The Dynamics of Information Collaboration: A Case Study of Blended IT Value Propositions for Health Information Exchange in Disability Determination

Recent developments in health information technology (health IT) for health information exchange suggest that successful public-private collaborations should devote more attention to understanding the dynamics of collaboration. In the context of health information sharing for disability determination, this case study examines early instances of public-private interorganizational sharing of health information. The theoretical focus of the paper is on the construction of blended value propositions and their role in collaboration for health information exchange. For this purpose, we performed a case analysis of a prototype health IT application to be shared between the United States Social Security Administration and Beth Israel Deaconess Medical Center. The case analysis found that business, socio-organizational, and technical dynamics were operative during the planning and execution of the prototype. From a theoretical perspective, the case study provides insight into blended value propositions in terms of understanding and potentially predicting the success of newly established Health Information Exchanges (HIEs). The findings have implications for further development of collaboration value propositions and their evolution over the course of IT deployments for health information exchange

Managers’ Family-Supportive Supervisory Behaviors: A Multilevel Perspective

Using a combination of trait and situational variables we develop a model to explore the antecedents of managers’ family-supportive behaviors. Our model hypotheses were tested using data gathered from a sample of 312 subordinates matched to 92 managers. Hierarchical linear modeling (HLM) of the nested data yielded results that show both an individual manager’s trait (i.e., empathy) and situational variables (i.e., subordinate’s family-to-work conflict and leader–subordinate exchange quality) significantly predicted managers’ supportive behaviors. Additional HLM analyses showed that the manager’s gender (trait) and group work-to-family conflict (situation) moderated the relationship between manager’s empathy and family-supportive behaviors. Our results suggest that managers’ family-supportive behaviors are related to individual characteristics of the manager and to subordinate workgroup contexts, but not to organizational culture

Provenance and Paleogeography of the 25-17 Ma Rainbow Gardens Formation: Evidence for Tectonic Activity at Ca. 19 Ma and Internal Drainage rather than Throughgoing Paleorivers on the Southwestern Colorado Plateau

The paleogeographic evolution of the Lake Mead region of southern Nevada and northwest Arizona is crucial to understanding the geologic history of the U.S. Southwest, including the evolution of the Colorado Plateau and formation of the Grand Canyon. The ca. 25–17 Ma Rainbow Gardens Formation in the Lake Mead region, the informally named, roughly coeval Jean Conglomerate, and the ca. 24–19 Ma Buck and Doe Conglomerate southeast of Lake Mead hold the only stratigraphic evidence for the Cenozoic pre-extensional geology and paleogeography of this area. Building on prior work, we present new sedimentologic and stratigraphic data, including sandstone provenance and detrital zircon data, to create a more detailed paleogeographic picture of the Lake Mead, Grand Wash Trough, and Hualapai Plateau region from 25 to 18 Ma. These data confirm that sediment was sourced primarily from Paleozoic strata exposed in surrounding Sevier and Laramide uplifts and active volcanic fields to the north. In addition, a distinctive signal of coarse sediment derived from Proterozoic crystalline basement first appeared in the southwestern corner of the basin ca. 25 Ma at the beginning of Rainbow Gardens Formation deposition and then prograded north and east ca. 19 Ma across the southern half of the basin. Regional thermochronologic data suggest that Cretaceous deposits likely blanketed the Lake Mead region by the end of Sevier thrusting. Post-Laramide northward cliff retreat off the Kingman/Mogollon uplifts left a stepped erosion surface with progressively younger strata preserved northward, on which Rainbow Gardens Formation strata were deposited. Deposition of the Rainbow Gardens Formation in general and the 19 Ma progradational pulse in particular may reflect tectonic uplift events just prior to onset of rapid extension at 17 Ma, as supported by both thermochronology and sedimentary data. Data presented here negate the California and Arizona River hypotheses for an “old” Grand Canyon and also negate models wherein the Rainbow Gardens Formation was the depocenter for a 25–18 Ma Little Colorado paleoriver flowing west through East Kaibab paleocanyons. Instead, provenance and paleocurrent data suggest local to regional sources for deposition of the Rainbow Gardens Formation atop a stripped low-relief western Colorado Plateau surface and preclude any significant input from a regional throughgoing paleoriver entering the basin from the east or northeast

Genome-wide profiling of chromosome interactions in Plasmodium falciparum characterizes nuclear architecture and reconfigurations associated with antigenic variation.

Spatial relationships within the eukaryotic nucleus are essential for proper nuclear function. In Plasmodium falciparum, the repositioning of chromosomes has been implicated in the regulation of the expression of genes responsible for antigenic variation, and the formation of a single, peri-nuclear nucleolus results in the clustering of rDNA. Nevertheless, the precise spatial relationships between chromosomes remain poorly understood, because, until recently, techniques with sufficient resolution have been lacking. Here we have used chromosome conformation capture and second-generation sequencing to study changes in chromosome folding and spatial positioning that occur during switches in var gene expression. We have generated maps of chromosomal spatial affinities within the P. falciparum nucleus at 25 Kb resolution, revealing a structured nucleolus, an absence of chromosome territories, and confirming previously identified clustering of heterochromatin foci. We show that switches in var gene expression do not appear to involve interaction with a distant enhancer, but do result in local changes at the active locus. These maps reveal the folding properties of malaria chromosomes, validate known physical associations, and characterize the global landscape of spatial interactions. Collectively, our data provide critical information for a better understanding of gene expression regulation and antigenic variation in malaria parasites

Information Systems for Disability Determination: A Multi-Stakeholder Assessment of Electronic Medical Evidence Needs and Processes

This study focuses on Health Information Technology (Health IT) in improving the decision-making process concerning disability benefits. Using a multimethod, multilevel approach that includes case analysis and semi-structured interviews, this study examines the practices, challenges, and potential solutions or methods involved in adequate and timely collection of medical evidence through information technology (IT) to support disability determination. Researchers collected qualitative data through fifty-six semi-structured thirty-minute interviews with Disability Determination Services (DDS) personnel in three states. Based on site observations, interviews, and document analysis, they developed two provider case studies. To demonstrate the adequacy and timeliness of medical evidence collection, the study also examined and reviewed twelve disability claimant cases. Findings suggest that, at the payer and provider levels, electronic solutions provide more adequate and timely responses to medical evidence requests. Based on the case studies, implemented Health IT reduces incomplete medical evidence and decreases provider turnaround time in processing a payer’s requests. Among the claims examined, 50 percent received low scores for adequacy of medical evidence and 33 percent received high or medium scores for delay of return of medical evidence of record. This examination of disability determination demonstrated that Health IT holds promise for clinical data use in this context

Analysis of methods

Information is one of an organization's most important assets. For this reason the development and maintenance of an integrated information system environment is one of the most important functions within a large organization. The Integrated Information Systems Evolution Environment (IISEE) project has as one of its primary goals a computerized solution to the difficulties involved in the development of integrated information systems. To develop such an environment a thorough understanding of the enterprise's information needs and requirements is of paramount importance. This document is the current release of the research performed by the Integrated Development Support Environment (IDSE) Research Team in support of the IISEE project. Research indicates that an integral part of any information system environment would be multiple modeling methods to support the management of the organization's information. Automated tool support for these methods is necessary to facilitate their use in an integrated environment. An integrated environment makes it necessary to maintain an integrated database which contains the different kinds of models developed under the various methodologies. In addition, to speed the process of development of models, a procedure or technique is needed to allow automatic translation from one methodology's representation to another while maintaining the integrity of both. The purpose for the analysis of the modeling methods included in this document is to examine these methods with the goal being to include them in an integrated development support environment. To accomplish this and to develop a method for allowing intra-methodology and inter-methodology model element reuse, a thorough understanding of multiple modeling methodologies is necessary. Currently the IDSE Research Team is investigating the family of Integrated Computer Aided Manufacturing (ICAM) DEFinition (IDEF) languages IDEF(0), IDEF(1), and IDEF(1x), as well as ENALIM, Entity Relationship, Data Flow Diagrams, and Structure Charts, for inclusion in an integrated development support environment

Remembrance and Wellness Five Years After 9/11

It has been five years. For some people time has barely passed. Tuesday, September 11, 2001 feels like yesterday. To others these last five years seem an eternity. Many people have slipped back into their everyday lives. The horrific images, unimaginable sadness, security threats and unanswered questions have given way to a world that on the surface feels predictable and safe. But there are abrupt reminders that the world is not safe or predictable; everything familiar to us can change in an instant

Introducing e-consents in a clinical setting

Preeclampsia (PE) is a multiorgan hypertensive-disorder in pregnancy that causes significant maternal-fetal mortality and morbidity. The diagnostics and therapeutics for PE are limited due to its unclear etiology. Using the UI Maternal Fetal Tissue Bank, our lab has demonstrated that copeptin is robustly predictive of PE. To investigate copeptin further, we developed the Rule Out Pre-Eclampsia Study (ROPE). The ROPE study recruits women admitted to Labor and Delivery for evaluation of PE. Women are admitted for PE evaluation at all hours. Research team members are not available at all times to obtain consent which limits recruitment. Our project aimed to develop an electronic informed consent (e-IC) that is compliant with the Federal Regulation for Human Research Protection and is easy to use and readily understood by study participants. After obtaining IRB approval, simulated patients were given an iPad on which to read and evaluate the e-IC using a validated questionnaire, the Quality of Informed Consent (QuIC). Based on the QuIC, the e-IC was modified and re-tested. Participants demonstrated good comprehension of the e-IC as evidence by QuIC scores ranging from 61 to 96. Based on our results, the e-IC is an effective and efficient method for the Informed Consent process

R-loop formation during S phase is restricted by PrimPol-mediated repriming

During DNA replication conflicts with ongoing transcription are frequent and require careful management to avoid genetic instability. R-loops, three stranded nucleic acid structures comprising a DNA:RNA hybrid and displaced single stranded DNA, are important drivers of damage arising from such conflicts. How R-loops stall replication and the mechanisms that restrain their formation during S phase are incompletely understood. Here we show in vivo how R-loop formation drives a short purine-rich repeat, (GAA)10, to become a replication impediment that engages the repriming activity of the primase-polymerase PrimPol. Further, the absence of PrimPol leads to significantly increased R-loop formation around this repeat during S phase. We extend this observation by showing that PrimPol suppresses R-loop formation in genes harbouring secondary structure-forming sequences, exemplified by G quadruplex and H-DNA motifs, across the genome in both avian and human cells. Thus, R- loops promote the creation of replication blocks at susceptible structure-forming sequences, while PrimPol-dependent repriming limits the extent of unscheduled R-loop formation at these sequences, mitigating their impact on replication