Naresuan University Journal
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Problem list completeness in electronic health records: A multi-site study and assessment of success factors.
No full textOBJECTIVE: To assess problem list completeness using an objective measure across a range of sites, and to identify success factors for problem list completeness. METHODS: We conducted a retrospective analysis of electronic health record data and interviews at ten healthcare organizations within the United States, United Kingdom, and Argentina who use a variety of electronic health record systems: four self-developed and six commercial. At each site, we assessed the proportion of patients who have diabetes recorded on their problem list out of all patients with a hemoglobin A1c elevation>=7.0%, which is diagnostic of diabetes. We then conducted interviews with informatics leaders at the four highest performing sites to determine factors associated with success. Finally, we surveyed all the sites about common practices implemented at the top performing sites to determine whether there was an association between problem list management practices and problem list completeness. RESULTS: Problem list completeness across the ten sites ranged from 60.2% to 99.4%, with a mean of 78.2%. Financial incentives, problem-oriented charting, gap reporting, shared responsibility, links to billing codes, and organizational culture were identified as success factors at the four hospitals with problem list completeness at or near 90.0%. DISCUSSION: Incomplete problem lists represent a global data integrity problem that could compromise quality of care and put patients at risk. There was a wide range of problem list completeness across the healthcare facilities. Nevertheless, some facilities have achieved high levels of problem list completeness, and it is important to better understand the factors that contribute to success to improve patient safety. CONCLUSION: Problem list completeness varies substantially across healthcare facilities. In our review of EHR systems at ten healthcare facilities, we identified six success factors which may be useful for healthcare organizations seeking to improve the quality of their problem list documentation: financial incentives, problem oriented charting, gap reporting, shared responsibility, links to billing codes, and organizational culture
Investigating the Barriers Affecting the Implementation of E-Government: An Empirical Study in Jordan
No full textPriority oral health research identification for clinical decision-making.
No full textThe Cochrane Library is a core resource for clinical decision-making globally, by clinicians, guideline developers, healthcare providers and patients.The publication of Cochrane Library systematic reviews concerning oral health conditions has grown exponentially to over 215 individual titles (as of 20 June 2015) during the past 20 years.Consequently, maintaining updates of the most clinically important reviews to provide up-to-date and accurate sources of evidence for decision-making has become a pressing concern for the editorial group behind their production, Cochrane Oral Health Group.To identify priority research required by oral health decision-makers, the Cochrane OHG embarked on a consultation process across eight defined areas of dentistry (periodontology, operative (including endodontics) and prosthodontics, paediatric dentistry, dental public health, oral and maxillofacial surgery, oral medicine, orthodontics, cleft lip and/or palate) with existing authors (by email), with members of the public (by online survey), and established internationally clinically expert panels for each area of defined area of dentistry to discuss and ratify (by teleconference) a core portfolio of priority evidence to be produced and maintained on the Cochrane Library.The resulting portfolio of priority research encompasses 81 existing titles to be maintained, and an additional 15 new systematic reviews to be developed by the Cochrane OHG in due course.The Cochrane OHG has actively responded to the outcomes of this prioritisation process by allocating resources to primarily supporting the maintenance of identified priority evidence for the Cochrane Library
Failure modes in high strength and stiffness to weight scaffolds produced by Selective Laser Melting
No full textRe-inventing care planning in mental health: stakeholder accounts of the imagined implementation of a user/carer involved intervention
No full textSenses of ‘grammar’ in the eighteenth-century English tradition
No full textThe term grammar is elastic and flexible, a result of changing conventions in the grammatical tradition since the time of Greek philosophers and of the variety of senses that the term can convey. This paper will explore two sources of evidence that serve toshed light on the understanding of grammar in the eighteenth century, namely the divisions into primary constituents (orthography, orthoëpy, etymology, syntax and prosody) and the subsidiary content that accompanies the main parts of grammar (e.g.punctuation, lists of irregular verbs, figurative syntax). It will be shown that there is a great deal of uniformity and consistency in the enumeration of the primary parts of grammar, but also a rich variety of patterns and a richer overall variety in secondary material. Building on Ian Michael’s (1970) work on the English grammatical tradition, and using data from the Eighteenth-Century English Grammars database, this study will contribute to recent work in linguistic grammaticology by providing insights into whateighteenth-century writers considered essential for a good knowledge of grammar, at a time when proper and correct knowledge of English was a key instrument for social advancement, and a time when the growing literacy and readership revolutionised theprint cultur
A Self-Sensing Stator-Current-Based Control System of a DFIG Connected to a DC-Link
No full textThis paper presents a self-sensing technique for the field-oriented control and frequency regulation of a doubly fed induction generator connected to a dc-link. In this system, the stator circuits are connected to a dc-link through a diode bridge and the rotor circuits are controlled by a voltage source inverter connected to the same dc-link. As the diode bridge maintains the fundamental harmonics of the stator current and voltage approximately in phase, an almost zero average d-axis stator current results in the stator flux reference frame. This property is used to estimate the slip angle, required to implement the field orientation in the self-sensing technique in loaded conditions. At no load the system is controlled using a different methodology. The analysis and synthesis of the control chains are presented by analytic relations. The sensitivity study shows that the method exhibits reduced sensitivity to the parameter mismatch, resulting in a small orientation error. Experimental results confirm the good performance of the proposed method
An evaluation of the prognostic model PREDICT using the POSH cohort of women aged ⩽40 years at breast cancer diagnosis.
No full textBACKGROUND: Breast cancer is the most common cancer in younger women (aged ⩽40 years) in the United Kingdom. PREDICT (http://www.predict.nhs.uk) is an online prognostic tool developed to help determine the best available treatment and outcome for early breast cancer. This study was conducted to establish how well PREDICT performs in estimating survival in a large cohort of younger women recruited to the UK POSH study. METHODS: The POSH cohort includes data from 3000 women aged ⩽40 years at breast cancer diagnosis. Study end points were overall and breast cancer-specific survival at 5, 8, and 10 years. Evaluation of PREDICT included model discrimination and comparison of the number of predicted versus observed events. RESULTS: PREDICT provided accurate long-term (8- and 10-year) survival estimates for younger women. Five-year estimates were less accurate, with the tool overestimating survival by 25% overall, and by 56% for patients with oestrogen receptor (ER)-positive tumours. PREDICT underestimated survival at 5 years among patients with ER-negative tumours. CONCLUSIONS: PREDICT is a useful tool for providing reliable long-term (10-year) survival estimates for younger patients. However, for more accurate short-term estimates, the model requires further calibration using more data from young onset cases. Short-term prediction may be most relevant for the increasing number of women considering risk-reducing bilateral mastectomy