48 research outputs found
A survey of practices for the use of electronic health records to support research recruitment
Electronic health records (EHRs) provide great promise for identifying cohorts and enhancing research recruitment. Such approaches are sorely needed, but there are few descriptions in the literature of prevailing practices to guide their use. A multidisciplinary workgroup was formed to examine current practices in the use of EHRs in recruitment and to propose future directions. The group surveyed consortium members regarding current practices. Over 98% of the Clinical and Translational Science Award Consortium responded to the survey. Brokered and self-service data warehouse access are in early or full operation at 94% and 92% of institutions, respectively, whereas, EHR alerts to providers and to research teams are at 45% and 48%, respectively, and use of patient portals for research is at 20%. However, these percentages increase significantly to 88% and above if planning and exploratory work were considered cumulatively. For most approaches, implementation reflected perceived demand. Regulatory and workflow processes were similarly varied, and many respondents described substantive restrictions arising from logistical constraints and limitations on collaboration and data sharing. Survey results reflect wide variation in implementation and approach, and point to strong need for comparative research and development of best practices to protect patients and facilitate interinstitutional collaboration and multisite research
Information resource preferences by general pediatricians in office settings: a qualitative study
BACKGROUND: Information needs and resource preferences of office-based general pediatricians have not been well characterized. METHODS: Data collected from a sample of twenty office-based urban/suburban general pediatricians consisted of: (a) a demographic survey about participants' practice and computer use, (b) semi-structured interviews on their use of different types of information resources and (c) semi-structured interviews on perceptions of information needs and resource preferences in response to clinical vignettes representing cases in Genetics and Infectious Diseases. Content analysis of interviews provided participants' perceived use of resources and their perceived questions and preferred resources in response to vignettes. RESULTS: Participants' average time in practice was 15.4 years (2–28 years). All had in-office online access. Participants identified specialist/generalist colleagues, general/specialty pediatric texts, drug formularies, federal government/professional organization Websites and medical portals (when available) as preferred information sources. They did not identify decision-making texts, evidence-based reviews, journal abstracts, medical librarians or consumer health information for routine office use. In response to clinical vignettes in Genetics and Infectious Diseases, participants identified Question Types about patient-specific (diagnosis, history and findings) and general medical (diagnostic, therapeutic and referral guidelines) information. They identified specialists and specialty textbooks, history and physical examination, colleagues and general pediatric textbooks, and federal and professional organizational Websites as information sources. Participants with access to portals identified them as information resources in lieu of texts. For Genetics vignettes, participants identified questions about prenatal history, disease etiology and treatment guidelines. For Genetics vignettes, they identified patient history, specialists, general pediatric texts, Web search engines and colleagues as information sources. For Infectious Diseases (ID) vignettes, participants identified questions about patients' clinical status at presentation and questions about disease classification, diagnosis/therapy/referral guidelines and sources of patient education. For ID vignettes, they identified history, laboratory results, colleagues, specialists and personal experience as information sources. CONCLUSION: Content analysis of office-based general pediatricians' responses to clinical vignettes provided a qualitative description of their perceptions of information needs and preferences for information resource for cases in Genetics and Infectious Diseases. This approach may provide complementary information for discovering practitioner's information needs and resource preferences in different contexts
Threats of illegal, unregulated, and unreported fishing to biodiversity and food security in the Republic of the Congo
This is the final version. Available on open access from Wiley via the DOI in this recordIllegal, unregulated, and unreported (IUU) fishing poses a major threat to effective management of marine resources, impacting biodiversity and communities dependent on these coastal resources. Spatio-temporal patterns of industrial fisheries in developing countries are often poorly understood, with global efforts describing spatial patterns of fishing vessel activity currently based on automatic identification system (AIS) data. However, AIS is often not a legal requirement on fishing vessels, likely resulting in underestimates of the scale and distribution of legal and illegal fishing activity, which could have significant ramifications for targeted enforcement efforts and the management of fisheries resources. To help address this knowledge gap, we analysed three years of vessel monitoring system (VMS) data in partnership with the national fisheries department in the Republic of the Congo to describe the behaviour of national and distant water industrial fleets operating in these waters. We reveal the spatial footprint of the industrial fisheries fleet encompasses over one quarter of the Exclusive Economic Zone (EEZ), with an average of 73% of fishing activity taking place on the continental shelf (waters shallower than 200 m). In addition, our findings highlight that VMS is not acting as a deterrent or being effectively used as a pro-active management tool, with as much as 33% (13% on average) of fishing effort occurring within prohibited areas set aside to protect biodiversity, including artisanal fisheries resources; with the distant water fleet (DWF) responsible for as much as 84% of this illegal activity. Given the growth in industrial and distant water fleets across the region, as well as low levels of management and enforcement, these findings highlight that there is an urgent need for the global community to help strengthen regional and national capacity to analyse national scale datasets if efforts to combat IUU fishing are to be effective.Darwin InitiativeWaterloo FoundationWAITT Foundatio
Cryogenic vacuum considerations for future gravitational wave detectors
In recent years, gravitational wave observatories have conquered the world science scene due to their unprecedented capability to observe astrophysical signals. Those first observations opened up multimessenger astronomy and called for a tremendous R&D effort to improve the sensitivity of future detectors. One of the many issues to be solved, not to affect the desired sensitivity, is the noise induced by the use of room temperature mirrors, especially for the low-frequency detection range. The use of cryogenic mirrors to reduce such a noise source has been individuated as a viable solution to obtain the desired sensitivity at low frequency. Cryogenically cooled mirrors, routinely operating at 10 K, present a number of extraordinary challenges, one being the cryogenic vacuum system hosting the cold mirrors. Gases composing the residual vacuum will tend to cryosorb and build a contaminant ice layer (“frost”) on the mirror surface. Depending on such ice layer thickness, various unwanted detrimental effects may occur affecting mirror performances. This paper analyzes the consequences of hosting a cryogenically cooled mirror in a vacuum system and sets new limits for an acceptable operating pressure to avoid frost formation in a given period of continuous data taking. Since ice formation can be reduced but not avoided, we analyze potential mitigation methods to cure such a phenomenon. Thermal and nonthermal methods are analyzed and compared. Electron stimulated desorption is also considered as an alternative method to desorb the ice layer on mirrors. Finally, we briefly discuss further studies needed to validate the various methods with special care on their effects on the mirror perfection and optical properties