Critical Issues in EHR Implementation: Provider and Vendor Perspectives

Stakeholders, both internal and external, can have differing and sometimes conflicting perspectives and priorities even though each has a vested interest in organizational success. Using the lens of stakeholder theory, we examine the differing views of stakeholders (namely, medical providers and vendors) in the implementation of electronic health record (EHR) systems. The implementation process itself can be broken down into three phases: pre-implementation, during implementation, and post-implementation. After determining a comprehensive set of seventeen key issues relevant to each phase, we discovered that there are significant differences in the perceptions of EHR vendors and their customers in terms of which issues in each phase of an EHR implementation are most important. These findings indicate that vendors tend to underestimate the role of nursing staff and that providers tend to underestimate the role of security. Both groups, however, agree that physician support throughout the implementation is essential for success

Pasture and fodder shrub species for deep sandy soils.

Trial 90MO64 The evaluation of alternative pasture species on deep sandy soils. Location: Moora. Soil type: Deep siliceous sand, moisture at depth pH 5.9 - 6.1 in CaC12. Trial 90MO65 The evaluation of alternative pasture species on deep sandy soils. Location: West Gillingarra Soil type: Deep siliceous sand, moisture at depth pH 5.9 - 6.0 in CaC12 Trial 90MO66 The evaluation of alternative pasture species on deep sandy soils. Location: West Koojan Soil type: Deep siliceous sand pH 5.8 - 5.9 in CaC12 Trial 89BA40 Tagasaste establishment trial Location: Badgingarra Research Station. Soil type: poor quality grey sand over yellow sand at variable depth. Trial 87MO73 The evaluation of tagasaste under rotational grazing. Location: Lancelin Soil type: Very deep poor san

Perennial pastures for Western Australia

The aim of this project was to identify potential new perennial legumes and grasses to complement lucerne in phase farming and to identify the role and potential for perennial grasses in Western Australia.https://researchlibrary.agric.wa.gov.au/bulletins/1000/thumbnail.jp

Crizotinib-Resistant Mutants of EML4-ALK Identified Through an Accelerated Mutagenesis Screen

Activating gene rearrangements of anaplastic lymphoma kinase (ALK) have been identified as driver mutations in non-small-cell lung cancer, inflammatory myofibroblastic tumors, and other cancers. Crizotinib, a dual MET/ALK inhibitor, has demonstrated promising clinical activity in patients with non-small-cell lung cancer and inflammatory myofibroblastic tumors harboring ALK translocations. Inhibitors of driver kinases often elicit kinase domain mutations that confer resistance, and such mutations have been successfully predicted using in vitro mutagenesis screens. Here, this approach was used to discover an extensive set of ALK mutations that can confer resistance to crizotinib. Mutations at 16 residues were identified, structurally clustered into five regions around the kinase active site, which conferred varying degrees of resistance. The screen successfully predicted the L1196M, C1156Y, and F1174L mutations, recently identified in crizotinib-resistant patients. In separate studies, we demonstrated that crizotinib has relatively modest potency in ALK-positive non-small-cell lung cancer cell lines. A more potent ALK inhibitor, TAE684, maintained substantial activity against mutations that conferred resistance to crizotinib. Our study identifies multiple novel mutations in ALK that may confer clinical resistance to crizotinib, suggests that crizotinib's narrow selectivity window may underlie its susceptibility to such resistance and demonstrates that a more potent ALK inhibitor may be effective at overcoming resistance

Sheep Updates 2003 - Pastures

This session covers seven papers from different authors: 1. Pastures for saline land, Ed Barrett-Lennard 1Department of Agriculture, Western Australia, Hayley Norman, Robyn Dynes and David Masters CSIRO Livestock Industries, Centre for Mediterranean Agricultural Research, Floreat Park, 2. Feeding value - the essential link between pastures and animals CSIRO Livestock Industries, Centre for Environmental and Life Sciences 3. ‘Pastures from space’ - how do we do it, how well do we do it and what do producers think about it? Stephen Gherardi Department of Agriculture Western Australia Graham Donald Asoka Edirisinghe Dave Henry CSIRO Livestock Industries Chris Oldham Department of Agriculture Western Australia Richard Smith Department of Land Information Joanne Sneddon University of Western Australia Mike Hyder Department of Agriculture Western Australia Andrew Thompson Department of Primary Industries, Hamilton Victoria Kazue Tanaka Roy Latta Department of Agriculture Western Australia Chris Matthews CRC for Plant-based Management of Dryland Salinity Brad Nutt Department of Agriculture Western Australia Angelo Loi, Centre for Legumes in Mediterranean Agriculture, UWA Tim Wiley, Department of Agriculture Western Australi

Sheep Updates 2007 - part 3

This session covers seven papers from different authors: PROFITABILITY 1. Benchmarking demonstrates both the potential and realised productivity gains in the sheep and wool industry, Andrew Ritchie, Edward Riggall and James Hall, ICON Agriculture, Darkan 2. Improving sheep genetics will increase farm profitability, Gus Rose, Johan Greeff Department of Agriculture and Food Western Australia, John Young Farming Systems Analysis Service, WA 3. Meat, Merinos and making money in WA Pastoral Zone, M. Alchin, M. Young and T. Johnson, Department of Agriculture and Food Western Australia, GRAZING 4. Nitrogen - farmers\u27 friend or foe? John Lucy and Martin Staines, Department of Agriculture and Food Western Australia 5. Drought proofing grazing systems - a case study from Binnu 2006/7, Tim Wiley & Rob Grima, Department of Agriculture & Food Western Australia 6. Minimising \u27Esperance Storm\u27 livestock losses, Sandra Prosser and Matt Ryan, Department of Agriculture and Food Western Australia 7. Sub-tropical grasses in WA - what is their potential? Geoff Moore, Tony Albertsen, Department of Agriculture & Food Western Australia, Phil Barrett-Lennard, Evergreen Farming, George Woolston, John Titterington, Department of Agriculture and Food Western Australia, Sarah Knight, Irwin-Mingenew Group, Brianna Peake, Liebe Group, Buntine, W

Sheep Updates 2005 - Part 6

This session covers seven papers from different authors: PASTURES/GRAZING 1. New annual pastures - quality and quantity for fodder conservation?, Sarah Pugh and Giles Glasson, Department of Agriculture Western Australia 2. Saltland Pastures: Dispelling some Myths, Ed Barrett-Lennard1,3, Hayley Norman2,3, Matt Wilmat2,3, Meir Altman,3, Kelly Pearce2,3, Sally Phelan4, David Masters2,3, 1. Department of Agriculture, Western Australia, 2 CSIRO Livestock Industries, Floreat, WA, 3. CRC for Plant-based Management of Dryland Salinity 4. Saltland Pastures Association 3. Pastures: Putting profit back into sandplain, Nadine Eva, Department of Agriculture Western Australia. 4. Pastures from Space R - Can be used to make profitable strategic and tactical management decisions on farm, Brad Wooldridge, Farmer Wagin WA, Stephen Gherardi, Lucy Anderton, Department of Agriculture Western Australia, Gonzalo Mata, CSIRO Livestock Industries, Wembley, WA 5. Are new farming systems based on perenial pastures in south west Australia more profitable?, P. Sanford, Department of Agriculture Western Australia, J. Young, Farm Systems Analysis, Kojonup WA 6. Sown fodders, rotational grazing and Merinos make money in a drought, Tim Wiley, Department of Agriculture Western Australia, Richard Quinlan, Planfarm, Geraldton 7. Lifetime Wool - The \u27best bet\u27 optimum condition score profile for Merino ewes lambing in winter. Chris Oldham, Mike Hyder, Mandy Curnow, Samantha Giles, Department of Agriculture Western Australia, John Young, Farming Systems Analysis Service, Kojonup, Andrew Thompson, DPI Victoria, Hamilton

The genome of the versatile nitrogen fixer Azorhizobium caulinodans ORS571

<p>Abstract</p> <p>Background</p> <p>Biological nitrogen fixation is a prokaryotic process that plays an essential role in the global nitrogen cycle. <it>Azorhizobium caulinodans </it>ORS571 has the dual capacity to fix nitrogen both as free-living organism and in a symbiotic interaction with <it>Sesbania rostrata</it>. The host is a fast-growing, submergence-tolerant tropical legume on which <it>A. caulinodans </it>can efficiently induce nodule formation on the root system and on adventitious rootlets located on the stem.</p> <p>Results</p> <p>The 5.37-Mb genome consists of a single circular chromosome with an overall average GC of 67% and numerous islands with varying GC contents. Most nodulation functions as well as a putative type-IV secretion system are found in a distinct symbiosis region. The genome contains a plethora of regulatory and transporter genes and many functions possibly involved in contacting a host. It potentially encodes 4717 proteins of which 96.3% have homologs and 3.7% are unique for <it>A. caulinodans</it>. Phylogenetic analyses show that the diazotroph <it>Xanthobacter autotrophicus </it>is the closest relative among the sequenced genomes, but the synteny between both genomes is very poor.</p> <p>Conclusion</p> <p>The genome analysis reveals that <it>A. caulinodans </it>is a diazotroph that acquired the capacity to nodulate most probably through horizontal gene transfer of a complex symbiosis island. The genome contains numerous genes that reflect a strong adaptive and metabolic potential. These combined features and the availability of the annotated genome make <it>A. caulinodans </it>an attractive organism to explore symbiotic biological nitrogen fixation beyond leguminous plants.</p

The sinus tarsi approach in displaced intra-articular calcaneal fractures: a systematic review

Purpose: Although open reduction and internal fixation is currently considered the gold standard in surgical treatment of displaced intra-articular calcaneal fractures, various different approaches exist including the limited lateral approach. The aim of this systematic review was to combine the results of studies using the sinus tarsi approach, which is the most frequently applied limited lateral approach. Method: A literature search in the electronic databases of the Cochrane Library and Pubmed Medline, between January 1st 2000 to December 1st 2010, was conducted to identify studies in which the sinus tarsi approach or a modified sinus tarsi approach was utilized for the treatment of displaced intra-articular calcaneal fractures. The methodological quality of the included studies was assessed using the Coleman methodology score. Results: A total of eight case series reporting on 256 patients with 271 calcaneal fractures was identified. Overall good to excellent outcome was reached in three-quarters of all patients. An average complication rate of minor wound complications of 4.1% was reported and major wound complications in 0.7%. The need for a secondary subtalar arthrodesis occurred at an average rate of 4.3%. The average Coleman methodology score was 56.8 (range 39-72) points. Conclusion: The results, i.e. functional outcome and complication rates, of the sinus tarsi approach compare similarly or favourably to the extended lateral approach. Therefore, in the process of tailoring the best treatment modality to the right patient and the right fracture type, the sinus tarsi approach might be a valuable asset

Yoga for older adults with multimorbidity (the Gentle Years Yoga Trial): study protocol for a randomised controlled trial

Background: Multimorbidity is common in older adults and associated with high levels of illness burden and healthcare expenditure. The evidence base for how to manage older adults with multimorbidity is weak. Yoga might be a useful intervention because it has the potential to improve health-related quality of life, physical functioning, and several medical conditions. The British Wheel of Yoga’s Gentle Years Yoga© (GYY) programme was developed specifically for older adults, including those with chronic medical conditions. Data from a pilot trial suggested feasibility of using GYY in this population, but its effectiveness and cost-effectiveness remain uncertain. Methods: This is a multi-site, individually randomised, superiority trial with an embedded process evaluation and an economic analysis of cost-effectiveness. The trial will compare an experimental strategy of offering a 12-week GYY programme against a control strategy of no offer in community-dwelling adults aged 65 or over who have multimorbidity, defined as having two or more chronic conditions from a predefined list. The primary outcome is health-related quality of life measured using the EQ-5D-5L, the primary endpoint being the overall difference over 12 months. Both groups will continue to be able to access their usual care from primary, secondary, community, and social services. Participants, care providers, and yoga teachers will not be blinded to the allocated intervention. Outcome measures are primarily self-reported. The analysis will follow intention-to-treat principles. Discussion: This pragmatic randomised controlled trial will demonstrate if the GYY programme is an effective, costeffective, and viable addition to the management of older adults with multimorbidity. Trial registration: ISRCTN ISRCTN13567538. Registered on 18 March 2019 Keywords: Aged, Multimorbidity, Mind-body therapies, Health-related quality of life, Randomised controlled tria