Electronic Health Documentation using Integrated Nursing Education System: Nursing Students’ Experience, Perceptions, Attitudes and Intention to Use

Electronic health record (EHR) systems have been implemented in healthcare organizations in different countries including selected Malaysian hospitals in the last decade. Health professionals including nurses navigate EHR system in relation to patient history, nursing assessment and interventions, progress notes, vital signs, intakes-outputs, incident reports, physicians’ orders and so forth. Preparation of nursing students as the future professional nurses who would accept and utilize the EHR system proficiently for a safe delivery of healthcare practice is imperative. Through a cross-institutional memorandum of academic understanding in year 2015, the web application Integrated Nursing Education System (iNES), a simulated electronic health documentation, web-based application (at https://www.ines.sg) from the National University of Singapore (Kowitlawakul, 2014) has been made accessible to students in the Department of Nursing, Faculty of Medicine and Health Sciences (FMHS) of UNIMAS for teaching-learning purpose. This study aims to examine nursing students’ experience with the newly introduced technology and the extent of new learning that they may have gained. Students’ perceptions, attitudes, intention to use iNES and factors influencing their intention to use iNES for simulated EHR was also identified

A High Statistics Search for Ultra-High Energy Gamma-Ray Emission from Cygnus X-3 and Hercules X-1

We have carried out a high statistics (2 Billion events) search for ultra-high energy gamma-ray emission from the X-ray binary sources Cygnus X-3 and Hercules X-1. Using data taken with the CASA-MIA detector over a five year period (1990-1995), we find no evidence for steady emission from either source at energies above 115 TeV. The derived upper limits on such emission are more than two orders of magnitude lower than earlier claimed detections. We also find no evidence for neutral particle or gamma-ray emission from either source on time scales of one day and 0.5 hr. For Cygnus X-3, there is no evidence for emission correlated with the 4.8 hr X-ray periodicity or with the occurrence of large radio flares. Unless one postulates that these sources were very active earlier and are now dormant, the limits presented here put into question the earlier results, and highlight the difficulties that possible future experiments will have in detecting gamma-ray signals at ultra-high energies.Comment: 26 LaTeX pages, 16 PostScript figures, uses psfig.sty to be published in Physical Review

Read My Lips: Continuous Signer Independent Weakly Supervised Viseme Recognition

Abstract. This work presents a framework to recognise signer indepen-dent mouthings in continuous sign language, with no manual annotations needed. Mouthings represent lip-movements that correspond to pronun-ciations of words or parts of them during signing. Research on sign lan-guage recognition has focused extensively on the hands as features. But sign language is multi-modal and a full understanding particularly with respect to its lexical variety, language idioms and grammatical structures is not possible without further exploring the remaining information chan-nels. To our knowledge no previous work has explored dedicated viseme recognition in the context of sign language recognition. The approach is trained on over 180.000 unlabelled frames and reaches 47.1 % precision on the frame level. Generalisation across individuals and the influence of context-dependent visemes are analysed

Associations of autozygosity with a broad range of human phenotypes

In many species, the offspring of related parents suffer reduced reproductive success, a phenomenon known as inbreeding depression. In humans, the importance of this effect has remained unclear, partly because reproduction between close relatives is both rare and frequently associated with confounding social factors. Here, using genomic inbreeding coefficients (F-ROH) for >1.4 million individuals, we show that F-ROH is significantly associated (p <0.0005) with apparently deleterious changes in 32 out of 100 traits analysed. These changes are associated with runs of homozygosity (ROH), but not with common variant homozygosity, suggesting that genetic variants associated with inbreeding depression are predominantly rare. The effect on fertility is striking: F-ROH equivalent to the offspring of first cousins is associated with a 55% decrease [95% CI 44-66%] in the odds of having children. Finally, the effects of F-ROH are confirmed within full-sibling pairs, where the variation in F-ROH is independent of all environmental confounding.Peer reviewe

Guidelines for postoperative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations - Part II.

This article is freely available via Open Access. Click on the 'Additional Link' above to access the full-text via the publisher's site.Published (Open Access

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.</p