Electronic Consultations Between Primary and Specialty Care Clinicians: Early Insights

Outlines how e-consultation enables clinicians and specialists to communicate more easily and reduce the need for in-person referrals; experiences for patients, clinicians, and health systems; benefits such as continuity of care; and barriers to adoption

Index to Library Trends Volume 38

published or submitted for publicatio

The Early Stages of the Integration of the Internet in EU Newsrooms

The current study explores the perceived integration of the internet inside European newsrooms. The authors carried out a survey with 239 journalists working for 40 of the most-read outlets in 11 European countries.The study shows that journalists consider the internet a useful tool mainly for practical functions, rather than to enhance the core values and functions of their profession. However, news production continues to be based on direct interaction, and journalists’ professional identity is still anchored to print newspapers. Moreover, a lack of communication between publishers and newsrooms emerges. Professional and personal profiles and nationality play a relevant role in the development of attitudes towards the implementation of the internet in newsrooms

Scholarly Communication and the Use of Networked Information Sources

This paper examines the use of networked information sources in scholarly communication. Such use is reflected, among others, in the footnotes and bibliographies of scholarly articles published in print journals. Twenty-seven print journals representing a wide range of subjects were identified through the ISI's SCI and SSCI Journal Citation Reports. Journals that were selected were those that published the most influential papers in their respective fields during the period of 1990-1993, and thus consistently ranked at the top in terms of their impact factors. From these top journals, a total of 97 articles were selected for further review. Footnotes and bibliographies of those 97 articles were checked to determine if they contained references to networked information sources such as electronic journals and archives accessible through the network. Only two (out of 97) articles contained such references. Findings were discussed in light of other studies published in the relevant literature. Some explanations were also offered as to why references to networked information sources appear relatively infrequently in scholarly articles published in print journals

Simplified Second-Order Generalized Integrator - Frequency-Locked Loop

Second-Order Generalized Integrator –Frequency-Locked Loop (SOGI-FLL) is a popular technique available in the grid synchronization literature. This technique uses gain normalization in the frequency locked-loop. This increases the computational complex-ity. In this paper, we propose an alternative imple-mentation to reduce the computational complexity of the SOGI-FLL. The proposed implementation modifies mainly the frequency locked-loop part and requires normalized voltage measurement. dSPACE 1104 board-based hardware implementation shows that the proposed implementation executes 20 % faster than the standard implementation. This could be very beneficial for high switching frequency application e.g. ≥ 1 MHz. In ad-dition to the nominal frequency case, multiresonant implementation is also proposed to tackle grid harmonics using a simpler harmonic decoupling network. Small signal dynamical modeling and tuning are performed for both implementations. Dynamical equivalence is also established between the two implementations. Experimental comparative analysis demonstrates similar or better performance (depending on test scenarios) with respect to the standard implementation of the SOGI-FL

Evidence-based decision support for pediatric rheumatology reduces diagnostic errors.

BACKGROUND: The number of trained specialists world-wide is insufficient to serve all children with pediatric rheumatologic disorders, even in the countries with robust medical resources. We evaluated the potential of diagnostic decision support software (DDSS) to alleviate this shortage by assessing the ability of such software to improve the diagnostic accuracy of non-specialists. METHODS: Using vignettes of actual clinical cases, clinician testers generated a differential diagnosis before and after using diagnostic decision support software. The evaluation used the SimulConsult® DDSS tool, based on Bayesian pattern matching with temporal onset of each finding in each disease. The tool covered 5405 diseases (averaging 22 findings per disease). Rheumatology content in the database was developed using both primary references and textbooks. The frequency, timing, age of onset and age of disappearance of findings, as well as their incidence, treatability, and heritability were taken into account in order to guide diagnostic decision making. These capabilities allowed key information such as pertinent negatives and evolution over time to be used in the computations. Efficacy was measured by comparing whether the correct condition was included in the differential diagnosis generated by clinicians before using the software ( unaided ), versus after use of the DDSS ( aided ). RESULTS: The 26 clinicians demonstrated a significant reduction in diagnostic errors following introduction of the software, from 28% errors while unaided to 15% using decision support (p \u3c 0.0001). Improvement was greatest for emergency medicine physicians (p = 0.013) and clinicians in practice for less than 10 years (p = 0.012). This error reduction occurred despite the fact that testers employed an open book approach to generate their initial lists of potential diagnoses, spending an average of 8.6 min using printed and electronic sources of medical information before using the diagnostic software. CONCLUSIONS: These findings suggest that decision support can reduce diagnostic errors and improve use of relevant information by generalists. Such assistance could potentially help relieve the shortage of experts in pediatric rheumatology and similarly underserved specialties by improving generalists\u27 ability to evaluate and diagnose patients presenting with musculoskeletal complaints. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02205086