Using Health Information Technology to Enhance a Culture of Safety

It was astonishing to learn that as many as 98,000 Americans die annually in hospitals due to preventable medical errors. This number is expected to increase as many of the medical care occur in ambulatory settings outside hospitals. To Err is Human: Building a Safer Health System by the Institute of Medicine (IOM), had raised sufficient interest to a degree that patient safety is now recognized as a national health care issue. Therefore, a focus should be aimed at reducing medical errors and system failures by collecting and analyzing data to gain sufficient information, and bring attention to what the healthcare system is lackin

Improving Healthcare Quality with Evidence-Based Medicine

Physicians in recent years felt increasing pressure to work for long hours and to see more patients even though they have few hours in their normal routine hours to dedicate to self and continuing education. Physician usually makes their clinical decisions based on their own practical experience. Although these ways may be time efficient but it might not provide the best care decision when it comes to the patient. In EBM, physicians seeking additional information pose questions that guide research for ideal literature. During a normal single day, a physician can generate as many as 8 clinical questions, finding the most suitable answer which could then alter the physician way of management. Physicians need to practice EBM correctly but lack of time is a major issue as reported in the literature that an average practicing clinician spend less than one hour weekly reading evidence based information. Therefore busy physicians need to learn new technologies that would make practicing EBM more feasible

Cloud Computing and Healthcare Services

There is a significant volume of healthcare data generated daily. The data are important and vital for decision making and delivering the best care for patients. Cloud computing is a cost effective method that facilitates real-time data collection, data storage and exchange between healthcare organizations. Cloud infrastructure is characterized with a high throughput and a high volume storage; two important factors for efficient data analysis of large patients’ population. Security and privacy are of the major concerns for using cloud-based healthcare services. Healthcare organization should have electronic medical records in order to use the cloud infrastructure. In order to cope with the rapid advancements in information technology and the utilization of cloud based services, efforts should be dedicated to move healthcare data form the traditional paper based to the electronic format. Then, regional legislation and policies should be enacted to regulate and control the usage of healthcare data

Astronomical forcing of sedimentary cycles in the middle to late Miocene continental Calatayud Basin (NE Spain)

A high-resolution cyclostratigraphic and magnetostratigraphic study was carried out on cyclically bedded successions of middle Miocene lacustrine to distal alluvial fan-floodplain deposits from the Calatayud basin, in northeast Spain. Eight (partially overlapping) subsections near the village of Orera are correlated in detail using distinct sedimentary cycle patterns or by following marker beds in the field. Together they form the Orera Composite Section (OCS). Sedimentary cycles are recognised on at least two different scales. The basic small-scale cycles in the OCS consist of an alternation of grey and, occasionally, red clays with white, dolomite-rich, carbonate beds. They are arranged in largerscaled, so-called large-scale cycles based on repetitive changes in the overall carbonate-clay lithology. Two other, but less distinct, types of intermediate scale cyclicity are also recognised. In terms of depositional environment, the cycle hierarchy is interpreted to represent periodic lake expansion over the palaeo-alluvial fan-floodplain area. The palaeomagnetic results yield a reliable magnetostratigraphic record, which confirms the cyclostratigraphic correlations between the subsections in detail. Rock magnetic experiments reveal that haematite is the main magnetic carrier of the primary component. The magnetostratigraphy of the OCS is correlated straightforwardly with the geomagnetic polarity time scale. This resulted in an age of 10.7-12.8 Ma for the entire succession, which is supported by fossil micromammal findings. In addition, it also reveals the presence of two, possibly three, short new polarity intervals. Based on the number of cycles in the OCS the average periodicity of the basic small-scale cycles is approximately 23 000 yr, while the large-scale cycle indicates a periodicity of 400 000 yr. This suggests that these sedimentary cycles are controlled by astronomically induced climate changes causing lake-level fluctuations and thus resulting in the deposition of carbonate-clay cycles. The continental sequences of the OCS provide a unique opportunity to extend the astronomical polarity time scale into the middle Miocene. The overlap of such continental sequences in the Mediterranean area with time-equivalent astronomically induced marine sequences is fundamental for establishing marine^continental, bed-tobed, correlations and for understanding regional climate change

Analisis Miskonsepsi Siswa SMP Kelas VII Dalam Topik Operasi Hitung Bentuk Aljabar

Tesis ini bertujuan untuk mengetahui dan menganalisis miskonsepsi pada kemampuan berpikir aljabar siswa dan menggolongkan bentuk miskonsepsi yang dilakukan oleh siswa serta menemukan apa penyebab terjadinya miskonsepsi yang dilakukan oleh siswa kelas VII. Metode penelitian adalah deskriptif kualitatif sehingga data yang ada dianalisis dengan teknik analisis data kualitatif, yaitu proses mencari serta menyusun secara sistematis data yang diperoleh dari hasil tes diagnostik miskonsepsi, wawancara, dan observasi. Analisis data penelitian kualitatif dilakukan dengan mengorganisasikan data, menjabarkannya ke dalam unit-unit, melakukan penggolongan, menyusun ke dalam pola, memilih mana yang penting dan mana yang akan dikaji sehingga dapat dibuat suatu kesimpulan untuk disampaikan kepada orang lain. Subjek dalam penelitian ini adalah 106 orang siswa kelas VII. Soal yang diberikan soal uraian sebanyak 13 soal yang sebelumnya sudah divalidasi oleh validator. Soal juga diberikan sesuai dengan indikator soal yang berasal dari silabus. Berdasarkan analisis data ternyata banyak siswa yang salah konsep dalam memahami operasi aritmatika, dan tidak mampu menggeneralisasi dalam menentukan metode yang digunakan akibat kemampuan daya ingat siswa yang rendah, minat belajar siswa yang kurang, dan perkembangan kognitif siswa yang tidak sesuai dengan bahan ajar yang diminati, sehingga penanaman konsep belajar aljabar masih jadi hal yang rumit dan susah.. Miskonsepsi merupakan hal yang terpenting untuk diperhatikan dan perlu dicarikan solusi karena jika tidak ditanggulangi akan menyebabkan siswa mengalami miskonsepsi berkelanjutan dan berdampak buruk pada prestasi siswa

Typhoid and Paratyphoid Fever in Children

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67979/2/10.1177_000992286900800412.pd

Final state effects on superfluid 4^{\bf 4}He in the deep inelastic regime

A study of Final State Effects (FSE) on the dynamic structure function of superfluid $^4$He in the Gersch--Rodriguez formalism is presented. The main ingredients needed in the calculation are the momentum distribution and the semidiagonal two--body density matrix. The influence of these ground state quantities on the FSE is analyzed. A variational form of $\rho_2$ is used, even though simpler forms turn out to give accurate results if properly chosen. Comparison to the experimental response at high momentum transfer is performed. The predicted response is quite sensitive to slight variations on the value of the condensate fraction, the best agreement with experiment being obtained with $n_0=0.082$. Sum rules of the FSE broadening function are also derived and commented. Finally, it is shown that Gersch--Rodriguez theory produces results as accurate as those coming from other more recent FSE theories.Comment: 20 pages, RevTex 3.0, 11 figures available upon request, to be appear in Phys. Rev.

Beyond the binary collision approximation for the large-qq response of liquid 4^4He

We discuss corrections to the linear response of a many-body system beyond the binary collision approximation. We first derive for smooth pair interactions an exact expression of the response $\propto 1/q^2$, considerably simplifying existing forms and present also the generalization for interactions with a strong, short-range repulsion. We then apply the latter to the case of liquid $^4$He. We display the numerical influence of the $1/q^2$ correction around the quasi-elastic peak and in the low-intensity wings of the response, far from that peak. Finally we resolve an apparent contradiction in previous discussions around the fourth order cumulant expansion coefficient. Our results prove that the large-$q$ response of liquid $^4$He can be accurately understood on the basis of a dynamical theory.Comment: 19 p. Figs. available on reques

Comparison between the panoptic ophthalmoscope and the conventional direct ophthalmoscope in the detection of sight threatening diabetic retinopathy: the Kuching diabetic eye study

AK Tan, PS Mallika, S Aziz, T Asokumaran, G Intan HA Farida