Journal articles on the topic 'Electronic records Australia Management Case studies'
To see the other types of publications on this topic, follow the link: Electronic records Australia Management Case studies.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Electronic records Australia Management Case studies.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Buford, Anna, Henry Charles Ashworth, Farrah Lynn Ezzeddine, Sara Dada, Eliza Nguyen, Senan Ebrahim, Amy Zhang, et al. "Systematic review of electronic health records to manage chronic conditions among displaced populations." BMJ Open 12, no. 9 (September 2022): e056987. http://dx.doi.org/10.1136/bmjopen-2021-056987.
Full textAbstract:
ObjectivesThe objective of this study was to assess the impact of electronic health records (EHRs) on health outcomes and care of displaced people with chronic health conditions and determine barriers and facilitators to EHR implementation in displaced populations.DesignA systematic review protocol was developed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Systematic Reviews.Data sourcesMEDLINE, Embase, PsycINFO, CINAHL, Health Technology Assessment, Epub Ahead of Print, In-Process and Other Non-Indexed Citations, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews was searched from inception to 12 April 2021.Eligibility criteria for selected studiesInclusion criteria were original research articles, case reports and descriptions of EHR implementation in populations of displaced people, refugees or asylum seekers with related chronic diseases. Grey literature, reviews and research articles unrelated to chronic diseases or the care of refugees or asylum populations were excluded. Studies were assessed for risk of bias using a modified Cochrane, Newcastle-Ottawa and Joanna Briggs Institute tools.Data extraction and synthesisTwo reviewers independently extracted data from each study using Covidence. Due to heterogeneity across study design and specific outcomes, a meta-analysis was not possible. An inductive thematic analysis was conducted using NVivo V.12 (QSR International, Melbourne, Australia). An inductive analysis was used in order to uncover patterns and themes in the experiences, general outcomes and perceptions of EHR implementation.ResultsA total of 32 studies across nine countries were included: 14 in refugee camps/settlements and 18 in asylum countries. Our analysis suggested that EHRs improve health outcomes for chronic diseases by increasing provider adherence to guidelines or treatment algorithms, monitoring of disease indicators, patient counselling and patient adherence. In asylum countries, EHRs resource allocation to direct clinical care and public health services, as well as screening efforts. EHR implementation was facilitated by their adaptability and ability to integrate into management systems. However, barriers to EHR development, deployment and data analysis were identified in refugee settings.ConclusionOur results suggest that well-designed and integrated EHRs can be a powerful tool to improve healthcare systems and chronic disease outcomes in refugee settings. However, attention should be paid to the common barriers and facilitating actions that we have identified such as utilising a user-centred design. By implementing adaptable EHR solutions, health systems can be strengthened, providers better supported and the health of refugees improved.
2
Crowe, Bernard, and David Hailey. "Cardiac picture archiving and communication systems and telecardiology-technologies awaiting adoption." Journal of Telemedicine and Telecare 8, no. 3_suppl (December 2002): 9–11. http://dx.doi.org/10.1258/13576330260440691.
Full textAbstract:
summary Diagnostic and therapeutic procedures associated with cardiology are heavily supported by diagnostic imaging technology. The management of such images, including radiographs, echocardiography examinations and cardiac angiography studies, requires a suitable means of handling the data. A number of manufacturers are now offering picture archiving and communication systems (PACS) and telecardiology options. These could greatly improve the efficiency of data management for cardiac examinations, including linkage to radiology and hospital information systems and electronic patient records. A barrier to the implementation of cardiac PACS has been the relatively high capital cost. There have also been technical difficulties in implementing a suitable interface. Historical problems have included ‘turf wars’ between different specialist groups and a reluctance to shift from well established practice patterns. Early cooperative work between radiologists and cardiologists in the development of coronary arteriography has been replaced by contention between cardiologists, radiologists and vascular surgeons, often driven by economic considerations rather than the needs of the patient. At this stage, cardiac PACS and telecardiology have great potential for improving the coordinated care of cardiac patients in Australia.
3
Chiu, L., J. Digby-Bell, J. Seah, S. Melton, K. Taylor, and M. Sparrow. "P594 Utilisation of anti-TNF agents in phlegmonous Crohn’s disease: an Australian tertiary referral centre experience." Journal of Crohn's and Colitis 15, Supplement_1 (May 1, 2021): S542—S543. http://dx.doi.org/10.1093/ecco-jcc/jjab076.715.
Full textAbstract:
Abstract Background Phlegmonous Crohn’s disease (CD) is a complication of penetrating disease where traditional management was surgical. There are a paucity of studies evaluating its medical management. The aim of our single-centre, retrospective case series was to evaluate the efficacy and safety of anti-TNF therapy in managing phlegmonous CD. Methods Cases were identified through searching patient records for CT, MRI and intestinal ultrasound reports containing the words “Crohn’s” and “phlegmon”. Patients were included if found to have CD-related phlegmon subsequently started on anti-TNF. Patients were excluded if they were already on an anti-TNF at diagnosis, or underwent surgery prior to starting anti-TNF. Electronic review of patient records was undertaken to determine demographics, current medication, length of disease and surgery. Results Of the 66 cases identified, 11 fulfilled inclusion criteria. 2 cases required surgery at 38 and 197 days post-phlegmon diagnosis, both of which had earlier ceased anti-TNF due to failed trial and severe depression respectively. 4 patients discontinued anti-TNF during follow up: 1 experienced severe anaphylaxis, 1 failed anti-TNF trial, and 2 ceased due to personal preference (severe depression, concern about adverse effects). 8 of 10 had complete resolution of the phlegmon with 1 patient awaiting imaging 6 months post-phlegmon diagnosis. Conclusion 9 of 11 of our patient cohort avoided surgery after starting anti-TNF therapy for phlegmonous CD, out to a median follow up of 20 months. Our findings suggest anti-TNFs are generally well tolerated, and early commencement may be effective in preventing surgical intervention.
4
Clark, Kevin W., Susan Moller, and Lauri O'Brien. "Electronic patient journey boards a vital piece of the puzzle in patient flow." Australian Health Review 38, no. 3 (2014): 259. http://dx.doi.org/10.1071/ah13192.
Full textAbstract:
Objective Internationally, there is growing interest in the applicability of visual management in healthcare, although little is known about the extent of its effectiveness. In the past 5 years technical advances have permitted the integration of all relevant data into a singular display that can improve staff efficiency, accelerate decisions, streamline workflow processes and reduce oversights and errors in clinical practice. The aim of the case study is to describe the features and application of electronic patient journey boards (EPJBs) as an enabler to accelerate patient flow that has been demonstrated and evaluated in Queensland Health hospitals. Methods In 2012 and 2013 we collected ward-specific data that was sourced from the Queensland Hospital Admitted Patient Data Collection, determining the top 10 overnight diagnostic-related groups (DRGs) for each ward participating in the pilots. The Statistical Output Unit within Queensland Health then provided data and analysis on the ALOS for each of these DRGs for the period following an EPJB installation, along with the ALOS for the same DRGs for the corresponding period in the previous year. Results Patient length of stay reduced and display of estimated discharge dates improved with the introduction of EPJBs along with improved communication and information management resulting in time savings from 20 min per staff member per shift to 2.5 h per ward a day. Conclusion Queensland and South Australian Health systems have succeeded in ‘making the hospital patient journey visible’ through an innovative combination of information management and prominent display of key information related to patient care portrayed on large liquid crystal display (LCD) screens in hospital wards. What is known about the topic? No published studies have explored health services developing, piloting and evaluating Electronic Patient Journey Boards in a variety of clinical settings. What does this paper add? Until recently, paper-based health records and scheduled meetings were the only way for healthcare staff to communicate information to one another. In practice, this means that information vital to patient care is infrequently communicated between team members, is recorded in different places and in different ways, and is heavily reliant on care providers seeking out the information they need to perform effectively in their role. What are the implications for practitioners? This paper can be beneficial for managers and decision-makers of all healthcare organisations when considering streamlining a patients’ journey through a hospital with the assistance of visual management tools.
5
Abbasgholizadeh Rahimi, Samira, Michelle Cwintal, Yuhui Huang, Pooria Ghadiri, Roland Grad, Dan Poenaru, Genevieve Gore, Hervé Tchala Vignon Zomahoun, France Légaré, and Pierre Pluye. "Application of Artificial Intelligence in Shared Decision Making: Scoping Review." JMIR Medical Informatics 10, no. 8 (August 9, 2022): e36199. http://dx.doi.org/10.2196/36199.
Full textAbstract:
Background Artificial intelligence (AI) has shown promising results in various fields of medicine. It has the potential to facilitate shared decision making (SDM). However, there is no comprehensive mapping of how AI may be used for SDM. Objective We aimed to identify and evaluate published studies that have tested or implemented AI to facilitate SDM. Methods We performed a scoping review informed by the methodological framework proposed by Levac et al, modifications to the original Arksey and O'Malley framework of a scoping review, and the Joanna Briggs Institute scoping review framework. We reported our results based on the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) reporting guideline. At the identification stage, an information specialist performed a comprehensive search of 6 electronic databases from their inception to May 2021. The inclusion criteria were: all populations; all AI interventions that were used to facilitate SDM, and if the AI intervention was not used for the decision-making point in SDM, it was excluded; any outcome related to patients, health care providers, or health care systems; studies in any health care setting, only studies published in the English language, and all study types. Overall, 2 reviewers independently performed the study selection process and extracted data. Any disagreements were resolved by a third reviewer. A descriptive analysis was performed. Results The search process yielded 1445 records. After removing duplicates, 894 documents were screened, and 6 peer-reviewed publications met our inclusion criteria. Overall, 2 of them were conducted in North America, 2 in Europe, 1 in Australia, and 1 in Asia. Most articles were published after 2017. Overall, 3 articles focused on primary care, and 3 articles focused on secondary care. All studies used machine learning methods. Moreover, 3 articles included health care providers in the validation stage of the AI intervention, and 1 article included both health care providers and patients in clinical validation, but none of the articles included health care providers or patients in the design and development of the AI intervention. All used AI to support SDM by providing clinical recommendations or predictions. Conclusions Evidence of the use of AI in SDM is in its infancy. We found AI supporting SDM in similar ways across the included articles. We observed a lack of emphasis on patients’ values and preferences, as well as poor reporting of AI interventions, resulting in a lack of clarity about different aspects. Little effort was made to address the topics of explainability of AI interventions and to include end-users in the design and development of the interventions. Further efforts are required to strengthen and standardize the use of AI in different steps of SDM and to evaluate its impact on various decisions, populations, and settings.
6
Apolinário-Hagen, Jennifer, Jessica Kemper, and Carolina Stürmer. "Public Acceptability of E-Mental Health Treatment Services for Psychological Problems: A Scoping Review." JMIR Mental Health 4, no. 2 (April 3, 2017): e10. http://dx.doi.org/10.2196/mental.6186.
Full textAbstract:
Background Over the past decades, the deficient provision of evidence-based interventions for the prevention and treatment of mental health problems has become a global challenge across health care systems. In view of the ongoing diffusion of new media and mobile technologies into everyday life, Web-delivered electronic mental health (e-mental health) treatment services have been suggested to expand the access to professional help. However, the large-scale dissemination and adoption of innovative e-mental health services is progressing slowly. This discrepancy between potential and actual impact in public health makes it essential to explore public acceptability of e-mental health treatment services across health care systems. Objective This scoping review aimed to identify and evaluate recent empirical evidence for public acceptability, service preferences, and attitudes toward e-mental health treatments. On the basis of both frameworks for technology adoption and previous research, we defined (1) perceived helpfulness and (2) intentions to use e-mental health treatment services as indicators for public acceptability in the respective general population of reviewed studies. This mapping should reduce heterogeneity and help derive implications for systematic reviews and public health strategies. Methods We systematically searched electronic databases (MEDLINE/PubMed, PsycINFO, Psyndex, PsycARTICLES, and Cochrane Library, using reference management software for parallel searches) to identify surveys published in English in peer-reviewed journals between January 2010 and December 2015, focusing on public perceptions about e-mental health treatments outside the context of clinical, psychosocial, or diagnostic interventions. Both indicators were obtained from previous review. Exclusion criteria further involved studies targeting specific groups or programs. Results The simultaneous database search identified 76 nonduplicate records. Four articles from Europe and Australia were included in this scoping review. Sample sizes ranged from 217 to 2411 participants of ages 14-95 years. All included studies used cross-sectional designs and self-developed measures for outcomes related to both defined indicators of public acceptability. Three surveys used observational study designs, whereas one study was conducted as an experiment investigating the impact of brief educational information on attitudes. Taken together, the findings of included surveys suggested that e-mental health treatment services were perceived as less helpful than traditional face-to-face interventions. Additionally, intentions to future use e-mental health treatments were overall smaller in comparison to face-to-face services. Professional support was essential for help-seeking intentions in case of psychological distress. Therapist-assisted e-mental health services were preferred over unguided programs. Unexpectedly, assumed associations between familiarity with Web-based self-help for health purposes or “e-awareness” and intentions to use e-mental health services were weak or inconsistent. Conclusions Considering the marginal amount and heterogeneity of pilot studies focusing on public acceptability of e-mental health treatments, further research using theory-led approaches and validated measures is required to understand psychological facilitator and barriers for the implementation of innovative services into health care.
7
Kennedy, Aaron C., Daryl A. Jones, Glenn M. Eastwood, Duncan Wellington, Emily See, and Jane E. Lewis. "Improving the quality of family meeting documentation in the ICU at the end of life." Palliative Care and Social Practice 16 (January 2022): 263235242211288. http://dx.doi.org/10.1177/26323524221128838.
Full textAbstract:
Objective: Improve documentation quality of end-of-life family meetings in a tertiary intensive care unit (ICU). Design: Before-and-after interventional quality improvement project between October 2018 and February 2020 utilising an electronic pro-forma record. Setting: Australian, University affiliated, mixed medical-surgical 22 bed adult ICU. Participants: Patients who were admitted to the ICU for active management and subsequently died during that ICU admission. We enrolled 50 patients who died before and 50 patients after the introduction of the electronic family meeting pro-forma record. Intervention: Through collaboration with ICU medical and nursing staff, End-of-life Special Interest Group and Clinical Documentation Committee we developed the ICU Family Meeting Discussion Note as an electronic pro-forma record with multiple key fields of entry. Main outcome measures: Patient records were examined for the presence of documented details around patient’s admission, family meetings and specific elements surrounding the patient’s death. Results: The introduction of a pro-forma record markedly improved the quality of documentation of end-of-life care related family meetings. Documentation increased in recording hospital admission date/time (6% vs 84%), meeting location (14% vs 70%), the reason patients were absent from the meeting (34% vs 72%), the Medical Treatment Decision Maker (MTDM) (10% vs 44%), the patient’s resuscitation status (22% vs 54%), and treatment options discussed (78% vs 94%) ( p ⩽ 0.005 for all). Conclusion: Introducing an electronic pro-forma record to facilitate family meeting documentation increased the frequency of important recorded information. Further studies are required to assess whether documentation quality improvements are sustainable and whether they affect patient- or relative-centred outcomes.
8
Elliott, Rohan A., Cik Yin Lee, and Safeera Y. Hussainy. "Evaluation of a hybrid paper–electronic medication management system at a residential aged care facility." Australian Health Review 40, no. 3 (2016): 244. http://dx.doi.org/10.1071/ah14206.
Full textAbstract:
Objectives The aims of the study were to investigate discrepancies between general practitioners’ paper medication orders and pharmacy-prepared electronic medication administration charts, back-up paper charts and dose-administration aids, as well as delays between prescribing, charting and administration, at a 90-bed residential aged care facility that used a hybrid paper–electronic medication management system. Methods A cross-sectional audit of medication orders, medication charts and dose-administration aids was performed to identify discrepancies. In addition, a retrospective audit was performed of delays between prescribing and availability of an updated electronic medication administration chart. Medication administration records were reviewed retrospectively to determine whether discrepancies and delays led to medication administration errors. Results Medication records for 88 residents (mean age 86 years) were audited. Residents were prescribed a median of eight regular medicines (interquartile range 5–12). One hundred and twenty-five discrepancies were identified. Forty-seven discrepancies, affecting 21 (24%) residents, led to a medication administration error. The most common discrepancies were medicine omission (44.0%) and extra medicine (19.2%). Delays from when medicines were prescribed to when they appeared on the electronic medication administration chart ranged from 18 min to 98 h. On nine occasions (for 10% of residents) the delay contributed to missed doses, usually antibiotics. Conclusion Medication discrepancies and delays were common. Improved systems for managing medication orders and charts are needed. What is known about the topic? Hybrid paper–electronic medication management systems, in which prescribers’ orders are transcribed into an electronic system by pharmacy technicians and pharmacists to create medication administration charts, are increasingly replacing paper-based medication management systems in Australian residential aged care facilities. The accuracy and safety of these systems has not been studied. What does this paper add? The present study identified discrepancies between general practitioners’ orders and pharmacy-prepared electronic medication administration charts, back-up paper medication charts and dose-administration aids, as well as delays between ordering, charting and administering medicines. Discrepancies and delays sometimes led to medication administration errors. What are the implications for practitioners? Facilities that use hybrid systems need to implement robust systems for communicating medication changes to their pharmacy and reconciling prescribers’ orders against pharmacy-generated medication charts and dose-administration aids. Fully integrated, paperless medication management systems, in which prescribers’ electronic medication orders directly populate an electronic medication administration chart and are automatically communicated to the facility’s pharmacy, could improve patient safety.
9
Vaghasiya, Milan R., Simon K. Poon, Naren Gunja, and Jonathan Penm. "The Impact of Electronic Medication Management Systems on Medication Deviations on Admission and Discharge from Hospital." International Journal of Environmental Research and Public Health 20, no. 3 (January 19, 2023): 1879. http://dx.doi.org/10.3390/ijerph20031879.
Full textAbstract:
Medication errors at transition of care remain a concerning issue. In recent times, the use of integrated electronic medication management systems (EMMS) has caused a reduction in medication errors, but its effectiveness in reducing medication deviations at transition of care has not been studied in hospital-wide settings in Australia. The aim of this study is to assess medication deviations, such as omissions and mismatches, pre-EMMS and post-EMMS implementation at transition of care across a hospital. In this study, patient records were reviewed retrospectively to identify medication deviations (medication omissions and medication mismatches) at admission and discharge from hospital. A total of 400 patient records were reviewed (200 patients in the pre-EMMS and 200 patients in the post-EMMS group). Out of 400 patients, 112 in the pre-EMMS group and 134 patients in post-EMMS group met the inclusion criteria and were included in the analysis. A total of 105 out of 246 patients (42.7%) had any medication deviations on their medications. In the pre-EMMS group, 59 out of 112 (52.7%) patients had any deviations on their medications compared to 46 out of 134 patients (34.3%) from the post-EMMS group (p = 0.004). The proportion of patients with medication omitted from inpatient orders was 36.6% in the pre-EMMS cohort vs. 22.4% in the post-EMMS cohort (p = 0.014). Additionally, the proportion of patients with mismatches in medications on the inpatient charts compared to their medication history was 4.5% in the pre-EMMS group compared to 0% in the post-EMMS group (p = 0.019). Similarly, the proportion of patients with medications omitted from their discharge summary was 23.2% in the pre-EMMS group vs. 12.7% in the post-EMMS group (p = 0.03). Our study demonstrates a reduction in medication deviations after the implementation of the EMMS in hospital settings.
10
Hanna, Lisa, Stephen D. Gill, Laura Newstead, Melanie Hawkins, and Richard H. Osborne. "Patient perspectives on a personally controlled electronic health record used in regional Australia." Health Information Management Journal 46, no. 1 (August 6, 2016): 42–48. http://dx.doi.org/10.1177/1833358316661063.
Full textAbstract:
Background: Personally controlled electronic health records (PCEHRs) are being implemented throughout Australia; yet few studies have investigated patients’ experiences of using a PCEHR. Aim: To explore patients’ experiences and perspectives of using a locally developed PCEHR implemented in an Australian health service. Method: Twelve patients completed individual semi-structured telephone interviews, which underwent inductive analysis. Results: Participants described two main interdependent advantages of PCEHRs: improved quality of healthcare through better information sharing and enhanced patient capacity for self-management. To realise these advantages, widespread acceptance and use of PCEHRs by healthcare providers is required, and PCEHRs need to be simple to use and accessible. Conclusion: PCEHRs can produce tangible benefits for patients. However, maximum benefits will be realised when PCEHRs contain a complete collection of relevant health information and are carefully designed for easy use.
11
Hussin, Nurussobah, Saidatul Akmar Ismail, Saiful Farik Mat Yatin, Mohd Nazir Ahmad, and Mohd Shamsul Mohd Shoid. "Employing Qualitative Methods in Developing Functional Requirements for Electronic Records Management Research." International Journal of Engineering & Technology 7, no. 3.7 (July 4, 2018): 270. http://dx.doi.org/10.14419/ijet.v7i3.7.16389.
Full textAbstract:
This paper explores the justification of using a qualitative research method under the participatory paradigm. In order to develop the functional requirements of electronic court records management system in Malaysian Judiciary, the case study approach was chosen. The discussion begins by presenting the descriptions of methodology and methods employed, followed by the authors’ philosophical stance and the rationale for choosing a qualitative approach. Besides analysing the philosophical stance, the analysis of methods used in previous studies also provided insightful findings that helped ascertained the appropriate research method of the study. The development of twelve stages in developing the functional requirements specification based on the analysis of seven previous studies could be a reference material for other researchers. It is hoped that the knowledge that emerged when the functional requirements were developed could benefit readers and enhance their ability to apply as closely as possible to other studies or to make modifications for further research.
12
Hawash, Burkan, Umi Asma’ Mokhtar, Zawiyah M. Yusof, and Muaadh Mukred. "The adoption of electronic records management system (ERMS) in the Yemeni oil and gas sector." Records Management Journal 30, no. 1 (March 16, 2020): 1–22. http://dx.doi.org/10.1108/rmj-03-2019-0010.
Full textAbstract:
Purpose Identification of factors for electronic records management system (ERMS) adoption is important as it allows organizations to focus their efforts on these factors to ensure success. The purpose of this paper is to identify the factors that influence ERMS adoption in the Yemeni oil and gas (O&G) sector. Design/methodology/approach This paper conducts a systematic literature review (SLR) to extract the most common factors that could facilitate successful ERMS adoption. Information technology (IT) experts were asked to rank the extracted factors via an e-mail questionnaire and to recommend specific critical success factors that must be given extra attention to increasing the success of ERMS adoption. Essentially, the proposed methodology is technology-organization-environment (TOE) modeling to examine the important factors influencing decision-makers in the Yemeni O&G sector regarding ERMS adoption. Findings This paper identifies factors influencing ERMS adoption based on SLR and an expert-ranking survey. The data that were collected from IT experts were analyzed using the statistical package for the social sciences. The results showed that only 12 out of 20 factors were significant. The experts then added three new factors, resulting in 15 significant factors classified into the three dimensions as follows: technology, organization and environment. Originality/value Limited studies have been carried out in the context of the O&G sector, even among developed countries such as Canada, the UK and Australia. These studies have focused on a limited number of factors for ERMS adoption targeting better utilization of human resources, faster and more user-friendly system responses and suitability for organizational ease. This paper explores the factors that may prove useful in adopting of ERMS in the O&G sector of developing countries, similar to Yemen.
13
Wang, Taowei David, Krist Wongsuphasawat, Catherine Plaisant, and Ben Shneiderman. "Extracting Insights from Electronic Health Records: Case Studies, a Visual Analytics Process Model, and Design Recommendations." Journal of Medical Systems 35, no. 5 (May 4, 2011): 1135–52. http://dx.doi.org/10.1007/s10916-011-9718-x.
Full text
14
Robin, Libby, Steve Morton, and Mike Smith. "Writing a History of Scientific Endeavour in Australia’s Deserts." Historical Records of Australian Science 25, no. 2 (2014): 143. http://dx.doi.org/10.1071/hr14011.
Full textAbstract:
This special issue of Historical Records of Australian Science explores some of the sciences that have contributed to our understanding of inland Australia, country variously known as desert, the arid zone, drylands and the outback. The sciences that have concentrated on deserts include ecology, geomorphology, hydrology, rangeland management, geography, surveying, meteorology and geology, plus many others. In recognition that desert science has surged ahead in the past few decades, we have invited contributors who describe various different desert initiatives. We use these case studies to open up the discussion about how Australians see their desert lands, how this has changed over time and how desert scientists from the rest of the world regard the distinctive desert country in Australia.
15
Logan, Brendan, Kathryn H. Taffs, and Laura Cunningham. "Applying paleolimnological techniques in estuaries: a cautionary case study from Moreton Bay, Australia." Marine and Freshwater Research 61, no. 9 (2010): 1039. http://dx.doi.org/10.1071/mf09277.
Full textAbstract:
Paleoecological techniques are useful tools to identify restoration targets and natural variability for natural resource management programs. However, despite recent advances, caution is required when employing paleoecological techniques in estuaries, due to their dynamic nature relative to lake environments where these techniques were pioneered. This study used a novel combination of chronological, diatom, geochemical and isotopic data to assess the effectiveness of using these techniques in estuaries, and to develop an understanding of environmental changes within Moreton Bay, an open estuarine environment in subtropical east Australia. Results indicated mixed success, with 210Pb results indicating only background unsupported 210Pb levels, 14C results indicating sediment deposition from mixed sources, no diatom preservation and inconsistencies between geochemical and isotope proxies. Evidence did exist that the Moreton Bay sediments have been derived from different sources over the past 10 000 years. However, isotope records were not able to identify the likely sources of these sediments. Problems with diatom preservation were most probably due to the high salinity and temperatures associated with subtropical open embayment estuaries. Future studies attempting to identify environmental histories of estuaries should incorporate river-influenced locations rather than marine-dominated sites to ensure better diatom preservation and more definitive geochemical signals.
16
Eberl, M., G. Broffman, J. Pomerantz, N. Watroba, M. Reinhardt, M. C. Mahoney, C. Fox, and S. B. Edge. "Linked claims and medical records for case management of breast cancer diagnosis." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 6000. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.6000.
Full textAbstract:
6000 Background: Real time linkage of medical records and administrative claims may assist physicians in managing cancer care. Failure to obtain requisite follow-up (f/u) of abnormal mammograms may delay cancer diagnosis and impact outcome with studies showing that up to 20% of women do not get recommened f/u. We tested the accuracy of claims data linked to medical records in identifying women who did not receive f/u for an abnormal mammogram (BI-RADS 0,3,4,5). Methods: Electronic medical records in a staff model practice affiliated with a single payer were scanned to identify the BI-RADS code for all mammograms performed by practice radiologists. For each woman covered by the payer with a BI-RADS 0,3,4 or 5 mammogram, claims were searched for f/u breast procedures (imaging, biopsy, surgery). For women with more than 1 abnormal mammogram in the study period, only f/u of the first abnormal mammogram was studied. Cases were censured if their insurance coverage with the payer terminated before the required period of follow-up. Medical records of cases defined by claims as not having recommended f/u were reviewed to determine the accuracy of claims analysis. Results: 17,329 women covered by the payer had at least one mammogram in the practice from 1/1/2001 to 12/31/2003. The BI-RADS was 0, 3, 4 or 5 in 1,319 (7.5%). Among 1,206 eligible for f/u, 189 (16%) did not receive the BI-RADS recommended f/u (see table ). Medical record review showed that the claims search accurately identified the follow-up care in 95% of these cases. Conclusions: Administrative claims accurately identify care for diagnostic management of abnormal mammograms. Real-time linkage of claims to mammogram BI-RADS data is being tested as a regional case management system to assist physicians in assuring approrpriate follow-up for abnormal mammograms. [Table: see text] No significant financial relationships to disclose.
17
Porogo, Keneilwe Margret. "Digital preservation regulatory frameworks for e-government infrastructure in selected Ministries of Botswana." Journal of the South African Society of Archivists 55 (November 8, 2022): 137–46. http://dx.doi.org/10.4314/jsasa.v55i.10.
Full textAbstract:
This study assessed the digital preservation regulatory frameworks for digital records infrastructures in selected ministries in Botswana. Several research studies have been conducted but they did not clearly provide the regulatory frameworks affecting the preservation of digital records in the Botswana public service. The study adopted a pragmatic paradigm and embedded mixed method approach, whereby a cross-sectional survey and case study were deployed in each of the six selected ministries as a unit of analysis. Few ministries had implemented electronic records management systems that were not capable of preserving digital records even though they were expected to provide reliable, authentic and understandable records. The results revealed Botswana's weak legal system for digital records preservation.
18
Or, Calvin. "Pre-Implementation Case Studies Evaluating Workflow and Informatics Challenges in Private Primary Care Clinics for Electronic Medical Record Implementation." International Journal of Healthcare Information Systems and Informatics 10, no. 4 (October 2015): 56–64. http://dx.doi.org/10.4018/ijhisi.2015100104.
Full textAbstract:
Despite the potential benefits of electronic medical records (EMRs), their implementations have failed in a number of instances because of misfit between the technology design, work practices, workflows, and clinicians' needs. To promote effective design and implementation of an EMR system, the present pre-implementation study modeled the clinical workflow processes in private primary health care clinics and identified the associated gaps, weaknesses, and informatics challenges in the processes. Systematic field observations were performed to collect workflow data. Forty-three health care professionals (16 physicians and 27 clinical assistants) of fifteen private primary health care clinics were studied. The results, presented in a workflow diagram, demonstrate step-by-step details of the clinical work processes, their gaps and weaknesses, and possible improvement opportunities offered by the application of EMR. The workflow model provides important implications that may be applicable to other health care settings that plan to implement EMRs.
19
Ismail, Aliza, and Adnan Jamaludin. "Records professionals: an invisible profession in Malaysia." Records Management Journal 21, no. 1 (March 29, 2011): 69–75. http://dx.doi.org/10.1108/09565691111125116.
Full textAbstract:
PurposeThis study seeks to examine the existence of records professionals and their role in Malaysian organizations.Design/methodology/approachThe study compares case studies done in six government‐controlled companies. Interviews were conducted with the persons handling the records and information (including records in electronic environment) in the organizations. The interviews were then transcribed and analyzed manually to obtain the comparative data from each case.FindingsThe findings indicate that there are no “real” records professionals in Malaysian organizations. The responsibility and accountability of documenting and managing the organizations' records are dispersed and decentralized. Records managers as a profession are not established within the Malaysian organization structures. Generally there is no specific position of “records manager” in Malaysian organizations. However, the “archivists” are confined at the National Archives and there are no such positions at any of the case organizations studied.Research limitations/implicationsThe study selected six of the government‐controlled companies.Practical implicationsFindings and discovery of the study are significant in confirming that Malaysian organizations (both public and private) are taking their records management responsibilities very unconscientiously with little understanding and support from the top management. They have yet to realize the risk their organizations are facing for non‐compliance to records management standards and practices.Originality/valueThe study confirms the non‐existence of the records professional's position in the formal structures of Malaysian organizations. Though their roles and responsibilities are vital in the management and protection of records to support the business delivery of the organizations, their functions are carried out without due recognition to the profession.
20
Salmasi, Luca, and Enrico Capobianco. "Use of instrumental variables in electronic health record-driven models." Statistical Methods in Medical Research 27, no. 2 (April 7, 2016): 608–21. http://dx.doi.org/10.1177/0962280216641154.
Full textAbstract:
Precision medicine presents various methodological challenges whose assessment requires the consideration of multiple factors. In particular, the data multitude in the Electronic Health Records poses interoperability issues and requires novel inference strategies. A problem, though apparently a paradox, is that highly specific treatments and a variety of outcomes may hardly match with consistent observations (i.e., large samples). Why is it the case? Owing to the heterogeneity of Electronic Health Records, models for the evaluation of treatment effects need to be selected, and in some cases, the use of instrumental variables might be necessary. We studied the recently defined person-centered treatment effects in cancer and C-section contexts from Electronic Health Record sources and identified as an instrument the distance of patients from hospitals. We present first the rationale for using such instrument and then its model implementation. While for cancer patients consideration of distance turns out to be a penalty, implying a negative effect on the probability of receiving surgery, a positive effect is instead found in C-section due to higher propensity of scheduling delivery. Overall, the estimated person-centered treatment effects reveal a high degree of heterogeneity, whose interpretation remains context-dependent. With regard to the use of instruments in light of our two case studies, our suggestion is that this process requires ad hoc variable selection for both covariates and instruments and additional testing to ensure validity.
21
Jones, Julia L., Natalie G. Lumsden, Koen Simons, Anis Ta'eed, Maximilian P. de Courten, Tissa Wijeratne, Nicholas Cox, et al. "Using electronic medical record data to assess chronic kidney disease, type 2 diabetes and cardiovascular disease testing, recognition and management as documented in Australian general practice: a cross-sectional analysis." Family Medicine and Community Health 10, no. 1 (February 2022): e001006. http://dx.doi.org/10.1136/fmch-2021-001006.
Full textAbstract:
ObjectivesTo evaluate the capacity of general practice (GP) electronic medical record (EMR) data to assess risk factor detection, disease diagnostic testing, diagnosis, monitoring and pharmacotherapy for the interrelated chronic vascular diseases—chronic kidney disease (CKD), type 2 diabetes (T2D) and cardiovascular disease.DesignCross-sectional analysis of data extracted on a single date for each practice between 12 April 2017 and 18 April 2017 incorporating data from any time on or before data extraction, using baseline data from the Chronic Disease early detection and Improved Management in PrimAry Care ProjecT. Deidentified data were extracted from GP EMRs using the Pen Computer Systems Clinical Audit Tool and descriptive statistics used to describe the study population.SettingEight GPs in Victoria, Australia.ParticipantsPatients were ≥18 years and attended GP ≥3 times within 24 months. 37 946 patients were included.ResultsRisk factor and disease testing/monitoring/treatment were assessed as per Australian guidelines (or US guidelines if none available), with guidelines simplified due to limitations in data availability where required. Risk factor assessment in those requiring it: 30% of patients had body mass index and 46% blood pressure within guideline recommended timeframes. Diagnostic testing in at-risk population: 17% had diagnostic testing as per recommendations for CKD and 37% for T2D. Possible undiagnosed disease: Pathology tests indicating possible disease with no diagnosis already coded were present in 6.7% for CKD, 1.6% for T2D and 0.33% familial hypercholesterolaemia. Overall prevalence: Coded diagnoses were recorded in 3.8% for CKD, 6.6% for T2D, 4.2% for ischaemic heart disease, 1% for heart failure, 1.7% for ischaemic stroke, 0.46% for peripheral vascular disease, 0.06% for familial hypercholesterolaemia and 2% for atrial fibrillation. Pharmaceutical prescriptions: the proportion of patients prescribed guideline-recommended medications ranged from 44% (beta blockers for patients with ischaemic heart disease) to 78% (antiplatelets or anticoagulants for patients with ischaemic stroke).ConclusionsUsing GP EMR data, this study identified recorded diagnoses of chronic vascular diseases generally similar to, or higher than, reported national prevalence. It suggested low levels of extractable documented risk factor assessments, diagnostic testing in those at risk and prescription of guideline-recommended pharmacotherapy for some conditions. These baseline data highlight the utility of GP EMR data for potential use in epidemiological studies and by individual practices to guide targeted quality improvement. It also highlighted some of the challenges of using GP EMR data.
22
Eberl, M. M., C. H. Fox, G. Broffman, J. Pomerantz, J. Serghany, M. Reinhardt, N. Watroba, and S. B. Edge. "An automated practice-based intervention for case management of abnormal mammograms." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 6563. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.6563.
Full textAbstract:
6563 Background: Failure to obtain follow-up (f/u) of abnormal mammograms may delay cancer diagnosis and impact outcome; studies show up to 20% of women do not get recommended f/u. Our group previously established that administrative claims linked to medical records accurately identify care for management of abnormal mammograms. We are testing a case management system linking claims data to mammogram information to assist physicians in assuring appropriate f/u for abnormal mammograms. Methods: Electronic medical records in a staff model practice affiliated with a single payer are scanned to identify the BI-RADS code for all mammograms. The practice performs about 8,000 mammograms with about 500 abnormal mammograms annually. Physicians are notified of each abnormal mammogram and provided with a standardized care pathway for management. For each BI-RADS 0, 3, 4 or 5 mammogram, claims are searched for f/u breast procedures (imaging, biopsy, surgery). If recommended f/u (additional imaging for BI-RADS 0, biopsy by 2 months for BI-RADS 4 and 5, f/u imaging by 8 months for BI-RADS 3) is not observed, the ordering physician is alerted. Results: From 01/01/2001 to 12/31/2003, we observed that among women eligible for f/u, 189 (16%) did not receive BI-RADS recommended f/u care. In the prospective intervention from 1/1/06 - 6/30/06, 166 BI-RADS 0, 21 BI-RADS 4, and 3 BI-RADS 5 mammograms had 98.2%, 76.2%, and 100% appropriate f/u, respectively. From the alerts, all but one patient who refused biopsy received appropriate care. Conclusions: A practice intervention utilizing BI- RADS data linked to claims accurately identified missed f/u in a time frame when appropriate care can be delivered. This practice-based intervention has potential to improve the management of other cancers and chronic diseases. This intervention is being expanded on a community wide level. No significant financial relationships to disclose.
23
Liu, Yuchen, Jianhong (Cecilia) Xia, and Aloke Phatak. "Evaluating the Accuracy of Bluetooth-Based Travel Time on Arterial Roads: A Case Study of Perth, Western Australia." Journal of Advanced Transportation 2020 (February 21, 2020): 1–19. http://dx.doi.org/10.1155/2020/9541234.
Full textAbstract:
Bluetooth (BT) time-stamped media access control (MAC) address data have been used for traffic studies worldwide. Although Bluetooth (BT) technology has been widely recognised as an effective, low-cost traffic data source in freeway traffic contexts, it is still unclear whether BT technology can provide accurate travel time (TT) information in complex urban traffic environments. Therefore, this empirical study aims to systematically evaluate the accuracy of BT travel time estimates in urban arterial contexts. There are two major hurdles to deriving accurate TT information for arterial roads: the multiple detection problem and noise in BT estimates. To date, they have not been fully investigated, nor have well-accepted solutions been found. Using approximately two million records of BT time-stamped MAC address data from twenty weekdays, this study uses five different BT TT-matching methods to investigate and quantify the impact of multiple detection problems and the noise in BT TT estimates on the accuracy of average BT travel times. Our work shows that accurate Bluetooth-based travel time information on signalised arterial roads can be derived if an appropriate matching method can be selected to smooth out the remaining noise in the filtered travel time estimates. Overall, average-to-average and last-to-last matching methods are best for long (>1 km) and short (≤1 km) signalised arterial road segments, respectively. Furthermore, our results show that the differences between BT and ground truth average TTs or speeds are systematic, and adding a calibration is a pragmatic method to correct inaccurate BT average TTs or speeds. The results of this research can help researchers and road operators to better understand BT technology for TT analysis and consequently to optimise the deployment location and configuration of BT MAC address scanners.
24
Mallitt, Kylie-Ann, James Jansson, Levinia Crooks, David McGuigan, Handan Wand, and David P. Wilson. "Demand for HIV clinical services is increasing in Australia but supply is decreasing." Sexual Health 10, no. 1 (2013): 43. http://dx.doi.org/10.1071/sh12051.
Full textAbstract:
Background HIV clinical service planning requires accurate estimates of the number of people living with HIV (PLHIV) and the capacity of existing clinical services, each by geographical location. The aim of this study was to quantify current HIV clinical service capacity in Australia. Methods: This study was a retrospective analysis of records of HIV clinical service capacity in Australia. Participants were general practitioners who completed an annual survey in 2007–2009. Information on the number of hospital departments, sexual health services, antiretroviral-prescribing general practitioners (ARV-GPs) and shared-care services providing expertise in HIV management from 2007 to 2010 were also available. Results: From 2007 to 2009, the proportion of ARV-GP survey respondents treating 2–9 patients with HIV per week increased from 36.5% to 49.1%, with a corresponding decrease in the average proportion who saw less than one patient with HIV per week. The estimated number of PLHIV has increased by 12.5% in metropolitan areas, and 16.5% in rural and remote areas over the period 2007–2010; however, the total number of services with at least one HIV ARV-GP has decreased over the same period. Conclusions: Current methods to estimate clinical service capacity reveal decreasing supply in the workforce in Australia despite increasing numbers of PLHIV. Further training of HIV clinicians and their placement in regions of greatest supply–demand deficits are required. Further studies are required to precisely quantify and locate the capacity of the HIV clinical workforce with expertise in HIV case-management to enable efficient service planning.
25
Kennedy, Areti, Benjamin Turner, and Melissa Kendall. "Growth in a ‘New World’: Case Studies of Peer Leader Experiences in the STEPS Program for People With Acquired Brain Injury." Brain Impairment 12, no. 2 (September 1, 2011): 152–64. http://dx.doi.org/10.1375/brim.12.2.152.
Full textAbstract:
AbstractBackground: The Skills To Enable People and CommunitieS (STEPS) Program is a new information, support and skills program that aims to develop sustainable networks of support for individuals with acquired brain injury (ABI) and their families in communities throughout Queensland, Australia. The program adopts a self-management approach and is delivered by trained peer and professional leaders. Aim: To explore the experiences of both peer and lay leaders in the delivery of the STEPS Skills Program and coordination of STEPS Network Groups. Method: A multiple qualitative case study design was utilised to explore the unique experiences of three trained STEPS Program Leaders. Data collection entailed in-depth semistructured interviews with participants and further incorporated routine STEPS Program Leader descriptive data. The data analysis involved a four-stage approach that included assembling the raw case data, constructing case records, producing case narratives and cross-case pattern analysis. Results: Case study narratives were produced to describe participant experiences with the STEPS Program. The cross-case pattern analysis revealed two dimensions of comparison. The first dimension describes the process by which participants became STEPS Program Leaders, while the second dimension reflects the growth outcomes experienced by participants through their involvement with the STEPS Program. Specific growth outcomes are described in relation to the following domains: ‘expansion of social roles and skills’, ‘appreciation of life’, ‘interpersonal relationships and communication’, ‘confidence, personal strength and accomplishment’ and ‘growth in self as a person’. The results are also described with respect to a model that depicts the process of growth through STEPS Program delivery. Conclusion: Posttraumatic growth of peer leaders after brain injury can be facilitated within a therapeutic intervention such as the STEPS Program.
26
Glasbey, JC, F. Arshad, LM Almond, B. Vydianath, A. Desai, D. Gourevitch, and SJ Ford. "Gastrointestinal manifestations of extramedullary plasmacytoma: a narrative review and illustrative case reports." Annals of The Royal College of Surgeons of England 100, no. 5 (May 2018): 371–76. http://dx.doi.org/10.1308/rcsann.2018.0015.
Full textAbstract:
Introduction Solitary extramedullary plasmacytoma are rare, solid-mass tumours which appear immunophenotypically similar to multiple myeloma. The diagnosis and management of gastrointestinal plasmacytoma is complex and requires multidisciplinary input. This study presents a narrative review of intra-abdominal extramedullary plasmacytoma, illustrated with two case studies. Methods The PubMed database was searched without date restrictions for reports of intra-abdominal extramedullary plasmacytoma to synthesise a narrative review. Electronic records were reviewed at a high-volume, quaternary soft-tissue sarcoma centre to identify patients with histopathologically confirmed extramedullary plasmacytoma affecting the gastrointestinal tract. Results Gastrointestinal extramedullary plasmacytomas can present with mass effect or organ-specific dysfunction. Techniques for tissue diagnosis of extramedullary plasmacytoma vary dependent on location, with a formal diagnosis often being made from a resected specimen. Management can include surgery, radiotherapy, systemic chemotherapy or a combination. No high-quality evidence base exists to guide treatment. Two case studies of operated gastrointestinal extramedullary plasmacytoma are presented at different phases of disease progression, with a resultant impact on survival. Conclusion Intra-abdominal extramedullary plasmacytoma is a rare and heterogeneous condition that lacks consensus guidelines for diagnosis and management. Collaboration between international specialist centres will create better quality evidence for treatment of this cohort.
27
Vaddiraju, Anil Kumar, and S. Manasi. "E-governance: Learning from Karnataka." Indian Journal of Public Administration 65, no. 2 (June 2019): 416–29. http://dx.doi.org/10.1177/0019556119844582.
Full textAbstract:
The technological changes of the 20th and 21st centuries, the growth of computer technologies, digital technologies and telecommunications have changed the way the state conducts its functions and delivers governance. Whether or not they have improved the welfare function of the state, the way governance is delivered has been altered. In this article, we discuss the application of electronic governance (e-governance) in Karnataka with the help of three case studies. We discuss the cases of land records management in rural and urban areas and initiatives in Bengaluru traffic management. The case studies indicate that e-governance improves service delivery and that there are points to be gleaned from the successful implementation of the same in Karnataka. Finally, we argue that while there is necessity for optimism regarding the application of technology in service-delivery functions, the overall digitisation of economy may be something qualitatively different.
28
Erliyana, Ella, and Dwi Wahyu Rozanti. "Preventive and Curative Efforts in Archive Management Planning for the Threat of Natural Disasters in Indonesia." Record and Library Journal 5, no. 1 (October 1, 2019): 1. http://dx.doi.org/10.20473/rlj.v5-i1.2019.1-11.
Full textAbstract:
Background of the study: Archives have a very crucial role in the development of organization and institutions, Including in Indonesia. The importance of archival protection is in Determine records management planning in overcoming the impact of natural disasters.Purpose: The Efforts taken are preventive and curative actions that aim to minimize the risk of losing archives and as an effort to safeguard the importance of policy-making towards archives in the future.Method: This research is qualitative research with literature study method. The researcher raised a study that was in accordance with the topic of understanding, then made a map of the data related to preventive and curative Efforts in an effort to overcome natural disasters. In this case, the analysis of data is done through reference to books, journals, and other library materials Articles regarding preventive and curative actions in archival management and policy planning related to archives. Literature studies pay attention to relevance to the subject matter and to facilitate the understanding and direction of writing in accordance with the problems in the study.Findings: The results of this study indicate that disaster management consists of stages several items, namely mitigation, preparedness, response, and recovery.Conclusion: Prevailing Efforts are focused more on Preventing and protecting conventional archives from the disaster damage. The actions taken include storing archives in a safe and disaster-resistant place, storing archives with special equipment (vaulting), duplicating or duplicating records by transferring media in the form of Microfilms, microfiche, magnetic recordings, electronic records. While curative Efforts are repairs or maintenance of records with conditions that have or have begun to be damaged. Actions include lamination, encapsulation, reproduction of archives and recovery.
29
Liu, Yiyang, Khairul A. Siddiqi, Robert L. Cook, Jiang Bian, Patrick J. Squires, Elizabeth A. Shenkman, Mattia Prosperi, and Dushyantha T. Jayaweera. "Optimizing Identification of People Living with HIV from Electronic Medical Records: Computable Phenotype Development and Validation." Methods of Information in Medicine 60, no. 03/04 (September 2021): 084–94. http://dx.doi.org/10.1055/s-0041-1735619.
Full textAbstract:
Abstract Background Electronic health record (EHR)-based computable phenotype algorithms allow researchers to efficiently identify a large virtual cohort of Human Immunodeficiency Virus (HIV) patients. Built upon existing algorithms, we refined, improved, and validated an HIV phenotype algorithm using data from the OneFlorida Data Trust, a repository of linked claims data and EHRs from its clinical partners, which provide care to over 15 million patients across all 67 counties in Florida. Methods Our computable phenotype examined information from multiple EHR domains, including clinical encounters with diagnoses, prescription medications, and laboratory tests. To identify an HIV case, the algorithm requires the patient to have at least one diagnostic code for HIV and meet one of the following criteria: have 1+ positive HIV laboratory, have been prescribed with HIV medications, or have 3+ visits with HIV diagnostic codes. The computable phenotype was validated against a subset of clinical notes. Results Among the 15+ million patients from OneFlorida, we identified 61,313 patients with confirmed HIV diagnosis. Among them, 8.05% met all four inclusion criteria, 69.7% met the 3+ HIV encounters criteria in addition to having HIV diagnostic code, and 8.1% met all criteria except for having positive laboratories. Our algorithm achieved higher sensitivity (98.9%) and comparable specificity (97.6%) relative to existing algorithms (77–83% sensitivity, 86–100% specificity). The mean age of the sample was 42.7 years, 58% male, and about half were Black African American. Patients' average follow-up period (the time between the first and last encounter in the EHRs) was approximately 4.6 years. The median number of all encounters and HIV-related encounters were 79 and 21, respectively. Conclusion By leveraging EHR data from multiple clinical partners and domains, with a considerably diverse population, our algorithm allows more flexible criteria for identifying patients with incomplete laboratory test results and medication prescribing history compared with prior studies.
30
Cairns, Alexandra E., Louise Pealing, James M. N. Duffy, Nia Roberts, Katherine L. Tucker, Paul Leeson, Lucy H. MacKillop, and Richard J. McManus. "Postpartum management of hypertensive disorders of pregnancy: a systematic review." BMJ Open 7, no. 11 (November 2017): e018696. http://dx.doi.org/10.1136/bmjopen-2017-018696.
Full textAbstract:
ObjectivesHypertensive disorders of pregnancy (HDP) affect one in ten pregnancies and often persist postpartum when complications can occur. We aimed to determine the effectiveness and safety of pharmacological interventions, other interventions and different care models for postpartum hypertension management.DesignA systematic review was undertaken. Nine electronic databases, including Medline, were searched from inception to 16 March 2017. After duplicate removal, 4561 records were screened. Two authors independently selected studies, extracted study characteristics and data, and assessed methodological quality.SettingRandomised controlled trials, case–control studies and cohort studies from any country and healthcare setting.ParticipantsPostnatal women with HDP.InterventionsTherapeutic intervention for management of hypertension, compared with another intervention, placebo or no intervention.Primary and secondary outcome measuresOutcome data were collected for maternal mortality and severe morbidity; systolic, diastolic and mean arterial blood pressure (BP) control; and safety data. Secondary outcome data collected included the length of postnatal hospital stay and laboratory values.Results39 studies were included (n=2901). Results were heterogeneous in terms of intervention, comparison and outcome requiring a narrative approach. There were insufficient data to recommend any single pharmacological intervention. 18 studies reported calcium-channel blockers, vasodilators and beta-blockers lowered BP postpartum. 12 of these reported safety data. Limited data existed regarding management in the weeks following hospital discharge. Neither loop diuretics (three studies) nor corticosteroids (one study) produced clinical benefit. Uterine curettage significantly reduced BP over the first 48 hours postpartum (range 6–13 mm Hg) compared with standard care (eight studies), with safety data only reported by four of eight studies.ConclusionThere was insufficient evidence to recommend a particular BP threshold, agent or model of care, but three classes of antihypertensive appeared variably effective. Further comparative research, including robust safety data, is required. Curettage reduced BP, but without adequate reporting of harms, so it cannot currently be recommended.
31
Getahun, Darios, Jiaxiao M. Shi, Malini Chandra, Michael J. Fassett, Stacey Alexeeff, Theresa M. Im, Vicki Y. Chiu, et al. "Identifying Ectopic Pregnancy in a Large Integrated Health Care Delivery System: Algorithm Validation." JMIR Medical Informatics 8, no. 11 (November 30, 2020): e18559. http://dx.doi.org/10.2196/18559.
Full textAbstract:
Background Surveillance of ectopic pregnancy (EP) using electronic databases is important. To our knowledge, no published study has assessed the validity of EP case ascertainment using electronic health records. Objective We aimed to assess the validity of an enhanced version of a previously validated algorithm, which used a combination of encounters with EP-related diagnostic/procedure codes and methotrexate injections. Methods Medical records of 500 women aged 15-44 years with membership at Kaiser Permanente Southern and Northern California between 2009 and 2018 and a potential EP were randomly selected for chart review, and true cases were identified. The enhanced algorithm included diagnostic/procedure codes from the International Classification of Diseases, Tenth Revision, used telephone appointment visits, and excluded cases with only abdominal EP diagnosis codes. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall performance (Youden index and F-score) of the algorithm were evaluated and compared to the validated algorithm. Results There were 334 true positive and 166 true negative EP cases with available records. True positive and true negative EP cases did not differ significantly according to maternal age, race/ethnicity, and smoking status. EP cases with only one encounter and non-tubal EPs were more likely to be misclassified. The sensitivity, specificity, PPV, and NPV of the enhanced algorithm for EP were 97.6%, 84.9%, 92.9%, and 94.6%, respectively. The Youden index and F-score were 82.5% and 95.2%, respectively. The sensitivity and NPV were lower for the previously published algorithm at 94.3% and 88.1%, respectively. The sensitivity of surgical procedure codes from electronic chart abstraction to correctly identify surgical management was 91.9%. The overall accuracy, defined as the percentage of EP cases with correct management (surgical, medical, and unclassified) identified by electronic chart abstraction, was 92.3%. Conclusions The performance of the enhanced algorithm for EP case ascertainment in integrated health care databases is adequate to allow for use in future epidemiological studies. Use of this algorithm will likely result in better capture of true EP cases than the previously validated algorithm.
32
Baker, Zachary, Eric Jutkowitz, and Joseph Gaugler. "A Systematic Review of Interventions That Reduce Family and Friend Caregiving Time." Innovation in Aging 4, Supplement_1 (December 1, 2020): 350. http://dx.doi.org/10.1093/geroni/igaa057.1126.
Full textAbstract:
Abstract The decreasing number of family/friend caregivers available to help the rising number of older adults is creating a critical family care gap. For this reason, there is a growing need for interventions that reduce family/friend caregiving time. We systematically reviewed five electronic databases to identify randomized trials, case control, quasi-experimental, and cross-sectional studies that evaluated a modifiable element that could be targeted for interventions with care recipients 65+ and/or their family/friend caregivers and reported on an outcome of time spent caregiving. We excluded studies without a comparison, broadly defined. The initial search included 1,812 unique records. Following abstract and title screening 311 full-texts were reviewed. Fifty-five studies published between the years of 1990 and 2019 met inclusion criteria. Studies predominantly focused on care recipients with dementia (58%) and were largely conducted in western countries (91%). The categories of interventions reviewed included pharmaceuticals (25%), public long-term care financing (7%), case management (7%), care setting (16%), technology (7%), multi-component interventions (9%), skills building (15%), additional formal expertise/care (9%), and other (5%), with one study falling into multiple categories. Pharmaceuticals, case management, care setting, and multi-component interventions demonstrated promising evidence to reduce family/friend caregiving time. Methodologically, studies were inconsistent in measurement and ascertainment of caregiving time. Given the public health concerns of reduced availability of family/friend caregivers for older persons in the upcoming decades, caregiving interventions should consider measurements of caregiving time as key outcomes.
33
Baron, Jason R., and Anne Thurston. "What lessons can be learned from the US archivist’s digital mandate for 2019 and is there potential for applying them in lower resource countries?" Records Management Journal 26, no. 2 (July 18, 2016): 206–17. http://dx.doi.org/10.1108/rmj-04-2015-0015.
Full textAbstract:
Purpose This paper aims to present a high-level summary of the US archivist’s digital mandate for 2019, embodied in the publication “Managing Government Records”, issued on August 24, 2012, and a summary of US policy. The authors then consider the implications of the US e-recordkeeping initiative for lower-resource countries. Design/methodology/approach After setting out key elements of the US Archivist’s digital mandate, the paper proceeds to evaluate its policy implications for lower-resource countries based on the authors’ field experience and knowledge of case studies. Findings The USA is embarking on a state of the art approach for managing public sector archives in a digital form, with deadlines approaching for all federal agencies to manage e-mail and other e-records. Although a similar need exists in lesser-resourced countries, there are enormous barriers to successful implementation of a similar approach. Research limitations/implications The archivist’s 2019 digital mandate assumes that the technology sector will embrace the needs of public sector agencies in working on applicable electronic archiving solutions. Practical implications The Archivist’s Directive has the potential to be an enormous driver of change in the records management profession with respect to future management of increasingly digital archive collections. Vast collections of public sector e-mail and other forms of e-records potentially will be preserved under the directive, raising the stakes that archivists and records managers work on solutions in the area of long-term preservation and future access. Social implications The importance of capturing the activities of public-sector institutions in all countries for the purpose of openness, transparency and access cannot be overstated. In an increasingly digital age, new methods are needed to ensure that the historical record of governmental institutions is preserved and made accessible. Originality/value The US Archivist’s mandate represents a cutting-edge approach to long-term digital archiving with potential future applicability to the management of public sector records worldwide.
34
Metzger, Kristen E., Stephanie R. Black, Roderick C. Jones, Shaun R. Nelson, Ari Robicsek, Gordon M. Trenholme, Mary Alice Lavin, et al. "Identification, Management, and Clinical Characteristics of Hospitalized Patients with Influenza-Like Illness during the 2009 H1N1 Influenza Pandemic, Cook County, Illinois." Infection Control & Hospital Epidemiology 32, no. 10 (October 2011): 998–1002. http://dx.doi.org/10.1086/661912.
Full textAbstract:
Objective.To describe the identification, management, and clinical characteristics of hospitalized patients with influenza-like illness (ILI) during the peak period of activity of the 2009 pandemic strain of influenza A virus subtype H1N1 (2009 H1N1).Design.Retrospective review of electronic medical records.Patients and Setting.Hospitalized patients who presented to the emergency department during the period October 18 through November 14, 2009, at 4 hospitals in Cook County, Illinois, with the capacity to perform real-time reverse-transcriptase polymerase chain reaction testing for influenza.Methods.Vital signs and notes recorded within 1 calendar day after emergency department arrival were reviewed for signs and symptoms consistent with ILI. Cases of ILI were classified as recognized by healthcare providers if an influenza test was performed or if influenza was mentioned as a possible diagnosis in the physician notes. Logistic regression was used to determine the patient attributes and symptoms that were associated with ILI recognition and with influenza infection.Results.We identified 460 ILI case patients, of whom 412 (90%) had ILI recognized by healthcare providers, 389 (85%) were placed under airborne or droplet isolation precautions, and 243 (53%) were treated with antiviral medication. Of 401 ILI case patients tested for influenza, 91 (23%) had a positive result. Fourteen (3%) ILI case patients and none of the case patients who tested positive for influenza had sore throat in the absence of cough.Conclusions.Healthcare providers identified a high proportion of hospitalized ILI case patients. Further improvements in disease detection can be made through the use of advanced electronic health records and efficient diagnostic tests. Future studies should evaluate the inclusion of sore throat in the ILI case definition.
35
Daniel, Christel, and Dipak Kalra. "Clinical Research Informatics: Contributions from 2017." Yearbook of Medical Informatics 27, no. 01 (August 2018): 177–83. http://dx.doi.org/10.1055/s-0038-1641220.
Full textAbstract:
Objectives: To summarize key contributions to current research in the field of Clinical Research Informatics (CRI) and to select best papers published in 2017. Method: A bibliographic search using a combination of MeSH descriptors and free terms on CRI was performed using PubMed, followed by a double-blind review in order to select a list of candidate best papers to be then peer-reviewed by external reviewers. A consensus meeting between the two section editors and the editorial team was organized to finally conclude on the selection of best papers. Results: Among the 741 returned papers published in 2017 in the various areas of CRI, the full review process selected five best papers. The first best paper reports on the implementation of consent management considering patient preferences for the use of de-identified data of electronic health records for research. The second best paper describes an approach using natural language processing to extract symptoms of severe mental illness from clinical text. The authors of the third best paper describe the challenges and lessons learned when leveraging the EHR4CR platform to support patient inclusion in academic studies in the context of an important collaboration between private industry and public health institutions. The fourth best paper describes a method and an interactive tool for case-crossover analyses of electronic medical records for patient safety. The last best paper proposes a new method for bias reduction in association studies using electronic health records data. Conclusions: Research in the CRI field continues to accelerate and to mature, leading to tools and platforms deployed at national or international scales with encouraging results. Beyond securing these new platforms for exploiting large-scale health data, another major challenge is the limitation of biases related to the use of “real-world” data. Controlling these biases is a prerequisite for the development of learning health systems.
36
Laing, Joshua, Georgia Grant, Cecilia Harb, Elise White, Terence O’Brien, and Patrick Kwan. "130 Continuous EEG monitoring in australia: s first year audit of practice 2018–2019 of a combined hospital epilepsy program in melbourne." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A42.2—A42. http://dx.doi.org/10.1136/jnnp-2019-anzan.115.
Full textAbstract:
IntroductionContinuous EEG (cEEG) monitoring is essential for the optimal diagnosis and management of non-convulsive seizures. We audited the use of cEEG across two major metropolitan hospitals in Melbourne, Australia as part of a new combined epilepsy program. There are no reported case series of cEEG in Australia.MethodsData was collected retrospectively from consecutive patients who underwent cEEG monitoring as part of their acute inpatient care between Jan 2018 to Dec 2018 at the Alfred and Royal Melbourne Hospitals. All inpatient EEG studies over 1 hr were included. Elective cases from the epilepsy monitoring unit were excluded. Demographic and clinical information regarding their admission was collected. Descriptive statistics, and comparative analysis was performed.ResultsThere were 94 patients identified that underwent cEEG. 50% were male and 50% female, with an average age of 51.3 yrs. 45% were performed in the ICU, and 55% on the acute medical ward. The average duration of recording per patient was 86.2 hrs or 3.6 days. Of 89 of 94 available cEEG reports, seizures were seen in 55%, the majority being non-convulsive. Interictal discharges were seen in 60%. 19% (13/67 of available records) were dead at the time of the audit.ConclusionNon-convulsive seizures and non-convulsive status epilepticus is common and widely underrecognized without cEEG. We present 94 cases as part of our newly expanding cEEG program across two major Australian hospitals over a one year period, 55% with seizures which were predominantly non-convulsive. A prospective database will be designed for further quality improvement and future research.
37
Masini, Nicola, Giovanni Leucci, David Vera, Maria Sileo, Antonio Pecci, Sayri Garcia, Ronald López, Henry Holguín, and Rosa Lasaponara. "Towards Urban Archaeo-Geophysics in Peru. The Case Study of Plaza de Armas in Cusco." Sensors 20, no. 10 (May 19, 2020): 2869. http://dx.doi.org/10.3390/s20102869.
Full textAbstract:
One of the most complex challenges of heritage sciences is the identification and protection of buried archaeological heritage in urban areas and the need to manage, maintain and inspect underground services. Archaeology and geophysics, used in an integrated way, provide an important contribution to open new perspectives in understanding both the history of cities and in helping the decision makers in planning and governing the urban development and management. The problems of identification and interpretation of geophysical features in urban subsoil make it necessary to develop ad hoc procedures to be implemented and validated in significant case studies. This paper deals with the results of an interdisciplinary project in Cusco (Peru), the capital of Inca Empire, where the georadar method was applied for the first time in the main square. The georadar method was successfully employed based on knowledge of the historical evolution of Cusco and the availability of archaeological records provided by some excavations nearby the study area. Starting from a model for the electromagnetic wave reflection from archaeological structures and pipes, georadar results were interpreted by means of comparative morphological analysis of high amplitude values observed from time slices with reflectors visualized in the radargrams.
38
Shrestha, Pragya, Chung-Il Wi, Hongfang Liu, Katherine S. King, Euijung Ryu, Jung Hyun Kwon, Sunghwan Sohn, Miguel Park, and Young Juhn. "Risk of pneumonia in asthmatic children using inhaled corticosteroids: a nested case-control study in a birth cohort." BMJ Open 12, no. 3 (March 2022): e051926. http://dx.doi.org/10.1136/bmjopen-2021-051926.
Full textAbstract:
BackgroundInhaled corticosteroids (ICSs) are important in asthma management, but there are concerns regarding associated risk of pneumonia. While studies in asthmatic adults have shown inconsistent results, this risk in asthmatic children is unclear.ObjectiveOur aim was to determine the association of ICS use with pneumonia risk in asthmatic children.MethodsA nested case-control study was performed in the Mayo Clinic Birth Cohort. Asthmatic children (<18 years) with a physician diagnosis of asthma were identified from electronic medical records of children born at Mayo Clinic from 1997 to 2016 and followed until 31 December 2017. Pneumonia cases defined by Infectious Disease Society of America were 1:1 matched with controls without pneumonia by age, sex and asthma index date. Exposure was defined as ICS prescription at least 90 days prior to pneumonia. Associations of ICS use, type and dose (low, medium and high) with pneumonia risk were analysed using conditional logistic regression.ResultsOf the 2108 asthmatic children eligible for the study (70% mild intermittent and 30% persistent asthma), 312 children developed pneumonia during the study period. ICS use overall was not associated with risk of pneumonia (adjusted OR: 0.94, 95% CI: 0.62 to 1.41). Poorly controlled asthma was significantly associated with the risk of pneumonia (OR: 2.03, 95% CI: 1.35 to 3.05; p<0.001). No ICS type or dose was associated with risk of pneumonia.ConclusionICS use in asthmatic children was not associated with risk of pneumonia but poorly controlled asthma was. Future asthma studies may need to include pneumonia as a potential outcome of asthma management.
39
Nengomasha, Cathrine Tambudzai, and Alfred Chikomba. "Status of EDRMS implementation in the public sector in Namibia and Zimbabwe." Records Management Journal 28, no. 3 (November 19, 2018): 252–64. http://dx.doi.org/10.1108/rmj-08-2017-0023.
Full textAbstract:
Purpose The purpose of this study was to investigate the adoption and use of electronic document and records management system (EDRMS) in the public service in Namibia and Zimbabwe with the aim of establishing barriers and enablers, and best practices which each country could adopt from the other. Design/methodology/approach This multi-case study was informed by an interpretivist paradigm. Qualitative in nature, the study applied face-to-face interviews as the data collection method, supplemented by documents analysis. The study population was Namibia and Zimbabwe’s public sectors with units of analysis, being the governments’ ministries, offices and agencies which have implemented EDRMS. Findings The paper provides the state of EDRMS implementation in Namibia and Zimbabwe. It establishes how the two countries have implemented EDRMS and factors that have contributed to the success/failure of the implementation in both countries. Originality/value The paper is a response to the need for further research studies on the implementation of EDRMS in various countries.
40
Aibinu, Ajibade A., Simon Carter, Valerie Francis, and Paulo Vaz-Serra. "Request for information frequency and their turnaround time in construction projects." Built Environment Project and Asset Management 10, no. 1 (August 26, 2019): 1–15. http://dx.doi.org/10.1108/bepam-10-2018-0130.
Full textAbstract:
Purpose The purpose of this paper is to study the nature of request for information (RFIs) on construction projects by using data analytics to understand the frequency of RFIs, when they occur on projects, and the relationship between project characteristics and frequency of RFIs and between project characteristics and RFI turnaround time. Design/methodology/approach A data-analytic approach using RStudio and Minitab software on 168 construction project cases in Australia and New Zealand involving 1,032,949 correspondences and 53,042 RFI event records made available by Aconex, one of the world largest cloud-based project management platform. Findings Large and complex projects tend to have significantly larger number of RFI events per day and longer RFI turnaround when compared with smaller and less complex projects. Projects with fewer users per organisation recorded a higher RFI turnaround time when compared with projects with more users per organisation – users mean persons involved in managing the project using the online platform (an index of project complexity). RFIs occur early on less complex projects and occur later on more complex projects. Research limitations/implications Benchmarks of RFI incidences and turnaround time have been developed for various project characteristics and, practitioners can use them to monitor the RFI performance of projects. Organisations need to pay greater attention to staffing levels needed to handle RFIs to reduce RFI turnaround time. Originality/value A data-analytic study of RFI yielded insights for managing RFIs. The findings of previous studies on RFIs are difficult to generalise because they are based on single project case study. The influence of project characteristics on RFI frequency and RFI turnaround time is not yet known.
41
Paoloni, R., A. Georgiou, M. Prgomet, J. Westbrook, and J. Callen. "The Rate of Missed Test Results in an Emergency Department." Methods of Information in Medicine 49, no. 01 (2010): 37–43. http://dx.doi.org/10.3414/me09-01-0011.
Full textAbstract:
Summary Objectives: 1) To measure the incidence and impact of missed radiology and microbiology test results in an emergency department with an electronic test order and results viewing system, and 2) to assess the average times from test order to test availability. Methods: The study was conducted in the emergency department (ED) of a 370-bed metropolitan teaching hospital in Sydney, Australia. A computerised provider order entry (CPOE) system was used to order all diagnostic tests and view all test results. For microbiology and radiology tests electronic results were then printed for ED patients not admitted to the hospital to allow ED physicians to document follow-up. All radiology (n = 197) and microbiology (n = 66) tests ordered and results received for discharged ED patients were collected for a seven-day period. We measured the: 1) proportion of radiology and microbiology test results without follow-up for discharged patients; 2) impact of non follow-up on patient outcomes; 3) average time from radiological examination and microbiology specimen collection to reporting of results; and 4) average time from reporting of results to follow-up. Results: Two radiology (1.0%) and two microbiology reports (3.0%), all of which had negative findings, were never followed-up. Review of these patients’ medical records indicated there was no impact on patient outcomes or management. The average time from radiological examination to reporting of a result was 1.5 days, and from microbiology specimen collection to reporting was 2.5 days. Eighty-nine percent of radiology and 68% of microbiology results were followed-up on the same day that they were available to physicians. Conclusions: Our rates of missed test results are lower than those reported from studies where paper ordering and reporting systems were used. This suggests that the availability of CPOE systems may reduce the risk of these events. Electronic result delivery, with electronic endorsement to allow documentation of follow-up of test results, may provide additional efficiency benefits and further reduce the risk of test results which are not followed up.
42
Anderson, Jenna, Spencer Frost, Kian Keyashian, and Nir Modiano. "PENTOSAN POLYSULFATE-ASSOCIATED DYSPLASIA IN INFLAMMATORY BOWEL DISEASE: A CASE SERIES." Inflammatory Bowel Diseases 29, Supplement_1 (January 26, 2023): S29. http://dx.doi.org/10.1093/ibd/izac247.053.
Full textAbstract:
Abstract BACKGROUND Pentosan polysulfate is used for symptomatic management of interstitial cystitis. At one institution we incidentally noted six patients who were on this agent and had a diagnosis of inflammatory bowel disease (IBD). Three of these patients stopped the drug and all three had clinical and/or endoscopic improvement. Three of the six patients developed multifocal dysplasia. This observation led us to evaluate the hypothesis that pentosan polysulfate is associated with dysplasia in patients with IBD. METHODS We searched the electronic medical records at two tertiary care centers to identify patients using pentosan polysulfate who had a diagnosis of Crohn’s disease or ulcerative colitis. RESULTS Thirty patients who met the search criteria were identified. Of these, 10 (33.3%) had colonic dysplasia: 8 (80%) with low-grade dysplasia and 2 (20%) with both low- and high-grade dysplasia. Of the patients with dysplasia, 6 (60%) required colectomy for endoscopically unresectable dysplasia. Following physician consultation, three patients (10%) discontinued the drug and subsequently demonstrated clinical benefit and/or achieved endoscopic healing. CONCLUSIONS Inflammatory bowel disease patients at two institutions who had taken pentosan polysulfate had high rates of colonic dysplasia leading to surgery. Patients in this cohort who stopped this agent showed improvement in their colitis. These findings raise questions about whether pentosan polysulfate may play a causal role in both the development of colitis and the observed high rate of dysplasia. If larger studies validate these findings, this would indicate a readily identifiable subset of patients who are at high risk of developing colitis-associated malignancy.
43
Cheng, Feon, Jessica Redmond, and Deepa Handu. "Weight Management Interventions for Adults with Overweight or Obesity: An Evidence Scoping Review." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 166. http://dx.doi.org/10.1093/cdn/nzaa043_017.
Full textAbstract:
Abstract Objectives To conduct an evidence scoping review to determine the need and scope for a systematic review (SR) and evidence-based practice guideline (EBPG). The main objectives were to identify and characterize studies examining weight management interventions provided by a registered dietitian nutritionist or international equivalent (RDN) among adults with overweight or obesity. Methods An electronic literature search of six databases – MEDLINE (Ovid), Embase (Ovid), PyscINFO (Ovid), Cochrane CENTRAL (Ovid), Cochrane Database of Systematic Reviews (Ovid), and CINAHL (Ebsco) – was conducted. All types of peer-reviewed articles, except for narrative review, grey literature, and case study/report, published between January 2008 and April 26, 2019 were eligible. Two content advisors guided the process and reviewed the search plan and findings. Results The literature search resulted in 30,551 records: 29,756 were excluded during the first round of screening due to duplication or irrelevancy. Of the 811 full-text articles (including 16 articles identified through other sources) that were assessed, 139 met the criteria and were included. Studies were primarily based in the United States or Canada (43%) and 51% of them were conducted in the community setting. About 90% of the studies were clinical trials with varying intervention delivery modes, from face to face in an individual (42%) or group (37%) settings to telemedicine (21%). RDN(s) delivered the weight management intervention (especially the nutrition component) in all studies but some (61%) also involved an interdisciplinary team to deliver other components of the intervention. The average length of the intervention was about 9 months with a follow up that ranged from 0 to 9 years. The commonly reported outcomes were anthropometrics, endocrine and heart-related measures, nutrition intake, and physical activity. Conclusions Based on the scoping review, there were SRs and EBPGs on weight management interventions but none of them met our inclusion or exclusion criteria. Thus, it would be beneficial to conduct a SR/EBPG on adult weight management interventions provided by an RDN to guide practitioners and to evaluate their effects on nutrition-related outcomes. Funding Sources Weight Management Dietetic Practice Group, Academy of Nutrition and Dietetics Foundation, Academy of Nutrition and Dietetics
44
Gopal, Vinu V. "Registry-based pilot epidemiological study of traumatic brain injury in a tertiary trauma care center in Kerala, India – Difficulties encountered during data collection warranting the need for standardized electronic database." Surgical Neurology International 12 (August 16, 2021): 414. http://dx.doi.org/10.25259/sni_428_2021.
Full textAbstract:
Background: Head injury is referred to as a “silent epidemic” globally. Studies regarding epidemiology of head injury are very few especially in Kerala and most have conflicting reports. Unlike developed countries, there is no well-established system for collecting and managing information on traumatic brain injury (TBI) in India, especially in Kerala. The present study shares the difficulties encountered and the insights acquired by conducting a registry-based epidemiological pilot study for collecting a baseline data of traumatic head injury patients in a tertiary care center in Kerala. Methods: The pilot study was conducted to know the efficiency of present reporting system of a tertiary hospital in Kerala. We tried to collect retrospective data from December 2018 to December 2019 in the department of neurosurgery. As there was no standardized protocol or electronic database for data collection in hospital, we made a sample proforma for data collection. The patient details were obtained from medical records (case sheets), resident doctor’s, and staff nurse’s notes which included demography, clinical details, and radiological findings which were analyzed. Results: We were not able to fill the full details regarding demography, prehospital data, and clinicoetiological details which are important as far as head injury management is considered. The hospital records were grossly inadequate for full retrieval of information. Inadequate case definition and lack of centralized electronic reporting mechanisms were some of the major difficulties we faced obviating the need for collecting, managing, and utilizing epidemiological data using an electronic database. Conclusion: We believe that the present pilot study will give an insight regarding the difficulties encountered in collecting data regarding TBI. This study will be the first of its kind in Kerala highlighting the importance of maintaining a proper head injury electronic registry. The data from this study would definitely guide future experimental operational research on these unexplored areas which will be relevant in head injury policy-making in Kerala as well as in India.
45
Chen, Hui, Miguel Baptista Nunes, Lihong Zhou, and Guo Chao Peng. "Expanding the concept of requirements traceability." Aslib Proceedings 63, no. 2/3 (March 22, 2011): 168–87. http://dx.doi.org/10.1108/00012531111135646.
Full textAbstract:
PurposeDespite its tremendous success and achievements, the information science (IS) industry has been plagued by shadows of failure and inefficiency since its early days. This paper takes the stance that poor communication with target organizations and users is one of the major causes of these problems. If this communication is not properly recorded and managed, many of the agreed decisions may never be assumed by target organizations, therefore leaving project managers entirely responsible for failures or deviation from initial requirements. Nonetheless, the vast majority of Software (SW) development companies have very weak provision for Electronic Records Management (ERM). This is evident from the persistent use of ISO 9001 and ISO 90003 in their Quality Assurance (QA) and the consistent neglecting of the ISO 15489 standard for records management. This paper aims to examine this issueDesign/methodology/approachSince there are no studies in this area, this research employed an inductive qualitative research approach that consisted of a combination of critical literature review, an exploratory case study and thematic analysis.FindingsThis paper reports on the study of an SW company that implemented ERM policies and an in‐house system that not only supports the recording of documentation and evidence for every phase of the development, but also the very difficult processes of organizational learning.Practical implicationsThis paper is of interest to both IS academics and practitioners, namely those interested in QA and ERM.Originality/valueThere is very little research in this area that can inform both academics and practitioners on how to use ERM within SW project management practices. This paper aims at providing early insights into ways of addressing this gap and at generating discussion in this area.
46
Fernández-Abascal, B., M. Recio-Barbero, M. Saenz-Herrero, and R. Segarra. "Aripirazole-Long Acting Injectable in Pregnant Women with Schizophrenia: A Case Series." European Psychiatry 65, S1 (June 2022): S129—S130. http://dx.doi.org/10.1192/j.eurpsy.2022.355.
Full textAbstract:
Introduction Long-acting injectable antipsychotics (LAIs) have emerged as a new therapeutic option to treat patients suffering a psychotic disorder. To date, there is a lack of studies regarding safety and clinical use pattern of LAIs in pregnant women. Objectives Provide evidence and real world clinical data of pregnant women with schizophrenia who have been treated with long-acting aripiprazole monohydrate (aripiprazole once monthly [AOM] condition) during their pregnancy. Methods Descriptive real-world clinical experiences of pregnant women in treatment with AOM. The information was obtained by reviewing electronic medical records and by direct clinical observation management. Results The first six case-series describing the pregnancy course of women with schizophrenia treated with AOM. All of them remained psychopathologically stable through pregnancy, and their infants became healthy with normal developmental milestones (Table 1). Table 1. Clinical characteristics of six case-reports. Mothers 1 2 3 4 5 6 Maternal/Pregnancy outcomes Age(years) 35 29 35 31 38 30 Diagnosis Schizophrenia Schizophrenia Schizophrenia Schizophrenia Schizophrenia Schizophrenia AOM(mg/days) 400-300 400-300 400-300 160 300 400 Type of delivery Eutocic. Eutocic, preterm Eutocic Eutocic Eutocic Eutocic Neonatal outcomes Weight(grams) 3300 1800 3140 3102 2940 3400 Gender Female Female Male Male Male Male Developmental Abnormalities (years) No(3) No(2) No( 0.17) No(2) No(2) No(1.5) Conclusions The favorable results in this case-series suggest that despite the lack of evidence on reproductive safety and treatment with AOM during pregnancy, this therapeutic option should be considered in pregnant women with schizophrenia. However, further research on the use of long-acting antipsychotics in pregnant women is needed. Disclosure No significant relationships.
47
Pan, Xincheng, Rahmat Khezri, Amin Mahmoudi, Amirmehdi Yazdani, and GM Shafiullah. "Energy Management Systems for Grid-Connected Houses with Solar PV and Battery by Considering Flat and Time-of-Use Electricity Rates." Energies 14, no. 16 (August 16, 2021): 5028. http://dx.doi.org/10.3390/en14165028.
Full textAbstract:
This paper develops new practical rule-based energy management systems (EMSs) for typical grid-connected houses with solar photovoltaic (PV) and battery by considering different rates for purchasing and selling electricity. The EMSs are developed to supply the household’s loads and reduce operating costs of the system based on different options of flat and time-of-use (ToU) rates for buying and selling electricity prices. Four different options are evaluated and compared in this study: (1) Flat-Flat, (2) ToU-Flat, (3) Flat-ToU, and (4) ToU-ToU. The operation cost is calculated based on the electricity exchange with the main grid, the equivalent cost of PV generation, as well as the degradation cost of battery storage. The operation of the grid-connected house with rooftop solar PV and battery is evaluated for a sunny week in summer and a cloudy week in winter to investigate the proper performance for high and low generations of PV. While the developed rule-based EMS are generic and can be applied for any case studies, a grid-connected house in Australia is examined. For this purpose, real data of solar radiation, air temperature, electricity consumption, and electricity rates are used. It is found that the ToU-Flat option has the lowest operating cost for the customers.
48
Lopata, Audrius, Saulius Gudas, Rimantas Butleris, Vytautas Rudžionis, Liutauras Žioba, Ilona Veitaitė, Darius Dilijonas, Evaldas Grišius, and Maarten Zwitserloot. "Financial Data Anomaly Discovery Using Behavioral Change Indicators." Electronics 11, no. 10 (May 17, 2022): 1598. http://dx.doi.org/10.3390/electronics11101598.
Full textAbstract:
In this article we present an approach to financial data analysis and anomaly discovery. In our view, the assessment of performance management requires the monitoring of financial performance indicators (KPIs) and the characteristics of changes in KPIs over time. Based on this assumption, behavioral change indicators (BCIs) are introduced to detect and evaluate the changes in traditional KPIs in time series. Three types of BCIs are defined: absolute change indicators (BCI-A), relative change indicators (ratio indicators BCI-RE), and delta change indicators (D-BCI). The technique and advantages of using BCIs to identify unexpected deviations and assess the nature of KPI value changes in time series are discussed and illustrated in case studies. The architecture of the financial data analysis system for financial data anomaly detection is presented. The system prototype uses the Camunda business rules engine to specify KPIs and BCI thresholds. The prototype was successfully put into practice for an analysis of actual financial records (historical data).
49
Faltus, John, Kerry Mullenix, Claude T. Moorman, Kyle Beatty, and Mark E. Easley. "Case Series of First Metatarsophalangeal Joint Injuries in Division 1 College Athletes." Sports Health: A Multidisciplinary Approach 6, no. 6 (March 20, 2014): 519–26. http://dx.doi.org/10.1177/1941738114527546.
Full textAbstract:
Context: Injuries of the first metatarsophalangeal (hallux MP) joint can be debilitating in the athletic population. Turf toe and plantar plate injuries are typically diagnosed similarly. However, variance in injury mechanism as well as compromised integrity of soft tissue and ligamentous structures make it difficult to accurately diagnose specific hallux MP injuries. Recent literature has supported the use of both radiographic imaging and the Lachman test as reliable indicators of joint instability in the presence of hallux MP injuries. To date, research supporting specific rehabilitation interventions and return-to-play decision making for hallux MP injuries has been limited to case studies and suggested guidelines from literature reviews. There is limited evidence suggesting specific criteria for surgical and nonsurgical decision making in conjunction with rehabilitation progressions to return an athlete to sport when managing hallux MP injuries. Evidence Acquisition: A literature search was performed using Medline, PubMed, and Google Scholar to find and review articles from 1970 to 2013 that addressed the basic anatomy of the plantar plate, injuries to this anatomical structure, and the evaluation, diagnosis, surgical and nonsurgical management, and rehabilitation of these injuries, specifically in the athletic population. Medical information for each case was gathered from electronic medical records from the individual athletes cited in this case series, which included imaging reports, rehabilitation documentation, and both evaluation and surgical reports. No statistical analysis was used. Study Design: Case series. Level of Evidence: Level 4. Results: Treatment plans for each case varied depending on surgical and nonsurgical intervention and rehabilitation outcomes. However, each athlete was able to return to sports-specific activities. Conclusion: Successful outcomes for hallux MP injuries are contingent on thorough evaluation, appropriate clinical decision making with regard to surgical versus nonsurgical treatment planning, and a multidisciplinary team approach for ensuring a safe return to sport. Strength-of-Recommendation Taxonomy (SORT): C.
50
Bhoi, Suman, Mong Li Lee, Wynne Hsu, Hao Sen Andrew Fang, and Ngiap Chuan Tan. "Personalizing Medication Recommendation with a Graph-Based Approach." ACM Transactions on Information Systems 40, no. 3 (July 31, 2022): 1–23. http://dx.doi.org/10.1145/3488668.
Full textAbstract:
The broad adoption of electronic health records (EHRs) has led to vast amounts of data being accumulated on a patient’s history, diagnosis, prescriptions, and lab tests. Advances in recommender technologies have the potential to utilize this information to help doctors personalize the prescribed medications. However, existing medication recommendation systems have yet to make use of all these information sources in a seamless manner, and they do not provide a justification on why a particular medication is recommended. In this work, we design a two-stage personalized medication recommender system called PREMIER that incorporates information from the EHR. We utilize the various weights in the system to compute the contributions from the information sources for the recommended medications. Our system models the drug interaction from an external drug database and the drug co-occurrence from the EHR as graphs. Experiment results on MIMIC-III and a proprietary outpatient dataset show that PREMIER outperforms state-of-the-art medication recommendation systems while achieving the best tradeoff between accuracy and drug-drug interaction. Case studies demonstrate that the justifications provided by PREMIER are appropriate and aligned to clinical practices.