Providing better clinical reference sources at the point of care

Physicians frequently need clinical reference material at the time they are taking care of patients, but despite the widespread availability of seemingly appropriate resources, physicians do not consistently avail themselves. Previous research has shown that the main obstacle to resource use is lack of time to search, followed by inability to find the information even with extended searching. Using a randomly selected sample of previously published questions (Clinical Questions Collection at the National Library of Medicine), current online electronic clinical reference resources were searched. Search times, success rates, and result quality were compared. Retrieval of drug information was dominated by navigation time, whereas searches for other materials were dominated by search time. It was rare that actually reading the material required significant time. Based on the results, an improved interface for accessing clinical reference data is proposed. Key features include a "Fast" interface that minimizes navigation time to easily found resources and a "Flex" interface that minimizes search time for more arcane material.Master of Science in Information Scienc

THINKING SKILLS, ACADEMIC INTRINSIC MOTIVATION, ACADEMIC SELF-CONCEPT, AND ACADEMIC INDEPENDENCE IN HOMESCHOOLED CHILDREN

The purpose of this study was to examine thinking skills, academic intrinsic motivation, academic self-concept, and academic independence in homeschooled children. Homeschooled children ages 6-12 years old (N=46) completed the Test of Problem Solving 3: Elementary (TOPS), which measured the following thinking skills: making inferences, sequencing, answering negative questions, problem solving, predicting, and determining causes. The Homeschool Motivation Scale measured academic intrinsic motivation, academic self-concept, and academic independence. Parents completed a brief questionnaire. The results showed that homeschooled children’s TOPS scores were significantly higher than those of the test standardization sample for all six subscales and for the total test. There were significant positive correlations between TOPS total test scores and both academic intrinsic motivation and academic self-concept scores. TOPS total test scores were not consistently related to parental teaching techniques. This research suggests that thinking skills may be more advanced in homeschooled children than in children attending public schools

Energetic Correlation Between Solar Flares and Coronal Mass Ejections

We find a strong correlation between the kinetic energies (KEs) of the coronal mass ejections (CMEs) and the radiated energies of the associated solar flares for the events that occurred during the period of intense solar activity between 18 October and 08 November 2003. CME start times, speeds, mass and KEs were taken from Gopalswamy et al. (2005), who used SOHO/LASCO observations. The GOES observations of the associated flares were analyzed to find the peak soft X-ray (SXR) flux, the radiated energy in SXRs (L(sub sxR)), and the radiated energy from the emitting plasma across all wavelengths (L(sub hot)). RHESSI observations were also used to find the energy in non-thermal electrons, ions, and the plasma thermal energy for some events. For two events, SORCE/TIM observations of the total solar irradiance during a flare were also available to give the total radiated flare energy (L(sub total)).W e find that the total flare energies of the larger events are of the same order of magnitude as the CME KE with a stronger correlation than has been found in the past for other time intervals

Formative evaluation of a patient-specific clinical knowledge summarization tool

To iteratively design a prototype of a computerized clinical knowledge summarization (CKS) tool aimed at helping clinicians finding answers to their clinical questions; and to conduct a formative assessment of the usability, usefulness, efficiency, and impact of the CKS prototype on physicians’ perceived decision quality compared with standard search of UpToDate and PubMed

Willingness and Ability of Older Adults in the Emergency Department to Provide Clinical Information Using a Tablet Computer

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134983/1/jgs14366.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/134983/2/jgs14366_am.pd

Automatically extracting sentences from Medline citations to support clinicians' information needs

Online health knowledge resources contain answers to most of the information needs raised by clinicians in the course of care. However, significant barriers limit the use of these resources for decision-making, especially clinicians’ lack of time. In this study we assessed the feasibility of automatically generating knowledge summaries for a particular clinical topic composed of relevant sentences extracted from Medline citations

Computer-facilitated Review of Electronic Medical Records Reliably Identifies Emergency Department Interventions in Older Adults

An estimated 14% to 25% of all scientific studies in peer-reviewed emergency medicine (EM) journals are medical records reviews. The majority of the chart reviews in these studies are performed manually, a process that is both time-consuming and error-prone. Computer-based text search engines have the potential to enhance chart reviews of electronic emergency department (ED) medical records. The authors compared the efficiency and accuracy of a computer-facilitated medical record review of ED clinical records of geriatric patients with a traditional manual review of the same data and describe the process by which this computer-facilitated review was completed. Clinical data from consecutive ED patients age 65 years or older were collected retrospectively by manual and computer-facilitated medical record review. The frequency of three significant ED interventions in older adults was determined using each method. Performance characteristics of each search method, including sensitivity and positive predictive value, were determined, and the overall sensitivities of the two search methods were compared using McNemar's test. For 665 patient visits, there were 49 (7.4%) Foley catheters placed, 36 (5.4%) sedative medications administered, and 15 (2.3%) patients who received positive pressure ventilation. The computer-facilitated review identified more of the targeted procedures (99 of 100, 99%), compared to manual review (74 of 100 procedures, 74%; p < 0.0001). A practical, non-resource-intensive, computer-facilitated free-text medical record review was completed and was more efficient and accurate than manually reviewing ED records

The linked units of 5S rDNA and U1 snDNA of razor shells (Mollusca: Bivalvia: Pharidae)

[Abstract] The linkage between 5S ribosomal DNA and other multigene families has been detected in many eukaryote lineages, but whether it provides any selective advantage remains unclear. In this work, we report the occurrence of linked units of 5S ribosomal DNA (5S rDNA) and U1 small nuclear DNA (U1 snDNA) in 10 razor shell species (Mollusca: Bivalvia: Pharidae) from four different genera. We obtained several clones containing partial or complete repeats of both multigene families in which both types of genes displayed the same orientation. We provide a comprehensive collection of razor shell 5S rDNA clones, both with linked and nonlinked organisation, and the first bivalve U1 snDNA sequences. We predicted the secondary structures and characterised the upstream and downstream conserved elements, including a region at −25 nucleotides from both 5S rDNA and U1 snDNA transcription start sites. The analysis of 5S rDNA showed that some nontranscribed spacers (NTSs) are more closely related to NTSs from other species (and genera) than to NTSs from the species they were retrieved from, suggesting birth-and-death evolution and ancestral polymorphism. Nucleotide conservation within the functional regions suggests the involvement of purifying selection, unequal crossing-overs and gene conversions. Taking into account this and other studies, we discuss the possible mechanisms by which both multigene families could have become linked in the Pharidae lineage. The reason why 5S rDNA is often found linked to other multigene families seems to be the result of stochastic processes within genomes in which its high copy number is determinan

Schedule time compression : a method for project time-cost optimization.

http://www.archive.org/details/scheduletimecomp00med