijsenbergh, Maria; Van Weel, Chris

2015-06-01

To explore the views and experiences of general practitioners (GPs) in relation to recognition, recording, and treatment of mental health problems of undocumented migrants (UMs), and to gain insight in the reasons for under-registration of mental health problems in the electronic medical records. Qualitative study design with semi-structured interviews using a topic guide. Sixteen GPs in the Netherlands with clinical expertise in the care of UMs. GPs recognized many mental health problems in UMs. Barriers that prevented them from recording these problems and from delivering appropriate care were their low consultation rates, physical presentation of mental health problems, high number of other problems, the UM's lack of trust towards health care professionals, and cultural differences in health beliefs and language barriers. Referrals to mental health care organizations were often seen as problematic by GPs. To overcome these barriers, GPs provided personalized care as far as possible, referred to other primary care professionals such as social workers or mental health care nurses in their practice, and were a little less restrictive in prescribing psychotropics than guidelines recommended. GPs experienced a variety of barriers in engaging with UMs when identifying or suspecting mental health problems. This explains why there is a gap between the high recognition of mental health problems and the low recording of these problems in general practice files. It is recommended that GPs address mental health problems more actively, strive for continuity of care in order to gain trust of the UMs, and look for opportunities to provide mental care that is accessible and acceptable for UMs.

A practice-based evaluation of a liquid barrier film.

PubMed

Harding, Nicola

2002-05-01

In palliative care it is often the little things such as being comfortable that help to improve a patient's quality of life. When the opportunity arose in our hospice to take part in a practice-based evaluation of a product that promised to make patients more comfortable, we were pleased to take part. Our small-scale evaluation was part of a wider study of SuperSkin, a liquid barrier film designed to protect skin at risk of damage. Information was collected from the patient, patient's medical notes and the nursing staff - a patient daily diary record was used in addition to normal information recordings. We evaluated the efficacy of the product and found this liquid barrier film to have a positive effect in several ways. It appeared to assist in the healing of skin damaged by friction and shearing forces, and from excoriation from wound exudates, urine and faeces. In addition, it appeared to protect healthy, 'at risk' skin from the same problems.

End-user support for primary care electronic medical records: a qualitative case study of users’ needs, expectations and realities

PubMed Central

Shachak, Aviv; Montgomery, Catherine; Dow, Rustam; Barnsley, Jan; Tu, Karen; Jadad, Alejandro R.; Lemieux-Charles, Louise

2015-01-01

Support is considered an important factor for realizing the benefits of health information technology (HIT) but there is a dearth of research on the topic of support, especially in primary care. We conducted a qualitative multiple case study of 4 family health teams (FHTs) and one family health organization (FHO) in Ontario, Canada in an attempt to gain insight into users’ expectations and needs, and the realities of end-user support for primary care electronic medical records (EMRs). Data were collected by semi-structured interviews, documents review, and observation of training sessions. The analysis highlights the important role of on-site information technology (IT) staff and super-users in liaising with various stakeholders to solve technical problems and providing hardware and functional (‘how to’) support; the local development of data support practices to ensure consistent documentation; and the gaps that exist in users’ and support personnel’s understanding of each other’s work processes. PMID:26225209

Acceptance of direct physician access to a computer-based patient record in a managed care setting.

PubMed

Dewey, J B; Manning, P; Brandt, S

1993-01-01

Kaiser Permanente Mid-Atlantic States has developed a fully integrated outpatient information system which currently runs on an IBM ES9000 on a VM platform written in MUMPS. The applications include Lab, Radiology, Transcription, Appointments. Pharmacy, Encounter tracking, Hospitalizations, Referrals, Phone Advice, Pap tracking, Problem list, Immunization tracking, and Patient demographics. They are department specific and require input and output from a dumb terminal. We have developed a physician's work station to access this information using PC compatible computers running Microsoft Windows and a custom Microsoft Visual Basic 2.0 environment which draws from these 14 applications giving the physician a comprehensive view of all electronic medical records. Through rapid prototyping, voluntary participation, formal training and gradual implementation we have created an enthusiastic response. 95% of our physician PC users access the system each month. The use ranges from 0.2 to 3.0 screens of data viewed per patient visit. This response continues to drive the process toward still greater user acceptance and further practice enhancement.

Combining infobuttons and semantic web rules for identifying patterns and delivering highly-personalized education materials.

PubMed

Hulse, Nathan C; Long, Jie; Tao, Cui

2013-01-01

Infobuttons have been established to be an effective resource for addressing information needs at the point of care, as evidenced by recent research and their inclusion in government-based electronic health record incentive programs in the United States. Yet their utility has been limited to wide success for only a specific set of domains (lab data, medication orders, and problem lists) and only for discrete, singular concepts that are already documented in the electronic medical record. In this manuscript, we present an effort to broaden their utility by connecting a semantic web-based phenotyping engine with an infobutton framework in order to identify and address broader issues in patient data, derived from multiple data sources. We have tested these patterns by defining and testing semantic definitions of pre-diabetes and metabolic syndrome. We intend to carry forward relevant information to the infobutton framework to present timely, relevant education resources to patients and providers.

EMRlog method for computer security for electronic medical records with logic and data mining.

PubMed

Martínez Monterrubio, Sergio Mauricio; Frausto Solis, Juan; Monroy Borja, Raúl

2015-01-01

The proper functioning of a hospital computer system is an arduous work for managers and staff. However, inconsistent policies are frequent and can produce enormous problems, such as stolen information, frequent failures, and loss of the entire or part of the hospital data. This paper presents a new method named EMRlog for computer security systems in hospitals. EMRlog is focused on two kinds of security policies: directive and implemented policies. Security policies are applied to computer systems that handle huge amounts of information such as databases, applications, and medical records. Firstly, a syntactic verification step is applied by using predicate logic. Then data mining techniques are used to detect which security policies have really been implemented by the computer systems staff. Subsequently, consistency is verified in both kinds of policies; in addition these subsets are contrasted and validated. This is performed by an automatic theorem prover. Thus, many kinds of vulnerabilities can be removed for achieving a safer computer system.

EMRlog Method for Computer Security for Electronic Medical Records with Logic and Data Mining

PubMed Central

Frausto Solis, Juan; Monroy Borja, Raúl

2015-01-01

The proper functioning of a hospital computer system is an arduous work for managers and staff. However, inconsistent policies are frequent and can produce enormous problems, such as stolen information, frequent failures, and loss of the entire or part of the hospital data. This paper presents a new method named EMRlog for computer security systems in hospitals. EMRlog is focused on two kinds of security policies: directive and implemented policies. Security policies are applied to computer systems that handle huge amounts of information such as databases, applications, and medical records. Firstly, a syntactic verification step is applied by using predicate logic. Then data mining techniques are used to detect which security policies have really been implemented by the computer systems staff. Subsequently, consistency is verified in both kinds of policies; in addition these subsets are contrasted and validated. This is performed by an automatic theorem prover. Thus, many kinds of vulnerabilities can be removed for achieving a safer computer system. PMID:26495300

Amplification, Redundancy, and Quantum Chernoff Information

NASA Astrophysics Data System (ADS)

Zwolak, Michael; Riedel, C. Jess; Zurek, Wojciech H.

2014-04-01

Amplification was regarded, since the early days of quantum theory, as a mysterious ingredient that endows quantum microstates with macroscopic consequences, key to the "collapse of the wave packet," and a way to avoid embarrassing problems exemplified by Schrödinger's cat. Such a bridge between the quantum microworld and the classical world of our experience was postulated ad hoc in the Copenhagen interpretation. Quantum Darwinism views amplification as replication, in many copies, of the information about quantum states. We show that such amplification is a natural consequence of a broad class of models of decoherence, including the photon environment we use to obtain most of our information. This leads to objective reality via the presence of robust and widely accessible records of selected quantum states. The resulting redundancy (the number of copies deposited in the environment) follows from the quantum Chernoff information that quantifies the information transmitted by a typical elementary subsystem of the environment.

A secure and efficient password-based user authentication scheme using smart cards for the integrated EPR information system.

PubMed

Lee, Tian-Fu; Chang, I-Pin; Lin, Tsung-Hung; Wang, Ching-Cheng

2013-06-01

The integrated EPR information system supports convenient and rapid e-medicine services. A secure and efficient authentication scheme for the integrated EPR information system provides safeguarding patients' electronic patient records (EPRs) and helps health care workers and medical personnel to rapidly making correct clinical decisions. Recently, Wu et al. proposed an efficient password-based user authentication scheme using smart cards for the integrated EPR information system, and claimed that the proposed scheme could resist various malicious attacks. However, their scheme is still vulnerable to lost smart card and stolen verifier attacks. This investigation discusses these weaknesses and proposes a secure and efficient authentication scheme for the integrated EPR information system as alternative. Compared with related approaches, the proposed scheme not only retains a lower computational cost and does not require verifier tables for storing users' secrets, but also solves the security problems in previous schemes and withstands possible attacks.

Motivated recall in the service of the economic system: The case of anthropogenic climate change.

PubMed

Hennes, Erin P; Ruisch, Benjamin C; Feygina, Irina; Monteiro, Christopher A; Jost, John T

2016-06-01

The contemporary political landscape is characterized by numerous divisive issues. Unlike many other issues, however, much of the disagreement about climate change centers not on how best to take action to address the problem, but on whether the problem exists at all. Psychological studies indicate that, to the extent that sustainability initiatives are seen as threatening to the socioeconomic system, individuals may downplay environmental problems in order to defend and protect the status quo. In the current research, participants were presented with scientific information about climate change and later asked to recall details of what they had learned. Individuals who were experimentally induced (Study 1) or dispositionally inclined (Studies 2 and 3) to justify the economic system misremembered the evidence to be less serious, and this was associated with increased skepticism. However, when high system justifiers were led to believe that the economy was in a recovery, they recalled climate change information to be more serious than did those assigned to a control condition. When low system justifiers were led to believe that the economy was in recession, they recalled the information to be less serious (Study 3). These findings suggest that because system justification can impact information processing, simply providing the public with scientific evidence may be insufficient to inspire action to mitigate climate change. However, linking environmental information to statements about the strength of the economic system may satiate system justification needs and break the psychological link between proenvironmental initiatives and economic risk. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

EHR Big Data Deep Phenotyping

PubMed Central

Lenert, L.; Lopez-Campos, G.

2014-01-01

Summary Objectives Given the quickening speed of discovery of variant disease drivers from combined patient genotype and phenotype data, the objective is to provide methodology using big data technology to support the definition of deep phenotypes in medical records. Methods As the vast stores of genomic information increase with next generation sequencing, the importance of deep phenotyping increases. The growth of genomic data and adoption of Electronic Health Records (EHR) in medicine provides a unique opportunity to integrate phenotype and genotype data into medical records. The method by which collections of clinical findings and other health related data are leveraged to form meaningful phenotypes is an active area of research. Longitudinal data stored in EHRs provide a wealth of information that can be used to construct phenotypes of patients. We focus on a practical problem around data integration for deep phenotype identification within EHR data. The use of big data approaches are described that enable scalable markup of EHR events that can be used for semantic and temporal similarity analysis to support the identification of phenotype and genotype relationships. Conclusions Stead and colleagues’ 2005 concept of using light standards to increase the productivity of software systems by riding on the wave of hardware/processing power is described as a harbinger for designing future healthcare systems. The big data solution, using flexible markup, provides a route to improved utilization of processing power for organizing patient records in genotype and phenotype research. PMID:25123744

Impact of Hospital Information Systems on Emergency Patient Processing

PubMed Central

Rusnak, James E.

1981-01-01

The Emergency Department offers the Hospital Information System's designer some unique problems to solve in the operational areas of patient registration, order entry, charge recording, and treatment processing. In a number of instances, Hospital Information Systems implementers have encountered serious difficulties in trying to design system components to support the requirements of the Emergency Services Department's operations. Washington Hospital has developed a very effective system for Emergency Services. The system's features are designed to meet the special requirements of the department and to maximize the use of the data captured by the Hospital Information System. The system supports accurate and timely charging for services. The treatment of the patient has been dramatically improved through the use of a computerized order processing and control. The installed systems resulted in a higher quality of care and cost effective operations.

Cross-institutional document exchange system using clinical document architecture (CDA) with virtual printing method.

PubMed

Mihara, Naoki; Ueda, Kanayo; Manabe, Shirou; Takeda, Toshihiro; Shimai, Yoshie; Horishima, Hiroyuki; Murata, Taizo; Fujii, Ayumi; Matsumura, Yasushi

2015-01-01

Recently one patient received care from several hospitals at around the same time. When the patient visited a new hospital, the new hospital's physician tried to get patient information the previous hospital. Thus, patient information is frequently exchanged between them. Many types of healthcare facilities have implemented an electronic medical record system, but in Japan, healthcare information exchange is often done by paper. In other words, after a clinical doctor prints a referral document and sends it to another hospital's physician, another hospital's doctor receives it and scans to store the EMR in his own hospital's system. It is a wasteful way to exchange healthcare information about a patient. In order to solve this problem, we have developed a cross-institutional document exchange system using clinical document architecture (CDA) with a virtual printing method.

On the recovery of missing low and high frequency information from bandlimited reflectivity data

NASA Astrophysics Data System (ADS)

Sacchi, M. D.; Ulrych, T. J.

2007-12-01

During the last two decades, an important effort in the seismic exploration community has been made to retrieve broad-band seismic data by means of deconvolution and inversion. In general, the problem can be stated as a spectral reconstruction problem. In other words, given limited spectral information about the earth's reflectivity sequence, one attempts to create a broadband estimate of the Fourier spectra of the unknown reflectivity. Techniques based on the principle of parsimony can be effectively used to retrieve a sparse spike sequence and, consequently, a broad band signal. Alternatively, continuation methods, e.g., autoregressive modeling, can be used to extrapolate the recorded bandwidth of the seismic signal. The goal of this paper is to examine under what conditions the recovery of low and high frequencies from band-limited and noisy signals is possible. At the heart of the methods we discuss, is the celebrated non-Gaussian assumption so important in many modern signal processing methods, such as ICA, for example. Spectral recovery from limited information tends to work when the reflectivity consist of a few well isolated events. Results degrade with the number of reflectors, decreasing SNR and decreasing bandwidth of the source wavelet. Constrains and information-based priors can be used to stabilize the recovery but, as in all inverse problems, the solution is nonunique and effort is required to understand the level of recovery that is achievable, always keeping the physics of the problem in mind. We provide in this paper, a survey of methods to recover broad-band reflectivity sequences and examine the role that these techniques can play in the processing and inversion as applied to exploration and global seismology.

Development and implementation of a 'Mental Health Finder' software tool within an electronic medical record system.

PubMed

Swan, D; Hannigan, A; Higgins, S; McDonnell, R; Meagher, D; Cullen, W

2017-02-01

In Ireland, as in many other healthcare systems, mental health service provision is being reconfigured with a move toward more care in the community, and particularly primary care. Recording and surveillance systems for mental health information and activities in primary care are needed for service planning and quality improvement. We describe the development and initial implementation of a software tool ('mental health finder') within a widely used primary care electronic medical record system (EMR) in Ireland to enable large-scale data collection on the epidemiology and management of mental health and substance use problems among patients attending general practice. In collaboration with the Irish Primary Care Research Network (IPCRN), we developed the 'Mental Health Finder' as a software plug-in to a commonly used primary care EMR system to facilitate data collection on mental health diagnoses and pharmacological treatments among patients. The finder searches for and identifies patients based on diagnostic coding and/or prescribed medicines. It was initially implemented among a convenience sample of six GP practices. Prevalence of mental health and substance use problems across the six practices, as identified by the finder, was 9.4% (range 6.9-12.7%). 61.9% of identified patients were female; 25.8% were private patients. One-third (33.4%) of identified patients were prescribed more than one class of psychotropic medication. Of the patients identified by the finder, 89.9% were identifiable via prescribing data, 23.7% via diagnostic coding. The finder is a feasible and promising methodology for large-scale data collection on mental health problems in primary care.

Stabilizing l1-norm prediction models by supervised feature grouping.

PubMed

Kamkar, Iman; Gupta, Sunil Kumar; Phung, Dinh; Venkatesh, Svetha

2016-02-01

Emerging Electronic Medical Records (EMRs) have reformed the modern healthcare. These records have great potential to be used for building clinical prediction models. However, a problem in using them is their high dimensionality. Since a lot of information may not be relevant for prediction, the underlying complexity of the prediction models may not be high. A popular way to deal with this problem is to employ feature selection. Lasso and l1-norm based feature selection methods have shown promising results. But, in presence of correlated features, these methods select features that change considerably with small changes in data. This prevents clinicians to obtain a stable feature set, which is crucial for clinical decision making. Grouping correlated variables together can improve the stability of feature selection, however, such grouping is usually not known and needs to be estimated for optimal performance. Addressing this problem, we propose a new model that can simultaneously learn the grouping of correlated features and perform stable feature selection. We formulate the model as a constrained optimization problem and provide an efficient solution with guaranteed convergence. Our experiments with both synthetic and real-world datasets show that the proposed model is significantly more stable than Lasso and many existing state-of-the-art shrinkage and classification methods. We further show that in terms of prediction performance, the proposed method consistently outperforms Lasso and other baselines. Our model can be used for selecting stable risk factors for a variety of healthcare problems, so it can assist clinicians toward accurate decision making. Copyright © 2015 Elsevier Inc. All rights reserved.

39 CFR 262.4 - Records.

Code of Federal Regulations, 2010 CFR

2010-07-01

... STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT DEFINITIONS § 262.4 Records. Recorded information, regardless of media, format, or physical characteristics...) Corporate records. Those records series that are designated by the Records Office as containing information...

39 CFR 262.4 - Records.

Code of Federal Regulations, 2014 CFR

2014-07-01

... STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT DEFINITIONS § 262.4 Records. Recorded information, regardless of media, format, or physical characteristics...) Corporate records. Those records series that are designated by the Records Office as containing information...

39 CFR 262.4 - Records.

Code of Federal Regulations, 2011 CFR

2011-07-01

... STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT DEFINITIONS § 262.4 Records. Recorded information, regardless of media, format, or physical characteristics...) Corporate records. Those records series that are designated by the Records Office as containing information...

39 CFR 262.4 - Records.

Code of Federal Regulations, 2013 CFR

2013-07-01

... STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT DEFINITIONS § 262.4 Records. Recorded information, regardless of media, format, or physical characteristics...) Corporate records. Those records series that are designated by the Records Office as containing information...

39 CFR 262.4 - Records.

Code of Federal Regulations, 2012 CFR

2012-07-01

... STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT DEFINITIONS § 262.4 Records. Recorded information, regardless of media, format, or physical characteristics...) Corporate records. Those records series that are designated by the Records Office as containing information...

IceChrono v1: a probabilistic model to compute a common and optimal chronology for several ice cores

NASA Astrophysics Data System (ADS)

Parrenin, Frédéric

2015-04-01

Polar ice cores provide exceptional archives of past environmental conditions. The dating of ice cores is essential to interpret the paleo records that they contain, but it is a complicated problem since it involves different dating methods. Here I present IceChrono v1, a new probabilistic model to combine different kinds of chronological information to obtain a common and optimized chronology for several ice cores, as well as its uncertainty. It is based on the inversion of three quantities: the surface accumulation rate, the Lock-In Depth (LID) of air bubbles and the vertical thinning function. The chronological information used are: models of the sedimentation process (accumulation of snow, densification of snow into ice and air trapping, ice flow), ice and gas dated horizons, ice and gas dated depth intervals, Δdepth observations (depth shift between synchronous events recorded in the ice and in the air), stratigraphic links in between ice cores (ice-ice, air-air or mix ice-air and air-ice links). The optimization problem is formulated as a least squares problems, that is, all densities of probabilities are assumed gaussian. It is numerically solved using the Levenberg-Marquardt algorithm and a numerical evaluation of the model's Jacobian. IceChrono is similar in scope to the Datice model, but has differences from the mathematical, numerical and programming point of views. I apply IceChrono on an AICC2012-like experiment and I find similar results than Datice within a few centuries, which is a confirmation of both IceChrono and Datice codes. IceChrono v1 is freely available under the GPL v3 open source license.

Evaluation of a problem-specific SBAR tool to improve after-hours nurse-physician phone communication: a randomized trial.

PubMed

Joffe, Erel; Turley, James P; Hwang, Kevin O; Johnson, Todd R; Johnson, Craig W; Bernstam, Elmer V

2013-11-01

After-hours telephone communications are common in patient management. Patterns of communication of key information during after-hours phone calls were evaluated, and the utility of problem-specific Situation, Background, Assessment, Recommendation (SBAR) forms in improving this communication was assessed. In a randomized trial using a simulated on-call setting, 20 nurses called physicians regarding six cases adapted from inpatient records and based on the six most common reasons for after-hours nurse-physician communication. Three of the cases were handled without the SBAR forms (control cases), and three cases were handled with the forms (SBAR cases). Two cue types of communication were evaluated: situation cues, which conveyed the patient's situation (for example, a patient is confused), and background cues, which conveyed problem-specific data indicated on the SBAR forms (for example, the patient has a low sodium level). Ninety-two phone calls were analyzed (43 SBAR/49 controls). Most of the nurses reported the situation cues (SBAR 88%, control 84%, p = .60) but not the background cues. There was a trend toward fewer background cues communicated in the SBAR cases (14% versus 31%, p = .08). In 14% of the cases, on average, nurses omitted information or reported wrong information regarding the background cue. Physicians asked questions that resulted in the communication of the cues in a minority of the cases when the background cues were not originally provided by the nurses (SBAR 6%, control 16%, p = .39). In after-hours phone communication between physicians and nurses, significant information was often not communicated and physicians did not elicit the necessary information. Simply providing an SBAR-based form did not ensure complete communication of key information.

A new generation of tools for search, recovery and quality evaluation of World Wide Web medical resources.

PubMed

Aguillo, I

2000-01-01

Although the Internet is already a valuable information resource in medicine, there are important challenges to be faced before physicians and general users will have extensive access to this information. As a result of a research effort to compile a health-related Internet directory, new tools and strategies have been developed to solve key problems derived from the explosive growth of medical information on the Net and the great concern over the quality of such critical information. The current Internet search engines lack some important capabilities. We suggest using second generation tools (client-side based) able to deal with large quantities of data and to increase the usability of the records recovered. We tested the capabilities of these programs to solve health-related information problems, recognising six groups according to the kind of topics addressed: Z39.50 clients, downloaders, multisearchers, tracing agents, indexers and mappers. The evaluation of the quality of health information available on the Internet could require a large amount of human effort. A possible solution may be to use quantitative indicators based on the hypertext visibility of the Web sites. The cybermetric measures are valid for quality evaluation if they are derived from indirect peer review by experts with Web pages citing the site. The hypertext links acting as citations need to be extracted from a controlled sample of quality super-sites.

Reconciling disparate information in continuity of care documents: Piloting a system to consolidate structured clinical documents.

PubMed

Hosseini, Masoud; Jones, Josette; Faiola, Anthony; Vreeman, Daniel J; Wu, Huanmei; Dixon, Brian E

2017-10-01

Due to the nature of information generation in health care, clinical documents contain duplicate and sometimes conflicting information. Recent implementation of Health Information Exchange (HIE) mechanisms in which clinical summary documents are exchanged among disparate health care organizations can proliferate duplicate and conflicting information. To reduce information overload, a system to automatically consolidate information across multiple clinical summary documents was developed for an HIE network. The system receives any number of Continuity of Care Documents (CCDs) and outputs a single, consolidated record. To test the system, a randomly sampled corpus of 522 CCDs representing 50 unique patients was extracted from a large HIE network. The automated methods were compared to manual consolidation of information for three key sections of the CCD: problems, allergies, and medications. Manual consolidation of 11,631 entries was completed in approximately 150h. The same data were automatically consolidated in 3.3min. The system successfully consolidated 99.1% of problems, 87.0% of allergies, and 91.7% of medications. Almost all of the inaccuracies were caused by issues involving the use of standardized terminologies within the documents to represent individual information entries. This study represents a novel, tested tool for de-duplication and consolidation of CDA documents, which is a major step toward improving information access and the interoperability among information systems. While more work is necessary, automated systems like the one evaluated in this study will be necessary to meet the informatics needs of providers and health systems in the future. Copyright © 2017 Elsevier Inc. All rights reserved.

Effective chronic disease management: patients' perspectives on medication-related problems.

PubMed

Gordon, Karen; Smith, Felicity; Dhillon, Soraya

2007-03-01

To examine medication-related problems from the perspective of patients with a chronic condition and to identify how they may be supported in managing their medication. Patients prescribed medication for cardiovascular disease were recruited through five general medical surgeries and four community pharmacies in south London. Data were collected in 98 face-to-face interviews in participants' own homes. Interviews were designed to enable a detailed and holistic exploration of medication-related problems from participants' perspectives. Data were audio-recorded and transcribed verbatim to allow qualitative analysis. Five broad categories of medication-related problem emerged which were examined in the context of patients' perspectives on, and experiences of, the use of medicines and health services. These were concerns about and management of side effects; differing views regarding the use of medicines; cognitive, practical and sensory problems; lack of information or understanding; and problems with access to, and organisation of, services. All categories of problem had potential implications for the success of therapy in that they created barriers to adherence, access to medication or informed decision-making. The study demonstrated how patients actively engage in decision-making about their medicines in the home, if not in the consultation. The five categories of problem provide a focus for interventions by health professionals to support patients in achieving optimal theory outcomes. They demonstrate the need for a comprehensive approach, spanning patient education to the systems of delivery of care. Within the NHS in Britain, policy and practice initiatives are being designed to achieve this end. Further research should focus on the evaluation of professional practices and service developments in supporting patients in the self-management of their medicines.

Incidence of sleep pattern disturbance (SPD) in a hemodialysis sample.

PubMed

Strangio, D; Locking-Cusolito, H

1999-01-01

Personal experience suggests that sleep pattern disturbance (SPD) is a serious problem for the patients we serve. The purpose of this study was to identify the scope of sleep problems among all willing patients in a medium-sized hemodialysis unit in a university teaching centre. This descriptive study examined SPD through the use of a sleep diary that subjects were asked to complete each morning for a week. Subjects were asked to describe sleep latency, sleep quantity, number of arousals, whether they awoke feeling rested, factors that interfered with sleep the night before, and sleep inducers employed the night before. They were also asked to record their dialysis schedule. Each subject's chart was reviewed with respect to medications and evidence of other medical problems that interfered with sleep. Findings were benchmarked with results from the literature. Information regarding facilitators and barriers to sleep has provided some basis for an interdisciplinary plan of care to address this distressing problem.

Mental sets in conduct problem youth with psychopathic features: entity versus incremental theories of intelligence.

PubMed

Salekin, Randall T; Lester, Whitney S; Sellers, Mary-Kate

2012-08-01

The purpose of the current study was to examine the effect of a motivational intervention on conduct problem youth with psychopathic features. Specifically, the current study examined conduct problem youths' mental set (or theory) regarding intelligence (entity vs. incremental) upon task performance. We assessed 36 juvenile offenders with psychopathic features and tested whether providing them with two different messages regarding intelligence would affect their functioning on a task related to academic performance. The study employed a MANOVA design with two motivational conditions and three outcomes including fluency, flexibility, and originality. Results showed that youth with psychopathic features who were given a message that intelligence grows over time, were more fluent and flexible than youth who were informed that intelligence is static. There were no significant differences between the groups in terms of originality. The implications of these findings are discussed including the possible benefits of interventions for adolescent offenders with conduct problems and psychopathic features. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Efficient Workflows for Curation of Heterogeneous Data Supporting Modeling of U-Nb Alloy Aging

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

Ward, Logan Timothy; Hackenberg, Robert Errol

These are slides from a presentation summarizing a graduate research associate's summer project. The following topics are covered in these slides: data challenges in materials, aging in U-Nb Alloys, Building an Aging Model, Different Phase Trans. in U-Nb, the Challenge, Storing Materials Data, Example Data Source, Organizing Data: What is a Schema?, What does a "XML Schema" look like?, Our Data Schema: Nice and Simple, Storing Data: Materials Data Curation System (MDCS), Problem with MDCS: Slow Data Entry, Getting Literature into MDCS, Staging Data in Excel Document, Final Result: MDCS Records, Analyzing Image Data, Process for Making TTT Diagram, Bottleneckmore » Number 1: Image Analysis, Fitting a TTP Boundary, Fitting a TTP Curve: Comparable Results, How Does it Compare to Our Data?, Image Analysis Workflow, Curating Hardness Records, Hardness Data: Two Key Decisions, Before Peak Age? - Automation, Interactive Viz, Which Transformation?, Microstructure-Informed Model, Tracking the Entire Process, General Problem with Property Models, Pinyon: Toolkit for Managing Model Creation, Tracking Individual Decisions, Jupyter: Docs and Code in One File, Hardness Analysis Workflow, Workflow for Aging Models, and conclusions.« less

The New Method of Tsunami Source Reconstruction With r-Solution Inversion Method

NASA Astrophysics Data System (ADS)

Voronina, T. A.; Romanenko, A. A.

2016-12-01

Application of the r-solution method to reconstructing the initial tsunami waveform is discussed. This methodology is based on the inversion of remote measurements of water-level data. The wave propagation is considered within the scope of a linear shallow-water theory. The ill-posed inverse problem in question is regularized by means of a least square inversion using the truncated Singular Value Decomposition method. As a result of the numerical process, an r-solution is obtained. The method proposed allows one to control the instability of a numerical solution and to obtain an acceptable result in spite of ill posedness of the problem. Implementation of this methodology to reconstructing of the initial waveform to 2013 Solomon Islands tsunami validates the theoretical conclusion for synthetic data and a model tsunami source: the inversion result strongly depends on data noisiness, the azimuthal and temporal coverage of recording stations with respect to the source area. Furthermore, it is possible to make a preliminary selection of the most informative set of the available recording stations used in the inversion process.

Predicting who will drop out of nursing courses: a machine learning exercise.

PubMed

Moseley, Laurence G; Mead, Donna M

2008-05-01

The concepts of causation and prediction are different, and have different implications for practice. This distinction is applied here to studies of the problem of student attrition (although it is more widely applicable). Studies of attrition from nursing courses have tended to concentrate on causation, trying, largely unsuccessfully, to elicit what causes drop out. However, the problem may more fruitfully be cast in terms of predicting who is likely to drop out. One powerful method for attempting to make predictions is rule induction. This paper reports the use of the Answer Tree package from SPSS for that purpose. The main data set consisted of 3978 records on 528 nursing students, split into a training set and a test set. The source was standard university student records. The method obtained 84% sensitivity, 70% specificity, and 94% accuracy on previously unseen cases. The method requires large amounts of high quality data. When such data are available, rule induction offers a way to reduce attrition. It would be desirable to compare its results with those of predictions made by tutors using more informal conventional methods.

Resident and parental perceptions of adolescent problems and family communications in a low socioeconomic population.

PubMed

Hawley, L E; Shear, C L; Stark, A M; Goodman, P R

1984-11-01

This cross-sectional survey of a low socioeconomic patient group was designed to determine the prevalence and severity of parentally perceived behavioral problems in adolescents as well as to investigate the correlation between such problems and single parenting, family communications, and medical care delivered. The sample population consisted of 79 parents and 121 teenagers selected from a family practice center. The medical record and telephone interview were the sources of information. Results include a parental perception of a high prevalence of problems with school grades (48 percent), school attendance (38 percent), and household problems (chores and sibling rivalry). Of low prevalence but high severity were perceived problems related to suicidal ideation, running away, sexual activity, and gang membership. Single-parent homes had a threefold higher incidence of behavioral problems, a greater degree of communication, and a lower use of community resources than two-parent families. None of the approximately 400 perceived behavioral problems listed by parents was found in the family physicians' master problem list. The results indicate the need for physician education of low socioeconomic and single-parent patients with regard to communication and coping style. In addition, it appears that training programs should provide more education in the care of adolescents.

The OCHIN community information network: bringing together community health centers, information technology, and data to support a patient-centered medical village.

PubMed

Devoe, Jennifer E; Sears, Abigail

2013-01-01

Creating integrated, comprehensive care practices requires access to data and informatics expertise. Information technology (IT) resources are not readily available to individual practices. One model of shared IT resources and learning is a "patient-centered medical village." We describe the OCHIN Community Health Information Network as an example of this model; community practices have come together collectively to form an organization that leverages shared IT expertise, resources, and data, providing members with the means to fully capitalize on new technologies that support improved care. This collaborative facilitates the identification of "problem sheds" through surveillance of network-wide data, enables shared learning regarding best practices, and provides a "community laboratory" for practice-based research. As an example of a community of solution, OCHIN uses health IT and data-sharing innovations to enhance partnerships between public health leaders, clinicians in community health centers, informatics experts, and policy makers. OCHIN community partners benefit from the shared IT resource (eg, a linked electronic health record, centralized data warehouse, informatics, and improvement expertise). This patient-centered medical village provides (1) the collective mechanism to build community-tailored IT solutions, (2) "neighbors" to share data and improvement strategies, and (3) infrastructure to support innovations based on electronic health records across communities, using experimental approaches.

Reduced attentional blink for gambling-related stimuli in problem gamblers.

PubMed

Brevers, Damien; Cleeremans, Axel; Tibboel, Helen; Bechara, Antoine; Kornreich, Charles; Verbanck, Paul; Noël, Xavier

2011-09-01

Although there is considerable information concerning the attentional biases in psychoactive substance use and misuse, much less is known about the contribution of attentional processing in problem gambling. The aim of this study was to examine whether problem gamblers (PrG) exhibit attentional bias at the level of the encoding processing stage. Forty PrG and 35 controls participated in an attentional blink (AB) paradigm in which they were required to identify both gambling and neutral words that appeared in a rapid serial visual presentation. Explicit motivation (e.g., intrinsic/arousal, extrinsic, amotivation) toward the gambling cues was recorded. A diminished AB effect for gambling-related words compared to neutral targets was identified in PrG. In contrast, AB was similar when either gambling-related or neutral words were presented to controls. Furthermore, there was a significant positive correlation between the reduced AB for gambling-related words and the sub-score of intrinsic/arousal motivation to gamble in PrG. Such findings suggest that the PrG group exhibits an enhanced ability to process gambling-related information, which is associated with their desire to gamble for arousal reasons. Theoretical and clinical implications of these results are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

Image enhancement and quality measures for dietary assessment using mobile devices

NASA Astrophysics Data System (ADS)

Xu, Chang; Zhu, Fengqing; Khanna, Nitin; Boushey, Carol J.; Delp, Edward J.

2012-03-01

Measuring accurate dietary intake is considered to be an open research problem in the nutrition and health fields. We are developing a system, known as the mobile device food record (mdFR), to automatically identify and quantify foods and beverages consumed based on analyzing meal images captured with a mobile device. The mdFR makes use of a fiducial marker and other contextual information to calibrate the imaging system so that accurate amounts of food can be estimated from the scene. Food identification is a difficult problem since foods can dramatically vary in appearance. Such variations may arise not only from non-rigid deformations and intra-class variability in shape, texture, color and other visual properties, but also from changes in illumination and viewpoint. To address the color consistency problem, this paper describes illumination quality assessment methods implemented on a mobile device and three post color correction methods.

Image Enhancement and Quality Measures for Dietary Assessment Using Mobile Devices

PubMed Central

Xu, Chang; Zhu, Fengqing; Khanna, Nitin; Boushey, Carol J.; Delp, Edward J.

2016-01-01

Measuring accurate dietary intake is considered to be an open research problem in the nutrition and health fields. We are developing a system, known as the mobile device food record (mdFR), to automatically identify and quantify foods and beverages consumed based on analyzing meal images captured with a mobile device. The mdFR makes use of a fiducial marker and other contextual information to calibrate the imaging system so that accurate amounts of food can be estimated from the scene. Food identification is a difficult problem since foods can dramatically vary in appearance. Such variations may arise not only from non-rigid deformations and intra-class variability in shape, texture, color and other visual properties, but also from changes in illumination and viewpoint. To address the color consistency problem, this paper describes illumination quality assessment methods implemented on a mobile device and three post color correction methods. PMID:28572695

Translating and Transforming Care: People With Brain Injury and Caregivers Filling in a Disability Claim Form.

PubMed

Gillespie, Alex; Moore, Helen

2016-03-01

This article examines how the Disability Living Allowance claim form, used in the United Kingdom to allocate £13 billion of disability benefits, translates and transforms disability and care. Twenty-two people with acquired brain injury and their main informal caregivers (n = 44) were video-recorded filling in the disability claim form. Participants disagreed on 26% of the questions, revealing two types of problems. Translation problems arose as participants struggled to provide categorical responses to ambiguous questions and were unable to report contextual variability in care needs or divergences of perception. Transformation problems arose as participants resisted the way in which the form positioned them, forcing them to conceptualize their relationship in terms of dependency and burden. The disability claim form co-opts claimants to translate care and disability into bureaucratically predefined categories, and it transforms the care relationship that it purports to document. © The Author(s) 2015.

Supporting ontology-based keyword search over medical databases.

PubMed

Kementsietsidis, Anastasios; Lim, Lipyeow; Wang, Min

2008-11-06

The proliferation of medical terms poses a number of challenges in the sharing of medical information among different stakeholders. Ontologies are commonly used to establish relationships between different terms, yet their role in querying has not been investigated in detail. In this paper, we study the problem of supporting ontology-based keyword search queries on a database of electronic medical records. We present several approaches to support this type of queries, study the advantages and limitations of each approach, and summarize the lessons learned as best practices.

Best practice in unbilled account management: one medical center's story.

PubMed

Menaker, Debra; Miller, Joshua

2016-02-01

After implementing its new electronic health record, a large metropolitan academic medical center (AMC) decided to optimize its supporting business systems, beginning with billing. By identifying problems and taking the following corrective actions immediately, the AMC significantly reduced the number and average age of its unbilled accounts: Realigning system automation to improve routing efficiency. Facilitating interdisciplinary collaboration to better identify and correct the root causes of issues. Ensuring transparent data reporting by setting up different ways of viewing the underlying information.

Memory inhibition as a critical factor preventing creative problem solving.

PubMed

Gómez-Ariza, Carlos J; Del Prete, Francesco; Prieto Del Val, Laura; Valle, Tania; Bajo, M Teresa; Fernandez, Angel

2017-06-01

The hypothesis that reduced accessibility to relevant information can negatively affect problem solving in a remote associate test (RAT) was tested by using, immediately before the RAT, a retrieval practice procedure to hinder access to target solutions. The results of 2 experiments clearly showed that, relative to baseline, target words that had been competitors during selective retrieval were much less likely to be provided as solutions in the RAT, demonstrating that performance in the problem-solving task was strongly influenced by the predetermined accessibility status of the solutions in memory. Importantly, this was so even when participants were unaware of the relationship between the memory and the problem-solving procedures in the experiments. This finding is consistent with an inhibitory account of retrieval-induced forgetting effects and, more generally, constitutes support for the idea that the activation status of mental representations originating in a given task (e.g., episodic memory) can unwittingly have significant consequences for a different, unrelated task (e.g., problem solving). (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Installation Restoration Program. Phase II: Stage 1 Problem Confirmation Study, Duluth International Airport, Duluth, Minnesota.

DTIC Science & Technology

1984-10-01

8 iii "i t-. Table of Contents (cont.) Section Title Page -APPENDIX A Acronyms, Definitions, Nomenclature and Units of Measure B Scope of Work, Task...Identification/Records Search Phase II - Problem Confirmation and Quantification Phase III - Technology Base Development Phase IV - Corrective Action Only...Problem Identification/Records Search Phase II - Problem Confirmation and Quantification Phase III - Technology Base Development Phase IV - Corrective

An Interactive Program on Digitizing Historical Seismograms

NASA Astrophysics Data System (ADS)

Xu, Y.; Xu, T.

2013-12-01

Retrieving information from historical seismograms is of great importance since they are considered the unique sources that provide quantitative information of historical earthquakes. Modern techniques of seismology require digital forms of seismograms that are essentially a sequence of time-amplitude pairs. However, the historical seismograms, after scanned into computers, are two dimensional arrays. Each element of the arrays contains the grayscale value or RGB value of the corresponding pixel. The problem of digitizing historical seismograms, referred to as converting historical seismograms to digital seismograms, can be formulated as an inverse problem that generating sequences of time-amplitude pairs from a two dimension arrays. This problem has infinite solutions. The algorithm for automatic digitization of historical seismogram presented considers several features of seismograms, including continuity, smoothness of the seismic traces as the prior information, and assumes that the amplitude is a single-valued function of time. An interactive program based on the algorithm is also presented. The program is developed using Matlab GUI and has both automatic and manual modality digitization. Users can easily switch between them, and try different combinations to get the optimal results. Several examples are given to illustrate the results of digitizing seismograms using the program, including a photographic record and a wide-angle reflection/refraction seismogram. Digitized result of the program (redrawn using Golden Software Surfer for high resolution image). (a) shows the result of automatic digitization, and (b) is the result after manual correction.

Quality Requirements for Electronic Health Record Systems*. A Japanese-German Information Management Perspective.

PubMed

Winter, Alfred; Takabayashi, Katsuhiko; Jahn, Franziska; Kimura, Eizen; Engelbrecht, Rolf; Haux, Reinhold; Honda, Masayuki; Hübner, Ursula H; Inoue, Sozo; Kohl, Christian D; Matsumoto, Takehiro; Matsumura, Yasushi; Miyo, Kengo; Nakashima, Naoki; Prokosch, Hans-Ulrich; Staemmler, Martin

2017-08-07

For more than 30 years, there has been close cooperation between Japanese and German scientists with regard to information systems in health care. Collaboration has been formalized by an agreement between the respective scientific associations. Following this agreement, two joint workshops took place to explore the similarities and differences of electronic health record systems (EHRS) against the background of the two national healthcare systems that share many commonalities. To establish a framework and requirements for the quality of EHRS that may also serve as a basis for comparing different EHRS. Donabedian's three dimensions of quality of medical care were adapted to the outcome, process, and structural quality of EHRS and their management. These quality dimensions were proposed before the first workshop of EHRS experts and enriched during the discussions. The Quality Requirements Framework of EHRS (QRF-EHRS) was defined and complemented by requirements for high quality EHRS. The framework integrates three quality dimensions (outcome, process, and structural quality), three layers of information systems (processes and data, applications, and physical tools) and three dimensions of information management (strategic, tactical, and operational information management). Describing and comparing the quality of EHRS is in fact a multidimensional problem as given by the QRF-EHRS framework. This framework will be utilized to compare Japanese and German EHRS, notably those that were presented at the second workshop.

Single Nucleotide Polymorphism TGFβ1 R25P Correlates with Acute Toxicity during Neoadjuvant Chemoradiotherapy in Rectal Cancer Patients

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

Smith, J. Joshua; Wasserman, Isaac; Icahn School of Medicine at Mount Sinai, New York, New York

Purpose: To validate the finding of an association between single nucleotide polymorphisms (SNPs) and toxicity during chemoradiotherapy (CRT) in rectal cancer patients, in an independent population. Methods and Materials: The cohort consisted of 165 patients who received CRT for rectal cancer from 2006 to 2012. Prospectively recorded toxicity information, graded according to the Common Terminology Criteria for Adverse Events version 3.0, was retrieved from the medical record. Additionally, a subset of 52 patients recorded their gastrointestinal symptoms weekly during CRT, using the 7-item Bowel Problems Scale. Deoxyribonucleic acid was extracted from normal tissue in the proctectomy specimens and screened for 3more » SNPs: XRCC1 R399Q, XPD K751Q, and TGFβ1 R25P. Univariable and multivariable logistic regression models were constructed. Results: The median radiation dose was 50.4 Gy, and all patients received concurrent chemotherapy. Toxicities measured by the Common Terminology Criteria for Adverse Events were closely associated with patient-reported outcomes for the patients who completed the 7-item Bowel Problems Scale. Grade ≥3 toxicity occurred during CRT in 14 patients (8%). All 14 patients had either XRCC1 R399Q or TGFβ1 R25P polymorphisms. The TGFβ1 R25P polymorphism was significantly associated with grade ≥3 toxicity (odds ratio [OR] 3.47, P=.04) and, in patients who completed the Bowel Problems Scale, with grade ≥4 toxicity (OR 5.61, P=.02). The latter finding persisted in a multivariable logistic regression model controlling for ethnicity, age, and sex (adjusted OR 1.83, P=.02). Conclusions: We have validated the correlation between the TGFβ1 R25P SNP and acute toxicity during CRT in an independent cohort using both clinician- and patient-reported toxicity. The information from our study could be used as a basis to formulate a prospective trial testing the utility of this SNP as a biomarker of acute toxicity during neoadjuvant treatment in locally advanced rectal cancer.« less

Hydrology team

NASA Technical Reports Server (NTRS)

Ragan, R.

1982-01-01

General problems faced by hydrologists when using historical records, real time data, statistical analysis, and system simulation in providing quantitative information on the temporal and spatial distribution of water are related to the limitations of these data. Major problem areas requiring multispectral imaging-based research to improve hydrology models involve: evapotranspiration rates and soil moisture dynamics for large areas; the three dimensional characteristics of bodies of water; flooding in wetlands; snow water equivalents; runoff and sediment yield from ungaged watersheds; storm rainfall; fluorescence and polarization of water and its contained substances; discriminating between sediment and chlorophyll in water; role of barrier island dynamics in coastal zone processes; the relationship between remotely measured surface roughness and hydraulic roughness of land surfaces and stream networks; and modeling the runoff process.

[Standardisation of nursing care amongst patients in prison].

PubMed

Martínez-Delgado, M M

2014-01-01

To develop the Standardized Nursing Care Process format amongst patients in a prison. Observational, descriptive study, conducted on a sample of thirty patients in Soria Prison between March and June 2011. We collected information via a review of medical records and conducted an interview of nursing assessments using functional patterns. Subsequent nursing diagnoses and interrelated problems were obtained using NANDA taxonomy. The subsequent use of NIC and NOC taxonomy marked the activities and performance criteria for each diagnosis, in the same way as for interrelated problems. The nursing diagnoses found in the patient sample analyzed, and the frequency thereof, reveal peculiarities in terms of the health care needs of the prison population, which makes it possible to standardize nursing care plans for the population under study.

Towards a Usability and Error "Safety Net": A Multi-Phased Multi-Method Approach to Ensuring System Usability and Safety.

PubMed

Kushniruk, Andre; Senathirajah, Yalini; Borycki, Elizabeth

2017-01-01

The usability and safety of health information systems have become major issues in the design and implementation of useful healthcare IT. In this paper we describe a multi-phased multi-method approach to integrating usability engineering methods into system testing to ensure both usability and safety of healthcare IT upon widespread deployment. The approach involves usability testing followed by clinical simulation (conducted in-situ) and "near-live" recording of user interactions with systems. At key stages in this process, usability problems are identified and rectified forming a usability and technology-induced error "safety net" that catches different types of usability and safety problems prior to releasing systems widely in healthcare settings.

Mobile internet and technology for optical teaching reform in higher education

NASA Astrophysics Data System (ADS)

Zhou, Muchun; Zhao, Qi; Chen, Yanru

2017-08-01

There are some problems in optical education such as insufficient flexibility, individuality and adaptability to students who need information and education at present. The development of mobile internet and technology provides support to solve these problems. Basic characteristics, advantages and developments of these techniques used in education are presented in this paper. Mobile internet is introduced to reform the classroom teaching of optical courses. Mobile network tool selection, teaching resources construction and reform in teaching methods are discussed. Academic record and sampling surveys are used to assess intention to adopt mobile internet and learning effect of academic major of students, the results show that high quality optical education can be offered by adopting mobile internet and technologies in traditional instruction.

Towards the automated analysis and database development of defibrillator data from cardiac arrest.

PubMed

Eftestøl, Trygve; Sherman, Lawrence D

2014-01-01

During resuscitation of cardiac arrest victims a variety of information in electronic format is recorded as part of the documentation of the patient care contact and in order to be provided for case review for quality improvement. Such review requires considerable effort and resources. There is also the problem of interobserver effects. We show that it is possible to efficiently analyze resuscitation episodes automatically using a minimal set of the available information. A minimal set of variables is defined which describe therapeutic events (compression sequences and defibrillations) and corresponding patient response events (annotated rhythm transitions). From this a state sequence representation of the resuscitation episode is constructed and an algorithm is developed for reasoning with this representation and extract review variables automatically. As a case study, the method is applied to the data abstraction process used in the King County EMS. The automatically generated variables are compared to the original ones with accuracies ≥ 90% for 18 variables and ≥ 85% for the remaining four variables. It is possible to use the information present in the CPR process data recorded by the AED along with rhythm and chest compression annotations to automate the episode review.

Electronic data collection for clinical trials using tablet and handheld PCs

NASA Astrophysics Data System (ADS)

Alaoui, Adil; Vo, Minh; Patel, Nikunj; McCall, Keith; Lindisch, David; Watson, Vance; Cleary, Kevin

2005-04-01

This paper describes a system that uses electronic forms to collect patient and procedure data for clinical trials. During clinical trials, patients are typically required to provide background information such as demographics and medical history, as well as review and complete any consent forms. Physicians or their assistants then usually have additional forms for recording technical data from the procedure and for gathering follow-up information from patients after completion of the procedure. This approach can lead to substantial amounts of paperwork to collect and manage over the course of a clinical trial with a large patient base. By using e-forms instead, data can be transmitted to a single, centralized database, reducing the problem of managing paper forms. Additionally, the system can provide a means for relaying information from the database to the physician on his/her portable wireless device, such as to alert the physician when a patient has completed the pre-procedure forms and is ready to begin the procedure. This feature could improve the workflow in busy clinical practices. In the future, the system could be expanded so physicians could use their portable wireless device to pull up entire hospital records and view other pre-procedure data and patient images.

76 FR 66325 - Agency Information Collection Activities: Proposed Collection, Comments Requested; E-FOIA

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-26

... Division Record Information Dissemination Section (RIDS) will be submitting the following information... collection: Records Management Division/ Record Information Dissemination Section, Federal Bureau of... requesters etc). Abstract: The Record/Information Dissemination Section (RIDS) effectively plans, develops...

The Quality Control of Data in a Clinical Database System—The Patient Identification Problem *

PubMed Central

Lai, J. Chi-Sang; Covvey, H.D.; Sevcik, K.C.; Wigle, E.D.

1981-01-01

Ensuring the accuracy of patient identification and the linkage of records with the appropriate patient owner is the first level of quality control of data in a clinical database system. Without a unique patient identifier, the fact that patient identity may be recorded at different places and times means that multiple identities may be associated with a given patient and new records associated with any of these identities. Even when a unique patient identifier is utilized, errors introduced in the data handling process can result in the same problems. The outcome is that the retrieval request for a given record may fail, or an erroneously identified record may be retrieved. We have studied each of the ways this fundamental problem occurs and propose a solution based on record linkage techniques to detect errors of this type. Specifically, we propose a patient identification scheme for the situation where no unique health identifier is available and detail a method to find patient records with erroneous identifiers.

Electronic problem lists: a thematic analysis of a systematic literature review to identify aspects critical to success.

PubMed

Hodge, Chad M; Narus, Scott P

2018-05-01

Problem list data is a driving force for many beneficial clinical tools, yet these data remain underutilized. We performed a systematic literature review, pulling insights from previous research, aggregating insights into themes, and distilling themes into actionable advice. We sought to learn what changes we could make to existing applications, to the clinical workflow, and to clinicians' perceptions that would improve problem list utilization and increase the prevalence of problems data in the electronic medical record. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to systematically curate a corpus of pertinent articles. We performed a thematic analysis, looking for interesting excerpts and ideas. By aggregating excerpts from many authors, we gained broader, more inclusive insights into what makes a good problem list and what factors are conducive to its success. Analysis led to a list of 7 benefits of using the problem list, 15 aspects critical to problem list success, and knowledge to help inform policy development, such as consensus on what belongs on the problem list, who should maintain the problem list, and when. A list of suggestions is made on ways in which the problem list can be improved to increase utilization by clinicians. There is also a need for standard measurements of the problem list, so that lists can be measured, compared, and discussed with rigor and a common vocabulary.

28 CFR 20.33 - Dissemination of criminal history record information.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Dissemination of criminal history record... SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.33 Dissemination of criminal history record information. (a) Criminal history record information contained in the III System...

28 CFR 20.33 - Dissemination of criminal history record information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Dissemination of criminal history record... SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.33 Dissemination of criminal history record information. (a) Criminal history record information contained in the III System...

28 CFR 20.33 - Dissemination of criminal history record information.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Dissemination of criminal history record... SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.33 Dissemination of criminal history record information. (a) Criminal history record information contained in the III System...

28 CFR 20.33 - Dissemination of criminal history record information.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Dissemination of criminal history record... SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.33 Dissemination of criminal history record information. (a) Criminal history record information contained in the III System...

28 CFR 20.33 - Dissemination of criminal history record information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Dissemination of criminal history record... SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.33 Dissemination of criminal history record information. (a) Criminal history record information contained in the III System...

36 CFR 1290.3 - Sources of assassination records and additional records and information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Sources of assassination records and additional records and information. Assassination records and... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Sources of assassination records and additional records and information. 1290.3 Section 1290.3 Parks, Forests, and Public Property...

"Why the hell do we need electronic health records?". EHR acceptance among physicians in private practice in Austria: a qualitative study.

PubMed

Hackl, W O; Hoerbst, A; Ammenwerth, E

2011-01-01

Progress in the medical sciences, together with related technologies, in the past has led to higher specialization and has created a strong need to exchange health information across institutional borders. The concept of electronic health records (EHR) was introduced to fulfill these needs. Remarkably, many EHR introduction projects ran into trouble, not least because they lacked the acceptance of EHR among physicians. Negative emotions, such as anxiety and fear due to a lack of information, may cause change barriers and hamper physicians' acceptance of such projects. The goal of this study was to gain deeper insight into the negative emotions related to the intended implementation of a mandatory national electronic health record system (called ELGA) in Austria among physicians in private practice. Qualitative, problem-centered interviews were conducted with eight physicians in private practice in the capital region of Tyrol. The methods of qualitative content analysis were used to analyze the data. Three hundred and twenty-eight passages in the interviews were selected, annotated, and paraphrased. These passages were assigned to 139 different primary categories. Finally, 18 main categories in the form of statements were derived. They were correlated and a theoretical model was formed to explain the genesis of the detected fears and anxiety related to the ELGA project. The results show that the physicians feel uninformed and snubbed. They fear unknown changes, increased costs, as well as workload and surveillance without obtaining any advantages from using electronic health records in their daily practice. Impartial information campaigns that are tailored to the physicians' needs and questions as along with a comprehensive cost-benefit analysis could benefit the physicians' opinion of EHRs.

Efficient Record Linkage Algorithms Using Complete Linkage Clustering.

PubMed

Mamun, Abdullah-Al; Aseltine, Robert; Rajasekaran, Sanguthevar

2016-01-01

Data from different agencies share data of the same individuals. Linking these datasets to identify all the records belonging to the same individuals is a crucial and challenging problem, especially given the large volumes of data. A large number of available algorithms for record linkage are prone to either time inefficiency or low-accuracy in finding matches and non-matches among the records. In this paper we propose efficient as well as reliable sequential and parallel algorithms for the record linkage problem employing hierarchical clustering methods. We employ complete linkage hierarchical clustering algorithms to address this problem. In addition to hierarchical clustering, we also use two other techniques: elimination of duplicate records and blocking. Our algorithms use sorting as a sub-routine to identify identical copies of records. We have tested our algorithms on datasets with millions of synthetic records. Experimental results show that our algorithms achieve nearly 100% accuracy. Parallel implementations achieve almost linear speedups. Time complexities of these algorithms do not exceed those of previous best-known algorithms. Our proposed algorithms outperform previous best-known algorithms in terms of accuracy consuming reasonable run times.

Efficient Record Linkage Algorithms Using Complete Linkage Clustering

PubMed Central

Mamun, Abdullah-Al; Aseltine, Robert; Rajasekaran, Sanguthevar

2016-01-01

Data from different agencies share data of the same individuals. Linking these datasets to identify all the records belonging to the same individuals is a crucial and challenging problem, especially given the large volumes of data. A large number of available algorithms for record linkage are prone to either time inefficiency or low-accuracy in finding matches and non-matches among the records. In this paper we propose efficient as well as reliable sequential and parallel algorithms for the record linkage problem employing hierarchical clustering methods. We employ complete linkage hierarchical clustering algorithms to address this problem. In addition to hierarchical clustering, we also use two other techniques: elimination of duplicate records and blocking. Our algorithms use sorting as a sub-routine to identify identical copies of records. We have tested our algorithms on datasets with millions of synthetic records. Experimental results show that our algorithms achieve nearly 100% accuracy. Parallel implementations achieve almost linear speedups. Time complexities of these algorithms do not exceed those of previous best-known algorithms. Our proposed algorithms outperform previous best-known algorithms in terms of accuracy consuming reasonable run times. PMID:27124604

Much ado about aha!: Insight problem solving is strongly related to working memory capacity and reasoning ability.

PubMed

Chuderski, Adam; Jastrzębski, Jan

2018-02-01

A battery comprising 4 fluid reasoning tests as well as 13 working memory (WM) tasks that involved storage, recall, updating, binding, and executive control, was applied to 318 adults in order to evaluate the true relationship of reasoning ability and WM capacity (WMC) to insight problem solving, measured using 40 verbal, spatial, math, matchstick, and remote associates problems (insight problems). WMC predicted 51.8% of variance in insight problem solving and virtually explained its almost isomorphic link to reasoning ability (84.6% of shared variance). The strong link between WMC and insight pertained generally to most WM tasks and insight problems, was identical for problems solved with and without reported insight, was linear throughout the ability levels, and was not mediated by age, motivation, anxiety, psychoticism, and openness to experience. In contrast to popular views on the sudden and holistic nature of insight, the solving of insight problems results primarily from typical operations carried out by the basic WM mechanisms that are responsible for the maintenance, retrieval, transformation, and control of information in the broad range of intellectual tasks (including fluid reasoning). Little above and beyond WM is unique about insight. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

A Neuro-Oncology Workstation for Structuring, Modeling, and Visualizing Patient Records

PubMed Central

Hsu, William; Arnold, Corey W.; Taira, Ricky K.

2016-01-01

The patient medical record contains a wealth of information consisting of prior observations, interpretations, and interventions that need to be interpreted and applied towards decisions regarding current patient care. Given the time constraints and the large—often extraneous—amount of data available, clinicians are tasked with the challenge of performing a comprehensive review of how a disease progresses in individual patients. To facilitate this process, we demonstrate a neuro-oncology workstation that assists in structuring and visualizing medical data to promote an evidence-based approach for understanding a patient’s record. The workstation consists of three components: 1) a structuring tool that incorporates natural language processing to assist with the extraction of problems, findings, and attributes for structuring observations, events, and inferences stated within medical reports; 2) a data modeling tool that provides a comprehensive and consistent representation of concepts for the disease-specific domain; and 3) a visual workbench for visualizing, navigating, and querying the structured data to enable retrieval of relevant portions of the patient record. We discuss this workstation in the context of reviewing cases of glioblastoma multiforme patients. PMID:27583308

A Neuro-Oncology Workstation for Structuring, Modeling, and Visualizing Patient Records.

PubMed

Hsu, William; Arnold, Corey W; Taira, Ricky K

2010-11-01

The patient medical record contains a wealth of information consisting of prior observations, interpretations, and interventions that need to be interpreted and applied towards decisions regarding current patient care. Given the time constraints and the large-often extraneous-amount of data available, clinicians are tasked with the challenge of performing a comprehensive review of how a disease progresses in individual patients. To facilitate this process, we demonstrate a neuro-oncology workstation that assists in structuring and visualizing medical data to promote an evidence-based approach for understanding a patient's record. The workstation consists of three components: 1) a structuring tool that incorporates natural language processing to assist with the extraction of problems, findings, and attributes for structuring observations, events, and inferences stated within medical reports; 2) a data modeling tool that provides a comprehensive and consistent representation of concepts for the disease-specific domain; and 3) a visual workbench for visualizing, navigating, and querying the structured data to enable retrieval of relevant portions of the patient record. We discuss this workstation in the context of reviewing cases of glioblastoma multiforme patients.

Operating manual for the U.S. Geological Survey minimonitor, 1988 revised edition; punched-paper-tape model

USGS Publications Warehouse

Ficken, James H.; Scott, Carl T.

1988-01-01

This manual describes the U.S. Geological Survey Minimonitor Water Quality Data Measuring and Recording System. Instructions for calibrating, servicing, maintaining, and operating the system are provided. The Survey Minimonitor is a battery-powered , multiparameter water quality monitoring instrument designed for field use. A watertight can containing signal conditioners is connected with cable and waterproof connectors to various water quality sensors. Data are recorded on a punched paper-tape recorder. An external battery is required. The operation and maintenance of various sensors and signal conditioners are discussed, for temperature, specific conductance, dissolved oxygen, and pH. Calibration instructions are provided for each parameter, along with maintenance instructions. Sections of the report explain how to connect the Minimonitor to measure direct-current voltages, such as signal outputs from other instruments. Instructions for connecting a satellite data-collection platform or a solid-state data recorder to the Minimonitor are given also. Basic information is given for servicing the Minimonitor and trouble-shooting some of its electronic components. The use of test boxes to test sensors, isolate component problems, and verify calibration values is discussed. (USGS)

Attitudes of community pharmacists to antibiotic dispensing and microbial resistance: a qualitative study in Portugal.

PubMed

Roque, Fátima; Soares, Sara; Breitenfeld, Luiza; López-Durán, Ana; Figueiras, Adolfo; Herdeiro, Maria Teresa

2013-06-01

The inappropriate use of antibiotics is considered a main cause of microbial resistance. This is an important public health problem. Community pharmacists have an important role in the management of drugs for outpatients. Our study sought to explore pharmacists' knowledge, attitudes, perceptions and dispensing habits insofar as to antibiotics and microbial resistance. The study was developed with community pharmacists in the North of Portugal. Qualitative research in the form of focus groups (FG). Focus groups were conducted with 4-7 pharmacists, using a moderator. A topic guide was developed to lead the discussions, which were audio-recorded and transcribed. The study was carried out between December 2010 and March 2011 in the five districts of the Northern Health Region of Portugal (ARS-N). Pharmacists from different regions of each district were invited to participate in the study by an investigator responsible for the study. Participants were informed about the study and that sessions were audio-recorded to facilitate data interpretation. They signed an informed consent form before taking part in the focus groups. The Ethical Committee of ARS-N was informed of this study. Pharmacists' knowledge and perceptions on antibiotic use and microbial resistance, attitudes related to antibiotic dispensing habits, and pharmacists' suggestions to improve antibiotic use. A total of 6 focus groups were conducted with community pharmacists (n = 32). Attitudes related to the problem of resistance were attributed external responsibility, to patients, to physicians, to other pharmacies, and to veterinary consumption. Some attitudes were identified that could lead to antibiotic dispensing without a prescription. These attitudes are complacency, precaution and external complacency. Portuguese pharmacists perceive that antibiotic use and bacterial resistance could be improved, showing a behavioural intention to improve antibiotic dispensing habits.

Drilling, logging, and testing information from borehole UE-25 UZ{number_sign}16, Yucca Mountain, Nevada

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

Thamir, F.; Thordarson, W.; Kume, J.

Borehole UE-25 UZ{number_sign}16 is the first of two boreholes that may be used to determine the subsurface structure at Yucca Mountain by using vertical seismic profiling. This report contains information collected while this borehole was being drilled, logged, and tested from May 27, 1992, to April 22, 1994. It does not contain the vertical seismic profiling data. This report is intended to be used as: (1) a reference for drilling similar boreholes in the same area, (2) a data source on this borehole, and (3) a reference for other information that is available from this borehole. The reference information includesmore » drilling chronology, equipment, parameters, coring methods, penetration rates, completion information, drilling problems, and corrective actions. The data sources include lithology, fracture logs, a list of available borehole logs, and depths at which water was recorded. Other information is listed in an appendix that includes studies done after April 22, 1994.« less

Investigation of The Omaha System for dentistry.

PubMed

Jurkovich, M W; Ophaug, M; Salberg, S; Monsen, K

2014-01-01

Today, dentists and hygienists have inadequate tools to identify contributing factors to dental disease, diagnosis of disease or to document outcomes in a standardized and machine readable format. Increasing demand to find the most effective care methodologies make the development of further terminologies for dentistry more urgent. Preventive care is the focus of early efforts to define best practices. We reviewed one possibility with a history of public health documentation that might assist in these early efforts at identifying best practices. This paper examines, through a survey of dentists, the Omaha System Problem Classification Scheme. The survey requested that dentists rate the usefulness of knowing about specific signs and symptoms for each of the 42 problems within the Problem list of the Omaha System. Using a weighted scoring system, 22 of the 42 problems received over 50% of the possible maximum score and 30 of the 42 problems received at least 25% of the possible points. These findings suggests that further evaluation of The Omaha System, may be useful to dentistry. At a minimum, the survey provides additional information about non-physiological problems, signs, and symptoms that may be appropriate for documentation purposes within an electronic health record (EHR) used in dentistry.

Text mining approach to predict hospital admissions using early medical records from the emergency department.

PubMed

Lucini, Filipe R; S Fogliatto, Flavio; C da Silveira, Giovani J; L Neyeloff, Jeruza; Anzanello, Michel J; de S Kuchenbecker, Ricardo; D Schaan, Beatriz

2017-04-01

Emergency department (ED) overcrowding is a serious issue for hospitals. Early information on short-term inward bed demand from patients receiving care at the ED may reduce the overcrowding problem, and optimize the use of hospital resources. In this study, we use text mining methods to process data from early ED patient records using the SOAP framework, and predict future hospitalizations and discharges. We try different approaches for pre-processing of text records and to predict hospitalization. Sets-of-words are obtained via binary representation, term frequency, and term frequency-inverse document frequency. Unigrams, bigrams and trigrams are tested for feature formation. Feature selection is based on χ 2 and F-score metrics. In the prediction module, eight text mining methods are tested: Decision Tree, Random Forest, Extremely Randomized Tree, AdaBoost, Logistic Regression, Multinomial Naïve Bayes, Support Vector Machine (Kernel linear) and Nu-Support Vector Machine (Kernel linear). Prediction performance is evaluated by F1-scores. Precision and Recall values are also informed for all text mining methods tested. Nu-Support Vector Machine was the text mining method with the best overall performance. Its average F1-score in predicting hospitalization was 77.70%, with a standard deviation (SD) of 0.66%. The method could be used to manage daily routines in EDs such as capacity planning and resource allocation. Text mining could provide valuable information and facilitate decision-making by inward bed management teams. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Improved specimen reconstruction by Hilbert phase contrast tomography.

PubMed

Barton, Bastian; Joos, Friederike; Schröder, Rasmus R

2008-11-01

The low signal-to-noise ratio (SNR) in images of unstained specimens recorded with conventional defocus phase contrast makes it difficult to interpret 3D volumes obtained by electron tomography (ET). The high defocus applied for conventional tilt series generates some phase contrast but leads to an incomplete transfer of object information. For tomography of biological weak-phase objects, optimal image contrast and subsequently an optimized SNR are essential for the reconstruction of details such as macromolecular assemblies at molecular resolution. The problem of low contrast can be partially solved by applying a Hilbert phase plate positioned in the back focal plane (BFP) of the objective lens while recording images in Gaussian focus. Images recorded with the Hilbert phase plate provide optimized positive phase contrast at low spatial frequencies, and the contrast transfer in principle extends to the information limit of the microscope. The antisymmetric Hilbert phase contrast (HPC) can be numerically converted into isotropic contrast, which is equivalent to the contrast obtained by a Zernike phase plate. Thus, in-focus HPC provides optimal structure factor information without limiting effects of the transfer function. In this article, we present the first electron tomograms of biological specimens reconstructed from Hilbert phase plate image series. We outline the technical implementation of the phase plate and demonstrate that the technique is routinely applicable for tomography. A comparison between conventional defocus tomograms and in-focus HPC volumes shows an enhanced SNR and an improved specimen visibility for in-focus Hilbert tomography.

System Architecture for Temporal Information Extraction, Representation and Reasoning in Clinical Narrative Reports

PubMed Central

Zhou, Li; Friedman, Carol; Parsons, Simon; Hripcsak, George

2005-01-01

Exploring temporal information in narrative Electronic Medical Records (EMRs) is essential and challenging. We propose an architecture for an integrated approach to process temporal information in clinical narrative reports. The goal is to initiate and build a foundation that supports applications which assist healthcare practice and research by including the ability to determine the time of clinical events (e.g., past vs. present). Key components include: (1) a temporal constraint structure for temporal expressions and the development of an associated tagger; (2) a Natural Language Processing (NLP) system for encoding and extracting medical events and associating them with formalized temporal data; (3) a post-processor, with a knowledge-based subsystem to help discover implicit information, that resolves temporal expressions and deals with issues such as granularity and vagueness; and (4) a reasoning mechanism which models clinical reports as Simple Temporal Problems (STPs). PMID:16779164

Quality Control Methodology Of A Surface Wind Observational Database In North Eastern North America

NASA Astrophysics Data System (ADS)

Lucio-Eceiza, Etor E.; Fidel González-Rouco, J.; Navarro, Jorge; Conte, Jorge; Beltrami, Hugo

2016-04-01

This work summarizes the design and application of a Quality Control (QC) procedure for an observational surface wind database located in North Eastern North America. The database consists of 526 sites (486 land stations and 40 buoys) with varying resolutions of hourly, 3 hourly and 6 hourly data, compiled from three different source institutions with uneven measurement units and changing measuring procedures, instrumentation and heights. The records span from 1953 to 2010. The QC process is composed of different phases focused either on problems related with the providing source institutions or measurement errors. The first phases deal with problems often related with data recording and management: (1) compilation stage dealing with the detection of typographical errors, decoding problems, site displacements and unification of institutional practices; (2) detection of erroneous data sequence duplications within a station or among different ones; (3) detection of errors related with physically unrealistic data measurements. The last phases are focused on instrumental errors: (4) problems related with low variability, placing particular emphasis on the detection of unrealistic low wind speed records with the help of regional references; (5) high variability related erroneous records; (6) standardization of wind speed record biases due to changing measurement heights, detection of wind speed biases on week to monthly timescales, and homogenization of wind direction records. As a result, around 1.7% of wind speed records and 0.4% of wind direction records have been deleted, making a combined total of 1.9% of removed records. Additionally, around 15.9% wind speed records and 2.4% of wind direction data have been also corrected.

Re-Writing the Construction History of Boughton House (northamptonshire, Uk) with the Help of DOCU-TOOLS®

NASA Astrophysics Data System (ADS)

Schuster, J. C.

2017-08-01

The tablet-based software docu-tools digitize the documentation of buildings, simplifies construction and facility management and the data analysis in building and construction-history research. As a plan-based software, `pins' can be set to record data (images, audio, text etc.), each data point containing a time and date stamp. Once a pin is set and information recorded, it can never be deleted from the system, creating clear contentious-free documentation. Reports to any/all data recorded can immediately be generated through various templates in order to share, document, analyze and archive the information gathered. The software both digitizes building condition assessment, as well as simplifies the fully documented management and solving of problems and monitoring of a building. Used both in the construction industry and for documenting and analyzing historic buildings, docu-tools is a versatile and flexible tool that has become integral to my work as a building historian working on the conservation and curating of the historic built environment in Europe. I used the software at Boughton House, Northamptonshire, UK, during a one-year research project into the construction history of the building. The details of how docu-tools was used during this project will be discussed in this paper.

'What is not written does not exist': the importance of proper documentation of medication use history.

PubMed

Silvestre, Carina Carvalho; Santos, Lincoln Marques Cavalcante; de Oliveira-Filho, Alfredo Dias; de Lyra, Divaldo Pereira

2017-10-01

Medications are perceived as health risk factors, because they might cause damage if used improperly. In this context, an adequate assessment of medication use history should be encouraged, especially in transitions of care to avoid unintended medication discrepancies (UMDs). In a case-controlled study, we investigated potential risk factors for UMDs at hospital admission and found that 150 (42%) of the 358 patients evaluated had one or more UMDs. We were surprised to find that there was no record of a patient and/or relative interview on previous use of medication in 117 medical charts of adult patients (44.8%). Similarly, in the medical charts of 52 (53.6%) paediatric patients, there was no record of parents and/or relatives interviews about prior use of medications. One hundred thirty-seven medical charts of adult patients (52.4%) and seventy-two medical charts of paediatric patients (74.2%) had no record about medication allergies and intolerances. In other words, there was a lack of basic documentation regarding the patient's medication use history. As patients move between settings in care, there is insufficient tracking of verbal and written information related to medication changes, which results in a progressive and cumulative loss of information, as evidenced by problems associated with clinical transfers and medication orders. Proper documentation of medication information during transfer is a key step in the procedure; hence, it should be rightly performed. It remains unclear whether interviews, and other investigations about medication use history have been performed but have not been recorded as health-care data. Therefore, it is crucial to the improvement of medication use safety that documentation of all drug-related information-even if not directly related to the actual event-become routine practice in health-care organizations, since 'what is not written does not exist'.

The pattern of acute poisoning in a teaching hospital, north-west Ethiopia.

PubMed

Abula, Teferra; Wondmikun, Yared

2006-04-01

Poisoning by means of hazardous chemicals through ignorance, mishap or intentionally is becoming a serious health problem worldwide. Epidemiological data on this important health issue are, however, scarce in Ethiopia. The purpose of this study is to assess the pattern of acute poisonings and determine the approaches employed for the management of poisoning. The medical records of patients with acute poisonings presented to the Gondar University hospital between July 2001 and June 2004 were reviewed retrospectively. One hundred and two patients presenting to the emergency department of the hospital were due to acute poisoning; accounting for about 0.45% of emergency room admissions. Organophosphates, rat poison and alcohol were the commonly encountered poisoning agents (in about 70% of cases) mainly in adults possibly with suicidal or para-suicidal intention. The approaches employed in the management of poisoning mainly involved gastrointestinal decontamination procedures. Specific antidotes were used in a substantial number of patients. The fatality rate was 2.4%. Poisoning with suicidal intention is becoming a serious health problem particularly in adults. Pesticides are commonly used toxicants. The approaches in the management of poisoning are justifiable in some cases. However, much is to be done to improve the recording of patient-related information and record-keeping processes. Further large scale studies are required to investigate national trends of poisoning and factors associated with poisoning.

Lifetime of digital media: is optics the solution?

NASA Astrophysics Data System (ADS)

Spitz, Erich; Hourcade, Jean-Charles; Lalo", Franck

2010-01-01

While the short term and mid-term archiving of digital data and information can be handled reasonably well with modern techniques, the long term aspects of the problem (several decades or even centuries) are much more difficult to manage. The heart of the problem is the longevity of storage media, which presently does not go beyond a few years, maybe one or two decades in the best cases. In this article, we review the various strategies for long term archiving, with two main categories: active and passive. We evaluate the various recording media in terms of their longevity. We then discuss the recordable optical digital disks (RODDs) and the state of the art in this domain; the present situation is that, with the techniques that are implemented commercially, good prospects for long term archiving are not available. Nevertheless, the conceptual simplicity of RODDs could be exploited to create new recordable digital media; the improvements that are needed seem to be reachable with reasonable development effort. Since RODDs are now in strong competition with other systems (hard disks or flash memory for instance) that constantly make enormous progress, there seems to be little hope to see RODDs win the race of capacity; nevertheless, longevity could provide them with a new market, since the need for long term archiving is so pressing everywhere in the world.

77 FR 26047 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-02

... Service System (SSS) records. The SSS records contain both classification records and registration cards... information from or copies of SSS records they must provide on forms or letters certain information about the... obtain information from SSS records stored at NARA facilities. Dated: April 26, 2012. Michael L. Wash...

28 CFR 20.34 - Individual's right to access criminal history record information.

Code of Federal Regulations, 2011 CFR

2011-07-01

... history record information. 20.34 Section 20.34 Judicial Administration DEPARTMENT OF JUSTICE CRIMINAL JUSTICE INFORMATION SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.34 Individual's right to access criminal history record information. The procedures by which an individual may...

28 CFR 20.34 - Individual's right to access criminal history record information.

Code of Federal Regulations, 2013 CFR

2013-07-01

... history record information. 20.34 Section 20.34 Judicial Administration DEPARTMENT OF JUSTICE CRIMINAL JUSTICE INFORMATION SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.34 Individual's right to access criminal history record information. The procedures by which an individual may...

28 CFR 20.34 - Individual's right to access criminal history record information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... history record information. 20.34 Section 20.34 Judicial Administration DEPARTMENT OF JUSTICE CRIMINAL JUSTICE INFORMATION SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.34 Individual's right to access criminal history record information. The procedures by which an individual may...

28 CFR 20.34 - Individual's right to access criminal history record information.

Code of Federal Regulations, 2014 CFR

2014-07-01

... history record information. 20.34 Section 20.34 Judicial Administration DEPARTMENT OF JUSTICE CRIMINAL JUSTICE INFORMATION SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.34 Individual's right to access criminal history record information. The procedures by which an individual may...

28 CFR 20.34 - Individual's right to access criminal history record information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... history record information. 20.34 Section 20.34 Judicial Administration DEPARTMENT OF JUSTICE CRIMINAL JUSTICE INFORMATION SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.34 Individual's right to access criminal history record information. The procedures by which an individual may...

Travel Medicine Encounters of Australian General Practice Trainees-A Cross-Sectional Study.

PubMed

Morgan, Simon; Henderson, Kim M; Tapley, Amanda; Scott, John; van Driel, Mieke L; Spike, Neil A; McArthur, Lawrie A; Davey, Andrew R; Catzikiris, Nigel F; Magin, Parker J

2015-01-01

Travel medicine is a common and challenging area of clinical practice and practitioners need up-to-date knowledge and experience in a range of areas. Australian general practitioners (GPs) play a significant role in the delivery of travel medicine advice. We aimed to describe the rate and nature of travel medicine consultations, including both the clinical and educational aspects of the consultations. A cross-sectional analysis from an ongoing cohort study of GP trainees' clinical consultations was performed. Trainees contemporaneously recorded demographic, clinical, and educational details of consecutive patient consultations. Proportions of all problems/diagnoses managed in these consultations that were coded "travel-related" and "travel advice" were both calculated with 95% confidence intervals (CIs). Associations of a problem/diagnosis being "travel-related" or "travel advice" were tested using simple logistic regression within the generalized estimating equations (GEE) framework. A total of 856 trainees contributed data on 169,307 problems from 108,759 consultations (2010-2014). Travel-related and travel advice problems were managed at a rate of 1.1 and 0.5 problems per 100 encounters, respectively. Significant positive associations of travel-related problems were younger trainee and patient age; new patient to the trainee and practice; privately billing, larger, urban, and higher socioeconomic status practices; and involvement of the practice nurse. Trainees sought in-consultation information and generated learning goals in 34.7 and 20.8% of travel advice problems, respectively, significantly more than in non-travel advice problems. Significant positive associations of travel advice problems were seeking in-consultation information, generation of learning goals, longer consultation duration, and more problems managed. Our findings reinforce the importance of focused training in travel medicine for GP trainees and adequate exposure to patients in the practice setting. In addition, our findings have implications more broadly for the delivery of travel medicine in general practice. © 2015 International Society of Travel Medicine.

[Automated anesthesia record systems].

PubMed

Heinrichs, W; Mönk, S; Eberle, B

1997-07-01

The introduction of electronic anaesthesia documentation systems was attempted as early as in 1979, although their efficient application has become reality only in the past few years. The advantages of the electronic protocol are apparent: Continuous high quality documentation, comparability of data due to the availability of a data bank, reduction in the workload of the anaesthetist and availability of additional data. Disadvantages of the electronic protocol have also been discussed in the literature. By going through the process of entering data on the course of the anaesthetic procedure on the protocol sheet, the information is mentally absorbed and evaluated by the anaesthetist. This information may, however, be lost when the data are recorded fully automatically-without active involvement on the part of the anaesthetist. Recent publications state that by using intelligent alarms and/or integrated displays manual record keeping is no longer necessary for anaesthesia vigilance. The technical design of automated anaesthesia records depends on an integration of network technology into the hospital. It will be appropriate to connect the systems to the internet, but safety requirements have to be followed strictly. Concerning the database, client server architecture as well as language standards like SQL should be used. Object oriented databases will be available in the near future. Another future goal of automated anaesthesia record systems will be using knowledge based technologies within these systems. Drug interactions, disease related anaesthetic techniques and other information sources can be integrated. At this time, almost none of the commercially available systems has matured to a point where their purchase can be recommended without reservation. There is still a lack of standards for the subsequent exchange of data and a solution to a number of ergonomic problems still remains to be found. Nevertheless, electronic anaesthesia protocols will be required in the near future. The advantages of accurate documentation and quality control in the presence of careful planning outweight cost considerations by far.

Effect of automatic record keeping on vigilance and record keeping time.

PubMed

Allard, J; Dzwonczyk, R; Yablok, D; Block, F E; McDonald, J S

1995-05-01

We have evaluated the effect of an automatic anaesthesia record keeper (AARK) on record keeping time and vigilance. With informed patient consent and institutional approval, we videotaped the attending anaesthetist and his/her immediate surroundings during 66 surgical procedures. Thirty-seven cases were charted manually and the remaining 29 were charted with a commercially available AARK. In order to evaluate vigilance, a physician examiner entered the operating room unannounced once during 33 of the manually charted cases and during 22 of the automatically charted cases and asked the anaesthetist to turn away from the monitors and recall the current value of eight patient physiological variables. The examiner recorded the recalled values and also the actual current monitor values of these variables. The videotapes were reviewed and the anaesthetist's intraoperative time was categorized into 15 predefined activities, including intraoperative anaesthesia record keeping time. We compared recalled and actual variable values to determine if the recalled values were within clinically relevant error limits. There was no statistical difference between the mean percentage case time spent recording manually (14.11 (SD 3.98)%) and automatically (12.39 (3.92)%). Moreover, use of the AARK did not significantly affect vigilance. Despite major advances in monitoring technology over the past 14 years, record keeping still occupies 10-15% of the anaesthetist's intraoperative time. It appears that in using an AARK, the anaesthetist reallocates intraoperative record keeping time from manual charting to dealing with problems in the anaesthetist machine interface caused by inadequate design.

Electronic health records: essential tools in integrating substance abuse treatment with primary care

PubMed Central

Tai, Betty; Wu, Li-Tzy; Clark, H Westley

2012-01-01

While substance use problems are considered to be common in medical settings, they are not systematically assessed and diagnosed for treatment management. Research data suggest that the majority of individuals with a substance use disorder either do not use treatment or delay treatment-seeking for over a decade. The separation of substance abuse services from mainstream medical care and a lack of preventive services for substance abuse in primary care can contribute to under-detection of substance use problems. When fully enacted in 2014, the Patient Protection and Affordable Care Act 2010 will address these barriers by supporting preventive services for substance abuse (screening, counseling) and integration of substance abuse care with primary care. One key factor that can help to achieve this goal is to incorporate the standardized screeners or common data elements for substance use and related disorders into the electronic health records (EHR) system in the health care setting. Incentives for care providers to adopt an EHR system for meaningful use are part of the Health Information Technology for Economic and Clinical Health Act 2009. This commentary focuses on recent evidence about routine screening and intervention for alcohol/drug use and related disorders in primary care. Federal efforts in developing common data elements for use as screeners for substance use and related disorders are described. A pressing need for empirical data on screening, brief intervention, and referral to treatment (SBIRT) for drug-related disorders to inform SBIRT and related EHR efforts is highlighted. PMID:24474861

High-density digital recording

NASA Technical Reports Server (NTRS)

Kalil, F. (Editor); Buschman, A. (Editor)

1985-01-01

The problems associated with high-density digital recording (HDDR) are discussed. Five independent users of HDDR systems and their problems, solutions, and insights are provided as guidance for other users of HDDR systems. Various pulse code modulation coding techniques are reviewed. An introduction to error detection and correction head optimization theory and perpendicular recording are provided. Competitive tape recorder manufacturers apply all of the above theories and techniques and present their offerings. The methodology used by the HDDR Users Subcommittee of THIC to evaluate parallel HDDR systems is presented.

Healthcare and Guidelines: A Population-Based Survey of Recorded Medical Problems and Health Surveillance for People with Down syndrome

ERIC Educational Resources Information Center

Maatta, Tuomo; Maatta, Joonas; Tervo-Maatta, Tuula; Taanila, Anja; Kaski, Markus; Iivanainen, Matti

2011-01-01

Background: Medical problems are described in a population of persons with Down syndrome. Health surveillance is compared to the recommendations of national guidelines. Method: Case records from the specialised and primary healthcare and disability services were analysed. Results: A wide spectrum of age-specific medical and surgical problems was…

Cross-vendor evaluation of key user-defined clinical decision support capabilities: a scenario-based assessment of certified electronic health records with guidelines for future development

PubMed Central

Wright, Adam; Sittig, Dean F

2015-01-01

Objective Clinical decision support (CDS) is essential for delivery of high-quality, cost-effective, and safe healthcare. The authors sought to evaluate the CDS capabilities across electronic health record (EHR) systems. Methods We evaluated the CDS implementation capabilities of 8 Office of the National Coordinator for Health Information Technology Authorized Certification Body (ONC-ACB)-certified EHRs. Within each EHR, the authors attempted to implement 3 user-defined rules that utilized the various data and logic elements expected of typical EHRs and that represented clinically important evidenced-based care. The rules were: 1) if a patient has amiodarone on his or her active medication list and does not have a thyroid-stimulating hormone (TSH) result recorded in the last 12 months, suggest ordering a TSH; 2) if a patient has a hemoglobin A1c result >7% and does not have diabetes on his or her problem list, suggest adding diabetes to the problem list; and 3) if a patient has coronary artery disease on his or her problem list and does not have aspirin on the active medication list, suggest ordering aspirin. Results Most evaluated EHRs lacked some CDS capabilities; 5 EHRs were able to implement all 3 rules, and the remaining 3 EHRs were unable to implement any of the rules. One of these did not allow users to customize CDS rules at all. The most frequently found shortcomings included the inability to use laboratory test results in rules, limit rules by time, use advanced Boolean logic, perform actions from the alert interface, and adequately test rules. Conclusion Significant improvements in the EHR certification and implementation procedures are necessary. PMID:26104739

42 CFR 485.721 - Condition of participation: Clinical records.

Code of Federal Regulations, 2012 CFR

2012-10-01

... information and retrieval of records for research or administrative action. (f) Standard: Location and... information. (a) Standard: Protection of clinical record information. The organization recognizes the confidentiality of clinical record information and provides safeguards against loss, destruction, or unauthorized...

42 CFR 485.721 - Condition of participation: Clinical records.

Code of Federal Regulations, 2011 CFR

2011-10-01

... information and retrieval of records for research or administrative action. (f) Standard: Location and... information. (a) Standard: Protection of clinical record information. The organization recognizes the confidentiality of clinical record information and provides safeguards against loss, destruction, or unauthorized...

42 CFR 485.721 - Condition of participation: Clinical records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... information and retrieval of records for research or administrative action. (f) Standard: Location and... information. (a) Standard: Protection of clinical record information. The organization recognizes the confidentiality of clinical record information and provides safeguards against loss, destruction, or unauthorized...

42 CFR 485.721 - Condition of participation: Clinical records.

Code of Federal Regulations, 2014 CFR

2014-10-01

... information and retrieval of records for research or administrative action. (f) Standard: Location and... information. (a) Standard: Protection of clinical record information. The organization recognizes the confidentiality of clinical record information and provides safeguards against loss, destruction, or unauthorized...

42 CFR 485.721 - Condition of participation: Clinical records.

Code of Federal Regulations, 2013 CFR

2013-10-01

... information and retrieval of records for research or administrative action. (f) Standard: Location and... information. (a) Standard: Protection of clinical record information. The organization recognizes the confidentiality of clinical record information and provides safeguards against loss, destruction, or unauthorized...

Developing a fluid intelligence scale through a combination of Rasch modeling and cognitive psychology.

PubMed

Primi, Ricardo

2014-09-01

Ability testing has been criticized because understanding of the construct being assessed is incomplete and because the testing has not yet been satisfactorily improved in accordance with new knowledge from cognitive psychology. This article contributes to the solution of this problem through the application of item response theory and Susan Embretson's cognitive design system for test development in the development of a fluid intelligence scale. This study is based on findings from cognitive psychology; instead of focusing on the development of a test, it focuses on the definition of a variable for the creation of a criterion-referenced measure for fluid intelligence. A geometric matrix item bank with 26 items was analyzed with data from 2,797 undergraduate students. The main result was a criterion-referenced scale that was based on information from item features that were linked to cognitive components, such as storage capacity, goal management, and abstraction; this information was used to create the descriptions of selected levels of a fluid intelligence scale. The scale proposed that the levels of fluid intelligence range from the ability to solve problems containing a limited number of bits of information with obvious relationships through the ability to solve problems that involve abstract relationships under conditions that are confounded with an information overload and distraction by mixed noise. This scale can be employed in future research to provide interpretations for the measurements of the cognitive processes mastered and the types of difficulty experienced by examinees. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Scalable Decision Support at the Point of Care: A Substitutable Electronic Health Record App for Monitoring Medication Adherence

PubMed Central

Mandel, Joshua; Jonikas, Magdalena; Ramoni, Rachel Badovinac; Kohane, Isaac S; Mandl, Kenneth D

2013-01-01

Background Non-adherence to prescribed medications is a serious health problem in the United States, costing an estimated $100 billion per year. While poor adherence should be addressable with point of care health information technology, integrating new solutions with existing electronic health records (EHR) systems require customization within each organization, which is difficult because of the monolithic software design of most EHR products. Objective The objective of this study was to create a published algorithm for predicting medication adherence problems easily accessible at the point of care through a Web application that runs on the Substitutable Medical Apps, Reusuable Technologies (SMART) platform. The SMART platform is an emerging framework that enables EHR systems to behave as “iPhone like platforms” by exhibiting an application programming interface for easy addition and deletion of third party apps. The app is presented as a point of care solution to monitoring medication adherence as well as a sufficiently general, modular application that may serve as an example and template for other SMART apps. Methods The widely used, open source Django framework was used together with the SMART platform to create the interoperable components of this app. Django uses Python as its core programming language. This allows statistical and mathematical modules to be created from a large array of Python numerical libraries and assembled together with the core app to create flexible and sophisticated EHR functionality. Algorithms that predict individual adherence are derived from a retrospective study of dispensed medication claims from a large private insurance plan. Patients’ prescription fill information is accessed through the SMART framework and the embedded algorithms compute adherence information, including predicted adherence one year after the first prescription fill. Open source graphing software is used to display patient medication information and the results of statistical prediction of future adherence on a clinician-facing Web interface. Results The user interface allows the physician to quickly review all medications in a patient record for potential non-adherence problems. A gap-check and current medication possession ratio (MPR) threshold test are applied to all medications in the record to test for current non-adherence. Predictions of 1-year non-adherence are made for certain drug classes for which external data was available. Information is presented graphically to indicate present non-adherence, or predicted non-adherence at one year, based on early prescription fulfillment patterns. The MPR Monitor app is installed in the SMART reference container as the “MPR Monitor”, where it is publically available for use and testing. MPR is an acronym for Medication Possession Ratio, a commonly used measure of adherence to a prescribed medication regime. This app may be used as an example for creating additional functionality by replacing statistical and display algorithms with new code in a cycle of rapid prototyping and implementation or as a framework for a new SMART app. Conclusions The MPR Monitor app is a useful pilot project for monitoring medication adherence. It also provides an example that integrates several open source software components, including the Python-based Django Web framework and python-based graphics, to build a SMART app that allows complex decision support methods to be encapsulated to enhance EHR functionality. PMID:23876796

Scalable decision support at the point of care: a substitutable electronic health record app for monitoring medication adherence.

PubMed

Bosl, William; Mandel, Joshua; Jonikas, Magdalena; Ramoni, Rachel Badovinac; Kohane, Isaac S; Mandl, Kenneth D

2013-07-22

Non-adherence to prescribed medications is a serious health problem in the United States, costing an estimated $100 billion per year. While poor adherence should be addressable with point of care health information technology, integrating new solutions with existing electronic health records (EHR) systems require customization within each organization, which is difficult because of the monolithic software design of most EHR products. The objective of this study was to create a published algorithm for predicting medication adherence problems easily accessible at the point of care through a Web application that runs on the Substitutable Medical Apps, Reusuable Technologies (SMART) platform. The SMART platform is an emerging framework that enables EHR systems to behave as "iPhone like platforms" by exhibiting an application programming interface for easy addition and deletion of third party apps. The app is presented as a point of care solution to monitoring medication adherence as well as a sufficiently general, modular application that may serve as an example and template for other SMART apps. The widely used, open source Django framework was used together with the SMART platform to create the interoperable components of this app. Django uses Python as its core programming language. This allows statistical and mathematical modules to be created from a large array of Python numerical libraries and assembled together with the core app to create flexible and sophisticated EHR functionality. Algorithms that predict individual adherence are derived from a retrospective study of dispensed medication claims from a large private insurance plan. Patients' prescription fill information is accessed through the SMART framework and the embedded algorithms compute adherence information, including predicted adherence one year after the first prescription fill. Open source graphing software is used to display patient medication information and the results of statistical prediction of future adherence on a clinician-facing Web interface. The user interface allows the physician to quickly review all medications in a patient record for potential non-adherence problems. A gap-check and current medication possession ratio (MPR) threshold test are applied to all medications in the record to test for current non-adherence. Predictions of 1-year non-adherence are made for certain drug classes for which external data was available. Information is presented graphically to indicate present non-adherence, or predicted non-adherence at one year, based on early prescription fulfillment patterns. The MPR Monitor app is installed in the SMART reference container as the "MPR Monitor", where it is publically available for use and testing. MPR is an acronym for Medication Possession Ratio, a commonly used measure of adherence to a prescribed medication regime. This app may be used as an example for creating additional functionality by replacing statistical and display algorithms with new code in a cycle of rapid prototyping and implementation or as a framework for a new SMART app. The MPR Monitor app is a useful pilot project for monitoring medication adherence. It also provides an example that integrates several open source software components, including the Python-based Django Web framework and python-based graphics, to build a SMART app that allows complex decision support methods to be encapsulated to enhance EHR functionality.

Addressing immunization registry population inflation in adolescent immunization rates.

PubMed

Robison, Steve G

2015-01-01

While U.S. adolescent immunization rates are available annually at national and state levels, finding pockets of need may require county or sub-county information. Immunization information systems (IISs) are one tool for assessing local immunization rates. However, the presence of IIS records dating back to early childhood and challenges in capturing mobility out of IIS areas typically leads to denominator inflation. We examined the feasibility of weighting adolescent immunization records by length of time since last report to produce more accurate county adolescent counts and immunization rates. We compared weighted and unweighted adolescent denominators from the Oregon ALERT IIS, along with county-level Census Bureau estimates, with school enrollment counts from Oregon's annual review of seventh-grade school immunization compliance for public and private schools. Adolescent immunization rates calculated using weighted data, for the state as a whole, were also checked against comparable National Immunization Survey (NIS) rates. Weighting individual records by the length of time since last activity substantially improved the fit of IIS data to county populations for adolescents. A nonlinear logarithmic (ogive) weight produced the best fit to the school count data of all examined estimates. Overall, the ogive weighted results matched NIS adolescent rates for Oregon. The problem of mobility-inflated counts of teenagers can be addressed by weighting individual records based on time since last immunization. Well-populated IISs can rely on their own data to produce adolescent immunization rates and find pockets of need.

The evolution of methods for establishing evolutionary timescales

PubMed Central

2016-01-01

The fossil record is well known to be incomplete. Read literally, it provides a distorted view of the history of species divergence and extinction, because different species have different propensities to fossilize, the amount of rock fluctuates over geological timescales, as does the nature of the environments that it preserves. Even so, patterns in the fossil evidence allow us to assess the incompleteness of the fossil record. While the molecular clock can be used to extend the time estimates from fossil species to lineages not represented in the fossil record, fossils are the only source of information concerning absolute (geological) times in molecular dating analysis. We review different ways of incorporating fossil evidence in modern clock dating analyses, including node-calibrations where lineage divergence times are constrained using probability densities and tip-calibrations where fossil species at the tips of the tree are assigned dates from dated rock strata. While node-calibrations are often constructed by a crude assessment of the fossil evidence and thus involves arbitrariness, tip-calibrations may be too sensitive to the prior on divergence times or the branching process and influenced unduly affected by well-known problems of morphological character evolution, such as environmental influence on morphological phenotypes, correlation among traits, and convergent evolution in disparate species. We discuss the utility of time information from fossils in phylogeny estimation and the search for ancestors in the fossil record. This article is part of the themed issue ‘Dating species divergences using rocks and clocks’. PMID:27325838

The evolution of methods for establishing evolutionary timescales.

PubMed

Donoghue, Philip C J; Yang, Ziheng

2016-07-19

The fossil record is well known to be incomplete. Read literally, it provides a distorted view of the history of species divergence and extinction, because different species have different propensities to fossilize, the amount of rock fluctuates over geological timescales, as does the nature of the environments that it preserves. Even so, patterns in the fossil evidence allow us to assess the incompleteness of the fossil record. While the molecular clock can be used to extend the time estimates from fossil species to lineages not represented in the fossil record, fossils are the only source of information concerning absolute (geological) times in molecular dating analysis. We review different ways of incorporating fossil evidence in modern clock dating analyses, including node-calibrations where lineage divergence times are constrained using probability densities and tip-calibrations where fossil species at the tips of the tree are assigned dates from dated rock strata. While node-calibrations are often constructed by a crude assessment of the fossil evidence and thus involves arbitrariness, tip-calibrations may be too sensitive to the prior on divergence times or the branching process and influenced unduly affected by well-known problems of morphological character evolution, such as environmental influence on morphological phenotypes, correlation among traits, and convergent evolution in disparate species. We discuss the utility of time information from fossils in phylogeny estimation and the search for ancestors in the fossil record.This article is part of the themed issue 'Dating species divergences using rocks and clocks'. © 2016 The Authors.

For the Record: Information on Individuals [and] Remote Access to Corporate Public Records: Scanning the Field [and] The INCORP Files: Extracting Company Information from State Files.

ERIC Educational Resources Information Center

Paul, Nora; And Others

1991-01-01

Three articles assess increased availability of information about individuals and corporations. The first discusses databases that provide information on individuals--e.g., court records, real estate transactions, motor vehicles records, and credit information. The second compares databases that provide corporate information, and the third…

The European Cystic Fibrosis Society Patient Registry: valuable lessons learned on how to sustain a disease registry.

PubMed

Viviani, Laura; Zolin, Anna; Mehta, Anil; Olesen, Hanne Vebert

2014-06-07

Disease registries have the invaluable potential to provide an insight into the natural history of the disease under investigation, to provide useful information (e.g. through health indicators) for planning health care services and to identify suitable groups of patients for clinical trials enrolment. However, the establishment and maintenance of disease registries is a burdensome initiative from economical and organisational points of view and experience sharing on registries management is important to avoid waste of resources. The aim of this paper is to discuss the problems embedded in the institution and management of an international disease registry to warn against common mistakes that can derail the best of intentions: we share the experience of the European Cystic Fibrosis Society Patient Registry, which collects data on almost 30,000 patients from 23 countries. We discuss the major problems that researchers often encounter in the creation and management of disease registries: definition of the aims the registry has to reach, definition of the criteria for patients referral to the registry, definition of the information to record, set up of a data quality process, handling of missing data, maintenance of data confidentiality, regulation of data use and dissemination of research results. We give examples on how many crucial aspects were solved by the European Cystic Fibrosis Society Patient Registry regarding objectives, inclusion criteria and variables definition, data management, data quality controls, missing data handling, confidentiality maintenance, data use and results dissemination. We suggest an extensive literature research and discussions in working groups with different stake holders, including patient representatives, on the objectives, inclusion criteria and the information to record. We propose to pilot the recording of few variables and test the applicability of their definition first. The use of a shared electronic platform for data collection that automatically computes derived variables, and automatically performs basic data quality controls is a good data management practice, that also helps in reducing missing data. We found crucial for success the collaboration with existing national and international registries, cystic fibrosis organisations and patients' associations.

The European Cystic Fibrosis Society Patient Registry: valuable lessons learned on how to sustain a disease registry

PubMed Central

2014-01-01

Background Disease registries have the invaluable potential to provide an insight into the natural history of the disease under investigation, to provide useful information (e.g. through health indicators) for planning health care services and to identify suitable groups of patients for clinical trials enrolment. However, the establishment and maintenance of disease registries is a burdensome initiative from economical and organisational points of view and experience sharing on registries management is important to avoid waste of resources. The aim of this paper is to discuss the problems embedded in the institution and management of an international disease registry to warn against common mistakes that can derail the best of intentions: we share the experience of the European Cystic Fibrosis Society Patient Registry, which collects data on almost 30,000 patients from 23 countries. Methods We discuss the major problems that researchers often encounter in the creation and management of disease registries: definition of the aims the registry has to reach, definition of the criteria for patients referral to the registry, definition of the information to record, set up of a data quality process, handling of missing data, maintenance of data confidentiality, regulation of data use and dissemination of research results. Results We give examples on how many crucial aspects were solved by the European Cystic Fibrosis Society Patient Registry regarding objectives, inclusion criteria and variables definition, data management, data quality controls, missing data handling, confidentiality maintenance, data use and results dissemination. Conclusions We suggest an extensive literature research and discussions in working groups with different stake holders, including patient representatives, on the objectives, inclusion criteria and the information to record. We propose to pilot the recording of few variables and test the applicability of their definition first. The use of a shared electronic platform for data collection that automatically computes derived variables, and automatically performs basic data quality controls is a good data management practice, that also helps in reducing missing data. We found crucial for success the collaboration with existing national and international registries, cystic fibrosis organisations and patients’ associations. PMID:24908055

Identifying influenza-like illness presentation from unstructured general practice clinical narrative using a text classifier rule-based expert system versus a clinical expert.

PubMed

MacRae, Jayden; Love, Tom; Baker, Michael G; Dowell, Anthony; Carnachan, Matthew; Stubbe, Maria; McBain, Lynn

2015-10-06

We designed and validated a rule-based expert system to identify influenza like illness (ILI) from routinely recorded general practice clinical narrative to aid a larger retrospective research study into the impact of the 2009 influenza pandemic in New Zealand. Rules were assessed using pattern matching heuristics on routine clinical narrative. The system was trained using data from 623 clinical encounters and validated using a clinical expert as a gold standard against a mutually exclusive set of 901 records. We calculated a 98.2 % specificity and 90.2 % sensitivity across an ILI incidence of 12.4 % measured against clinical expert classification. Peak problem list identification of ILI by clinical coding in any month was 9.2 % of all detected ILI presentations. Our system addressed an unusual problem domain for clinical narrative classification; using notational, unstructured, clinician entered information in a community care setting. It performed well compared with other approaches and domains. It has potential applications in real-time surveillance of disease, and in assisted problem list coding for clinicians. Our system identified ILI presentation with sufficient accuracy for use at a population level in the wider research study. The peak coding of 9.2 % illustrated the need for automated coding of unstructured narrative in our study.

Impact of the DSM-V Attention Deficit Hyperactivity Disorder Criteria for Diagnosing Children With High IQ.

PubMed

Thongseiratch, Therdpong; Worachotekamjorn, Juthamas

2016-10-01

This study compared the number of attention deficit hyperactivity disorder (ADHD) cases defined by Diagnostic and Statistical Manual (DSM)-IV versus DSM-V criterion in children who have learning or behavioral problems with high IQ. The medical records of children ≤15 years of age who presented with learning or behavioral problems and underwent a Wechsler Intelligence Scale for Children (WISC)-III IQ test at the Pediatric Outpatient Clinic unit between 2010 and 2015 were reviewed. Information on DSM-IV and DSM-V criteria for ADHD were derived from computer-based medical records. Twenty-eight children who had learning or behavioral problems were identified to have a full-scale IQ ≥120. Sixteen of these high-IQ children met the DSM-IV criteria diagnosis for ADHD. Applying the extension of the age-of-onset criterion from 7 to 12 years in DSM-V led to an increase of three cases, all of which were the inattentive type ADHD. Including the pervasive developmental disorder criterion led to an increase of one case. The total number of ADHD cases also increased from 16 to 20 in this group. The data supported the hypothesis that applying the extension of the age-of-onset ADHD criterion and enabling the diagnosis of children with pervasive developmental disorders will increase the number of ADHD diagnoses among children with high IQ. © The Author(s) 2016.

An implementation of wireless medical image transmission system on mobile devices.

PubMed

Lee, SangBock; Lee, Taesoo; Jin, Gyehwan; Hong, Juhyun

2008-12-01

The advanced technology of computing system was followed by the rapid improvement of medical instrumentation and patient record management system. The typical examples are hospital information system (HIS) and picture archiving and communication system (PACS), which computerized the management procedure of medical records and images in hospital. Because these systems were built and used in hospitals, doctors out of hospital have problems to access them immediately on emergent cases. To solve these problems, this paper addressed the realization of system that could transmit the images acquired by medical imaging systems in hospital to the remote doctors' handheld PDA's using CDMA cellular phone network. The system consists of server and PDA. The server was developed to manage the accounts of doctors and patients and allocate the patient images to each doctor. The PDA was developed to display patient images through remote server connection. To authenticate the personal user, remote data access (RDA) method was used in PDA accessing the server database and file transfer protocol (FTP) was used to download patient images from the remove server. In laboratory experiments, it was calculated to take ninety seconds to transmit thirty images with 832 x 488 resolution and 24 bit depth and 0.37 Mb size. This result showed that the developed system has no problems for remote doctors to receive and review the patient images immediately on emergent cases.

42 CFR 485.60 - Condition of participation: Clinical records.

Code of Federal Regulations, 2013 CFR

2013-10-01

... retrieval and compilation of information. (a) Standard: Content. Each clinical record must contain sufficient information to identify the patient clearly and to justify the diagnosis and treatment. Entries in...: Protection of clinical record information. The facility must safeguard clinical record information against...

42 CFR 485.60 - Condition of participation: Clinical records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... retrieval and compilation of information. (a) Standard: Content. Each clinical record must contain sufficient information to identify the patient clearly and to justify the diagnosis and treatment. Entries in...: Protection of clinical record information. The facility must safeguard clinical record information against...

42 CFR 485.60 - Condition of participation: Clinical records.

Code of Federal Regulations, 2014 CFR

2014-10-01

... retrieval and compilation of information. (a) Standard: Content. Each clinical record must contain sufficient information to identify the patient clearly and to justify the diagnosis and treatment. Entries in...: Protection of clinical record information. The facility must safeguard clinical record information against...

42 CFR 485.60 - Condition of participation: Clinical records.

Code of Federal Regulations, 2011 CFR

2011-10-01

... retrieval and compilation of information. (a) Standard: Content. Each clinical record must contain sufficient information to identify the patient clearly and to justify the diagnosis and treatment. Entries in...: Protection of clinical record information. The facility must safeguard clinical record information against...

76 FR 54743 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-02

...; and also including information in the following categories: Personnel: Records concern military and... permanent records providing core information technology to records management support programs (Freedom of..., including any personal identifiers or contact information. FOR FURTHER INFORMATION CONTACT: Mr. Leroy Jones...

Online information system for data collection of cattle quality

NASA Astrophysics Data System (ADS)

Sugiharti, E.; Arifudin, R.; Putra, A. T.

2018-03-01

Innovation and development of the science and technology which proclaimed by the government through Ristekdikti need to be supported. On the other hand, the Department of Animal Husbandry and Fisheries began introducing the Cattle Card system that contains the identity of each farm animal. Therefore, UNNES especially the Department of Computer Science of FMIPA UNNES, need to give positive contribution in the field of Science and Technology to support the manual system of Cattle Card, through the preparation of prototype of the online information system of data collection of cattle in Semarang regency. The main problem is how to monitor the data of cattle quality through online information system in Semarang regency? The purpose of this research is to produce the prototype of an online information system for data collection of cattle quality in Semarang regency. Main activities: (1) Prepare the flowchart of an online system for data collection of cattle quality. (2) Collecting data to obtain data on identity descriptions of each cattle, owners, mutation records, and health records of livestock cattle. (3) Creation of the prototype of an online information system for data collection of cattle quality in Semarang Regency. The results, (1) had been produced the prototype of an online information system for data collection of cattle in the region of Semarang regency. (2) Socialization of the online information system for cattle quality data collection and exploring input from various related stakeholders. (3) There had been a limited trial of prototypes of the system in Pabelan district in the working area of the Department of Animal Husbandry and Fisheries of Semarang regency and succeeded well.

Global climatic trends as revealed by the recorded data

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

Ellsaesser, H.W.; MacCracken, M.C.; Walton, J.J.

Recent results from climate models have led to the prediction that a global warming due to increasing atmospheric CO/sub 2/ is now imminent, if it has not already occurred. In an effort to develop more definitive information on this question, a detailed review has been conducted of prior efforts to unravel climatic change from the various types of recorded observational data available. Most of the more definitive of the prior analyses: along with evaluative comments by the various authors: have been assembled herein. There appears little doubt that the average surface air temperature of at least northern hemisphere has beenmore » increasing since the beginning of recorded data with most of the warming occurring in a brief period circa 1920. The fragmentary early data suggest significant cooling prior to 1883 such that 25--50% of the subsequent warming may represent a return to earlier levels. Whether the overall warming constitutes a climate change remains an unresolved problem, as does the cause of the warming.« less

A Problem-Oriented Record System for Counselors.

ERIC Educational Resources Information Center

Law, Joseph; And Others

1981-01-01

Recommends the adoption of Weed's Problem Oriented Records System by practitioners and supervisors. Also discusses the purposes of recordkeeping in counseling and establishes criteria for adopting documentation systems. Case examples illustrate the applicability of Weed's approach in counseling and practicum supervision. (Author)

Is the biggest security threat to medical information simply a lack of understanding?

PubMed

Williams, Patricia A H

2011-01-01

Connecting Australian health services and the e-health initiative is a major focus in the current health environment. Many issues are presented as key to its success including solving issues with confidentiality and privacy. However, the main problem may not be these issues in sharing information but the fact that the point of origin of such records is still relatively insecure. This paper highlights why this may be the case. Research into the security of medical information has shown that many primary healthcare providers are unable to create an environment with effective information security. Numerous factors contribute to this complex situation including a trustful environment, the resultant security culture and the capability of individual healthcare organisations. Further, the growing importance of new directions in the use of patient information is considered. This paper discusses these issues and positions them within the complex environment that is healthcare. In our current health system infrastructure, the points of origin of patient information are our most vulnerable. This entwined with progressively new uses of this information expose additional security concerns, such as re-identification of information, that require attention.

Security of the distributed electronic patient record: a case-based approach to identifying policy issues.

PubMed

Anderson, J G

2000-11-01

The growth of managed care and integrated delivery systems has created a new commodity, health information and the technology that it requires. Surveys by Deloitte and Touche indicate that over half of the hospitals in the US are in the process of implementing electronic patient record (EPR) systems. The National Research Council has established that industry spends as much as $15 billion on information technology (IT), an amount that is expanding by 20% per year. The importance of collecting, electronically storing, and using the information is undisputed. This information is needed by consumers to make informed choices; by physicians to provide appropriate quality clinical care: and by health plans to assess outcomes, control costs and monitor quality. The collection, storage and communication of a large variety of personal patient data, however, present a major dilemma. How can we provide the data required by the new forms of health care delivery and at the same time protect the personal privacy of patients? Recent debates concerning medical privacy legislation, software regulation, and telemedicine suggest that this dilemma will not be easily resolved. The problem is systemic and arises out of the routine use and flow of information throughout the health industry. Health care information is primarily transferred among authorized users. Not only is the information used for patient care and financial reimbursement, secondary users of the information include medical, nursing, and allied health education, research, social services, public health, regulation, litigation, and commercial purposes such as the development of new medical technology and marketing. The main threats to privacy and confidentiality arise from within the institutions that provide patient care as well as institutions that have access to patient data for secondary purposes.

36 CFR 1236.10 - What records management controls must agencies establish for records in electronic information...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Implementing Electronic Information Systems § 1236.10 What records management controls must agencies establish for records in electronic information systems? The following types of records management controls are... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false What records management...

36 CFR 1236.10 - What records management controls must agencies establish for records in electronic information...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Implementing Electronic Information Systems § 1236.10 What records management controls must agencies establish for records in electronic information systems? The following types of records management controls are... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false What records management...

36 CFR 1236.10 - What records management controls must agencies establish for records in electronic information...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Implementing Electronic Information Systems § 1236.10 What records management controls must agencies establish for records in electronic information systems? The following types of records management controls are... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false What records management...

36 CFR § 1236.10 - What records management controls must agencies establish for records in electronic information...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Implementing Electronic Information Systems § 1236.10 What records management controls must agencies establish for records in electronic information systems? The following types of records management controls are... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true What records management...

36 CFR 1236.10 - What records management controls must agencies establish for records in electronic information...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Implementing Electronic Information Systems § 1236.10 What records management controls must agencies establish for records in electronic information systems? The following types of records management controls are... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false What records management...

17 CFR 160.30 - Procedures to safeguard customer records and information.

Code of Federal Regulations, 2010 CFR

2010-04-01

... customer records and information. 160.30 Section 160.30 Commodity and Securities Exchanges COMMODITY... Date § 160.30 Procedures to safeguard customer records and information. Every futures commission... physical safeguards for the protection of customer records and information. These policies and procedures...

Exploring the relationship between quality of life and mental health problems in children: implications for measurement and practice.

PubMed

Sharpe, Helen; Patalay, Praveetha; Fink, Elian; Vostanis, Panos; Deighton, Jessica; Wolpert, Miranda

2016-06-01

Quality of life is typically reduced in children with mental health problems. Understanding the relationship between quality of life and mental health problems and the factors that moderate this association is a pressing priority. This was a cross-sectional study involving 45,398 children aged 8-13 years from 880 schools in England. Self-reported quality of life was assessed using nine items from the KIDSCREEN-10 and mental health was assessed using the Me and My School Questionnaire. Demographic information (gender, age, ethnicity, socio-economic status) was also recorded. Quality of life was highest in children with no problems and lowest in children with both internalising and externalising problems. There was indication that quality of life may be reduced in children with internalising problems compared with externalising problems. Approximately 12 % children with mental health problems reported high quality of life. The link between mental health and quality of life was moderated by gender and age but not by socio-economic status or ethnicity. This study supports previous work showing mental health and quality of life are related but not synonymous. The findings have implications for measuring quality of life in child mental health settings and the need for approaches to support children with mental health problems that are at particular risk of poor quality of life.

A contemporary case study illustrating the integration of health information technologies into the organisation and clinical practice of radiation oncology.

PubMed

Miller, Alexis Andrew; Phillips, Aaron K

The development of software in radiation oncology departments has seen the increase in capability from the Record and Verify software focused on patient safety to a fully-fledged Oncology Information System (OIS). This paper reports on the medical aspects of the implementation of a modern Oncology Information System (IMPAC MultiAccess, also known as the Siemens LANTIS) in a New Zealand hospital oncology department. The department was successful in translating paper procedures into electronic procedures, and the report focuses on the changes in approach to organisation and data use that occurred. The difficulties that were faced, which included procedural re-design, management of change, removal of paper, implementation cost, integration with the HIS, quality assurance and datasets, are highlighted along with the local solutions developed to overcome these problems.

The lower saxony bank of health. rationale, principles, services, organization and architectural framework.

PubMed

Plischke, M; Wagner, M; Haarbrandt, B; Rochon, M; Schwartze, J; Tute, E; Bartkiewicz, T; Kleinschmidt, T; Seidel, C; Schüttig, H; Haux, R

2014-01-01

This article is part of a Focus Theme of METHODS of Information in Medicine on Health Record Banking. Poor communication of health care information between health care providers (HCP) is still a major problem. One recent approach is the concept of Health Record Banking. With this report we want to introduce the Lower Saxony Bank of Health (LSBH) to the international community. The main objective of this paper is to report and explain: 1) why this organization has been founded, 2) which basic principles have been set, 3) which services will be provided, 4) which type of organization has been chosen, and 5) which architectural framework has been selected. To report and discuss how we plan to achieve the intended objectives. The LSBH was founded as an entrepreneurial company, regarding itself as a neutral third-party information broker. The bank does not store medical documents on its central servers but offers a document registry with links to documents stored at participating health care providers. Subject to valid patient consent, the LSBH grants access to these documents to authorized health care providers. To implement our services, we chose the established technical frameworks of the Integrating the Healthcare Enterprise (IHE) initiative using cross-enterprise document sharing (XDS). Different approaches to establish health information exchange (HIE) are in early stages and some have failed in the past. Health Record Banking can address major challenges described in the literature about HIE. The future will show if our provider-sponsored business model is sustainable. After reaching a stable network, we intend to add additional HCPs, e.g., care homes or ambulance services, to the network.

18 CFR 3b.204 - Safeguarding information in manual and computer-based record systems.

Code of Federal Regulations, 2014 CFR

2014-04-01

... information in manual and computer-based record systems. 3b.204 Section 3b.204 Conservation of Power and Water... Collection of Records § 3b.204 Safeguarding information in manual and computer-based record systems. (a) The administrative and physical controls to protect the information in the manual and computer-based record systems...

18 CFR 3b.204 - Safeguarding information in manual and computer-based record systems.

Code of Federal Regulations, 2011 CFR

2011-04-01

... information in manual and computer-based record systems. 3b.204 Section 3b.204 Conservation of Power and Water... Collection of Records § 3b.204 Safeguarding information in manual and computer-based record systems. (a) The administrative and physical controls to protect the information in the manual and computer-based record systems...

18 CFR 3b.204 - Safeguarding information in manual and computer-based record systems.

Code of Federal Regulations, 2012 CFR

2012-04-01

... information in manual and computer-based record systems. 3b.204 Section 3b.204 Conservation of Power and Water... Collection of Records § 3b.204 Safeguarding information in manual and computer-based record systems. (a) The administrative and physical controls to protect the information in the manual and computer-based record systems...

18 CFR 3b.204 - Safeguarding information in manual and computer-based record systems.

Code of Federal Regulations, 2013 CFR

2013-04-01

... information in manual and computer-based record systems. 3b.204 Section 3b.204 Conservation of Power and Water... Collection of Records § 3b.204 Safeguarding information in manual and computer-based record systems. (a) The administrative and physical controls to protect the information in the manual and computer-based record systems...

Identification of approximately duplicate material records in ERP systems

NASA Astrophysics Data System (ADS)

Zong, Wei; Wu, Feng; Chu, Lap-Keung; Sculli, Domenic

2017-03-01

The quality of master data is crucial for the accurate functioning of the various modules of an enterprise resource planning (ERP) system. This study addresses specific data problems arising from the generation of approximately duplicate material records in ERP databases. Such problems are mainly due to the firm's lack of unique and global identifiers for the material records, and to the arbitrary assignment of alternative names for the same material by various users. Traditional duplicate detection methods are ineffective in identifying such approximately duplicate material records because these methods typically rely on string comparisons of each field. To address this problem, a machine learning-based framework is developed to recognise semantic similarity between strings and to further identify and reunify approximately duplicate material records - a process referred to as de-duplication in this article. First, the keywords of the material records are extracted to form vectors of discriminating words. Second, a machine learning method using a probabilistic neural network is applied to determine the semantic similarity between these material records. The approach was evaluated using data from a real case study. The test results indicate that the proposed method outperforms traditional algorithms in identifying approximately duplicate material records.

Strategies for improving the collection of 24-hour urine for analysis in the clinical laboratory: redesigned instructions, opinion surveys, and application of reference change value to micturition.

PubMed

Tormo, Consuelo; Lumbreras, Blanca; Santos, Ana; Romero, Luis; Conca, Minerva

2009-12-01

-The preanalytic phase of 24-hour urine collection, before clinical analysis, requires the active participation of patients and usually takes place outside the laboratory. -We verify whether distribution of adequate information to health care personnel and patients will result in fewer preanalytic incidents. We also determine the intraindividual biologic variability associated with micturition and the corresponding reference change value (RCV). -The intervention provided training for 24-hour urine collection to the health care personnel of the 20th health district of the Valencian community in Spain. The preanalytic incidents related to 24-hour micturition were estimated before and after the intervention. An opinion survey on the problems involved in urine collection was also conducted among patients. The Harris formula was used to calculate the RCV. -Before the intervention, 130 preanalytic incidents were recorded (11.5%) and after the intervention, 76 (8.6%) (P = .04) were recorded. Of the 130 incidents recorded before the intervention, 63 (48.5%) involved omission to indicate the urine volume, and of the 76 incidents recorded after the intervention, only 1 (1.3%) (P < .001) involved this omission. Forty of 302 patients (13.2%) surveyed reported problems and more than half (175; 57.9%) had to collect various urine samples sequentially. The RCV determined was 54.5% for a percentage of variation in volume of 24-hour urine (PVVI) of 19.0 +/- 16.5%. Therefore, micturition associated with a PVVI >+/-54.5% suggests that 24-hour urine collection by the patient was incomplete. The results obtained when applying the RCV after the intervention showed that 6.3% of the 24-hour urine samples should be rejected. -The percentage of preanalytic incidents was reduced by providing health care personnel with information and training. The percentage of variation in volume of 24-hour urine can be used to evaluate the variation in patients' micturition. Reference change value was shown to be useful when determining whether 24-hour urine was properly collected.

Adaptive estimation of hand movement trajectory in an EEG based brain-computer interface system

NASA Astrophysics Data System (ADS)

Robinson, Neethu; Guan, Cuntai; Vinod, A. P.

2015-12-01

Objective. The various parameters that define a hand movement such as its trajectory, speed, etc, are encoded in distinct brain activities. Decoding this information from neurophysiological recordings is a less explored area of brain-computer interface (BCI) research. Applying non-invasive recordings such as electroencephalography (EEG) for decoding makes the problem more challenging, as the encoding is assumed to be deep within the brain and not easily accessible by scalp recordings. Approach. EEG based BCI systems can be developed to identify the neural features underlying movement parameters that can be further utilized to provide a detailed and well defined control command set to a BCI output device. A real-time continuous control is better suited for practical BCI systems, and can be achieved by continuous adaptive reconstruction of movement trajectory than discrete brain activity classifications. In this work, we adaptively reconstruct/estimate the parameters of two-dimensional hand movement trajectory, namely movement speed and position, from multi-channel EEG recordings. The data for analysis is collected by performing an experiment that involved center-out right-hand movement tasks in four different directions at two different speeds in random order. We estimate movement trajectory using a Kalman filter that models the relation between brain activity and recorded parameters based on a set of defined predictors. We propose a method to define these predictor variables that includes spatial, spectral and temporally localized neural information and to select optimally informative variables. Main results. The proposed method yielded correlation of (0.60 ± 0.07) between recorded and estimated data. Further, incorporating the proposed predictor subset selection, the correlation achieved is (0.57 ± 0.07, p {\\lt }0.004) with significant gain in stability of the system, as well as dramatic reduction in number of predictors (76%) for the savings of computational time. Significance. The proposed system provides a real time movement control system using EEG-BCI with control over movement speed and position. These results are higher and statistically significant compared to existing techniques in EEG based systems and thus promise the applicability of the proposed method for efficient estimation of movement parameters and for continuous motor control.

[Effects of marijuana on cognition: a review form the neurobiological perspective].

PubMed

Torres, Gladys; Fiestas, Fabián

2012-03-01

Marijuana is one of the most commonly used psychoactive substances in society, mainly among youths. Its use has been consistently associated with several health problems, many of which have in common an impairment in the cognitive processes of behavior, including the memory, attention, emotion and decision making. There is evidence suggesting that cannabinoids, marijuana's primary psychoactive substance, have a negative effect in short-term memory, working memory, and decision making. It has also been found that cannabinoids affect attention and the interaction between cognitive events and emotion. This information can be used as an argument of biological plausibility to assess clinical and epidemiological research findings that show that marijuana`s use is associated to problems such as traffic accidents, psychosis, depression and poor academic records, among others.

A comparative study of machine learning models for ethnicity classification

NASA Astrophysics Data System (ADS)

Trivedi, Advait; Bessie Amali, D. Geraldine

2017-11-01

This paper endeavours to adopt a machine learning approach to solve the problem of ethnicity recognition. Ethnicity identification is an important vision problem with its use cases being extended to various domains. Despite the multitude of complexity involved, ethnicity identification comes naturally to humans. This meta information can be leveraged to make several decisions, be it in target marketing or security. With the recent development of intelligent systems a sub module to efficiently capture ethnicity would be useful in several use cases. Several attempts to identify an ideal learning model to represent a multi-ethnic dataset have been recorded. A comparative study of classifiers such as support vector machines, logistic regression has been documented. Experimental results indicate that the logical classifier provides a much accurate classification than the support vector machine.

Absence of Association between Behavior Problems in Childhood and Hypertension in Midlife.

PubMed

Saad, Sadiq M; Randhawa, Gurch; Pang, Dong

2016-01-01

It is known that behavior in childhood is associated with certain physical and mental health problems in midlife. However, there is limited evidence on the role of childhood behavior problems in the development of hypertension in adulthood. The present study aimed to examine whether behavior problems in childhood influenced the risk of hypertension in midlife in the United Kingdom 1958 birth cohort. The 1958 British birth cohort comprised 17,638 individuals born in the first week of March 1958 in the United Kingdom. Behavior problems were assessed at 7, 11, and 16 years of age by parents and teachers. At age 45, blood pressure was measured and hypertension was recorded if blood pressure was ≥140/90 mm Hg or if the participants were informed by their health professionals that they had high blood pressure. Behavioral information was reported according to the Rutter Children's Behaviour Questionnaire (RCBQ) and the Bristol Social Adjustment Guide (BSAG). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine behavior problems in childhood in relation to hypertension at 45 years of age according to logistic regression analysis, with adjustment for sex, social class in childhood and adulthood, childhood cognition, birth weight, gestational age at birth, body mass index (BMI), smoking, alcohol consumption, and physical activity. Behavior problems reported by parents at 7, 11, and 16 years were not associated with hypertension in midlife (OR, 0.93; 95% CI, 0.81, 1.07; OR, 0.95; 95% CI, 0.81, 1.11; OR, 0.98; 95% CI, 0.85, 1.12, respectively). Similarly, teacher-reported behavior problems at 7, 11, and 16 years were not associated with hypertension in midlife (OR, 0.92; 95% CI, 0.72, 1.18; OR, 0.92; 95% CI, 0.84, 1.02; OR, 1.03; 95% CI, 0.92, 1.15, respectively). Further separate analyses showed similar results for males and females. There is no association between behavior problems in childhood and hypertension in midlife.

[Electronic medical records in Bosnia-Herzegovina. The electronic card--the medical record of the future in Boznia-Herzegovina].

PubMed

Masić, I; Pandza, H; Ridanović, Z; Dover, M

1997-01-01

The biggest problem in organisation of the effective and rational health care of good quality in Bosnia quality and Herzegovina is a functional and updated Health Information System. In this system, important role play Health Statistic System in which documentation and evidence are very important segment. Developed countries proceeded from the manual and semiautomatic method of medical data processing and system management to the new methods of entering, storage, transfer, searching and protection of data using electronic equipment. Recently, the competition between manufacturers of the Smart Card and Laser Card is reality. Also scientific and professional debate exists about the standard card for storage of medical information in Health Care System. First option is supported by West European countries that developing Smart Card called Eurocard and second by USA and Far East countries. Because the Health Care System and other segments of Society of Bosnia and Herzegovina innovate intensively similar systems, the authors of this article intend to open discussion, and to show advantages and failures of each technological medium.

Wireless Technology Infrastructures for Authentication of Patients: PKI that Rings

PubMed Central

Sax, Ulrich; Kohane, Isaac; Mandl, Kenneth D.

2005-01-01

As the public interest in consumer-driven electronic health care applications rises, so do concerns about the privacy and security of these applications. Achieving a balance between providing the necessary security while promoting user acceptance is a major obstacle in large-scale deployment of applications such as personal health records (PHRs). Robust and reliable forms of authentication are needed for PHRs, as the record will often contain sensitive and protected health information, including the patient's own annotations. Since the health care industry per se is unlikely to succeed at single-handedly developing and deploying a large scale, national authentication infrastructure, it makes sense to leverage existing hardware, software, and networks. This report proposes a new model for authentication of users to health care information applications, leveraging wireless mobile devices. Cell phones are widely distributed, have high user acceptance, and offer advanced security protocols. The authors propose harnessing this technology for the strong authentication of individuals by creating a registration authority and an authentication service, and examine the problems and promise of such a system. PMID:15684133

Wireless technology infrastructures for authentication of patients: PKI that rings.

PubMed

Sax, Ulrich; Kohane, Isaac; Mandl, Kenneth D

2005-01-01

As the public interest in consumer-driven electronic health care applications rises, so do concerns about the privacy and security of these applications. Achieving a balance between providing the necessary security while promoting user acceptance is a major obstacle in large-scale deployment of applications such as personal health records (PHRs). Robust and reliable forms of authentication are needed for PHRs, as the record will often contain sensitive and protected health information, including the patient's own annotations. Since the health care industry per se is unlikely to succeed at single-handedly developing and deploying a large scale, national authentication infrastructure, it makes sense to leverage existing hardware, software, and networks. This report proposes a new model for authentication of users to health care information applications, leveraging wireless mobile devices. Cell phones are widely distributed, have high user acceptance, and offer advanced security protocols. The authors propose harnessing this technology for the strong authentication of individuals by creating a registration authority and an authentication service, and examine the problems and promise of such a system.

Building an organic computing device with multiple interconnected brains

PubMed Central

Pais-Vieira, Miguel; Chiuffa, Gabriela; Lebedev, Mikhail; Yadav, Amol; Nicolelis, Miguel A. L.

2015-01-01

Recently, we proposed that Brainets, i.e. networks formed by multiple animal brains, cooperating and exchanging information in real time through direct brain-to-brain interfaces, could provide the core of a new type of computing device: an organic computer. Here, we describe the first experimental demonstration of such a Brainet, built by interconnecting four adult rat brains. Brainets worked by concurrently recording the extracellular electrical activity generated by populations of cortical neurons distributed across multiple rats chronically implanted with multi-electrode arrays. Cortical neuronal activity was recorded and analyzed in real time, and then delivered to the somatosensory cortices of other animals that participated in the Brainet using intracortical microstimulation (ICMS). Using this approach, different Brainet architectures solved a number of useful computational problems, such as discrete classification, image processing, storage and retrieval of tactile information, and even weather forecasting. Brainets consistently performed at the same or higher levels than single rats in these tasks. Based on these findings, we propose that Brainets could be used to investigate animal social behaviors as well as a test bed for exploring the properties and potential applications of organic computers. PMID:26158615

Nursing record systems: effects on nursing practice and health care outcomes.

PubMed

Currell, R; Urquhart, C

2003-01-01

A nursing record system is the record of care planned and/or given to individual patients/clients by qualified nurses or other caregivers under the direction of a qualified nurse. Nursing record systems may be an effective way of influencing nurse practice. To assess the effects of nursing record systems on nursing practice and patient outcomes. We searched The Cochrane Library, the EPOC trial register (October 2002), MEDLINE, Cinahl, Sigle, and databases of the Royal College of Nursing, King's Fund, the NHS Centre for Reviews and Dissemination, and the Institute of Electrical Engineers up to August 1999; and OCLC First Search, Department of Health database, NHS Register of Computer Applications and the Health Visitors' Association database up to the end of 1995. We hand searched the Journal of Nursing Administration (1971-1999), Computers in Nursing (1984-1999), Information Technology in Nursing (1989-1999) and reference lists of articles. We also hand searched the major health informatics conference proceedings. We contacted experts in the field of nursing informatics, suppliers of nursing computer systems, and relevant Internet groups. To update the review the Medline, Cinahl, British Nursing Index, Aslib Index to Theses databases were all searched from 1998 to 2002. The Journal of Nursing Administration, Computers in Nursing, Information Technology in Nursing were all hand searched up to 2002. The searches of the other databases and grey literature included in the original review, were not updated (except for Health Care Computing Conference and Med Info) as the original searches produced little relevant material. Randomised trials, controlled before and after studies and interrupted time series comparing one kind of nursing record system with another, in hospital, community or primary care settings. The participants were qualified nurses, students or health care assistants working under the direction of a qualified nurse and patients receiving care recorded and/or planned using nursing record systems. Two reviewers independently assessed trial quality and extracted data. Eight trials involving 1497 people were included. In three studies of client held records, there were no overall positive or negative effects, although some administrative benefits through fewer missing notes were suggested. A paediatric pain management sheet study showed a positive effect on the children's pain intensity. A computerised nursing care planning study showed a negative effect on documented nursing care planning, although two other computerised nursing information studies showed an increase in recording but no change in patient outcomes. Care planning took longer with these computerised systems, but the numbers of patients and nurses included in these studies was small. A controlled before-and-after study of two paper nursing record systems showed improvement in meeting documentation standards. No evidence was found of effects on practice attributable to changes in record systems. Although there is a paucity of studies of sufficient methodological rigour to yield reliable results in this area, it is clear from the literature that it is possible to set up randomised trials or other quasi-experimental designs needed to produce evidence for practice. The research undertaken so far may have suffered both from methodological problems and faulty hypotheses. Qualitative nursing research to explore the relationship between practice and information use, could be used as a precursor to the design and testing of nursing information systems.

Identification and Management of Information Problems by Emergency Department Staff

PubMed Central

Murphy, Alison R.; Reddy, Madhu C.

2014-01-01

Patient-care teams frequently encounter information problems during their daily activities. These information problems include wrong, outdated, conflicting, incomplete, or missing information. Information problems can negatively impact the patient-care workflow, lead to misunderstandings about patient information, and potentially lead to medical errors. Existing research focuses on understanding the cause of these information problems and the impact that they can have on the hospital’s workflow. However, there is limited research on how patient-care teams currently identify and manage information problems that they encounter during their work. Through qualitative observations and interviews in an emergency department (ED), we identified the types of information problems encountered by ED staff, and examined how they identified and managed the information problems. We also discuss the impact that these information problems can have on the patient-care teams, including the cascading effects of information problems on workflow and the ambiguous accountability for fixing information problems within collaborative teams. PMID:25954457

Technology Assessment of High Capacity Data Storage Systems: Can We Avoid a Data Survivability Crisis?

NASA Technical Reports Server (NTRS)

Halem, M.; Shaffer, F.; Palm, N.; Salmon, E.; Raghavan, S.; Kempster, L.

1998-01-01

This technology assessment of long-term high capacity data storage systems identifies an emerging crisis of severe proportions related to preserving important historical data in science, healthcare, manufacturing, finance and other fields. For the last 50 years, the information revolution, which has engulfed all major institutions of modem society, centered itself on data-their collection, storage, retrieval, transmission, analysis and presentation. The transformation of long term historical data records into information concepts, according to Drucker, is the next stage in this revolution towards building the new information based scientific and business foundations. For this to occur, data survivability, reliability and evolvability of long term storage media and systems pose formidable technological challenges. Unlike the Y2K problem, where the clock is ticking and a crisis is set to go off at a specific time, large capacity data storage repositories face a crisis similar to the social security system in that the seriousness of the problem emerges after a decade or two. The essence of the storage crisis is as follows: since it could take a decade to migrate a peta-byte of data to a new media for preservation, and the life expectancy of the storage media itself is only a decade, then it may not be possible to complete the transfer before an irrecoverable data loss occurs. Over the last two decades, a number of anecdotal crises have occurred where vital scientific and business data were lost or would have been lost if not for major expenditures of resources and funds to save this data, much like what is happening today to solve the Y2K problem. A pr-ime example was the joint NASA/NSF/NOAA effort to rescue eight years worth of TOVS/AVHRR data from an obsolete system, which otherwise would have not resulted in the valuable 20-year long satellite record of global warming. Current storage systems solutions to long-term data survivability rest on scalable architectures having parallel paths for data migration.

Understanding factors that influence the integration of acute malnutrition interventions into the national health system in Niger.

PubMed

Deconinck, Hedwig; Hallarou, Mahaman Elh; Pesonen, Anais; Gérard, Jean Christophe; Criel, Bart; Donnen, Philippe; Macq, Jean

2016-12-01

Since 2007 to address a high burden, integration of acute malnutrition has been promoted in Niger. This paper studies factors that influenced the integration process of acute malnutrition into the Niger national health system.We used qualitative methods of observation, key informant interviews and focus group discussions at national level, two districts and nine communities selected through convenience sampling, as well as document review. A framework approach constructed around the problem, intervention, adoption system, health system characteristics and broad context guided the analysis. Data were recorded on paper, transcribed in a descriptive record, coded by themes deduced by building on the framework and triangulated for comprehensiveness.Key facilitating factors identified were knowledge and recognition of the problem helped by accurate information; effectiveness of decentralized continuity of care; compatibility with goals, support and involvement of health actors; and leadership for aligning policies and partnerships and mobilizing resources within a favourable political context driven by multisectoral development goals. Key hindering factors identified were not fully understanding severity, causes and consequences of the problem; limited utilization and trust in health interventions; high workload, and health worker turnover and attrition; and high dependence on financial and technical support based on short-term emergency funding within a context of high demographic pressure.The study uncovered influencing factors of integrating acute malnutrition into the national health system and their complex dynamics and relationships. It elicited the need for goal-oriented strategies and alignment of health actors to achieve sustainability, and systems thinking to understand pathways that foster integration. We recommend that context-specific learning of integrating acute malnutrition may expand to include causal modelling and scenario testing to inform strategy designs. The method may also be applied to monitor progress of integrating nutrition by the multisectoral nutrition plan to guide change. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Customer and household matching: resolving entity identity in data warehouses

NASA Astrophysics Data System (ADS)

Berndt, Donald J.; Satterfield, Ronald K.

2000-04-01

The data preparation and cleansing tasks necessary to ensure high quality data are among the most difficult challenges faced in data warehousing and data mining projects. The extraction of source data, transformation into new forms, and loading into a data warehouse environment are all time consuming tasks that can be supported by methodologies and tools. This paper focuses on the problem of record linkage or entity matching, tasks that can be very important in providing high quality data. Merging two or more large databases into a single integrated system is a difficult problem in many industries, especially in the wake of acquisitions. For example, managing customer lists can be challenging when duplicate entries, data entry problems, and changing information conspire to make data quality an elusive target. Common tasks with regard to customer lists include customer matching to reduce duplicate entries and household matching to group customers. These often O(n2) problems can consume significant resources, both in computing infrastructure and human oversight, and the goal of high accuracy in the final integrated database can be difficult to assure. This paper distinguishes between attribute corruption and entity corruption, discussing the various impacts on quality. A metajoin operator is proposed and used to organize past and current entity matching techniques. Finally, a logistic regression approach to implementing the metajoin operator is discussed and illustrated with an example. The metajoin can be used to determine whether two records match, don't match, or require further evaluation by human experts. Properly implemented, the metajoin operator could allow the integration of individual databases with greater accuracy and lower cost.

MedBlock: Efficient and Secure Medical Data Sharing Via Blockchain.

PubMed

Fan, Kai; Wang, Shangyang; Ren, Yanhui; Li, Hui; Yang, Yintang

2018-06-21

With the development of electronic information technology, electronic medical records (EMRs) have been a common way to store the patients' data in hospitals. They are stored in different hospitals' databases, even for the same patient. Therefore, it is difficult to construct a summarized EMR for one patient from multiple hospital databases due to the security and privacy concerns. Meanwhile, current EMRs systems lack a standard data management and sharing policy, making it difficult for pharmaceutical scientists to develop precise medicines based on data obtained under different policies. To solve the above problems, we proposed a blockchain-based information management system, MedBlock, to handle patients' information. In this scheme, the distributed ledger of MedBlock allows the efficient EMRs access and EMRs retrieval. The improved consensus mechanism achieves consensus of EMRs without large energy consumption and network congestion. In addition, MedBlock also exhibits high information security combining the customized access control protocols and symmetric cryptography. MedBlock can play an important role in the sensitive medical information sharing.

77 FR 14770 - Notice of Proposed Information Collection Requests

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-13

... Collection Clearance Division, Privacy, Information and Records Management Services, Office of Management... Collection Clearance Division, Privacy, Information and Records Management Services, Office of Management..., Acting Director, Information Collection Clearance Division, Privacy, Information and Records Management...

32 CFR 903.10 - Information collections, records, and forms or information management tools (IMTS).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Information collections, records, and forms or information management tools (IMTS). 903.10 Section 903.10 National Defense Department of Defense (Continued... Information collections, records, and forms or information management tools (IMTS). (a) Information...

32 CFR 903.10 - Information collections, records, and forms or information management tools (IMTS).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 6 2014-07-01 2014-07-01 false Information collections, records, and forms or information management tools (IMTS). 903.10 Section 903.10 National Defense Department of Defense (Continued... Information collections, records, and forms or information management tools (IMTS). (a) Information...

32 CFR 903.10 - Information collections, records, and forms or information management tools (IMTS).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 6 2013-07-01 2013-07-01 false Information collections, records, and forms or information management tools (IMTS). 903.10 Section 903.10 National Defense Department of Defense (Continued... Information collections, records, and forms or information management tools (IMTS). (a) Information...

32 CFR 903.10 - Information collections, records, and forms or information management tools (IMTS).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 6 2011-07-01 2011-07-01 false Information collections, records, and forms or information management tools (IMTS). 903.10 Section 903.10 National Defense Department of Defense (Continued... Information collections, records, and forms or information management tools (IMTS). (a) Information...

32 CFR 903.10 - Information collections, records, and forms or information management tools (IMTS).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Information collections, records, and forms or information management tools (IMTS). 903.10 Section 903.10 National Defense Department of Defense (Continued... Information collections, records, and forms or information management tools (IMTS). (a) Information...

Development of a Method to Obtain More Accurate General and Oral Health Related Information Retrospectively

PubMed Central

A, Golkari; A, Sabokseir; D, Blane; A, Sheiham; RG, Watt

2017-01-01

Statement of Problem: Early childhood is a crucial period of life as it affects one’s future health. However, precise data on adverse events during this period is usually hard to access or collect, especially in developing countries. Objectives: This paper first reviews the existing methods for retrospective data collection in health and social sciences, and then introduces a new method/tool for obtaining more accurate general and oral health related information from early childhood retrospectively. Materials and Methods: The Early Childhood Events Life-Grid (ECEL) was developed to collect information on the type and time of health-related adverse events during the early years of life, by questioning the parents. The validity of ECEL and the accuracy of information obtained by this method were assessed in a pilot study and in a main study of 30 parents of 8 to 11 year old children from Shiraz (Iran). Responses obtained from parents using the final ECEL were compared with the recorded health insurance documents. Results: There was an almost perfect agreement between the health insurance and ECEL data sets (Kappa value=0.95 and p < 0.001). Interviewees remembered the important events more accurately (100% exact timing match in case of hospitalization). Conclusions: The Early Childhood Events Life-Grid method proved to be highly accurate when compared with recorded medical documents. PMID:28959773

75 FR 78203 - Privacy Act of 1974: New System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-15

... Promotion Programs Information Retrieval (RPPIR) (New) SECURITY CLASSIFICATION: Unclassified, sensitive, for..., Agricultural Marketing Service. ACTION: Notice of a new system of records for information collected pursuant to... records to its inventory of records systems. The system of record will cover information collected under...

Management Review: Progress and Challenges at the Defense Logistics Agency.

DTIC Science & Technology

1986-04-01

with safety and worklife problems (warehousing schemes, replacement or improvement of equipment, loading dock shelters, and employee orientation systems... balances . Accuracy of DCASR Contingent The contingent liability record is one of the more important records Liability Records maintained by DCASRs because...needed for making management decisions and for certifying to the accu- racy of ULO balances . Problems in Data Reported to Based on our interviews with

47 CFR 0.460 - Requests for inspection of records which are routinely available for public inspection.

Code of Federal Regulations, 2013 CFR

2013-10-01

... COMMISSION GENERAL COMMISSION ORGANIZATION General Information Public Information and Inspection of Records... permit their location by staff personnel. The information needed to locate the records will vary, depending on the records requested. Advice concerning the kind of information needed to locate particular...

47 CFR 0.460 - Requests for inspection of records which are routinely available for public inspection.

Code of Federal Regulations, 2014 CFR

2014-10-01

... COMMISSION GENERAL COMMISSION ORGANIZATION General Information Public Information and Inspection of Records... permit their location by staff personnel. The information needed to locate the records will vary, depending on the records requested. Advice concerning the kind of information needed to locate particular...

47 CFR 0.460 - Requests for inspection of records which are routinely available for public inspection.

Code of Federal Regulations, 2012 CFR

2012-10-01

... COMMISSION GENERAL COMMISSION ORGANIZATION General Information Public Information and Inspection of Records... permit their location by staff personnel. The information needed to locate the records will vary, depending on the records requested. Advice concerning the kind of information needed to locate particular...

New Unintended Adverse Consequences of Electronic Health Records

PubMed Central

Wright, A.; Ash, J.; Singh, H.

2016-01-01

Summary Although the health information technology industry has made considerable progress in the design, development, implementation, and use of electronic health records (EHRs), the lofty expectations of the early pioneers have not been met. In 2006, the Provider Order Entry Team at Oregon Health & Science University described a set of unintended adverse consequences (UACs), or unpredictable, emergent problems associated with computer-based provider order entry implementation, use, and maintenance. Many of these originally identified UACs have not been completely addressed or alleviated, some have evolved over time, and some new ones have emerged as EHRs became more widely available. The rapid increase in the adoption of EHRs, coupled with the changes in the types and attitudes of clinical users, has led to several new UACs, specifically: complete clinical information unavailable at the point of care; lack of innovations to improve system usability leading to frustrating user experiences; inadvertent disclosure of large amounts of patient-specific information; increased focus on computer-based quality measurement negatively affecting clinical workflows and patient-provider interactions; information overload from marginally useful computer-generated data; and a decline in the development and use of internally-developed EHRs. While each of these new UACs poses significant challenges to EHR developers and users alike, they also offer many opportunities. The challenge for clinical informatics researchers is to continue to refine our current systems while exploring new methods of overcoming these challenges and developing innovations to improve EHR interoperability, usability, security, functionality, clinical quality measurement, and information summarization and display. PMID:27830226

Information Summary, Area of Concern: Saginaw River and Saginaw Bay.

DTIC Science & Technology

1991-03-01

useful in predicting loadings in areas where no data currently exist. S~ ills MDNR maintains a Pollution Emergency Alerting System ( PEAS ) to receive...reports of accidental discharges and related problems. PEAS records from January 1984 to October 1986 show that 101 discharge incidents occurred in the...341 1.00 144.2 65.9 20.1 241.1 277.9 Kawkawlin River 234 0.73 105.5 46.0 11.3 170.5 201.7 Sebewaing River 325 0.96 138.6 62.6 18.7 230.7 266.7 Pigeon

Tracking Pulse Oximeter Findings Before, During and After Titration of Mandibular Advancement Devices (MAD) for Patients With Mild to Moderate Obstructive Sleep Apnea (OSA)

DTIC Science & Technology

2015-06-01

CP AP because of claustrophobia, noise, nose bleeds, dermatitis and nasal bridge sores. In many cases, these effects are due to incorrect pressure...checked for contact data in case a subject must be contacted due to scheduling problems, or some new information is learned that a subject needs to know...Subject initiated contacts via phone or email to the PI with respect to adverse events, side effects or questions will be recorded on an electronic log

How cortical neurons help us see: visual recognition in the human brain

PubMed Central

Blumberg, Julie; Kreiman, Gabriel

2010-01-01

Through a series of complex transformations, the pixel-like input to the retina is converted into rich visual perceptions that constitute an integral part of visual recognition. Multiple visual problems arise due to damage or developmental abnormalities in the cortex of the brain. Here, we provide an overview of how visual information is processed along the ventral visual cortex in the human brain. We discuss how neurophysiological recordings in macaque monkeys and in humans can help us understand the computations performed by visual cortex. PMID:20811161

Use of a hand-held computer observational tool to improve communication for care planning and psychosocial well-being

PubMed Central

Corazzini, Kirsten; Rapp, Carla Gene; McConnell, Eleanor S.; Anderson, Ruth A.

2013-01-01

Staff development nurses in long-term care are challenged to implement training programs that foster quality unlicensed assistive personnel (UAP) care and improve the transfer of their observations to licensed nursing staff for care planning. This study describes the outcomes of a program where UAP recorded behavioral problems of residents to inform care. Findings suggest staff development nurses who aim to improve UAP reporting without simultaneously targeting licensed nursing staff behaviors may worsen nursing staff relationships. PMID:19182546

FAS 33: accurately recording effects of changing prices.

PubMed

Sage, L G

1987-02-01

FAS 33 addresses the problem of distortion in conventional historical cost financial statements because of changing prices. It requires 1300 business enterprises to report selected changing price data on a supplementary basis. It has been demonstrated that it is also feasible and beneficial for hospitals to present price disclosures as supplementary information to their financial statements. The possible application of FAS 33 is supported on the basis that the accounting and reporting methods of healthcare institutions are similar to the accounting and reporting practices of profit-seeking entities.

Comprehensive Yet Scalable Health Information Systems for Low Resource Settings: A Collaborative Effort in Sierra Leone

PubMed Central

Braa, Jørn; Kanter, Andrew S.; Lesh, Neal; Crichton, Ryan; Jolliffe, Bob; Sæbø, Johan; Kossi, Edem; Seebregts, Christopher J.

2010-01-01

We address the problem of how to integrate health information systems in low-income African countries in which technical infrastructure and human resources vary wildly within countries. We describe a set of tools to meet the needs of different service areas including managing aggregate indicators, patient level record systems, and mobile tools for community outreach. We present the case of Sierra Leone and use this case to motivate and illustrate an architecture that allows us to provide services at each level of the health system (national, regional, facility and community) and provide different configurations of the tools as appropriate for the individual area. Finally, we present a, collaborative implementation of this approach in Sierra Leone. PMID:21347003

Electroencephalogram and Alzheimer's Disease: Clinical and Research Approaches

PubMed Central

Tsolaki, Anthoula; Kazis, Dimitrios; Kompatsiaris, Ioannis; Kosmidou, Vasiliki; Tsolaki, Magda

2014-01-01

Alzheimer's disease (AD) is a neurodegenerative disorder that is characterized by cognitive deficits, problems in activities of daily living, and behavioral disturbances. Electroencephalogram (EEG) has been demonstrated as a reliable tool in dementia research and diagnosis. The application of EEG in AD has a wide range of interest. EEG contributes to the differential diagnosis and the prognosis of the disease progression. Additionally such recordings can add important information related to the drug effectiveness. This review is prepared to form a knowledge platform for the project entitled “Cognitive Signal Processing Lab,” which is in progress in Information Technology Institute in Thessaloniki. The team tried to focus on the main research fields of AD via EEG and recent published studies. PMID:24868482

A parallel data management system for large-scale NASA datasets

NASA Technical Reports Server (NTRS)

Srivastava, Jaideep

1993-01-01

The past decade has experienced a phenomenal growth in the amount of data and resultant information generated by NASA's operations and research projects. A key application is the reprocessing problem which has been identified to require data management capabilities beyond those available today (PRAT93). The Intelligent Information Fusion (IIF) system (ROEL91) is an ongoing NASA project which has similar requirements. Deriving our understanding of NASA's future data management needs based on the above, this paper describes an approach to using parallel computer systems (processor and I/O architectures) to develop an efficient parallel database management system to address the needs. Specifically, we propose to investigate issues in low-level record organizations and management, complex query processing, and query compilation and scheduling.

Safety risks associated with the lack of integration and interfacing of hospital health information technologies: a qualitative study of hospital electronic prescribing systems in England.

PubMed

Cresswell, Kathrin M; Mozaffar, Hajar; Lee, Lisa; Williams, Robin; Sheikh, Aziz

2017-07-01

Substantial sums of money are being invested worldwide in health information technology. Realising benefits and mitigating safety risks is however highly dependent on effective integration of information within systems and/or interfacing to allow information exchange across systems. As part of an English programme of research, we explored the social and technical challenges relating to integration and interfacing experienced by early adopter hospitals of standalone and hospital-wide multimodular integrated electronic prescribing (ePrescribing) systems. We collected longitudinal qualitative data from six hospitals, which we conceptualised as case studies. We conducted 173 interviews with users, implementers and software suppliers (at up to three different times), 24 observations of system use and strategic meetings, 17 documents relating to implementation plans, and 2 whole-day expert round-table discussions. Data were thematically analysed initially within and then across cases, drawing on perspectives surrounding information infrastructures. We observed that integration and interfacing problems obstructed effective information transfer in both standalone and multimodular systems, resulting in threats to patient safety emerging from the lack of availability of timely information and duplicate data entry. Interfacing problems were immediately evident in some standalone systems where users had to cope with multiple log-ins, and this did not attenuate over time. Multimodular systems appeared at first sight to obviate such problems. However, with these systems, there was a perceived lack of data coherence across modules resulting in challenges in presenting a comprehensive overview of the patient record, this possibly resulting from the piecemeal implementation of modules with different functionalities. Although it was possible to access data from some primary care systems, we found poor two-way transfer of data between hospitals and primary care necessitating workarounds, which in turn led to the opportunity for new errors associated with duplicate and manual information transfer. Extending ePrescribing to include modules with other clinically important information needed to support care was still an aspiration in most sites, although some advanced multimodular systems had begun implementing this functionality. Multimodular systems were, however, seen as being difficult to interface with external systems. The decision to pursue a strategy of purchasing standalone systems and then interfacing these, or one of buying hospital-wide multimodular systems, is a pivotal one for hospitals in realising the vision of achieving a fully integrated digital record, and this should be predicated on a clear appreciation of the relative trade-offs between these choices. While multimodular systems offered somewhat better usability, standalone systems provided greater flexibility and opportunity for innovation, particularly in relation to interoperability with external systems and in relation to customisability to the needs of different user groups. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Clinical care management and workflow by episodes.

PubMed Central

Claus, P. L.; Carpenter, P. C.; Chute, C. G.; Mohr, D. N.; Gibbons, P. S.

1997-01-01

This paper describes the implementation of clinically defined episodes of care and the introduction of an episode-based summary list of patient problems across Mayo Clinic Rochester in 1996 and 1997. Although Mayo's traditional paper-based system has always relied on a type of 'episode of care' (called the "registration") for patient and history management, a new, more clinically relevant definition of episode of care was put into practice in November 1996. This was done to improve care management and operational processes and to provide a basic construct for the electronic medical record. Also since November 1996, a computer-generated summary list of patient problems, the "Master Sheet Summary Report," organized by episode, has been placed in all patient histories. In the third quarter of 1997, the ability to view the episode-based problem summary online was made available to the 3000+ EMR-capable workstations deployed across the Mayo Rochester campus. In addition, the clinically oriented problem summarization process produces an improved basic "package" of clinical information expected to lead to improved analytic decision support, outcomes analysis and epidemiological research. PMID:9357595

Comparing Web and Touch Screen Transaction Log Files

PubMed Central

Huntington, Paul; Williams, Peter

2001-01-01

Background Digital health information is available on a wide variety of platforms including PC-access of the Internet, Wireless Application Protocol phones, CD-ROMs, and touch screen public kiosks. All these platforms record details of user sessions in transaction log files, and there is a growing body of research into the evaluation of this data. However, there is very little research that has examined the problems of comparing the transaction log files of kiosks and the Internet. Objectives To provide a first step towards examining the problems of comparing the transaction log files of kiosks and the Internet. Methods We studied two platforms: touch screen kiosks and a comparable Web site. For both of these platforms, we examined the menu structure (which affects transaction log file data), the log-file structure, and the metrics derived from log-file records. Results We found substantial differences between the generated metrics. Conclusions None of the metrics discussed can be regarded as an effective way of comparing the use of kiosks and Web sites. Two metrics stand out as potentially comparable and valuable: the number of user sessions per hour and user penetration of pages. PMID:11720960

[Adoption in China of children with special needs: the "green passage"].

PubMed

Oliván Gonzalvo, G

2007-10-01

Requests of international adoption in China can be processed by the ordinary way and by the so-called way "green passage" (GP). All the children for adoption by the GP have special needs because to suffer from congenital malformations, chronic diseases or development disabilities that will need medical or surgical treatment and a specialized monitoring in the adoptive country. The medical literature warns that the preadoptive medical records from China do not offer absolute guarantee of veracity. This problem has been observed in adoptions by the ordinary way of children diagnosed like healthy, but also it can happen in children for adoption by the GP. The clinical cases of three children with special needs recently assigned to Spanish families are presented. We think that in all the assignations of children with special needs from China, the Adoption Organizations must offer to the families the complete medical records, the certified results of the laboratory tests and the pictures so that, of exclusive and absolutely confidential manner, they consult with specialized doctors in order to obtain the highest information of the health problems and to value the medical prognosis before taking a decision on the acceptance of the adoption.

Analyses of Response-Stimulus Sequences in Descriptive Observations

ERIC Educational Resources Information Center

Samaha, Andrew L.; Vollmer, Timothy R.; Borrero, Carrie; Sloman, Kimberly; Pipkin, Claire St. Peter; Bourret, Jason

2009-01-01

Descriptive observations were conducted to record problem behavior displayed by participants and to record antecedents and consequences delivered by caregivers. Next, functional analyses were conducted to identify reinforcers for problem behavior. Then, using data from the descriptive observations, lag-sequential analyses were conducted to examine…

Epidemiology of paediatric presentations with musculoskeletal problems in primary care.

PubMed

Tan, Albert; Strauss, Victoria Y; Protheroe, Joanne; Dunn, Kate M

2018-02-06

Musculoskeletal disease is a common cause of morbidity, but there is a paucity of musculoskeletal research focusing on paediatric populations, particularly in primary care settings. In particular, there is limited information on population consultation frequency in paediatric populations, and frequency varies by age and sex. Few studies have examined paediatric musculoskeletal consultation frequency for different body regions. The objective was to determine the annual consultation prevalence of regional musculoskeletal problems in children in primary care. Musculoskeletal codes within the Read morbidity Code system were identified and grouped into body regions. Consultations for children aged three to seventeen in 2006 containing these codes were extracted from recorded consultations at twelve general practices contributing to a general practice consultation database (CiPCA). Annual consultation prevalence per 10,000 registered persons for the year 2006 was determined, stratified by age and sex, for problems in individual body regions. Over 8 % (8.27%, 95% CI 7.86 to 8.68%) of the 16,862 children consulted with a musculoskeletal problem during 2006. Annual consultation prevalence for any musculoskeletal problem was significantly higher in males than females (male: female prevalence ratio 1.18, 95% CI 1.06 to 1.31). Annual consultation prevalence increased with age and the most common body regions consulted for were the foot, knee and back all of which had over 100 consultations (109, 104 and 101 respectively) per 10,000 persons per year. This study provides new and detailed information on patterns of paediatric musculoskeletal consultations in primary care. Musculoskeletal problems in children are varied and form a significant part of the paediatric primary care workload. The findings of this study may be used as a resource for planning future studies.

Lost opportunities for intervention: undetected markers for the development of serious juvenile delinquency.

PubMed

Stouthamer-Loeber, Magda; Loeber, Rolf

2002-01-01

Persistent serious delinquency in young males rarely starts without a history of problem behaviour in childhood. This paper addresses the following questions: (1) At what age does persistent serious offending emerge for the first time? (2) What proportion of persistent serious delinquent boys qualifies for a diagnosis of a disruptive behaviour disorder? (3) What proportion of persistent serious delinquent boys receive help for their behavioural or educational problems, either from mental health professionals or from personnel at school? Eight waves of assessments from the oldest sample (ages 13 to 18.5) of the Pittsburgh Youth Study were used to classify boys as persistent serious violent offenders, persistent serious property offenders, persistent non-serious offenders, and non-offenders based on their self-reports. Juvenile court records, diagnostic information and information about help for mental health problems were used. Almost half of the boys who eventually become a persistent serious offender already have an onset of their serious delinquent behaviour by age 12. Two-thirds of the boys who come to the attention of the juvenile court already had behaviour problems for at least five years, and one-third were diagnosed as having a disruptive behaviour disorder by age 13. However, less than half of the persistent serious delinquents had received any help from either mental health professionals or from personnel in schools. Early behaviour problems and a diagnosis of disruptive behaviour disorder constitute targets for intervention. The relatively low rate of interventions for boys with these problems and who later become persistent serious offenders indicates a high under-utilization of opportunities to prevent serious delinquency by parents and professionals.

Nurses' perceptions and problems in the usability of a medication safety app.

PubMed

Ankem, Kalyani; Cho, Sookyung; Simpson, Diana

2017-10-16

The majority of medication apps support medication adherence. Equally, if not more important, is medication safety. Few apps report on medication safety, and fewer studies have been conducted with these apps. The usability of a medication safety app was tested with nurses to reveal their perceptions of the graphical user interface and to discover problems they encountered in using the app. Usability testing of the app was conducted with RN-BSN students and informatics students (n = 18). Perceptions of the graphical components were gathered in pretest and posttest questionnaires, and video recordings of the usability testing were transcribed. The significance of the difference in mean performance time for 8 tasks was tested, and qualitative analysis was deployed to identify problems encountered and to rate the severity of each problem. While all participants perceived the graphical user interface as easy to understand, nurses took significantly more time to complete certain tasks. More nurses found the medication app to be lacking in intuitiveness of user interface design, in capability to match real-world data, and in providing optimal information architecture. To successfully integrate mobile devices in healthcare, developers must address the problems that nurses encountered in use of the app.