WorldWideScience

Sample records for patient record epr

  1. Introducing the electronic patient record (EPR) in a hospital setting: boundary work and shifting constructions of professional identities.

    Science.gov (United States)

    Håland, Erna

    2012-06-01

    Today's healthcare sector is being transformed by several ongoing processes, among them the introduction of new technologies, new financial models and new ways of organising work. The introduction of the electronic patient record (EPR) is representative and part of these extensive changes. Based on interviews with health personnel and office staff in a regional hospital in Norway, and with health administrators and information technology service-centre staff in the region, the article examines how the introduction of the EPR, as experienced by the participants, affects the work practices and boundaries between various professional groups in the healthcare system and discusses the implications this has for the understanding of medical practice. The article shows how the EPR has become part of the professionals' boundary work; expressing shifting constructions of professional identities. © 2011 The Author. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  2. The evaluation of the compatibility of electronic patient record (EPR) system with nurses' management needs in a developing country.

    Science.gov (United States)

    Kahouei, Mehdi; Zadeh, Jamileh Mahdi; Roghani, Panoe Seyed

    2015-04-01

    In a developing country like Iran, wasting economic resources has a number of negative consequences. Therefore, it is crucial that problems of introducing new electronic systems be identified and addressed early to avoid failure of the programs. The purpose of this study was to evaluate head nurses' and supervisors' perceptions about the efficiency of the electronic patient record (EPR) system and its impact on nursing management tasks in order to provide useful recommendations. This descriptive study was performed in teaching hospitals affiliated to Semnan University of Medical Sciences, Iran. An anonymous self-administered questionnaire was developed. Head nurses and supervisors were included in this study. It was found that the EPR system was immature and was not proportionate to the operational level. Moreover, few head nurses and supervisors agreed on the benefits of the EPR system on the performance of their duties such as planning, organizing, budgeting, and coordinating. It is concluded that in addition to the technical improvements, the social and cultural factors should be considered to improve the acceptability of electronic systems through social marketing in the different aspects of nursing management. It is essential that health information technology managers emphasize on training head nurses and supervisors to design technology corresponding to their needs rather than to accept poorly designed technology. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Hiding Electronic Patient Record (EPR) in medical images: A high capacity and computationally efficient technique for e-healthcare applications.

    Science.gov (United States)

    Loan, Nazir A; Parah, Shabir A; Sheikh, Javaid A; Akhoon, Jahangir A; Bhat, Ghulam M

    2017-09-01

    A high capacity and semi-reversible data hiding scheme based on Pixel Repetition Method (PRM) and hybrid edge detection for scalable medical images has been proposed in this paper. PRM has been used to scale up the small sized image (seed image) and hybrid edge detection ensures that no important edge information is missed. The scaled up version of seed image has been divided into 2×2 non overlapping blocks. In each block there is one seed pixel whose status decides the number of bits to be embedded in the remaining three pixels of that block. The Electronic Patient Record (EPR)/data have been embedded by using Least Significant and Intermediate Significant Bit Substitution (ISBS). The RC4 encryption has been used to add an additional security layer for embedded EPR/data. The proposed scheme has been tested for various medical and general images and compared with some state of art techniques in the field. The experimental results reveal that the proposed scheme besides being semi-reversible and computationally efficient is capable of handling high payload and as such can be used effectively for electronic healthcare applications. Copyright © 2017. Published by Elsevier Inc.

  4. Quality assessment of information about medications in primary care electronic patient record (EPR systems

    Directory of Open Access Journals (Sweden)

    Maria Pous

    2010-06-01

    Conclusions This project highlighted the poor quality of drug information provided by these EPR programmes. The ten-item tool seems suitable for assessing their quality. Based on this analysis, we have proposed a set of ten quality standards for prescribing software.

  5. Image-based electronic patient records for secured collaborative medical applications.

    Science.gov (United States)

    Zhang, Jianguo; Sun, Jianyong; Yang, Yuanyuan; Liang, Chenwen; Yao, Yihong; Cai, Weihua; Jin, Jin; Zhang, Guozhen; Sun, Kun

    2005-01-01

    We developed a Web-based system to interactively display image-based electronic patient records (EPR) for secured intranet and Internet collaborative medical applications. The system consists of four major components: EPR DICOM gateway (EPR-GW), Image-based EPR repository server (EPR-Server), Web Server and EPR DICOM viewer (EPR-Viewer). In the EPR-GW and EPR-Viewer, the security modules of Digital Signature and Authentication are integrated to perform the security processing on the EPR data with integrity and authenticity. The privacy of EPR in data communication and exchanging is provided by SSL/TLS-based secure communication. This presentation gave a new approach to create and manage image-based EPR from actual patient records, and also presented a way to use Web technology and DICOM standard to build an open architecture for collaborative medical applications.

  6. Unity in Diversity: Electronic Patient Record Use in Multidisciplinary Practice

    OpenAIRE

    Oborn, Eivor; Barrett, Michael; Davidson, Elizabeth

    2011-01-01

    In this paper we examine the use of electronic patient records (EPR) by clinical specialists in their development of multidisciplinary care for diagnosis and treatment of breast cancer. We develop a practice theory lens to investigate EPR use across multidisciplinary team practice. Our findings suggest that there are oppositional tendencies towards diversity in EPR use and unity which emerges across multidisciplinary work, and this influences the outcomes of EPR use. The value of this persp...

  7. An imaging informatics-based ePR (electronic patient record) system for providing decision support in evaluating dose optimization in stroke rehabilitation

    Science.gov (United States)

    Liu, Brent J.; Winstein, Carolee; Wang, Ximing; Konersman, Matt; Martinez, Clarisa; Schweighofer, Nicolas

    2012-02-01

    Stroke is one of the major causes of death and disability in America. After stroke, about 65% of survivors still suffer from severe paresis, while rehabilitation treatment strategy after stroke plays an essential role in recovery. Currently, there is a clinical trial (NIH award #HD065438) to determine the optimal dose of rehabilitation for persistent recovery of arm and hand paresis. For DOSE (Dose Optimization Stroke Evaluation), laboratory-based measurements, such as the Wolf Motor Function test, behavioral questionnaires (e.g. Motor Activity Log-MAL), and MR, DTI, and Transcranial Magnetic Stimulation (TMS) imaging studies are planned. Current data collection processes are tedious and reside in various standalone systems including hardcopy forms. In order to improve the efficiency of this clinical trial and facilitate decision support, a web-based imaging informatics system has been implemented together with utilizing mobile devices (eg, iPAD, tablet PC's, laptops) for collecting input data and integrating all multi-media data into a single system. The system aims to provide clinical imaging informatics management and a platform to develop tools to predict the treatment effect based on the imaging studies and the treatment dosage with mathematical models. Since there is a large amount of information to be recorded within the DOSE project, the system provides clinical data entry through mobile device applications thus allowing users to collect data at the point of patient interaction without typing into a desktop computer, which is inconvenient. Imaging analysis tools will also be developed for structural MRI, DTI, and TMS imaging studies that will be integrated within the system and correlated with the clinical and behavioral data. This system provides a research platform for future development of mathematical models to evaluate the differences between prediction and reality and thus improve and refine the models rapidly and efficiently.

  8. Instant availability of patient records, but diminished availability of patient information: A multi-method study of GP's use of electronic patient records

    Directory of Open Access Journals (Sweden)

    Grimsmo Anders

    2008-03-01

    Full Text Available Abstract Background In spite of succesful adoption of electronic patient records (EPR by Norwegian GPs, what constitutes the actual benefits and effects of the use of EPRs in the perspective of the GPs and patients has not been fully characterized. We wanted to study primary care physicians' use of electronic patient record (EPR systems in terms of use of different EPR functions and the time spent on using the records, as well as the potential effects of EPR systems on the clinician-patient relationship. Methods A combined qualitative and quantitative study that uses data collected from focus groups, observations of primary care encounters and a questionnaire survey of a random sample of general practitioners to describe their use of EPR in primary care. Results The overall availability of individual patient records had improved, but the availability of the information within each EPR was not satisfactory. GPs' use of EPRs were efficient and comprehensive, but have resulted in transfer of administrative work from secretaries to physicians. We found no indications of disturbance of the clinician-patient relationship by use of computers in this study. Conclusion Although GPs are generally satisfied with their EPRs systems, there are still unmet needs and functionality to be covered. It is urgent to find methods that can make a better representation of information in large patient records as well as prevent EPRs from contributing to increased administrative workload of physicians.

  9. Socio-technical considerations in epilepsy electronic patient record implementation.

    LENUS (Irish Health Repository)

    Mc Quaid, Louise

    2010-05-01

    Examination of electronic patient record (EPR) implementation at the socio-technical interface. This study was based on the introduction of an anti-epileptic drug (AED) management module of an EPR in an epilepsy out-patient clinic. The objective was to introduce the module to a live clinical setting within strictly controlled conditions to evaluate its usability and usefulness.

  10. Increase of weakly acidic gas esophagopharyngeal reflux (EPR) and swallowing-induced acidic/weakly acidic EPR in patients with chronic cough responding to proton pump inhibitors.

    Science.gov (United States)

    Kawamura, O; Shimoyama, Y; Hosaka, H; Kuribayashi, S; Maeda, M; Nagoshi, A; Zai, H; Kusano, M

    2011-05-01

    Gastro-esophageal reflux disease (GERD)-related chronic cough (CC) may have multifactorial causes. To clarify the characteristics of esophagopharyngeal reflux (EPR) events in CC patients whose cough was apparently influenced by gastro-esophageal reflux (GER), we studied patients with CC clearly responding to full-dose proton pump inhibitor (PPI) therapy (CC patients). Ten CC patients, 10 GERD patients, and 10 healthy controls underwent 24-h ambulatory pharyngo-esophageal impedance and pH monitoring. Weakly acidic reflux was defined as a decrease of pH by >1 unit with a nadir pH >4. In six CC patients, monitoring was repeated after 8 weeks of PPI therapy. The number of each EPR event and the symptom association probability (SAP) were calculated. Symptoms were evaluated by a validated GERD symptom questionnaire. Weakly acidic gas EPR and swallowing-induced acidic/weakly acidic EPR only occurred in CC patients, and the numbers of such events was significantly higher in the CC group than in the other two groups (P pump inhibitor therapy abolished swallowing-induced acidic/weakly acidic EPR, reduced weakly acidic gas EPR, and improved symptoms (all P gas EPR and swallowing-induced acidic/weakly acidic EPR. A direct effect of acidic mist or liquid refluxing into the pharynx may contribute to chronic cough, while cough may also arise indirectly from reflux via a vago-vagal reflex in some patients. © 2011 Blackwell Publishing Ltd.

  11. Electronic patient record: what makes care providers use it?

    NARCIS (Netherlands)

    Michel-Verkerke, M.B.

    2013-01-01

    Despite the enormous progress that is made, many healthcare professionals still experience problems regarding patient information and patient records. For a long time the expectation is that an electronic patient record (EPR) will solve these problems. In this research the factors determining the

  12. Patient records and clinical overview

    DEFF Research Database (Denmark)

    Jensen, Lotte Groth

    the possibilities to mark up pages in personal ways and add personal notes to it. On the other hand, the EPR provides quick and easy access to lot of information and once information is entered in the EPR they stay in place. Information in the EPR is often updated due to real time entry, which avoid...... that information has to travel physically between different departments or different hospitals. Another advantage in the creation of clinical overview, when using an EPR, is that the record is never lost. If you have access to a computer, you have access to the record. Besides this, the search function...... at hospitals, these results indicate that you need to think besides the presentation of information. If the physicians are supposed to create an overview, information should be presented in ways that enables them to interpret and make sense of this information. At the same time, to support the creation...

  13. Development of the regional EPR and PACS sharing system on the infrastructure of cloud computing technology controlled by patient identifier cross reference manager.

    Science.gov (United States)

    Kondoh, Hiroshi; Teramoto, Kei; Kawai, Tatsurou; Mochida, Maki; Nishimura, Motohiro

    2013-01-01

    A Newly developed Oshidori-Net2, providing medical professionals with remote access to electronic patient record systems (EPR) and PACSs of four hospitals, of different venders, using cloud computing technology and patient identifier cross reference manager. The operation was started from April 2012. The patients moved to other hospital were applied. Objective is to show the merit and demerit of the new system.

  14. Expectations for the next generation of electronic patient records in primary care: a triangulated study

    Directory of Open Access Journals (Sweden)

    Tom Christensen

    2008-05-01

    Conclusions Progress toward a problem-oriented EPR system based on episodes of care that includes decision support is necessary to satisfy the needs expressed by GPs. Further research could solve the problem of integration of functionality for consultation with specialists and integration with patient held records. Results from this study could contribute to further development of the next generation of EPRs in primary care, as well as inspire the application of EPRs in other parts of the health sector.

  15. Electronic patient record and archive of records in Cardio.net system for telecardiology.

    Science.gov (United States)

    Sierdziński, Janusz; Karpiński, Grzegorz

    2003-01-01

    In modern medicine the well structured patient data set, fast access to it and reporting capability become an important question. With the dynamic development of information technology (IT) such question is solved via building electronic patient record (EPR) archives. We then obtain fast access to patient data, diagnostic and treatment protocols etc. It results in more efficient, better and cheaper treatment. The aim of the work was to design a uniform Electronic Patient Record, implemented in cardio.net system for telecardiology allowing the co-operation among regional hospitals and reference centers. It includes questionnaires for demographic data and questionnaires supporting doctor's work (initial diagnosis, final diagnosis, history and physical, ECG at the discharge, applied treatment, additional tests, drugs, daily and periodical reports). The browser is implemented in EPR archive to facilitate data retrieval. Several tools for creating EPR and EPR archive were used such as: XML, PHP, Java Script and MySQL. The separate question is the security of data on WWW server. The security is ensured via Security Socket Layer (SSL) protocols and other tools. EPR in Cardio.net system is a module enabling the co-work of many physicians and the communication among different medical centers.

  16. Norwegians GPs' use of electronic patient record systems.

    Science.gov (United States)

    Christensen, Tom; Faxvaag, Arild; Loerum, Hallvard; Grimsmo, Anders

    2009-12-01

    To evaluate GPs use of three major electronic patient record systems with emphasis on the ability of the systems to support important clinical tasks and to compare the findings with results from a study of the three major hospital-wide systems. A national, cross-sectional questionnaire survey was conducted in Norwegian primary care. 247 (73%) of 338 GPs responded. Proportions of the respondents who reported to use the EPR system to conduct 23 central clinical tasks, differences in the proportions of users of different EPR systems and user satisfaction and perceived usefulness of the EPR system were measured. The GPs reported extensive use of their EPR systems to support clinical tasks. There were no significant differences in functionality between the systems, but there were differences in reported software and hardware dysfunction and user satisfaction. The respondents reported high scores in computer literacy and there was no correlation between computer usage and respondent age or gender. A comparison with hospital physicians' use of three hospital-wide EPR systems revealed that GPs had higher usage than the hospital-based MDs. Primary care EPR systems support clinical tasks far better than hospital systems with better overall user satisfaction and reported impact on the overall quality of the work. EPR systems in Norwegian primary care that have been developed in accordance with the principles of user-centered design have achieved widespread adoption and highly integrated use. The quality and efficiency of the clinical work has increased in contrast to the situation of their hospital colleagues, who report more modest use and benefits of EPR systems.

  17. The electronic patient record as a meaningful audit tool - Accountability and autonomy in general practitioner work

    DEFF Research Database (Denmark)

    Winthereik, Brit Ross; van der Ploeg, I.; Berg, Marc

    2007-01-01

    Health authorities increasingly request that general practitioners (GPs) use information and communication technologies such as electronic patient records (EPR) for accountability purposes. This article deals with the use of EPRs among general practitioners in Britain. It examines two ways in which...... makes them active in finding ways that turn the EPR into a meaningful tool for them, that is, a tool that helps them provide what they see as good care. The article's main contribution is to show how accountability and autonomy are coproduced; less professional autonomy does not follow from more...... GPs use the EPR for accountability purposes. One way is to generate audit reports on the basis of the information that has been entered into the record. The other is to let the computer intervene in the clinical process through prompts. The article argues that GPs' ambivalence toward using the EPR...

  18. Visual patient records

    NARCIS (Netherlands)

    Luu, M.D.

    2015-01-01

    Patient information is often complex and fragmented; visualization can help to obtain and communicate insights. To move from paper medical records to interactive and visual patient records is a big challenge. This project aims to move towards this ultimate goal by providing an interactive prototype

  19. Physically-based biodosimetry using in vivo EPR of teeth in patients undergoing total body irradiation

    Science.gov (United States)

    Williams, Benjamin B.; Dong, Ruhong; Nicolalde, Roberto J.; Matthews, Thomas P.; Gladstone, David J.; Demidenko, Eugene; Zaki, Bassem I.; Salikhov, Ildar K.; Lesniewski, Piotr N.; Swartz, Harold M.

    2014-01-01

    Purpose The ability to estimate individual exposures to radiation following a large attack or incident has been identified as a necessity for rational and effective emergency medical response. In vivo electron paramagnetic resonance (EPR) spectroscopy of tooth enamel has been developed to meet this need. Materials and methods A novel transportable EPR spectrometer, developed to facilitate tooth dosimetry in an emergency response setting, was used to measure upper incisors in a model system, in unirradiated subjects, and in patients who had received total body doses of 2 Gy. Results A linear dose response was observed in the model system. A statistically significant increase in the intensity of the radiation-induced EPR signal was observed in irradiated versus unirradiated subjects, with an estimated standard error of dose prediction of 0.9 + 0.3 Gy. Conclusions These results demonstrate the current ability of in vivo EPR tooth dosimetry to distinguish between subjects who have not been irradiated and those who have received exposures that place them at risk for acute radiation syndrome. Procedural and technical developments to further increase the precision of dose estimation and ensure reliable operation in the emergency setting are underway. With these developments EPR tooth dosimetry is likely to be a valuable resource for triage following potential radiation exposure of a large population. PMID:21696339

  20. Toward best practice: leveraging the electronic patient record as a clinical data warehouse.

    Science.gov (United States)

    Ledbetter, C S; Morgan, M W

    2001-01-01

    Automating clinical and administrative processes via an electronic patient record (EPR) gives clinicians the point-of-care tools they need to deliver better patient care. However, to improve clinical practice as a whole and then evaluate it, healthcare must go beyond basic automation and convert EPR data into aggregated, multidimensional information. Unfortunately, few EPR systems have the established, powerful analytical clinical data warehouses (CDWs) required for this conversion. This article describes how an organization can support best practice by leveraging a CDW that is fully integrated into its EPR and clinical decision support (CDS) system. The article (1) discusses the requirements for comprehensive CDS, including on-line analytical processing (OLAP) of data at both transactional and aggregate levels, (2) suggests that the transactional data acquired by an OLTP EPR system must be remodeled to support retrospective, population-based, aggregate analysis of those data, and (3) concludes that this aggregate analysis is best provided by a separate CDW system.

  1. Understanding health care providers' reluctance to adopt a national electronic patient record: an empirical and legal analysis

    NARCIS (Netherlands)

    Zwaanswijk, M.; Ploem, M. C.; Wiesman, F. J.; Verheij, R. A.; Friele, R. D.; Gevers, J. K. M.

    2013-01-01

    Several countries are implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs on the efficiency, continuity, safety and quality of care, their overall adoption remains low and meets resistance from involved parties. The implementation of the Dutch

  2. Understanding health care providers' reluctance to adopt a national electronic patient record : An empirical and legal analysis

    NARCIS (Netherlands)

    Zwaanswijk, M.; Ploem, M.C.; Wiesman, F.J.; Verheij, R.A.; Friele, R.D.; Gevers, J.K.M.

    2013-01-01

    Background: Several countries are implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs on the efficiency, continuity, safety and quality of care, their overall adoption remains low and meets resistance from involved parties. The implementation of

  3. Economic outcomes of a dental electronic patient record.

    Science.gov (United States)

    Langabeer, James R; Walji, Muhammad F; Taylor, David; Valenza, John A

    2008-10-01

    The implementation of an electronic patient record (EPR) in many sectors of health care has been suggested to have positive relationships with both quality of care and improved pedagogy, although evaluation of actual results has been somewhat disillusioning. Evidence-based dentistry clearly suggests the need for tools and systems to improve care, and an EPR is a critical tool that has been widely proposed in recent years. In dental schools, EPR systems are increasingly being adopted, despite obstacles such as high costs, time constraints necessary for process workflow change, and overall project complexity. The increasing movement towards cost-effectiveness analyses in health and medicine suggests that the EPR should generally cover expenses, or produce total benefits greater than its combined costs, to ensure that resources are being utilized efficiently. To test the underlying economics of an EPR, we utilized a pre-post research design with a probability-based economic simulation model to analyze changes in performance and costs in one dental school. Our findings suggest that the economics are positive, but only when student fees are treated as an incremental revenue source. In addition, other performance indicators appeared to have significant changes, although most were not comprehensively measured pre-implementation, making it difficult to truly understand the performance differential-such pre-measurement of expected benefits is a key lesson learned. This article also provides recommendations for dental clinics and universities that are about to embark on this endeavor.

  4. Introduction of a national electronic patient record in The Netherlands: some legal issues

    NARCIS (Netherlands)

    Ploem, Corrette; Gevers, Sjef

    2011-01-01

    The electronic patient record (EPR) is a major technological development within the healthcare sector. Many hospitals across Europe already use institution-based electronic patient records, which allow not only for electronic exchange of patient data within the hospital, but potentially also for

  5. Overcoming structural constraints to patient utilization of electronic medical records: a critical review and proposal for an evaluation framework.

    Science.gov (United States)

    Winkelman, Warren J; Leonard, Kevin J

    2004-01-01

    There are constraints embedded in medical record structure that limit use by patients in self-directed disease management. Through systematic review of the literature from a critical perspective, four characteristics that either enhance or mitigate the influence of medical record structure on patient utilization of an electronic patient record (EPR) system have been identified: environmental pressures, physician centeredness, collaborative organizational culture, and patient centeredness. An evaluation framework is proposed for use when considering adaptation of existing EPR systems for online patient access. Exemplars of patient-accessible EPR systems from the literature are evaluated utilizing the framework. From this study, it appears that traditional information system research and development methods may not wholly capture many pertinent social issues that arise when expanding access of EPR systems to patients. Critically rooted methods such as action research can directly inform development strategies so that these systems may positively influence health outcomes.

  6. Display methods of electronic patient record screens: patient privacy concerns.

    Science.gov (United States)

    Niimi, Yukari; Ota, Katsumasa

    2013-01-01

    To provide adequate care, medical professionals have to collect not only medical information but also information that may be related to private aspects of the patient's life. With patients' increasing awareness of information privacy, healthcare providers have to pay attention to the patients' right of privacy. This study aimed to clarify the requirements of the display method of electronic patient record (EPR) screens in consideration of both patients' information privacy concerns and health professionals' information needs. For this purpose, semi-structured group interviews were conducted of 78 medical professionals. They pointed out that partial concealment of information to meet patients' requests for privacy could result in challenges in (1) safety in healthcare, (2) information sharing, (3) collaboration, (4) hospital management, and (5) communication. They believed that EPRs should (1) meet the requirements of the therapeutic process, (2) have restricted access, (3) provide convenient access to necessary information, and (4) facilitate interprofessional collaboration. This study provides direction for the development of display methods that balance the sharing of vital information and protection of patient privacy.

  7. Attitudes toward inter-hospital electronic patient record exchange: discrepancies among physicians, medical record staff, and patients.

    Science.gov (United States)

    Wang, Jong-Yi; Ho, Hsiao-Yun; Chen, Jen-De; Chai, Sinkuo; Tai, Chih-Jaan; Chen, Yung-Fu

    2015-07-12

    In this era of ubiquitous information, patient record exchange among hospitals still has technological and individual barriers including resistance to information sharing. Most research on user attitudes has been limited to one type of user or aspect. Because few analyses of attitudes toward electronic patient records (EPRs) have been conducted, understanding the attitudes among different users in multiple aspects is crucial to user acceptance. This proof-of-concept study investigated the attitudes of users toward the inter-hospital EPR exchange system implemented nationwide and focused on discrepant behavioral intentions among three user groups. The system was designed by combining a Health Level 7-based protocol, object-relational mapping, and other medical informatics techniques to ensure interoperability in realizing patient-centered practices. After implementation, three user-specific questionnaires for physicians, medical record staff, and patients were administered, with a 70 % response rate. The instrument showed favorable convergent construct validity and internal consistency reliability. Two dependent variables were applied: the attitudes toward privacy and support. Independent variables comprised personal characteristics, work characteristics, human aspects, and technology aspects. Major statistical methods included exploratory factor analysis and general linear model. The results from 379 respondents indicated that the patients highly agreed with privacy protection by their consent and support for EPRs, whereas the physicians remained conservative toward both. Medical record staff was ranked in the middle among the three groups. The three user groups demonstrated discrepant intentions toward privacy protection and support. Experience of computer use, level of concerns, usefulness of functions, and specifically, reason to use electronic medical records and number of outpatient visits were significantly associated with the perceptions. Overall, four

  8. Participation, Power, Critique: Constructing a Standard for Electronic Patient Records

    DEFF Research Database (Denmark)

    Bossen, Claus

    2006-01-01

      The scope of participatory design is discussed through the case of a national standard for electronic patient records (EPR) in Denmark. Currently within participatory design, the relationship between participatory methods and techniques on the one hand and critical and emancipatory aims...... on the other hand is discussed. Some argue that participation in itself entails a strive towards democracy, others argue that the tendency to focus upon tools, techniques and the arena of single projects should be supplemented with emancipatory aims, such as technology assessment and critique of dominance....... These issues are discussed through the controversies around the test in late 2004 of a prototype application based on BEHR, a standard developed from 1999 to 2005 for EPRs. I argue that participation is valuable, but that the scope of participatory design should also include critical conceptualizations...

  9. Perampanel: An audit of clinical experience using the epilepsy electronic patient record.

    LENUS (Irish Health Repository)

    Ryan, E

    2016-07-01

    Perampanel is a non-competitive antagonist of AMPA glutamate receptors on post synaptic neurons. The aim of this study was to conduct an audit of the experience of perampanel treatment in Ireland based on the interrogation of the national epilepsy electronic patient record (EPR). A retrospective audit was compiled which reviewed the progress of patients who had been treated across two regional epilepsy centres. The EPR was used to identify patients and collect information relevant to their perampanel therapy. Collected data was entered into a statistical package for social sciences for analysis using descriptive statistics.\\r\

  10. Using text-mining techniques in electronic patient records to identify ADRs from medicine use

    DEFF Research Database (Denmark)

    Warrer, Pernille; Hansen, Ebba Holme; Jensen, Lars Juhl

    2012-01-01

    This literature review included studies that use text-mining techniques in narrative documents stored in electronic patient records (EPRs) to investigate ADRs. We searched PubMed, Embase, Web of Science and International Pharmaceutical Abstracts without restrictions from origin until July 2011. We...... included empirically based studies on text mining of electronic patient records (EPRs) that focused on detecting ADRs, excluding those that investigated adverse events not related to medicine use. We extracted information on study populations, EPR data sources, frequencies and types of the identified ADRs......, medicines associated with ADRs, text-mining algorithms used and their performance. Seven studies, all from the United States, were eligible for inclusion in the review. Studies were published from 2001, the majority between 2009 and 2010. Text-mining techniques varied over time from simple free text...

  11. SU-C-BRD-05: Non-Invasive in Vivo Biodosimetry in Radiotherapy Patients Using Electron Paramagnetic Resonance (EPR) Spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Bahar, N; Roberts, K; Stabile, F; Mongillo, N; Decker, RD; Wilson, LD; Husain, Z; Contessa, J; Carlson, DJ [Yale University School of Medicine, New Haven, Connecticut (United States); Williams, BB; Flood, AB; Swartz, HM [Geisel Medical School at Dartmouth University, Hanover, New Hampshire (United States)

    2015-06-15

    Purpose: Medical intervention following a major, unplanned radiation event can elevate the human whole body exposure LD50 from 3 to 7 Gy. On a large scale, intervention cannot be achieved effectively without accurate and efficient triage. Current methods of retrospective biodosimetry are restricted in capability and applicability; published human data is limited. We aim to further develop, validate, and optimize an automated field-deployable in vivo electron paramagnetic resonance (EPR) instrument that can fill this need. Methods: Ionizing radiation creates highly-stable, carbonate-based free radicals within tooth enamel. Using a process similar to nuclear magnetic resonance, EPR directly measures the presence of radiation-induced free radicals. We performed baseline EPR measurements on one of the upper central incisors of total body irradiation (TBI) and head and neck (H&N) radiotherapy patients before their first treatment. Additional measurements were performed between subsequent fractions to examine the EPR response with increasing radiation dose. Independent dosimetry measurements were performed with optically-stimulated luminescent dosimeters (OSLDs) and diodes to more accurately establish the relationship between EPR signal and delivered radiation dose. Results: 36 EPR measurements were performed over the course of four months on two TBI and four H & N radiotherapy patients. We observe a linear increase in EPR signal with increasing dose across the entirety of the tested range. A linear least squares-weighted fit of delivered dose versus measured signal amplitude yields an adjusted R-square of 0.966. The standard error of inverse prediction (SEIP) is 1.77 Gy. For doses up to 7 Gy, the range most relevant to triage, we calculate an SEIP of 1.29 Gy. Conclusion: EPR spectroscopy provides a promising method of retrospective, non-invasive, in vivo biodosimetry. Our preliminary data show an excellent correlation between predicted signal amplitude and delivered

  12. Attitudes of nursing staff towards electronic patient records: a questionnaire survey.

    NARCIS (Netherlands)

    Veer, A.J.E. de; Francke, A.L.

    2010-01-01

    BACKGROUND: A growing number of health care organizations are implementing a system of electronic patient records (EPR). This implies a change in work routines for nursing staff, but it could also be regarded as an opportunity to improve the quality of care. OBJECTIVE: The objective of this paper is

  13. How Healthcare Professionals "Make Sense" of an Electronic Patient Record Adoption

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Aanestad, Margunn

    2007-01-01

    This article examines how healthcare professionals experience an Electronic Patient Record (EPR) adoption process. Based on a case study from two surgical wards in Danish hospitals, we analyze the healthcare professionals' conceptions of the technology, how it relates to their professional roles...

  14. Develop security architecture for both in-house healthcare information systems and electronic patient record

    Science.gov (United States)

    Zhang, Jianguo; Chen, Xiaomeng; Zhuang, Jun; Jiang, Jianrong; Zhang, Xiaoyan; Wu, Dongqing; Huang, H. K.

    2003-05-01

    In this paper, we presented a new security approach to provide security measures and features in both healthcare information systems (PACS, RIS/HIS), and electronic patient record (EPR). We introduced two security components, certificate authoring (CA) system and patient record digital signature management (DSPR) system, as well as electronic envelope technology, into the current hospital healthcare information infrastructure to provide security measures and functions such as confidential or privacy, authenticity, integrity, reliability, non-repudiation, and authentication for in-house healthcare information systems daily operating, and EPR exchanging among the hospitals or healthcare administration levels, and the DSPR component manages the all the digital signatures of patient medical records signed through using an-symmetry key encryption technologies. The electronic envelopes used for EPR exchanging are created based on the information of signers, digital signatures, and identifications of patient records stored in CAS and DSMS, as well as the destinations and the remote users. The CAS and DSMS were developed and integrated into a RIS-integrated PACS, and the integration of these new security components is seamless and painless. The electronic envelopes designed for EPR were used successfully in multimedia data transmission.

  15. Using text-mining techniques in electronic patient records to identify ADRs from medicine use.

    Science.gov (United States)

    Warrer, Pernille; Hansen, Ebba Holme; Juhl-Jensen, Lars; Aagaard, Lise

    2012-05-01

    This literature review included studies that use text-mining techniques in narrative documents stored in electronic patient records (EPRs) to investigate ADRs. We searched PubMed, Embase, Web of Science and International Pharmaceutical Abstracts without restrictions from origin until July 2011. We included empirically based studies on text mining of electronic patient records (EPRs) that focused on detecting ADRs, excluding those that investigated adverse events not related to medicine use. We extracted information on study populations, EPR data sources, frequencies and types of the identified ADRs, medicines associated with ADRs, text-mining algorithms used and their performance. Seven studies, all from the United States, were eligible for inclusion in the review. Studies were published from 2001, the majority between 2009 and 2010. Text-mining techniques varied over time from simple free text searching of outpatient visit notes and inpatient discharge summaries to more advanced techniques involving natural language processing (NLP) of inpatient discharge summaries. Performance appeared to increase with the use of NLP, although many ADRs were still missed. Due to differences in study design and populations, various types of ADRs were identified and thus we could not make comparisons across studies. The review underscores the feasibility and potential of text mining to investigate narrative documents in EPRs for ADRs. However, more empirical studies are needed to evaluate whether text mining of EPRs can be used systematically to collect new information about ADRs. © 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.

  16. Overcoming Structural Constraints to Patient Utilization of Electronic Medical Records: A Critical Review and Proposal for an Evaluation Framework

    OpenAIRE

    Winkelman, Warren J.; Leonard, Kevin J.

    2004-01-01

    There are constraints embedded in medical record structure that limit use by patients in self-directed disease management. Through systematic review of the literature from a critical perspective, four characteristics that either enhance or mitigate the influence of medical record structure on patient utilization of an electronic patient record (EPR) system have been identified: environmental pressures, physician centeredness, collaborative organizational culture, and patient centeredness. An ...

  17. EPR: Evidence and fallacy.

    Science.gov (United States)

    Nichols, Joseph W; Bae, You Han

    2014-09-28

    The enhanced permeability and retention (EPR) of nanoparticles in tumors has long stood as one of the fundamental principles of cancer drug delivery, holding the promise of safe, simple and effective therapy. By allowing particles preferential access to tumors by virtue of size and longevity in circulation, EPR provided a neat rationale for the trend toward nano-sized drug carriers. Following the discovery of the phenomenon by Maeda in the mid-1980s, this rationale appeared to be well justified by the flood of evidence from preclinical studies and by the clinical success of Doxil. Clinical outcomes from nano-sized drug delivery systems, however, have indicated that EPR is not as reliable as previously thought. Drug carriers generally fail to provide superior efficacy to free drug systems when tested in clinical trials. A closer look reveals that EPR-dependent drug delivery is complicated by high tumor interstitial fluid pressure (IFP), irregular vascular distribution, and poor blood flow inside tumors. Furthermore, the animal tumor models used to study EPR differ from clinical tumors in several key aspects that seem to make EPR more pronounced than in human patients. On the basis of this evidence, we believe that EPR should only be invoked on a case-by-case basis, when clinical evidence suggests the tumor type is susceptible. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. A Regional PD Strategy for EPR Systems: Evidence-Based IT Development

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Hertzum, Morten

    2006-01-01

    One of the five regions in Denmark has initiated a remark-able and alternative strategy for the development of Elec-tronic Patient Record (EPR) systems. This strategy is driven by Participatory Design (PD) experiments and based on evidence of positive effects on the clinical practice when using EPR...... systems. We present this PD strategy and our related research on evidence-based IT development. We report from a newly completed PD experiment with EPR in the region conducted through a close collaboration compris-ing a neurological stroke unit, the region’s EPR unit, the vendor, as well as the authors....

  19. Which Parts of a Clinical Process EPR Needs Special Configuration

    DEFF Research Database (Denmark)

    Barlach, Anders; Simonsen, Jesper

    2007-01-01

    Subject: Which parts of an electronic patient record (EPR) can initially form a stable standard solution to be used by all clinicians? And which parts of an EPR can we predict needs initial as well as on-going re-configuration to meet the needs from diverse medical specialties. Purpose: To analyze...... which screen types in a clinical process that can be standard configured and which are subject to initial as well as on-going re-configuration. Methods and results: A pilot-project implementing a fully functional clinical process EPR was configured and used at a neurological ward, replacing all paper...... records 24/7. The analysis characterizes the different types of screens, a total of 243 included in the EPR solution. All screens have been extracted from the application and analyzed for changes – in total 222 changes. Discussion and conclusion: Most screens (87%) are very stable. Few (13%) are subjected...

  20. Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method

    Science.gov (United States)

    Greenhalgh, Trisha; Potts, Henry W W; Wong, Geoff; Bark, Pippa; Swinglehurst, Deborah

    2009-01-01

    Context: The extensive research literature on electronic patient records (EPRs) presents challenges to systematic reviewers because it covers multiple research traditions with different underlying philosophical assumptions and methodological approaches. Methods: Using the meta-narrative method and searching beyond the Medline-indexed literature, this review used “conflicting” findings to address higher-order questions about how researchers had differently conceptualized and studied the EPR and its implementation. Findings: Twenty-four previous systematic reviews and ninety-four further primary studies were considered. Key tensions in the literature centered on (1) the EPR (“container” or “itinerary”); (2) the EPR user (“information-processer” or “member of socio-technical network”); (3) organizational context (“the setting within which the EPR is implemented” or “the EPR-in-use”); (4) clinical work (“decision making” or “situated practice”); (5) the process of change (“the logic of determinism” or “the logic of opposition”); (6) implementation success (“objectively defined” or “socially negotiated”); and (7) complexity and scale (“the bigger the better” or “small is beautiful”). Conclusions: The findings suggest that EPR use will always require human input to recontextualize knowledge; that even though secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work may be made less efficient; that paper may offer a unique degree of ecological flexibility; and that smaller EPR systems may sometimes be more efficient and effective than larger ones. We suggest an agenda for further research. PMID:20021585

  1. Patients' thoughts on patient- retained medical records

    African Journals Online (AJOL)

    was also thought to motivate the patients to act on the advice given, and the records also served as a reminder to take their ... to use it and to standardise the information that is recorded; and health planners should be motivated to implement .... Table I: Combined list of themes identified and quotations supporting them.

  2. The EPR reactor

    International Nuclear Information System (INIS)

    Lacoste, A.C.; Dupuy, Ph.; Gupta, O.; Perez, J.R.; Emond, D.; Cererino, G.; Rousseau, J.M.; Jeffroy, F.; Evrard, J.M.; Seiler, J.M.; Azarian, G.; Chaumont, B.; Dubail, A.; Fischer, M.; Tiippana, P.; Hyvarinen, J.; Zaleski, C.P.; Meritet, S.; Iglesias, F.; Vincent, C.; Massart, S.; Graillat, G.; Esteve, B.; Mansillon, Y.; Gatinol, C.; Carre, F.

    2005-01-01

    This document reviews economical and environmental aspects of the EPR project. The following topics are discussed: role and point of view of the French Nuclear Safety Authority on EPR, control of design and manufacturing of EPR by the French Nuclear Safety Authority, assessment by IRSN of EPR safety, research and development in support of EPR, STUK safety review of EPR design, standpoint on EPR, the place of EPR in the French energy policy, the place of EPR in EDF strategy, EPR spearhead of nuclear rebirth, the public debate, the local stakes concerning the building of EPR in France at Flamanville (Manche) and the research on fourth generation reactors. (A.L.B.)

  3. Computerized extraction of information on the quality of diabetes care from free text in electronic patient records of general practitioners

    NARCIS (Netherlands)

    Voorham, Jaco; Denig, Petra

    2007-01-01

    Objective: This study evaluated a computerized method for extracting numeric clinical measurements related to diabetes care from free text in electronic patient records (EPR) of general practitioners. Design and Measurements: Accuracy of this number-oriented approach was compared to manual chart

  4. Getting on with your computer is associated with job satisfaction in primary care: entrants to primary care should be assessed for their competency with electronic patient record systems

    Directory of Open Access Journals (Sweden)

    Simon de Lusignan

    2014-02-01

    Full Text Available Job satisfaction in primary care is associated with getting on with your computer. Many primary care professionals spend longer interacting with their computer than anything else in their day. However, the computer often makes demands rather than be an aid or supporter that has learned its user’s preferences. The use of electronic patient record (EPR systems is underrepresented in the assessment of entrants to primary care, and in definitions of the core competencies of a family physician/general practitioner. We call for this to be put right: for the use of the EPR to support direct patient care and clinical governance to be given greater prominence in training and assessment. In parallel, policy makers should ensure that the EPR system use is orientated to ensuring patients receive evidence-based care, and EPR system suppliers should explore how their systems might better support their clinician users, in particular learning their preferences.

  5. Getting on with your computer is associated with job satisfaction in primary care: entrants to primary care should be assessed for their competency with electronic patient record systems.

    Science.gov (United States)

    de Lusignan, Simon; Pearce, Christopher; Munro, Neil

    2013-01-01

    Job satisfaction in primary care is associated with getting on with your computer. Many primary care professionals spend longer interacting with their computer than anything else in their day. However, the computer often makes demands rather than be an aid or supporter that has learned its user's preferences. The use of electronic patient record (EPR) systems is underrepresented in the assessment of entrants to primary care, and in definitions of the core competencies of a family physician/general practitioner. We call for this to be put right: for the use of the EPR to support direct patient care and clinical governance to be given greater prominence in training and assessment. In parallel, policy makers should ensure that the EPR system use is orientated to ensuring patients receive evidence-based care, and EPR system suppliers should explore how their systems might better support their clinician users, in particular learning their preferences.

  6. Using rapid scan EPR to improve the detection limit of quantitative EPR by more than one order of magnitude

    OpenAIRE

    Möser, J.; Lips, K.; Tseytlin, M.; Eaton, G.; Eaton, S.; Schnegg, A

    2017-01-01

    X band rapid scan EPR was implemented on a commercially available Bruker ELEXSYS E580 spectrometer. Room temperature rapid scan and continuous wave EPR spectra were recorded for amorphous silicon powder samples. By comparing the resulting signal intensities the feasibility of performing quantitative rapid scan EPR is demonstrated. For different hydrogenated amorphous silicon samples, rapid scan EPR results in signal to noise improvements by factors between 10 and 50. Rapid scan EPR is thus ca...

  7. A secure and efficient password-based user authentication scheme using smart cards for the integrated EPR information system.

    Science.gov (United States)

    Lee, Tian-Fu; Chang, I-Pin; Lin, Tsung-Hung; Wang, Ching-Cheng

    2013-06-01

    The integrated EPR information system supports convenient and rapid e-medicine services. A secure and efficient authentication scheme for the integrated EPR information system provides safeguarding patients' electronic patient records (EPRs) and helps health care workers and medical personnel to rapidly making correct clinical decisions. Recently, Wu et al. proposed an efficient password-based user authentication scheme using smart cards for the integrated EPR information system, and claimed that the proposed scheme could resist various malicious attacks. However, their scheme is still vulnerable to lost smart card and stolen verifier attacks. This investigation discusses these weaknesses and proposes a secure and efficient authentication scheme for the integrated EPR information system as alternative. Compared with related approaches, the proposed scheme not only retains a lower computational cost and does not require verifier tables for storing users' secrets, but also solves the security problems in previous schemes and withstands possible attacks.

  8. Dose-specific adverse drug reaction identification in electronic patient records: temporal data mining in an inpatient psychiatric population.

    Science.gov (United States)

    Eriksson, Robert; Werge, Thomas; Jensen, Lars Juhl; Brunak, Søren

    2014-04-01

    Data collected for medical, filing and administrative purposes in electronic patient records (EPRs) represent a rich source of individualised clinical data, which has great potential for improved detection of patients experiencing adverse drug reactions (ADRs), across all approved drugs and across all indication areas. The aim of this study was to take advantage of techniques for temporal data mining of EPRs in order to detect ADRs in a patient- and dose-specific manner. We used a psychiatric hospital's EPR system to investigate undesired drug effects. Within one workflow the method identified patient-specific adverse events (AEs) and links these to specific drugs and dosages in a temporal manner, based on integration of text mining results and structured data. The structured data contained precise information on drug identity, dosage and strength. When applying the method to the 3,394 patients in the cohort, we identified AEs linked with a drug in 2,402 patients (70.8 %). Of the 43,528 patient-specific drug substances prescribed, 14,736 (33.9 %) were linked with AEs. From these links we identified multiple ADRs (p patient population, larger doses were prescribed to sedated patients than non-sedated patients; five antipsychotics [corrected] exhibited a significant difference (p<0.05). Finally, we present two cases (p < 0.05) identified by the workflow. The method identified the potentially fatal AE QT prolongation caused by methadone, and a non-described likely ADR between levomepromazine and nightmares found among the hundreds of identified novel links between drugs and AEs (p < 0.05). The developed method can be used to extract dose-dependent ADR information from already collected EPR data. Large-scale AE extraction from EPRs may complement or even replace current drug safety monitoring methods in the future, reducing or eliminating manual reporting and enabling much faster ADR detection.

  9. Displays of authority in the clinical consultation: a linguistic ethnographic study of the electronic patient record.

    Science.gov (United States)

    Swinglehurst, Deborah

    2014-10-01

    The introduction of computers into general practice settings has profoundly changed the dynamics of the clinical consultation. Previous research exploring the impact of the computer (in what has been termed the 'triadic' consultation) has shown that computer use and communication between doctor and patient are intricately coordinated and inseparable. Swinglehurst et al. have recently been critical of the ongoing tendency within health communication research to focus on 'the computer' as a relatively simple 'black box', or as a material presence in the consultation. By re-focussing on the electronic patient record (EPR) and conceptualising this as a complex collection of silent but consequential voices, they have opened up new and more nuanced possibilities for analysis. This orientation makes visible a tension between the immediate contingencies of the interaction as it unfolds moment-by-moment and the more standardised, institutional demands which are embedded in the EPR ('dilemma of attention'). In this paper I extend this work, presenting an in-depth examination of how participants in the consultation manage this tension. I used linguistic ethnographic methods to study 54 video recorded consultations from a dataset collected between 2007 and 2008 in two UK general practices, combining microanalysis of the consultation with ethnographic attention to the wider organisational and institutional context. My analysis draws on the theoretical work of Erving Goffman and Mikhail Bakhtin, incorporating attention to the 'here and now' of the interaction as well as an appreciation of the 'distributed' nature of the EPR, its role in hosting and circulating new voices, and in mediating participants' talk and social practices. It reveals - in apparently fleeting moments of negotiation and contestation - the extent to which the EPR shapes the dynamic construction, display and circulation of authority in the contemporary consultation. Copyright © 2014 The Author. Published by

  10. EPR and Bell Locality

    OpenAIRE

    Norsen, Travis

    2004-01-01

    A new formulation of the EPR argument is presented, one which uses John Bell's mathematically precise local causality condition in place of the looser locality assumption which was used in the original EPR paper and on which Niels Bohr seems to have based his objection to the EPR argument. The new formulation of EPR bears a striking resemblance to Bell's derivation of his famous inequalities. The relation between these two arguments -- in particular, the role of EPR as part one of Bell's two-...

  11. Worldwide telemedicine services based on distributed multimedia electronic patient records by using the second generation Web server hyperwave.

    Science.gov (United States)

    Quade, G; Novotny, J; Burde, B; May, F; Beck, L E; Goldschmidt, A

    1999-01-01

    A distributed multimedia electronic patient record (EPR) is a central component of a medicine-telematics application that supports physicians working in rural areas of South America, and offers medical services to scientists in Antarctica. A Hyperwave server is used to maintain the patient record. As opposed to common web servers--and as a second generation web server--Hyperwave provides the capability of holding documents in a distributed web space without the problem of broken links. This enables physicians to browse through a patient's record by using a standard browser even if the patient's record is distributed over several servers. The patient record is basically implemented on the "Good European Health Record" (GEHR) architecture.

  12. Using rapid-scan EPR to improve the detection limit of quantitative EPR by more than one order of magnitude.

    Science.gov (United States)

    Möser, J; Lips, K; Tseytlin, M; Eaton, G R; Eaton, S S; Schnegg, A

    2017-08-01

    X-band rapid-scan EPR was implemented on a commercially available Bruker ELEXSYS E580 spectrometer. Room temperature rapid-scan and continuous-wave EPR spectra were recorded for amorphous silicon powder samples. By comparing the resulting signal intensities the feasibility of performing quantitative rapid-scan EPR is demonstrated. For different hydrogenated amorphous silicon samples, rapid-scan EPR results in signal-to-noise improvements by factors between 10 and 50. Rapid-scan EPR is thus capable of improving the detection limit of quantitative EPR by at least one order of magnitude. In addition, we provide a recipe for setting up and calibrating a conventional pulsed and continuous-wave EPR spectrometer for rapid-scan EPR. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Providing a complete online multimedia patient record.

    Science.gov (United States)

    Dayhoff, R. E.; Kuzmak, P. M.; Kirin, G.; Frank, S.

    1999-01-01

    Seamless integration of all types of patient data is a critical feature for clinical workstation software. The Dept. of Veterans Affairs has developed a multimedia online patient record that includes traditional medical chart information as well as a wide variety of medical images from specialties such as cardiology, pulmonary and gastrointestinal medicine, pathology, radiology, hematology, and nuclear medicine. This online patient record can present data in ways not possible with a paper chart or other physical media. Obtaining a critical mass of information online is essential to achieve the maximum benefits from an integrated patient record system. Images Figure 1 Figure 2 PMID:10566357

  14. EPR STUDIES OF THERMALLY STERILIZED VASELINUM ALBUM.

    Science.gov (United States)

    Ramos, Paweł; Pilawa, Barbara

    2015-01-01

    Electron paramagnetic resonance (EPR) spectroscopy was used for examination of free radicals in thermally treated vaselinum album (VA). Thermal treatment in hot air as sterilization process was tested. Conditions of thermal sterilization were chosen according to the pharmaceutical norms. Vaselinum album was heated at the following conditions (T--temperature, t--time): T = 160°C and t = 120 min, T = 170°C and t = 60 min and T = 180°C and t = 30 min. The aim of this work was to determine concentration and free radical properties of thermally sterilized VA. EPR analysis for VA was done 15 min after sterilization. EPR measurements were done at room temperature. EPR spectra were recorded in the range of microwave power of 2.2-70 mW. g-Factor, amplitudes (A) and line width (ΔBpp) of the spectra were determined. The shape of the EPR spectra was analyzed. Free radical concentration (N) in the heated samples was determined. EPR spectra were not obtained for the non heated VA. EPR spectra were detected for all thermally sterilized samples. The spectra revealed complex character, their asymmetry depends on microwave power. The lowest free radicals concentration was found for the VA sterilized at 180°C during 30 min. EPR spectroscopy is proposed as the method useful for optimization of sterilization process of drugs.

  15. A prototype of a computerized patient record.

    Science.gov (United States)

    Adelhard, K; Eckel, R; Hölzel, D; Tretter, W

    1995-01-01

    Computerized medical record systems (CPRS) should present user and problem oriented views of the patient file. Problem lists, clinical course, medication profiles and results of examinations have to be recorded in a computerized patient record. Patient review screens should give a synopsis of the patient data to inform whenever the patient record is opened. Several different types of data have to be stored in a patient record. Qualitative and quantitative measurements, narratives and images are such examples. Therefore, a CPR must also be able to handle these different data types. New methods and concepts appear frequently in medicine. Thus a CPRS must be flexible enough to cope with coming demands. We developed a prototype of a computer based patient record with a graphical user interface on a SUN workstation. The basis of the system are a dynamic data dictionary, an interpreter language and a large set of basic functions. This approach gives optimal flexibility to the system. A lot of different data types are already supported. Extensions are easily possible. There is also almost no limit concerning the number of medical concepts that can be handled by our prototype. Several applications were built on this platform. Some of them are presented to exemplify the patient and problem oriented handling of the CPR.

  16. EPR spectroscopic investigation of psoriatic finger nails.

    Science.gov (United States)

    Nakagawa, Kouichi; Minakawa, Satoko; Sawamura, Daisuke

    2013-11-01

    Nail lesions are common features of psoriasis and found in almost half of the patients. However, there is no feasible spectroscopic method evaluating changes and severity of nail psoriasis. EPR (electron paramagnetic resonance) might be feasible for evaluating nail conditions in the patients of psoriasis. Finger nails of five cases with nail psoriasis, (three females and two males) were examined. Nail samples were subjected to the EPR assay. The small piece of the finger nail (1.5 × 5 mm(2)) was incubated in ~50 μM 5-DSA (5-doxylstearic acid) aqueous solutions for about 60 min at 37°C. After rinsing and wiping off the excess 5-DSA solution, the nail samples were measured by EPR. EPR spectra were analyzed using the intensity ratio (Fast/Slow) of the two motions at the peaks of the lower magnetic field. We observed two distinguishable sites on the basis of the EPR results. In addition, the modern EPR calculation was performed to analyze the spectra obtained. The nail psoriasis-related region is 2~3 times higher than that of the control. The present EPR results show that there are two distinguishable sites in the nail. In the case of nail psoriasis, the fragile components are 2~3 times more than those of the control. Thus, the EPR method is thought to be a novel and reliable method of evaluating the nail psoriasis. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Patient Perceptions of Electronic Health Records

    Science.gov (United States)

    Lulejian, Armine

    2011-01-01

    Research objective. Electronic Health Records (EHR) are expected to transform the way medicine is delivered with patients/consumers being the intended beneficiaries. However, little is known regarding patient knowledge and attitudes about EHRs. This study examined patient perceptions about EHR. Study design. Surveys were administered following…

  18. Digital imaging and electronic patient records in pathology using an integrated department information system with PACS.

    Science.gov (United States)

    Kalinski, Thomas; Hofmann, Harald; Franke, Dagmar-Sybilla; Roessner, Albert

    2002-01-01

    Picture archiving and communication systems have been widely used in radiology thus far. Owing to the progress made in digital photo technology, their use in medicine opens up further opportunities. In the field of pathology, digital imaging offers new possiblities for the documentation of macroscopic and microscopic findings. Digital imaging has the advantage that the data is permanently and readily available, independent of conventional archives. In the past, PACS was a separate entity. Meanwhile, however, PACS has been integrated in DIS, the department information system, which was also run separately in former times. The combination of these two systems makes the administration of patient data, findings and images easier. Moreover, thanks to the introduction of special communication standards, a data exchange between different department information systems and hospital information systems (HIS) is possible. This provides the basis for a communication platform in medicine, constituting an electronic patient record (EPR) that permits an interdisciplinary treatment of patients by providing data of findings and images from clinics treating the same patient. As the pathologic diagnosis represents a central and often therapy-determining component, it is of utmost importance to add pathologic diagnoses to the EPR. Furthermore, the pathologist's work is considerably facilitated when he is able to retrieve additional data from the patient file. In this article, we describe our experience gained with the combined PACS and DIS systems recently installed at the Department of Pathology, University of Magdeburg. Moreover, we evaluate the current situation and future prospects for PACS in pathology.

  19. A web-based database for EPR centers in semiconductors

    International Nuclear Information System (INIS)

    Umeda, T.; Hagiwara, S.; Katagiri, M.; Mizuochi, N.; Isoya, J.

    2006-01-01

    We develop a web-based database system for electron paramagnetic resonance (EPR) centers in semiconductors. This database is available to anyone at http://www.kc.tsukuba.ac.jp/div-media/epr/. It currently has more than 300 records of the spin-Hamiltonian parameters for major known EPR centers. One can upload own new records to the database or can use simulation tools powered by EPR-NMR(C). Here, we describe the features and objectives of this database, and mention some future plans

  20. Sharing electronic health records: the patient view

    Directory of Open Access Journals (Sweden)

    John Powell

    2006-03-01

    Full Text Available The introduction of a national electronic health record system to the National Health Service (NHS has raised concerns about issues of data accuracy, security and confidentiality. The primary aim of this project was to identify the extent to which primary care patients will allow their local electronic record data to be shared on a national database. The secondary aim was to identify the extent of inaccuracies in the existing primary care records, which will be used to populate the new national Spine. Fifty consecutive attenders to one general practitioner were given a paper printout of their full primary care electronic health record. Participants were asked to highlight information which they would not want to be shared on the national electronic database of records, and information which they considered to be incorrect. There was a 62% response rate (31/50. Five of the 31 patients (16% identified information that they would not want to be shared on the national record system. The items they identified related almost entirely to matters of pregnancy, contraception, sexual health and mental health. Ten respondents (32% identified incorrect information in their records (some of these turned out to be correct on further investigation. The findings in relation to data sharing fit with the commonly held assumption that matters related to sensitive or embarrassing issues, which may affect how the patient will be treated by other individuals or institutions, are most likely to be censored by patients. Previous work on this has tended to ask hypothetical questions concerning data sharing rather than examine a real situation. A larger study of representative samples of patients in both primary and secondary care settings is needed to further investigate issues of data sharing and consent.

  1. Dynamic consent: a possible solution to improve patient confidence and trust in how electronic patient records are used in medical research.

    Science.gov (United States)

    Williams, Hawys; Spencer, Karen; Sanders, Caroline; Lund, David; Whitley, Edgar A; Kaye, Jane; Dixon, William G

    2015-01-13

    With one million people treated every 36 hours, routinely collected UK National Health Service (NHS) health data has huge potential for medical research. Advances in data acquisition from electronic patient records (EPRs) means such data are increasingly digital and can be anonymised for research purposes. NHS England's care.data initiative recently sought to increase the amount and availability of such data. However, controversy and uncertainty following the care.data public awareness campaign led to a delay in rollout, indicating that the success of EPR data for medical research may be threatened by a loss of patient and public trust. The sharing of sensitive health care data can only be done through maintaining such trust in a constantly evolving ethicolegal and political landscape. We propose that a dynamic consent model, whereby patients can electronically control consent through time and receive information about the uses of their data, provides a transparent, flexible, and user-friendly means to maintain public trust. This could leverage the huge potential of the EPR for medical research and, ultimately, patient and societal benefit.

  2. 78 FR 45454 - Patient Access to Records

    Science.gov (United States)

    2013-07-29

    ... regarding current and future health care. Removing barriers to a veteran's access to VA records will support... patient autonomy and shared decision making. Removing this regulation will directly benefit veterans by... property, Infants and children, Inventions and patents, Parking, Penalties, Privacy, Reporting and...

  3. Medical application of EPR

    International Nuclear Information System (INIS)

    Eichhoff, Uwe; Hoefer, Peter

    2015-01-01

    Selected applications of continuous-wave EPR in medicine are reviewed. This includes detection of reactive oxygen and nitrogen species, pH measurements and oxymetry. Applications of EPR imaging are demonstrated on selected examples and future developments to faster imaging methods are discussed

  4. EPR study on gamma-irradiated fruits dehydrated via osmosis

    Energy Technology Data Exchange (ETDEWEB)

    Yordanov, N.D. [Laboratory EPR, Institute of Catalysis, Bulgarian Academy of Sciences, 1113 Sofia (Bulgaria)]. E-mail: ndyepr@bas.bg; Aleksieva, K. [Laboratory EPR, Institute of Catalysis, Bulgarian Academy of Sciences, 1113 Sofia (Bulgaria)

    2007-06-15

    The shape and time stability of the electron paramagnetic resonance (EPR) spectra of non- and {gamma}-irradiated papaya, melon, cherry and fig samples dehydrated via osmosis are reported. It is shown that non-irradiated samples are generally EPR silent whereas {gamma}-irradiated exhibit 'sugar-like' EPR spectra. The recorded EPR spectra are monitored for a period of 7 months after irradiation (stored at low humidity and in the dark). The results suggest longer period of unambiguous identification of the radiation processing of osmose dehydrated fruits. Therefore, the Protocol EN 13708,2001 issued by CEN is fully applicable for the studied fruit samples.

  5. EPR study on gamma-irradiated fruits dehydrated via osmosis

    International Nuclear Information System (INIS)

    Yordanov, N.D.; Aleksieva, K.

    2007-01-01

    The shape and time stability of the electron paramagnetic resonance (EPR) spectra of non- and γ-irradiated papaya, melon, cherry and fig samples dehydrated via osmosis are reported. It is shown that non-irradiated samples are generally EPR silent whereas γ-irradiated exhibit 'sugar-like' EPR spectra. The recorded EPR spectra are monitored for a period of 7 months after irradiation (stored at low humidity and in the dark). The results suggest longer period of unambiguous identification of the radiation processing of osmose dehydrated fruits. Therefore, the Protocol EN 13708,2001 issued by CEN is fully applicable for the studied fruit samples

  6. EPR study on gamma-irradiated fruits dehydrated via osmosis

    Science.gov (United States)

    Yordanov, N. D.; Aleksieva, K.

    2007-06-01

    The shape and time stability of the electron paramagnetic resonance (EPR) spectra of non- and γ-irradiated papaya, melon, cherry and fig samples dehydrated via osmosis are reported. It is shown that non-irradiated samples are generally EPR silent whereas γ-irradiated exhibit "sugar-like" EPR spectra. The recorded EPR spectra are monitored for a period of 7 months after irradiation (stored at low humidity and in the dark). The results suggest longer period of unambiguous identification of the radiation processing of osmose dehydrated fruits. Therefore, the Protocol EN 13708,2001 issued by CEN is fully applicable for the studied fruit samples.

  7. EPR investigation of some gamma-irradiated medicines

    International Nuclear Information System (INIS)

    Aleksieva, Katerina; Yordanov, Nicola

    2016-01-01

    The results of EPR studies on three medical tablets – Galanthamine, Cytisine and Tribulus terrestris before and after gamma-irradiation are reported. Before irradiation Galanthamine and Cytisine tablets are EPR silent, whereas Tribulus terrestris show a broad singlet line with g factor 2.2084±0.002. The same spectrum is recorded after irradiation. After gamma-sterilization, however, Galanthamine and Cytisine tablets exhibit a typical EPR spectrum due to gamma induced free radicals in lactose used as an excipient. These stable free radicals can be used for identification of radiation processing for a long time after it. Key words: medical tablets, gamma-irradiation, EPR

  8. [Nutritional status recording in hospitalized patient notes].

    Science.gov (United States)

    Matos, L; Teixeira, M A; Henriques, A; Tavares, M M; Alvares, L; Antunes, A; Amaral, Teresa F

    2007-01-01

    The prevalence of disease-related malnutrition (DRM) is described to be of 30-60% on admission to hospital, and of 10% in the community. It has been associated with worse clinical outcomes, namely higher morbidity and mortality as well as higher frequency of health care and its associated costs. The lack of screening and monitoring of nutritional status have been said to be risk factors for the increased prevalence of DRM during hospital stay. The aims of this study were to evaluate the importance given by health care professionals to certain aspects related with nutritional status (weight, food intake) of hospital patients and to see if there were any differences between the under and non undernourished ones. A systematic sample of patients from six hospitals was collected. Pregnancy, paediatric age and critical illness were exclusion criteria as well as incapacity to fulfil nutritional risk screening protocol and length-of-stay less than 24h. Socio-demographic, anthropometric data and clinical notes (e.g. weight, food/nutrient intake) from medical records were collected and Nutritional Risk Screening 2002 protocol was applied. A total of 1152 patients were included in this study. The prevalence of nutritional risk varied between 28.5% and 47.3% while undernutrition classified by anthropometrical parameters was considerably lower (6.3% to 14.9%). Two thirds of the patients had their food intake monitored and registered in medical records but only one third were weighted. Undernourished patients had their food intake more frequently monitored but their weight was less frequently measured, than the well-nourished ones. DRM prevalence amongst hospital patients on admission is significantly high. Clinical notes regarding nutritional status is rather infrequent on medical records. This study showed that urges the need to empower health care providers of the importance of the screening and monitoring of weight and food intake, on admission and during hospital stay.

  9. Patient health record on a smart card.

    Science.gov (United States)

    Naszlady, A; Naszlady, J

    1998-02-01

    A validated health questionnaire has been used for the documentation of a patient's history (826 items) and of the findings from physical examination (591 items) in our clinical ward for 25 years. This computerized patient record has been completed in EUCLIDES code (CEN TC/251) for laboratory tests and an ATC and EAN code listing for the names of the drugs permanently required by the patient. In addition, emergency data were also included on an EEPROM chipcard with a 24 kb capacity. The program is written in FOX-PRO language. A group of 5000 chronically ill in-patients received these cards which contain their health data. For security reasons the contents of the smart card is only accessible by a doctor's PIN coded key card. The personalization of each card was carried out in our health center and the depersonalized alphanumeric data were collected for further statistical evaluation. This information served as a basis for a real need assessment of health care and for the calculation of its cost. Code-combined with an optical card, a completely paperless electronic patient record system has been developed containing all three information carriers in medicine: Texts, Curves and Pictures.

  10. Selfcalibrated alanine/EPR dosimeters. A new generation of solid state/EPR dosimeters

    International Nuclear Information System (INIS)

    Yordanov, N.D.; Gancheva, V.

    1999-01-01

    Alanine/EPR dosimeters are well established as secondary, reference dosimeters for high-energy radiation. However, there are various sources of uncertainty in the evaluation of absorbed dose. This arises primarily from the necessity to calibrate each EPR spectrometer and each batch of dosimeters before their use. In order to overcome this disadvantage, a new generation alanine/EPR dosimeter has been developed, and its possibilities as a radiation detector are reported. Principally, it is a mixture of alanine, some quantity of EPR active substance, and a binding material. The EPR active substance, acting as an internal EPR standard, is chosen to have EPR parameters which are independent of the irradiation dose. The simultaneous recording of the spectra of both the sample and the standard under the same experimental conditions and the estimation of the ratio I alanine /I Mn as a function of the absorbed dose strongly reduces the uncertainties. The response of these dosimeters for 60 Co γ-radiation exhibits excellent linearity and reproducibility in the range of absorbed dose, 10 2 - 5 x 10 4 Gy. (author)

  11. One-way EPR steering and genuine multipartite EPR steering

    Science.gov (United States)

    He, Qiongyi; Reid, Margaret D.

    2012-11-01

    We propose criteria and experimental strategies to realise the Einstein-Podolsky-Rosen (EPR) steering nonlocality. One-way steering can be obtained where there is asymmetry of thermal noise on each system. We also present EPR steering inequalities that act as signatures and suggest how to optimise EPR correlations in specific schemes so that the genuine multipartite EPR steering nonlocality (EPR paradox) can also possibly be realised. The results presented here also apply to the spatially separated macroscopic atomic ensembles.

  12. Simple group password-based authenticated key agreements for the integrated EPR information system.

    Science.gov (United States)

    Lee, Tian-Fu; Chang, I-Pin; Wang, Ching-Cheng

    2013-04-01

    The security and privacy are important issues for electronic patient records (EPRs). The goal of EPRs is sharing the patients' medical histories such as the diagnosis records, reports and diagnosis image files among hospitals by the Internet. So the security issue for the integrated EPR information system is essential. That is, to ensure the information during transmission through by the Internet is secure and private. The group password-based authenticated key agreement (GPAKE) allows a group of users like doctors, nurses and patients to establish a common session key by using password authentication. Then the group of users can securely communicate by using this session key. Many approaches about GAPKE employ the public key infrastructure (PKI) in order to have higher security. However, it not only increases users' overheads and requires keeping an extra equipment for storing long-term secret keys, but also requires maintaining the public key system. This investigation presents a simple group password-based authenticated key agreement (SGPAKE) protocol for the integrated EPR information system. The proposed SGPAKE protocol does not require using the server or users' public keys. Each user only remembers his weak password shared with a trusted server, and then can obtain a common session key. Then all users can securely communicate by using this session key. The proposed SGPAKE protocol not only provides users with convince, but also has higher security.

  13. Utility of electronic patient records in primary care for stroke secondary prevention trials

    Directory of Open Access Journals (Sweden)

    Ashworth Mark

    2011-02-01

    Full Text Available Abstract Background This study aimed to inform the design of a pragmatic trial of stroke prevention in primary care by evaluating data recorded in electronic patient records (EPRs as potential outcome measures. The study also evaluated achievement of recommended standards of care; variation between family practices; and changes in risk factor values from before to after stroke. Methods Data from the UK General Practice Research Database (GPRD were analysed for 22,730 participants with an index first stroke between 2003 and 2006 from 414 family practices. For each subject, the EPR was evaluated for the 12 months before and after stroke. Measures relevant to stroke secondary prevention were analysed including blood pressure (BP, cholesterol, smoking, alcohol use, body mass index (BMI, atrial fibrillation, utilisation of antihypertensive, antiplatelet and cholesterol lowering drugs. Intraclass correlation coefficients (ICC were estimated by family practice. Random effects models were fitted to evaluate changes in risk factor values over time. Results In the 12 months following stroke, BP was recorded for 90%, cholesterol for 70% and body mass index (BMI for 47%. ICCs by family practice ranged from 0.02 for BP and BMI to 0.05 for LDL and HDL cholesterol. For subjects with records available both before and after stroke, the mean reductions from before to after stroke were: mean systolic BP, 6.02 mm Hg; diastolic BP, 2.78 mm Hg; total cholesterol, 0.60 mmol/l; BMI, 0.34 Kg/m2. There was an absolute reduction in smokers of 5% and heavy drinkers of 4%. The proportion of stroke patients within the recommended guidelines varied from less than a third (29% for systolic BP, just over half for BMI (54%, and over 90% (92% on alcohol consumption. Conclusions Electronic patient records have potential for evaluation of outcomes in pragmatic trials of stroke secondary prevention. Stroke prevention interventions in primary care remain suboptimal but important

  14. New Generation of self-calibrated SS/EPR dosimeters: Alanine/EPR dosimeters

    International Nuclear Information System (INIS)

    Yordanov, N.D.; Gancheva, V.

    1999-01-01

    A new type of solid state/EPR dosimeters is described. Principally, it contains radiation sensitive diamagnetic material, some quantity of EPR active, but radiation insensitive, substance (for example Mn 2+ /MgO) and a binding material. In the present case alanine is used as a radiation sensitive substance. With this dosimeter, the EPR spectra of alanine and Mn 2+ are simultaneously recorded and the calibration graph represents the ratio of alanine versus Mn 2+ EPR signal intensity as a function of absorbed dose. In this way the reproducibility of the results is expected to be improved significantly including their intercomparison among different laboratories. Homogeneity of the prepared dosimeters and their behaviour (fading of EPR signals with time, influence of different meteorological conditions) show satisfactory reproducibility and stability with time. Because two different EPR active samples are recorded simultaneously, the influence of some instrument setting parameters (microwave power, modulation amplitude and modulation frequency) on the ratio I alanine /I Mn is also investigated. (author)

  15. Selective saturation method for EPR dosimetry with tooth enamel

    International Nuclear Information System (INIS)

    Ignatiev, E.A.; Romanyukha, A.A.; Koshta, A.A.; Wieser, A.

    1996-01-01

    The method of selective saturation is based on the difference in the microwave (mw) power dependence of the background and radiation induced EPR components of the tooth enamel spectrum. The subtraction of the EPR spectrum recorded at low mw power from that recorded at higher mw power provides a considerable reduction of the background component in the spectrum. The resolution of the EPR spectrum could be improved 10-fold, however simultaneously the signal-to-noise ratio was found to be reduced twice. A detailed comparative study of reference samples with known absorbed doses was performed to demonstrate the advantage of the method. The application of the selective saturation method for EPR dosimetry with tooth enamel reduced the lower limit of EPR dosimetry to about 100 mGy. (author)

  16. The EPR paradox revisited

    International Nuclear Information System (INIS)

    Cantrell, C.D.; Scully, M.O.

    1978-01-01

    Einstein, Podolsky and Rosen (EPR) argued in 1935 that quantum mechanics fails to give an adequate description of physical reality, and also cannot give a consistent wave-function description of certain phenomena. The authors show that a calculation based upon the reduced density matrix removes the formal inconsistency pointed out by EPR. The spirit of the present paper is that of a pedagogical review. (Auth.)

  17. EPR paradox revisited

    Energy Technology Data Exchange (ETDEWEB)

    Cantrell, C.D.; Scully, M.O.

    1978-07-01

    Einstein, Podolsky, and Rosen (EPR) argued in 1935 that quantum mechanics fails to give an adequate description of physical reality, and also cannot give a consistent wave-function description of certain phenomena. It is shown that a calculation based upon the reduced density matrix removes the formal inconsistency pointed out by EPR. The spirit of the present paper is that of a pedagogical review.

  18. Comparison of continuous wave, spin echo, and rapid scan EPR of irradiated fused quartz

    International Nuclear Information System (INIS)

    Mitchell, Deborah G.; Quine, Richard W.; Tseitlin, Mark; Meyer, Virginia; Eaton, Sandra S.; Eaton, Gareth R.

    2011-01-01

    The E' defect in irradiated fused quartz has spin lattice relaxation times (T 1 ) about 100-300 μs and spin-spin relaxation times (T 2 ) up to about 200 μs, depending on the concentration of defects and other species in the sample. These long relaxation times make it difficult to record an unsaturated continuous wave (CW) electron paramagnetic resonance (EPR) signal that is free of passage effects. Signals measured at X-band (∼9.5 GHz) by three EPR methods: conventional slow-scan field-modulated EPR, rapid scan EPR, and pulsed EPR, were compared. To acquire spectra with comparable signal-to-noise, both pulsed and rapid scan EPR require less time than conventional CW EPR. Rapid scan spectroscopy does not require the high power amplifiers that are needed for pulsed EPR. The pulsed spectra, and rapid scan spectra obtained by deconvolution of the experimental data, are free of passage effects.

  19. Identification of irradiated crab using EPR

    Energy Technology Data Exchange (ETDEWEB)

    Maghraby, A. [Radiation Dosimetry Department, National Institute for Standards (NIS), Ministry of Scientific Research, Haram, 12211- Giza, P.O. Box: 136 (Egypt)]. E-mail: maghrabism@yahoo.com

    2007-02-15

    EPR spectroscopy is a fast and powerful technique for the identification of irradiated food. Crab exoskeleton was divided into six parts: dactyl, cheliped, carapace, apron, swimming legs, and walking legs. Samples of the exoskeleton were prepared and irradiated to Cs-137 gamma radiation in the range (1.156-5.365 kGy). EPR spectra of unirradiated as well as irradiated samples were recorded and analyzed. Response to gamma radiation was plotted for each part of the exoskeleton, dactyl was found to be the most sensitive part, followed by the apron (38%), cheliped (37%), walking legs (30%), swimming legs (24%), and carapace (21%) relative to the dactyl response.

  20. Identification of irradiated crab using EPR

    International Nuclear Information System (INIS)

    Maghraby, A.

    2007-01-01

    EPR spectroscopy is a fast and powerful technique for the identification of irradiated food. Crab exoskeleton was divided into six parts: dactyl, cheliped, carapace, apron, swimming legs, and walking legs. Samples of the exoskeleton were prepared and irradiated to Cs-137 gamma radiation in the range (1.156-5.365 kGy). EPR spectra of unirradiated as well as irradiated samples were recorded and analyzed. Response to gamma radiation was plotted for each part of the exoskeleton, dactyl was found to be the most sensitive part, followed by the apron (38%), cheliped (37%), walking legs (30%), swimming legs (24%), and carapace (21%) relative to the dactyl response

  1. A Hash Based Remote User Authentication and Authenticated Key Agreement Scheme for the Integrated EPR Information System.

    Science.gov (United States)

    Li, Chun-Ta; Weng, Chi-Yao; Lee, Cheng-Chi; Wang, Chun-Cheng

    2015-11-01

    To protect patient privacy and ensure authorized access to remote medical services, many remote user authentication schemes for the integrated electronic patient record (EPR) information system have been proposed in the literature. In a recent paper, Das proposed a hash based remote user authentication scheme using passwords and smart cards for the integrated EPR information system, and claimed that the proposed scheme could resist various passive and active attacks. However, in this paper, we found that Das's authentication scheme is still vulnerable to modification and user duplication attacks. Thereafter we propose a secure and efficient authentication scheme for the integrated EPR information system based on lightweight hash function and bitwise exclusive-or (XOR) operations. The security proof and performance analysis show our new scheme is well-suited to adoption in remote medical healthcare services.

  2. EPR study of free radicals in bread

    Science.gov (United States)

    Yordanov, Nicola D.; Mladenova, Ralitsa

    2004-05-01

    The features of the recorded EPR spectra of paramagnetic species formed in bread and rusk are reported. The appearance of free radicals in them is only connected with their thermal treatment since the starting materials (flour and grains) exhibit very weak EPR signal. The obtained EPR spectra are complex and indicate that: (i) the relative number of paramagnetic species depends on the temperature and treating time of the raw product; (ii) the g-values are strongly temperature dependent with a tendency to coincide at t≥220 °C. Because of the relatively low (150-220 °C) temperature of thermal treatment, the studied free radicals can be assumed to appear in the course of the browning (Maillard) reaction and not to the carbonization of the material.

  3. PropeR: a multi disciplinary EPR system

    NARCIS (Netherlands)

    van der Linden, Helma; Boers, Gerrit; Tange, Huibert; Talmon, Jan; Hasman, Arie

    2003-01-01

    This article describes the architecture of an EPR system developed for the PropeR project. This EPR system not only aims at supporting home care of stroke patients, but is also designed in such a way that it can be ported to other medical services without much effort. We will briefly describe the

  4. Biomolecular EPR spectroscopy

    CERN Document Server

    Hagen, Wilfred Raymond

    2008-01-01

    Comprehensive, Up-to-Date Coverage of Spectroscopy Theory and its Applications to Biological SystemsAlthough a multitude of books have been published about spectroscopy, most of them only occasionally refer to biological systems and the specific problems of biomolecular EPR (bioEPR). Biomolecular EPR Spectroscopy provides a practical introduction to bioEPR and demonstrates how this remarkable tool allows researchers to delve into the structural, functional, and analytical analysis of paramagnetic molecules found in the biochemistry of all species on the planet. A Must-Have Reference in an Intrinsically Multidisciplinary FieldThis authoritative reference seamlessly covers all important bioEPR applications, including low-spin and high-spin metalloproteins, spin traps and spin lables, interaction between active sites, and redox systems. It is loaded with practical tricks as well as do's and don'ts that are based on the author's 30 years of experience in the field. The book also comes with an unprecedented set of...

  5. Limits in EPR dosimetry for irradiated dried fruits discrimination

    International Nuclear Information System (INIS)

    Brasoveanu, Mirela M. E-mirela@alpha.infim.ro; Nemtanu, R.; Minea, R.; Grecu, V.V.

    2003-01-01

    Irradiation of food induces free radical species. EPR dosimetry in irradiated goods puts in evidence if these radicals are stable in environmental condition. Irradiation of dried fruits has been carried out. Their behaviour under irradiation was investigated and correlation between EPR signal and irradiation dose was determined. Electrons of 6 MeV (mean energy) and doses up to 10 kGy were used. EPR spectra were recorded with a Jeol spectrometer, JES-ME-3X tip, with a 100 kHz modulation. The dried fruits can be separated into categories depending on the EPR signal intensity. Strong signals are observed in those fruits in which possible crystalline-like phases exist. As the amount of crystallized sugar decreases, the EPR signals become weaker. Dependencies on irradiation dose give a linear correlation below 10 kGy. The spectra are compared to irradiated sugar and differences and similarities are discussed. (authors)

  6. 42 CFR 491.10 - Patient health records.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Patient health records. 491.10 Section 491.10...: Conditions for Certification; and FQHCs Conditions for Coverage § 491.10 Patient health records. (a) Records... systematically organized. (3) For each patient receiving health care services, the clinic or center maintains a...

  7. [Electronic patient record as the tool for better patient safety].

    Science.gov (United States)

    Schneider, Henning

    2015-01-01

    Recent studies indicate again that there is a deficit in the use of electronic health records (EHR) in German hospitals. Despite good arguments in favour of their use, such as the rapid availability of data, German hospitals shy away from a wider implementation. The reason is the high cost of installing and maintaining the EHRs, for the benefit is difficult to evaluate in monetary terms for the hospital. Even if a benefit can be shown it is not necessarily evident within the hospital, but manifests itself only in the health system outside. Many hospitals only manage to partly implement EHR resulting in increased documentation requirements which reverse their positive effect.In the United States, electronic medical records are also viewed in light of their positive impact on patient safety. In particular, electronic medication systems prove the benefits they can provide in the context of patient safety. As a result, financing systems have been created to promote the digitalisation of hospitals in the United States. This has led to a large increase in the use of IT systems in the United States in recent years. The Universitätsklinikum Eppendorf (UKE) introduced electronic patient records in 2009. The benefits, in particular as regards patient safety, are numerous and there are many examples to illustrate this position. These positive results are intended to demonstrate the important role EHR play in hospitals. A financing system of the ailing IT landscape based on the American model is urgently needed to benefit-especially in terms of patient safety-from electronic medical records in the hospital.

  8. EPR Dosimetry in Irradiated Fingernails

    International Nuclear Information System (INIS)

    Spinella, M.R.; Dubner, D.L.; Bof, E.

    2010-01-01

    The Electron Paramagnetic Resonance (EPR) is being transformed in a complementary tool of biologically-based methods for evaluation of dose after accidental radiation exposure. Many efforts are being carried out in laboratories to evaluate the performance of different materials for its use in EPR doses measurements and for improving the current methods for spectrum analysis and calibration curves determinations. In our country the EPR techniques have been used in different areas with dosimetric (alanine) and non dosimetric purposes. Now we are performing the first studies to obtain properly dose response curves to be used for accidental dose assessments through irradiated fingernails. It is by now well known that the fingernails present two types of signals, a background one (BKS), originated in elastic and inelastic mechanical deformations and the radio induced one (RIS), object of interest (I). In this work we will present some of the previous studies performed to characterize the fingernail samples and we analyse the additive dose method for data obtained employing the technique of the substraction of the spectrum recorded at two different microwave powers in order to reduce the BKS signal. Fingernail samples collected from different donors were treated by soaking in water during 10 min and 5 min drying on paper towel and the BKS signals were studied previously its irradiation. The statistical analysis (R statistics) show a distribution with a Standard Deviation of 24% respects to its media. During these studies we also conserved in freezer for more than 6 months irradiated fingernails that, were periodically measured and the statistical analysis of the peak to peak amplitude show a normal distribution through the Quantile correlation test with a SD 11% respected to its median. (authors)

  9. EPR paradox revisited

    Energy Technology Data Exchange (ETDEWEB)

    Klippert, R. [Centro Brasileiro de Pesquisas Fisicas (CBPF), Rio de Janeiro, RJ (Brazil)

    1999-07-01

    In a seminal paper from 1935 Einstein, Podolsky and Rosen produced one of the most powerful weapon against the unpredictability of the world ensured by quantum mechanics. The recent production of entangled states, with all its possible future applications in quantum computation, re-open the possibility of testing EPR states on physical grounds. The present intends to present a challenge to the wedding of classical (special) relativity with quantum mechanics, the so called relativistic quantum mechanics. Making use of the same apparatus devised in EPR, it is shown that non local quantum states are incompatible with either their possibility of being measured or else with Lorentz invariance (or even with both). (author)

  10. Disentangling overlapping high-field EPR spectra of organic radicals: Identification of light-induced polarons in the record fullerene-free solar cell blend PBDB-T:ITIC

    Science.gov (United States)

    Van Landeghem, Melissa; Maes, Wouter; Goovaerts, Etienne; Van Doorslaer, Sabine

    2018-03-01

    We present a combined high-field EPR and DFT study of light-induced radicals in the bulk heterojunction blend of PBDB-T:ITIC, currently one of the highest efficiency non-fullerene donor:acceptor combinations in organic photovoltaics. We demonstrate two different approaches for disentangling the strongly overlapping high-field EPR spectra of the positive and negative polarons after charge separation: (1) relaxation-filtered field-swept EPR based on the difference in T1 spin-relaxation times and (2) field-swept EDNMR-induced EPR by exploiting the presence of 14N hyperfine couplings in only one of the radical species, the small molecule acceptor radical. The approach is validated by light-induced EPR spectra on related blends and the spectral assignment is underpinned by DFT computations. The broader applicability of the spectral disentangling methods is discussed.

  11. Disentangling overlapping high-field EPR spectra of organic radicals: Identification of light-induced polarons in the record fullerene-free solar cell blend PBDB-T:ITIC.

    Science.gov (United States)

    Van Landeghem, Melissa; Maes, Wouter; Goovaerts, Etienne; Van Doorslaer, Sabine

    2018-03-01

    We present a combined high-field EPR and DFT study of light-induced radicals in the bulk heterojunction blend of PBDB-T:ITIC, currently one of the highest efficiency non-fullerene donor:acceptor combinations in organic photovoltaics. We demonstrate two different approaches for disentangling the strongly overlapping high-field EPR spectra of the positive and negative polarons after charge separation: (1) relaxation-filtered field-swept EPR based on the difference in T 1 spin-relaxation times and (2) field-swept EDNMR-induced EPR by exploiting the presence of 14 N hyperfine couplings in only one of the radical species, the small molecule acceptor radical. The approach is validated by light-induced EPR spectra on related blends and the spectral assignment is underpinned by DFT computations. The broader applicability of the spectral disentangling methods is discussed. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. EPR: the nuclear impasse

    International Nuclear Information System (INIS)

    Marillier, F.

    2008-01-01

    The questions relative to the climatic change constitute crucial challenges for the next ten years. In this context the author aims to show how the EPR project illustrates the nuclear french ''autism''. He presents and analyzes the international and environmental impacts of this obsolete technology, as a project useless and dangerous. (A.L.B.)

  13. HyPR Device: Mobile Support for Hybrid Patient Records

    DEFF Research Database (Denmark)

    Houben, Steven; Frost, Mads; Bardram, Jakob E

    2014-01-01

    The patient record is one of the central artifacts in medical work that is used to organize, communicate and coordinate important information related to patient care. In many hospitals a double record consisting of an electronic and paper part is maintained. This practice introduces a number of c......PR device decreases configuration work, supports mobility in clinical work and increases awareness on patient data.......The patient record is one of the central artifacts in medical work that is used to organize, communicate and coordinate important information related to patient care. In many hospitals a double record consisting of an electronic and paper part is maintained. This practice introduces a number...... introduce the HyPR Device, a device that merges the paper and electronic patient record into one system. We provide results from a clinical simulation with eight clinicians and discuss the functional, design and infrastructural requirements of such hybrid patient records. Our study suggests that the Hy...

  14. EPR detection of foods preserved with ionizing radiation

    Science.gov (United States)

    Stachowicz, W.; Burlinska, G.; Michalik, J.

    1998-06-01

    The applicability of the epr technique for the detection of dried vegetables, mushrooms, some spices, flavour additives and some condiments preserved with ionizing radiation is discussed. The epr signals recorded after exposure to gamma rays and to beams of 10 MeV electrons from linac are stable, intense and specific enough as compared with those observed with nonirradiated samples and could be used for the detection of irradiation. However, stability of radiation induced epr signals produced in these foods depends on storage condition. No differences in shapes (spectral parameters) and intensities of the epr spectra recorded with samples exposed to the same doses of gamma rays ( 60Co) and 10 MeV electrons were observed

  15. EPR detection of foods preserved with ionizing radiation

    International Nuclear Information System (INIS)

    Stachowicz, W.; Burlinska, G.; Michalik, J.

    1998-01-01

    The applicability of the epr technique for the detection of dried vegetables, mushrooms, some spices, flavour additives and some condiments preserved with ionizing radiation is discussed. The epr signals recorded after exposure to gamma rays and to the beams of 10 MeV electrons from linac are stable, intense and specific enough as compared with those observed with nonirradiated samples and could be used for the detection of irradiation. However, stability of radiation induced epr signals produced in these foods depends on storage condition. No differences in shapes (spectral parameters) and intensities of the epr spectra recorded with samples exposed to the same doses of gamma rays ( 60 Co) and 10 MeV electrons were observed

  16. EPR detection of foods preserved with ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    Stachowicz, W.; Burlinska, G.; Michalik, J

    1998-06-01

    The applicability of the epr technique for the detection of dried vegetables, mushrooms, some spices, flavour additives and some condiments preserved with ionizing radiation is discussed. The epr signals recorded after exposure to gamma rays and to the beams of 10 MeV electrons from linac are stable, intense and specific enough as compared with those observed with nonirradiated samples and could be used for the detection of irradiation. However, stability of radiation induced epr signals produced in these foods depends on storage condition. No differences in shapes (spectral parameters) and intensities of the epr spectra recorded with samples exposed to the same doses of gamma rays ({sup 60}Co) and 10 MeV electrons were observed.

  17. Echo detected EPR as a tool for detecting radiation-induced defect signals in pottery

    International Nuclear Information System (INIS)

    Zoleo, Alfonso; Bortolussi, Claudia; Brustolon, Marina

    2011-01-01

    Archaeological fragments of pottery have been investigated by using CW-EPR and Echo Detected EPR (EDEPR). EDEPR allows to remove the CW-EPR dominant Fe(III) background spectrum, hiding much weaker signals potentially useful for dating purpose. EDEPR spectra attributed to a methyl radical and to feldspar defects have been recorded at room and low temperature for an Iron Age cooking ware (700 B.C.). A study on the dependence of EDEPR intensity over absorbed dose on a series of γ-irradiated brick samples (estimated age of 562 ± 140 B.C.) has confirmed the potential efficacy of the proposed method for spotting defect signals out of the strong iron background. - Highlights: → Fe(III) CW-EPR signals cover CW-EPR-detectable defects in ceramics. → Echo detected EPR gets rid of Fe(III) signals, disclosing defect signals. → Echo detected EPR detects defect signals even at relatively low doses.

  18. Multifrequency EPR study on freeze-dried fruits before and after X-ray irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Yordanov, N.D. [Laboratory EPR, Institute of Catalysis, Bulgarian Academy of Sciences, 1113 Sofia (Bulgaria)]. E-mail: ndyepr@bas.bg; Aleksieva, K. [Laboratory EPR, Institute of Catalysis, Bulgarian Academy of Sciences, 1113 Sofia (Bulgaria); Dimitrova, A. [Laboratory EPR, Institute of Catalysis, Bulgarian Academy of Sciences, 1113 Sofia (Bulgaria); Georgieva, L. [Institute of Cryobiology and Food Technologies, 1162 Sofia (Bulgaria); Tzvetkova, E. [Institute of Cryobiology and Food Technologies, 1162 Sofia (Bulgaria)

    2006-09-15

    X-, K- and Q-band EPR studies on lyophilized whole pulp parts of blue plum, apricot, peach, melon as well as achens and pulp separately of strawberry before and after X-ray irradiation are reported. Before irradiation all samples show in X band a weak singlet EPR line with g=2.0030+/-0.0005, except melon, which is EPR silent. Immediately after irradiation all samples exhibit complex fruit-depending spectra, which decay with time and change to give, in ca. 50days, an asymmetric singlet EPR line with g=2.0041+/-0.0005. Only apricot pulp gave a typical ''sugar-like'' EPR spectrum. Singlet EPR lines recorded after irradiation in X -band are K- and Q-band resolved as typical anisotropic EPR spectra with g{sub ||}=2.0023+/-0.0003 and g{sub -}bar =2.0041+/-0.0005. In addition, K- and Q-band EPR spectra of all samples show a superposition with the six EPR lines of Mn{sup 2+} naturally present in the fruits. The saturation behavior of the EPR spectra of achens of lyophilized and fresh strawberry is also studied. The differences in g factors of samples before and after X-ray irradiation might be used for the identification of radiation processing of fruits in the case of pulp and the differences in the EPR saturation behavior might be used for the achens of strawberry.

  19. Multifrequency EPR study on freeze-dried fruits before and after X-ray irradiation

    Science.gov (United States)

    Yordanov, N. D.; Aleksieva, K.; Dimitrova, A.; Georgieva, L.; Tzvetkova, E.

    2006-09-01

    X-, K- and Q-band EPR studies on lyophilized whole pulp parts of blue plum, apricot, peach, melon as well as achens and pulp separately of strawberry before and after X-ray irradiation are reported. Before irradiation all samples show in X band a weak singlet EPR line with g=2.0030±0.0005, except melon, which is EPR silent. Immediately after irradiation all samples exhibit complex fruit-depending spectra, which decay with time and change to give, in ca. 50 days, an asymmetric singlet EPR line with g=2.0041±0.0005. Only apricot pulp gave a typical "sugar-like" EPR spectrum. Singlet EPR lines recorded after irradiation in X -band are K- and Q-band resolved as typical anisotropic EPR spectra with g=2.0023±0.0003 and g⊥=2.0041±0.0005. In addition, K- and Q-band EPR spectra of all samples show a superposition with the six EPR lines of Mn 2+ naturally present in the fruits. The saturation behavior of the EPR spectra of achens of lyophilized and fresh strawberry is also studied. The differences in g factors of samples before and after X-ray irradiation might be used for the identification of radiation processing of fruits in the case of pulp and the differences in the EPR saturation behavior might be used for the achens of strawberry.

  20. EPR (European Pressurized Reactor)

    International Nuclear Information System (INIS)

    2015-01-01

    This document presents the EPR (European Pressurized Reactor), a modernised version of PWRs which uses nuclear fission. It indicates to which category it belongs (third generation). It briefly describes its operation: recalls on nuclear fission, electricity production in a nuclear reactor. It presents and comments its characteristics: power, thermal efficiency, redundant systems for safety control, double protective enclosure, expected lifetime, use of MOX fuel, modular design. It discusses economic stakes (expected higher nuclear electricity competitiveness, but high construction costs), and safety challenges (design characteristics, critics by nuclear safety authorities about the safety data processing system). It presents the main involved actors (Areva, EDF) and competitors in the field of advanced reactors (Rosatom with its VVER 1200, General Electric with its ABWR and its ESBWR, Mitsubishi with its APWR, Westinghouse with its AP100) while outlining the importance of certifications and delays to obtain them. After having evoked key data on EPR fuel consumption, it indicates reactors under construction, evokes potential markets and perspectives

  1. Clinical Databases Originating in Electronic Patient Records

    Czech Academy of Sciences Publication Activity Database

    Zvárová, Jana

    2002-01-01

    Roč. 22, č. 1 (2002), s. 43-60 ISSN 0208-5216 R&D Projects: GA MŠk LN00B107 Keywords : medical informatics * tekemedicine * electronic health record * electronic medical guidelines * decision-support systems * cardiology Subject RIV: BD - Theory of Information

  2. EPR, kvantemekanik og Bohr

    OpenAIRE

    Nielsen, Morten Klockmann

    2007-01-01

    Dette projekt omhandler området hvor filosofi og fysik smelter sammen. Kvantemekanikkens tilblivelse fik en hård medfart hvilket diskussionerne mellem især Albert Einstein og Niels Bohr vidner om. De var hovedpersoner i striden om hvordan kvantemekanikken skulle fortolkes, og diskussionen kulminerede i 1935 hvor Einstein sammen med kollegerne Podolsky og Rosen offentliggjorde en artikel med titlen “Can Quantum-Mechanical Description of Physical Reality Be Considered Complete?” (EPR-artiklen)....

  3. EPR a strategic choice

    International Nuclear Information System (INIS)

    2003-01-01

    How can we answer to the increasing demand of electric power, resulting of the demographic evolution and needed to the economic development, without exhausting the fossil resources? The answers are function of the countries and imply an optimization of the production and the consumption. This document published by the Areva Group aims to show the advantages of the nuclear energy: economical and environmental advantages. A special chapter is devoted to the European Pressurized Reactor, EPR. (A.L.B.)

  4. EPR spectroscopy of spices

    Directory of Open Access Journals (Sweden)

    R. T. Тimakova

    2016-01-01

    Full Text Available From 01 January 2017 you enter the interstate standard GOST 33271-2015 “Dry Spices, herbs and vegetable seasonings. Manual exposure in order to combat pathogens and other microorganisms” which States that the absorbed dose of radiation to the spices should be from 3 to 30 kGy. The study found that before the introduction of permissive legislative framework in the consumer market of Russia there are irradiated food products (chili, ground chili, ground spicy chili, black pepper. For radiation monitoring of food safety, we used the method of electron paramagnetic resonance (EPR, which allows quickly and with a high degree of reliability to establish the fact of irradiation. It is established that all samples of spices irradiated with dose of 12 kGy (technology radappertization gave typical spectra of the signals established by the method of electron paramagnetic resonance in the domestic EPR spectrometer, the intensity, amplitude and peak width of the EPR signal of samples of spices with the increase of irradiation dose increases. It is proven that repeated exposure no effect accumulation. Integration with 2017 Russia in the global practi ce of using radiation technologies of processing of food products and food raw materials with the purpose of extending shelf life confirms the need for a data Bank on the radiation sensitivity of various food products to determine the optimal doses and the eff ect of radiation doses on the shelf life and quality of products.

  5. Electron paramagnetic resonance (EPR) biodosimetry

    International Nuclear Information System (INIS)

    Desrosiers, Marc; Schauer, David A.

    2001-01-01

    Radiation-induced electron paramagnetic resonance (EPR) signals were first reported by Gordy et al. [Proc. Natl. Acad. Sci. USA 41 (1955) 983]. The application of EPR spectroscopy to ionizing radiation dosimetry was later proposed by Brady et al. [Health Phys. 15 (1968) 43]. Since that time EPR dosimetry has been applied to accident and epidemiologic dose reconstruction, radiation therapy, food irradiation, quality assurance programs and archaeological dating. Materials that have been studied include bone, tooth enamel, alanine and quartz. This review paper presents the fundamentals and applications of EPR biodosimetry. Detailed information regarding sample collection and preparation, EPR measurements, dose reconstruction, and data analysis and interpretation will be reviewed for tooth enamel. Examples of EPR biodosimetry application in accidental overexposures, radiopharmaceutical dose assessment and retrospective epidemiologic studies will also be presented

  6. EPR spectroscopy at DNP conditions

    International Nuclear Information System (INIS)

    Heckmann, J.; Goertz, St.; Meyer, W.; Radtke, E.; Reicherz, G.

    2004-01-01

    In terms of dynamic nuclear polarization (DNP) studies and systematic target material research it is crucial to know the EPR lineshape of the DNP relevant paramagnetic centers. Therefore in Bochum an EPR spectrometer has been implemented into the 4 He evaporation DNP facility in order to perform EPR studies at DNP conditions (B=2.5 T, T=1 K). The spectrometer hardware and performance as well as first results are presented

  7. Quantitative EPR A Practitioners Guide

    CERN Document Server

    Eaton, Gareth R; Barr, David P; Weber, Ralph T

    2010-01-01

    This is the first comprehensive yet practical guide for people who perform quantitative EPR measurements. No existing book provides this level of practical guidance to ensure the successful use of EPR. There is a growing need in both industrial and academic research to provide meaningful and accurate quantitative EPR results. This text discusses the various sample, instrument and software related aspects required for EPR quantitation. Specific topics include: choosing a reference standard, resonator considerations (Q, B1, Bm), power saturation characteristics, sample positioning, and finally, putting all the factors together to obtain an accurate spin concentration of a sample.

  8. Clinical EPR: Unique Opportunities and Some Challenges

    Science.gov (United States)

    Swartz, Harold M.; Williams, Benjamin B.; Zaki, Bassem I.; Hartford, Alan C.; Jarvis, Lesley A.; Chen, Eunice; Comi, Richard J.; Ernstoff, Marc S.; Hou, Huagang; Khan, Nadeem; Swarts, Steven G.; Flood, Ann B.; Kuppusamy, Periannan

    2014-01-01

    Electron paramagnetic resonance (EPR) spectroscopy has been well established as a viable technique for measurement of free radicals and oxygen in biological systems, from in vitro cellular systems to in vivo small animal models of disease. However, the use of EPR in human subjects in the clinical setting, although attractive for a variety of important applications such as oxygen measurement, is challenged with several factors including the need for instrumentation customized for human subjects, probe and regulatory constraints. This paper describes the rationale and development of the first clinical EPR systems for two important clinical applications, namely, measurement of tissue oxygen (oximetry), and radiation dose (dosimetry) in humans. The clinical spectrometers operate at 1.2 GHz frequency and use surface loop resonators capable of providing topical measurements up to 1 cm depth in tissues. Tissue pO2 measurements can be carried out noninvasively and repeatedly after placement of an oxygen-sensitive paramagnetic material (currently India ink) at the site of interest. Our EPR dosimetry system is capable of measuring radiation-induced free radicals in the tooth of irradiated human subjects to determine the exposure dose. These developments offer potential opportunities for clinical dosimetry and oximetry, which include guiding therapy for individual patients with tumors or vascular disease, by monitoring of tissue oxygenation. Further work is in progress to translate this unique technology to routine clinical practice. PMID:24439333

  9. Digital audio recordings improve the outcomes of patient consultations

    DEFF Research Database (Denmark)

    Wolderslund, Maiken; Kofoed, Poul-Erik; Holst, René

    2017-01-01

    OBJECTIVES: To investigate the effects on patients' outcome of the consultations when provided with: a Digital Audio Recording (DAR) of the consultation and a Question Prompt List (QPL). METHODS: This is a three-armed randomised controlled cluster trial. One group of patients received standard care......, while the other two groups received either the QPL in combination with a recording of their consultation or only the recording. Patients from four outpatient clinics participated: Paediatric, Orthopaedic, Internal Medicine, and Urology. The effects were evaluated by patient-administered questionnaires...

  10. Can audio recording improve patients' recall of outpatient consultations?

    DEFF Research Database (Denmark)

    Wolderslund, Maiken; Kofoed, Poul-Erik; Axboe, Mette

    Introduction In order to give patients possibility to listen to their consultation again, we have designed a system which gives the patients access to digital audio recordings of their consultations. An Interactive Voice Response platform enables the audio recording and gives the patients access...... and those who have not (control).The audio recordings and the interviews are coded according to six themes: Test results, Treatment, Risks, Future tests, Advice and Plan. Afterwards the extent of patients recall is assessed by comparing the accuracy of the patient’s statements (interview...

  11. Getting data out of the electronic patient record: critical steps in building a data warehouse for decision support.

    Science.gov (United States)

    Ebidia, A; Mulder, C; Tripp, B; Morgan, M W

    1999-01-01

    Health care has taken advantage of computers to streamline many clinical and administrative processes. However, the potential of health care information technology as a source of data for clinical and administrative decision support has not been fully explored. This paper describes the process of developing on-line analytical processing (OLAP) capacity from data generated in an on-line transaction processing (OLTP) system (the electronic patient record). We discuss the steps used to evaluate the EPR system, retrieve the data, and create an analytical data warehouse accessible for analysis. We also summarize studies based on the data (lab re-engineering, practice variation in diagnostic decision-making and evaluation of a clinical alert). Besides producing a useful data warehouse, the process also increased understanding of organizational and cost considerations in purchasing OLAP tools. We discuss the limitations of our approach and ways in which these limitations can be addressed.

  12. Influence of glycemic control on some real-time biomarkers of free radical formation in type 2 diabetic patients: An EPR study.

    Science.gov (United States)

    Gadjeva, Veselina Georgieva; Goycheva, Petia; Nikolova, Galina; Zheleva, Antoaneta

    2017-11-01

    The pathology of diabetes is associated with several mechanisms, one of which is oxidative stress (OS). The relationship between OS and diabetic complications has been extensively investigated. OS has been suggested to be involved in the genesis of both macroand microangiopathy. In contrast, the relationship between OS and insulin action is a neglected research area. The aim of this study is to elucidate the effect of glycemic control in type 2 diabetic patients by following the serum levels of some real-time oxidative stress biomarkers. The study group consisted of 53 type 2 diabetic patients (31 with poor glycemic control and 22 with good glycemic control) and 24 healthy control subjects. The oxidative stress biomarkers (ROS, Asc• and •NO) were measured by using electron paramagnetic resonance spectroscopy (EPR) methods and compared with clinical parameters. The statistically significantly higher levels of ROS products and •NO in type 2 diabetic patients in both groups compared to controls mean that the oxidation processes take place at the time the survey is performed. Free radical overproduction persists after the normalization of the glucose levels, and oxidative stress may be involved in the "metabolic memory" effect. This is confirmed by the positive correlation between ROS levels/•NO and average blood glucose levels, triglycerides, and total cholesterol. Furthermore, the low level of the ascorbate radical in both diabetes groups compared to controls confirmed an increase in oxidation processes. Higher levels of real-time biomarkers show that intensive insulin treatment does not lead to the expected decrease in oxidative processes involving ROS and •NO, probably due to "metabolic memory".

  13. Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work

    DEFF Research Database (Denmark)

    Houben, Steven; Frost, Mads; Bardram, Jakob E

    2015-01-01

    explored the integration of paper and digital technology, there are still a wide range of open issues in the design of technologies that integrate digital and paper-based medical records. This paper studies the use of one such novel technology, called the Hybrid Patient Record (HyPR), that is designed......The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approaches...... to digitally augment a paper medical record. We report on two studies: a field study in which we describe the benefits and challenges of using a combination of electronic and paper-based medical records in a large university hospital and a deployment study in which we analyze how 8 clinicians used the Hy...

  14. A secure effective dynamic group password-based authenticated key agreement scheme for the integrated EPR information system

    Directory of Open Access Journals (Sweden)

    Vanga Odelu

    2016-01-01

    Full Text Available With the rapid growth of the Internet, a lot of electronic patient records (EPRs have been developed for e-medicine systems. The security and privacy issues of EPRs are important for the patients in order to understand how the hospitals control the use of their personal information, such as name, address, e-mail, medical records, etc. of a particular patient. Recently, Lee et al. proposed a simple group password-based authenticated key agreement protocol for the integrated EPR information system (SGPAKE. However, in this paper, we show that Lee et al.’s protocol is vulnerable to the off-line weak password guessing attack and as a result, their scheme does not provide users’ privacy. To withstand this security weakness found in Lee et al.’s scheme, we aim to propose an effective dynamic group password-based authenticated key exchange scheme for the integrated EPR information system, which retains the original merits of Lee et al.’s scheme. Through the informal and formal security analysis, we show that our scheme provides users’ privacy, perfect forward security and known-key security, and also protects online and offline password guessing attacks. Furthermore, our scheme efficiently supports the dynamic group password-based authenticated key agreement for the integrated EPR information system. In addition, we simulate our scheme for the formal security verification using the widely-accepted AVISPA (Automated Validation of Internet Security Protocols and Applications tool and show that our scheme is secure against passive and active attacks.

  15. EPR design for maintenance

    International Nuclear Information System (INIS)

    Krugmann, U.

    1998-01-01

    Preventive maintenance is very important in achieving high plant availability. For the European Pressurized Reactor (EPR) preventive maintenance has been carefully addressed in the design stage. This is particularly necessary because of the traditionally different maintenance strategies employed in France and Germany. This paper emphasizes the following features introduced in the ERP design to minimize the duration of the refueling outage: (1) containment accessibility during power operation; (2) overall plant layout to facilitate inspections and maintenances within the containment; and (3) safety system design for enabling preventive maintenance during power operation. (author)

  16. Electronic patient records in action: Transforming information into professionally relevant knowledge.

    Science.gov (United States)

    Winman, Thomas; Rystedt, Hans

    2011-03-01

    The implementation of generic models for organizing information in complex institutions like those in healthcare creates a gap between standardization and the need for locally relevant knowledge. The present study addresses how this gap can be bridged by focusing on the practical work of healthcare staff in transforming information in EPRs into knowledge that is useful for everyday work. Video recording of shift handovers on a rehabilitation ward serves as the empirical case. The results show how extensive selections and reorganizations of information in EPRs are carried out in order to transform information into professionally relevant accounts. We argue that knowledge about the institutional obligations and professional ways of construing information are fundamental for these transitions. The findings point to the need to consider the role of professional knowledge inherent in unpacking information in efforts to develop information systems intended to bridge between institutional and professional boundaries in healthcare. © The Author(s) 2011.

  17. HOSPITAL INFORMATION SYSTEMS: A STUDY OF ELECTRONIC PATIENT RECORDS

    Directory of Open Access Journals (Sweden)

    Pedro Luiz Cortês

    2011-05-01

    Full Text Available The importance of patient records, also known as medical records, is related to different needs and objectives, as they constitute permanent documents on the health of patients. With the advancement of information technologies and systems, patient records can be stored in databases, resulting in a positive impact on patient care. Based on these considerations, a research question that arises is “what are the benefits and problems that can be seen with the use of electronic versions of medical records?” This question leads to the formulation of the following hypothesis: although problems can be identified during the process of using electronic record systems, the benefits outweigh the difficulties, thereby justifying their use. To respond to the question and test the presented hypothesis, a research study was developed with users of the same electronic record system, consisting of doctors, nurses, and administrative personnel in three hospitals located in the city of São Paulo, Brazil. The results show that, despite some problems in their usage, the benefits of electronic patient records outweigh possible disadvantages.

  18. Hybrid Patient Record – Supporting Hybrid Interaction in Clinical Wards

    DEFF Research Database (Denmark)

    Houben, Steven; Schmidt, Mathias; Frost, Mads

    2015-01-01

    Despite the widespread dissemination of the electronic health record, the paper medical record remains an important central artefact in modern clinical work. A number of new technological solutions have been proposed to mitigate some of the configuration, mobility and awareness problems that emerge...... when using this dual record setup. In this paper, we present one such technology, the HyPR device, in which a paper record is augmented with an electronic sensing platform that is designed to reduce the configuration overhead, provide awareness cues and support mobility across the patient ward. Our...

  19. Dose-Specific Adverse Drug Reaction Identification in Electronic Patient Records: Temporal Data Mining in an Inpatient Psychiatric Population

    DEFF Research Database (Denmark)

    Eriksson, Robert; Werge, Thomas; Jensen, Lars Juhl

    2014-01-01

    patient-specific adverse events (AEs) and links these to specific drugs and dosages in a temporal manner, based on integration of text mining results and structured data. The structured data contained precise information on drug identity, dosage and strength.When applying the method to the 3,394 patients...... all indication areas.The aim of this study was to take advantage of techniques for temporal data mining of EPRs in order to detect ADRs in a patient- and dose-specific manner.We used a psychiatric hospital’s EPR system to investigate undesired drug effects. Within one workflow the method identified...

  20. Emergency Preservation and Resuscitation for Cardiac Arrest from Trauma (EPR CAT)

    Science.gov (United States)

    2016-12-01

    Award Number: W81XWH-07-1-0682 TITLE: Emergency Preservation and Resuscitation for Cardiac Arrest from Trauma ( EPR -CAT) PRINCIPAL INVESTIGATOR...Preservation and Resuscitation ( EPR ) was developed to rapidly preserve the organism during ischemia, using hypothermia, drugs, and fluids, to “buy time...privileges for cannulation for the EPR flush. This has been accomplished. Given the complexity of our planned intervention for trauma patients in

  1. How patients can improve the accuracy of their medical records.

    Science.gov (United States)

    Dullabh, Prashila M; Sondheimer, Norman K; Katsh, Ethan; Evans, Michael A

    2014-01-01

    Assess (1) if patients can improve their medical records' accuracy if effectively engaged using a networked Personal Health Record; (2) workflow efficiency and reliability for receiving and processing patient feedback; and (3) patient feedback's impact on medical record accuracy. Improving medical record' accuracy and associated challenges have been documented extensively. Providing patients with useful access to their records through information technology gives them new opportunities to improve their records' accuracy and completeness. A new approach supporting online contributions to their medication lists by patients of Geisinger Health Systems, an online patient-engagement advocate, revealed this can be done successfully. In late 2011, Geisinger launched an online process for patients to provide electronic feedback on their medication lists' accuracy before a doctor visit. Patient feedback was routed to a Geisinger pharmacist, who reviewed it and followed up with the patient before changing the medication list shared by the patient and the clinicians. The evaluation employed mixed methods and consisted of patient focus groups (users, nonusers, and partial users of the feedback form), semi structured interviews with providers and pharmacists, user observations with patients, and quantitative analysis of patient feedback data and pharmacists' medication reconciliation logs. (1) Patients were eager to provide feedback on their medications and saw numerous advantages. Thirty percent of patient feedback forms (457 of 1,500) were completed and submitted to Geisinger. Patients requested changes to the shared medication lists in 89 percent of cases (369 of 414 forms). These included frequency-or dosage changes to existing prescriptions and requests for new medications (prescriptions and over-the counter). (2) Patients provided useful and accurate online feedback. In a subsample of 107 forms, pharmacists responded positively to 68 percent of patient requests for

  2. From PACS to Web-based ePR system with image distribution for enterprise-level filmless healthcare delivery.

    Science.gov (United States)

    Huang, H K

    2011-07-01

    The concept of PACS (picture archiving and communication system) was initiated in 1982 during the SPIE medical imaging conference in New Port Beach, CA. Since then PACS has been matured to become an everyday clinical tool for image archiving, communication, display, and review. This paper follows the continuous development of PACS technology including Web-based PACS, PACS and ePR (electronic patient record), enterprise PACS to ePR with image distribution (ID). The concept of large-scale Web-based enterprise PACS and ePR with image distribution is presented along with its implementation, clinical deployment, and operation. The Hong Kong Hospital Authority's (HKHA) integration of its home-grown clinical management system (CMS) with PACS and ePR with image distribution is used as a case study. The current concept and design criteria of the HKHA enterprise integration of the CMS, PACS, and ePR-ID for filmless healthcare delivery are discussed, followed by its work-in-progress and current status.

  3. EPR structure of the gamma irradiated alanine spectrum

    Energy Technology Data Exchange (ETDEWEB)

    Cabral P, A; Jimenez D, H; Urena N, F; Galindo, S; Bosch, P

    1992-03-15

    In this study is shown that the broadened five-line EPR pattern of the gamma irradiated alanine possibly decomposes into a more complex pattern when the recorded spectrum is subject to an operation of deconvolution. The EPR powder spectra of gamma irradiated DL- and L-alanine with and without binders are analysed. In all recorded spectra, each observed line is resolved into an asymmetrical triplet when a Gaussian distribution of 8.2 gauss width is removed, by deconvolution, from the observed spectrum. On the other hand, from a simple fitting analysis carried out on the original data, one encounters that some calculated relations between characteristic parameters, such as intensity ratios, deviate consistently from assumed height ratios. Both, from deconvolution and fitting results, a different structure is suggested for the observed broadened five-line EPR pattern of {gamma}-irradiated powder DL- and L-alanine. (Author)

  4. EPR structure of the gamma irradiated alanine spectrum

    International Nuclear Information System (INIS)

    Cabral P, A.; Jimenez D, H.; Urena N, F.; Galindo, S.; Bosch, P.

    1992-03-01

    In this study is shown that the broadened five-line EPR pattern of the gamma irradiated alanine possibly decomposes into a more complex pattern when the recorded spectrum is subject to an operation of deconvolution. The EPR powder spectra of gamma irradiated DL- and L-alanine with and without binders are analysed. In all recorded spectra, each observed line is resolved into an asymmetrical triplet when a Gaussian distribution of 8.2 gauss width is removed, by deconvolution, from the observed spectrum. On the other hand, from a simple fitting analysis carried out on the original data, one encounters that some calculated relations between characteristic parameters, such as intensity ratios, deviate consistently from assumed height ratios. Both, from deconvolution and fitting results, a different structure is suggested for the observed broadened five-line EPR pattern of γ-irradiated powder DL- and L-alanine. (Author)

  5. EPR of uranium ions

    International Nuclear Information System (INIS)

    Ursu, I.; Lupei, V.

    1984-02-01

    A review of the electron paramagnetic resonance data on the uranium ions is given. After a general account of the electronic structure of the uranium free atoms and ions, the influence of the external fields (magnetic field, crystal fields) is discussed. The main information obtained from EPR studies on the uranium ions in crystals are emphasized: identification of the valence and of the ground electronic state, determination of the structure of the centers, crystal field effects, role of the intermediate coupling and of the J-mixing, role of the covalency, determination of the nuclear spin, maqnetic dipole moment and electric quadrupole moment of the odd isotopes of uranium. These data emphasize the fact that the actinide group has its own identity and this is accutely manifested at the beginning of the 5fsup(n) series encompassed by the uranium ions. (authors)

  6. Keeping record of the postoperative nursing care of patients

    Directory of Open Access Journals (Sweden)

    L. Roets

    2002-09-01

    Full Text Available The aim of this research project was to evaluate the recordkeeping of postoperative nursing care. A total of 186 randomly selected patient records were evaluated in terms of a checklist that included the most important parameters for postoperative nursing care. All the patients underwent operations under general anaesthetic in one month in a Level 3 hospital and were transferred to general wards after the operations. The data collected was analysed by means of frequencies. One finding was that the neurological status of most patients was assessed but that little attention was paid in the patient records to emotional status and physical comfort. The respiratory and circulatory status of the patients and their fluid balance were inadequately recorded. The patients were well monitored for signs of external haemorrhage, but in most cases haemorrhage was checked only once, on return from the theatre. Although the patients’ pain experience were well-monitored, follow-up actions after the administration of pharmacological agents was poor. The surgical intervention was fully described and, generally speaking, the records were complete and legible, but the signatures and ranks of the nurses were illegible. Allergies were indicated in the most important records. The researchers recommend that a comprehensive and easily usable documentation form be used in postoperative nursing care. Such a form would serve as a checklist and could ensure to a large degree that attention is given to the most important postoperative parameters. Errors and negligence could also be reduced by this means.

  7. A security analysis of the Dutch electronic patient record system

    NARCIS (Netherlands)

    van 't Noordende, G.

    2010-01-01

    In this article, we analyze the security architecture of the Dutch Electronic Patient Dossier (EPD) system. Intended as a national infrastructure for exchanging medical patient records among authorized parties (particularly, physicians), the EPD has to address a number of requirements, ranging from

  8. Security in the Dutch electronic patient record system

    NARCIS (Netherlands)

    van 't Noordende, G.

    2010-01-01

    In this article, we analyze the security architecture of the Dutch Electronic Patient Dossier (EPD) system. Intended as a mandatory infrastructure for exchanging medical records of most if not all patients in the Netherlands among authorized parties (particularly, physicians), the EPD has to address

  9. Medical record search engines, using pseudonymised patient identity: an alternative to centralised medical records.

    Science.gov (United States)

    Quantin, Catherine; Jaquet-Chiffelle, David-Olivier; Coatrieux, Gouenou; Benzenine, Eric; Allaert, François-André

    2011-02-01

    The purpose of our multidisciplinary study was to define a pragmatic and secure alternative to the creation of a national centralised medical record which could gather together the different parts of the medical record of a patient scattered in the different hospitals where he was hospitalised without any risk of breaching confidentiality. We first analyse the reasons for the failure and the dangers of centralisation (i.e. difficulty to define a European patients' identifier, to reach a common standard for the contents of the medical record, for data protection) and then propose an alternative that uses the existing available data on the basis that setting up a safe though imperfect system could be better than continuing a quest for a mythical perfect information system that we have still not found after a search that has lasted two decades. We describe the functioning of Medical Record Search Engines (MRSEs), using pseudonymisation of patients' identity. The MRSE will be able to retrieve and to provide upon an MD's request all the available information concerning a patient who has been hospitalised in different hospitals without ever having access to the patient's identity. The drawback of this system is that the medical practitioner then has to read all of the information and to create his own synthesis and eventually to reject extra data. Faced with the difficulties and the risks of setting up a centralised medical record system, a system that gathers all of the available information concerning a patient could be of great interest. This low-cost pragmatic alternative which could be developed quickly should be taken into consideration by health authorities. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  10. EPR Flamanville 3, Site Management

    International Nuclear Information System (INIS)

    Menager, Antoine

    2014-01-01

    Antoine Menager, the EPR Flamanville 3 Site Manager described the organization and the management of the Flamanville site during the construction phase. He placed emphasis on Health and Safety, Environmental and Social Responsibility and on Nuclear Safety and Quality

  11. Towards EPR (European pressurized reactor)

    International Nuclear Information System (INIS)

    Anon.

    2003-01-01

    According to the French industry minister, it is nonsense continuing delaying the construction of an EPR prototype because France needs it in order to renew timely its park of nuclear reactors. The renewing is expected to begin in 2020 and will be assured with third generation reactors like EPR. A quick launching of the EPR prototype is necessary to have it being in service by 2012, the feedback operating experience that will be accumulated over the 8 years that will follow will be necessary to optimize the industrial version and to have it ready by 2020. The EPR reactor has indisputable assets: modern, safer, more competitive and it will produce less wastes than present nuclear reactors. The construction cost of an EPR prototype is estimated to 3 milliard Euros and the nuclear industry operators propose to finance it completely. The EPR prototype does not jeopardize the ambitious French program about renewable energy sources, France is committed to produce 21% of its electricity from renewable energies by 2010 and 10 milliard Euros will be invested over this period on wind energy. Nuclear energy and alternative energies must be considered as 2 aspects of a diversified energy policy. (A.C.)

  12. SU-E-T-502: Biometrically Accepted Patient Records

    International Nuclear Information System (INIS)

    Basavatia, A; Kalnicki, S; Garg, M; Lukaj, A; Hong, L; Fret, J; Yaparpalvi, R; Tome, W

    2014-01-01

    Purpose: To implement a clinically useful palm vein pattern recognition biometric system to treat the correct treatment plan to the correct patient each and every time and to check-in the patient into the department to access the correct medical record. Methods: A commercially available hand vein scanning system was paired to Aria and utilized an ADT interface from the hospital electronic health system. Integration at two points in Aria, version 11 MR2, first at the appointment tracker screen for the front desk medical record access and second at the queue screen on the 4D treatment console took place for patient daily time-out. A test patient was utilized to check accuracy of identification as well as to check that no unintended interactions take place between the 4D treatment console and the hand vein scanning system. This system has been in clinical use since December 2013. Results: Since implementation, 445 patients have been enrolled into our biometric system. 95% of patients learn the correct methodology of hand placement on the scanner in the first try. We have had two instances of patient not found because of a bad initial scan. We simply erased the scanned metric and the patient enrolled again in those cases. The accuracy of the match is 100% for each patient, we have not had one patient misidentified. We can state this because we still use patient photo and date of birth as identifiers. A QA test patient is run monthly to check the integrity of the system. Conclusion: By utilizing palm vein scans along with the date of birth and patient photo, another means of patient identification now exits. This work indicates the successful implementation of technology in the area of patient safety by closing the gap of treating the wrong plan to a patient in radiation oncology. FOJP Service Corporation covered some of the costs of the hardware and software of the palm vein pattern recognition biometric system

  13. SU-E-T-502: Biometrically Accepted Patient Records

    Energy Technology Data Exchange (ETDEWEB)

    Basavatia, A; Kalnicki, S; Garg, M; Lukaj, A; Hong, L [Montefiore Medical Center, Bronx, NY (United States); Fret, J [Montefiore Information Technology, Yonkers, NY (United States); Yaparpalvi, R [Montefiore Medical Center, Bronx, NY (United States); Montefiore Medical Center, Bronx, NY (United States); Tome, W [Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY (United States)

    2014-06-01

    Purpose: To implement a clinically useful palm vein pattern recognition biometric system to treat the correct treatment plan to the correct patient each and every time and to check-in the patient into the department to access the correct medical record. Methods: A commercially available hand vein scanning system was paired to Aria and utilized an ADT interface from the hospital electronic health system. Integration at two points in Aria, version 11 MR2, first at the appointment tracker screen for the front desk medical record access and second at the queue screen on the 4D treatment console took place for patient daily time-out. A test patient was utilized to check accuracy of identification as well as to check that no unintended interactions take place between the 4D treatment console and the hand vein scanning system. This system has been in clinical use since December 2013. Results: Since implementation, 445 patients have been enrolled into our biometric system. 95% of patients learn the correct methodology of hand placement on the scanner in the first try. We have had two instances of patient not found because of a bad initial scan. We simply erased the scanned metric and the patient enrolled again in those cases. The accuracy of the match is 100% for each patient, we have not had one patient misidentified. We can state this because we still use patient photo and date of birth as identifiers. A QA test patient is run monthly to check the integrity of the system. Conclusion: By utilizing palm vein scans along with the date of birth and patient photo, another means of patient identification now exits. This work indicates the successful implementation of technology in the area of patient safety by closing the gap of treating the wrong plan to a patient in radiation oncology. FOJP Service Corporation covered some of the costs of the hardware and software of the palm vein pattern recognition biometric system.

  14. EPR studies of gamma-irradiated taurine single crystals

    Energy Technology Data Exchange (ETDEWEB)

    Bulut, A. E-mail: abulut@samsun.omu.edu.tr; Karabulut, B.; Tapramaz, R.; Koeksal, F

    2000-04-01

    An EPR study of gamma-irradiated taurine [C{sub 2}H{sub 7}NO{sub 3}S] single crystal was carried out at room temperature. The EPR spectra were recorded in the three at mutually perpendicular planes. There are two magnetically distinct sites in monoclinic lattice. The principle values of g and hyperfine constants for both sites were calculated. The results have indicated the presence of {sup 32}SO{sup -}{sub 2} and {sup 33}SO{sup -}{sub 2} radicals. The hyperfine values of {sup 33}SO{sup -}{sub 2} radical were used to obtain O-S-O bond angle for both sites.

  15. EPR studies of gamma-irradiated taurine single crystals

    International Nuclear Information System (INIS)

    Bulut, A.; Karabulut, B.; Tapramaz, R.; Koeksal, F.

    2000-01-01

    An EPR study of gamma-irradiated taurine [C 2 H 7 NO 3 S] single crystal was carried out at room temperature. The EPR spectra were recorded in the three at mutually perpendicular planes. There are two magnetically distinct sites in monoclinic lattice. The principle values of g and hyperfine constants for both sites were calculated. The results have indicated the presence of 32 SO - 2 and 33 SO - 2 radicals. The hyperfine values of 33 SO - 2 radical were used to obtain O-S-O bond angle for both sites

  16. Can audio recording of outpatient consultations improve patient outcome?

    DEFF Research Database (Denmark)

    Wolderslund, Maiken; Kofoed, Poul-Erik; Axboe, Mette

    different departments: Orthopedics, Urology, Internal Medicine and Pediatrics. A total of 5,460 patients will be included from the outpatient clinics. All patients randomized to an intervention group are offered audio recording of their consultation. An Interactive Voice Response platform enables an audio....... The intervention will be evaluated using a questionnaire measuring different aspect of patients recall and understanding of the information given, patients need for additional information subsequent to the consultation and their overall satisfaction with the consultation. Results The study will be conducted from...

  17. EPR by Areva. EPR the 1600+ MWe reactor

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-07-01

    This brochure presents the GEN III+ EPR reactor designed by the Areva and Siemens consortium. The EPR reactor is a direct descendent of the well-proven N4 and KONVOI reactors, the most modern reactors in France and Germany. The EPR was designed by teams from KWU/Siemens and Framatome, EDF in France and the major German utilities, working in collaboration with both French and German safety authorities. The EPR integrates the results of decades of R and D programs, in particular those performed by the CEA (French Atomic Energy Commission) and the Karlsruhe Research Center in Germany. The EPR benefits from the experience of several thousand reactor-years of operation of pressurized water reactor technology. This experience has put 87 AREVA PWRs online throughout the world. Innovative Features: - An outer shell covering the reactor building, the spent fuel building and two of the four safeguard buildings provides protection against large commercial or military aircraft crash. - A heavy neutron reflector that surrounds the reactor core lowers uranium consumption. - An axial economizer inside the steam generator allows a high level of steam pressure and therefore high plant efficiency. - A core catcher allows passive collection and retention of the molten core should the reactor vessel fail in the highly unlikely event of a core melt. - A digital technology and a fully computerized control room with an operator friendly man-machine interface improve the reactor protection system.

  18. EPR by Areva. EPR the 1600+ MWe reactor

    International Nuclear Information System (INIS)

    2008-01-01

    This brochure presents the GEN III+ EPR reactor designed by the Areva and Siemens consortium. The EPR reactor is a direct descendent of the well-proven N4 and KONVOI reactors, the most modern reactors in France and Germany. The EPR was designed by teams from KWU/Siemens and Framatome, EDF in France and the major German utilities, working in collaboration with both French and German safety authorities. The EPR integrates the results of decades of R and D programs, in particular those performed by the CEA (French Atomic Energy Commission) and the Karlsruhe Research Center in Germany. The EPR benefits from the experience of several thousand reactor-years of operation of pressurized water reactor technology. This experience has put 87 AREVA PWRs online throughout the world. Innovative Features: - An outer shell covering the reactor building, the spent fuel building and two of the four safeguard buildings provides protection against large commercial or military aircraft crash. - A heavy neutron reflector that surrounds the reactor core lowers uranium consumption. - An axial economizer inside the steam generator allows a high level of steam pressure and therefore high plant efficiency. - A core catcher allows passive collection and retention of the molten core should the reactor vessel fail in the highly unlikely event of a core melt. - A digital technology and a fully computerized control room with an operator friendly man-machine interface improve the reactor protection system

  19. EPR by Areva. The path of greatest certainty

    International Nuclear Information System (INIS)

    2008-01-01

    AREVA's Evolutionary Power Reactor (EPR) is the first Generation III+ reactor design currently being built to answer the world's growing demand for clean and reliable electricity generation. Already under construction in Finland, France and China, the EPR is also being considered by America, United Kingdom, South Africa and other countries for the development of their nuclear fleet. The EPR is now clearly destined to become the mainstay of standardized, efficient reactor fleets around the globe. AREVA's EPR incorporates unbeatable know-how provided by an uninterrupted track record of reactor building activities and backed by decades of feedback experience from operating PWRs, including the most recent. The EPR is a Franco-German initiative which benefited from the stringent scrutiny of safety authorities from both countries, at each stage of the project. The EPR has already secured construction licenses from two of the world's most demanding safety authorities in France and Finland and is currently in line for a design certification and a combined construction and operating license (COL) in the USA. It is also taking part in the licensing process recently launched in the United Kingdom. Europe's leading utilities have granted the EPR their approval under the 'European Utilities Requirements' and have further expressed individual interest in the design and performance of the EPR for their businesses. AREVA is the only Gen III+ reactor constructor in the world with ongoing building experience. To date, AREVA is the only vendor who has the necessary field experience that future customers can benefit: - Detailed design completed; - Experience feedback from 87 PWR; - 3 projects going on; - Continuous PWR experience in design and construction. Close to 100% of the EPR primary circuit heavy components are sourced directly from AREVA's integrated plants. Engineering, manufacturing, services and fuel cycle management are totally integrated and mastered by AREVA. From its

  20. EPR by Areva. The path of greatest certainty

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-07-01

    AREVA's Evolutionary Power Reactor (EPR) is the first Generation III+ reactor design currently being built to answer the world's growing demand for clean and reliable electricity generation. Already under construction in Finland, France and China, the EPR is also being considered by America, United Kingdom, South Africa and other countries for the development of their nuclear fleet. The EPR is now clearly destined to become the mainstay of standardized, efficient reactor fleets around the globe. AREVA's EPR incorporates unbeatable know-how provided by an uninterrupted track record of reactor building activities and backed by decades of feedback experience from operating PWRs, including the most recent. The EPR is a Franco-German initiative which benefited from the stringent scrutiny of safety authorities from both countries, at each stage of the project. The EPR has already secured construction licenses from two of the world's most demanding safety authorities in France and Finland and is currently in line for a design certification and a combined construction and operating license (COL) in the USA. It is also taking part in the licensing process recently launched in the United Kingdom. Europe's leading utilities have granted the EPR their approval under the 'European Utilities Requirements' and have further expressed individual interest in the design and performance of the EPR for their businesses. AREVA is the only Gen III+ reactor constructor in the world with ongoing building experience. To date, AREVA is the only vendor who has the necessary field experience that future customers can benefit: - Detailed design completed; - Experience feedback from 87 PWR; - 3 projects going on; - Continuous PWR experience in design and construction. Close to 100% of the EPR primary circuit heavy components are sourced directly from AREVA's integrated plants. Engineering, manufacturing, services and fuel cycle management are totally

  1. Free radical EPR in delineating oil bearing zones

    International Nuclear Information System (INIS)

    Sharma, R.K.; Kumar, V.; Das, T.K.; Gundu Rao, T.K.

    1993-01-01

    Presence of naturally occurring gamma ray activity has long been detected in oil/gas wells is invariably carried out for formation evaluation. Similarly, presence of free radicals in oil bearing formations has also been known for quite sometime. Present paper deals with a systematic study of detecting these free radicals in oil wells and correlations of these with x-ray and other logs for identification of hydrocarbon bearing zones. Present study attempts to establish EPR as as inexpensive and reliable tool in comparison with gamma ray and neutron density logs recorded in exploratory oil wells. EPR studies have been carried out in an exploratory well between depth intervals 1600 m-1400 m located in south of existing producing field in Bombay Offshore region. Based on these results, an EPR log has been prepared and compared with gamma ray and neutron density logs. (author). 4 refs., 1 fig., 1 tab

  2. Prevalence of accurate nursing documentation in patient records

    NARCIS (Netherlands)

    Paans, Wolter; Sermeus, Walter; Nieweg, Roos; van der Schans, Cees

    2010-01-01

    AIM: This paper is a report of a study conducted to describe the accuracy of nursing documentation in patient records in hospitals. Background.  Accurate nursing documentation enables nurses to systematically review the nursing process and to evaluate the quality of care. Assessing nurses' reports

  3. The computerized patient record: Where do we stand?

    NARCIS (Netherlands)

    Jaspers, M. W. M.; Knaup, P.; Schmidt, D.

    2006-01-01

    OBJECTIVES: To provide an overview of trends in research, developments and implementations of the computerized patient record (CPR) of the last two years. METHODS: We surveyed the medical informatics literature, spanning the years 2004-2005, focusing on publications on CPRs. RESULTS: The main trends

  4. Patients prefer electronic medical records - fact or fiction?

    Science.gov (United States)

    Masiza, Melissa; Mostert-Phipps, Nicky; Pottasa, Dalenca

    2013-01-01

    Incomplete patient medical history compromises the quality of care provided to a patient while well-kept, adequate patient medical records are central to the provision of good quality of care. According to research, patients have the right to contribute to decision-making affecting their health. Hence, the researchers investigated their views regarding a paper-based system and an electronic medical record (EMR). An explorative approach was used in conducting a survey within selected general practices in the Nelson Mandela Metropole. The majority of participants thought that the use of a paper-based system had no negative impact on their health. Participants expressed concerns relating to the confidentiality of their medical records with both storage mediums. The majority of participants indicated they prefer their GP to computerise their consultation details. The main objective of the research on which this poster is based was to investigate the storage medium of preference for patients and the reasons for their preference. Overall, 48% of the 85 participants selected EMRs as their preferred storage medium and the reasons for their preference were also uncovered.

  5. The EPR layout design

    International Nuclear Information System (INIS)

    Mast, U.; Le Carrer, P.Y.

    2001-01-01

    General: The European Pressurised Water Reactor (EPR) is a French - German development for the next generation of Pressurised Water Reactor. The new reactor design is based on the experiences of operation and design of nuclear power plants in both countries. The EPR fulfils enhanced safety standards, higher availability and a longer service life. Utilities aspects: For the Utilities one important requirement is the reduction of personnel exposure during maintenance and in-service inspection. The other significant requirement is of economic nature. The main points influencing costs, which have also impact on the layout, are: outage times, accessibility of the reactor building and the available maintenance and set down areas. The Utilities have also required to load the spent fuel assemblies into the shipping cask from the bottom of the fuel pool, because of the exclusion of the drop of the cask and in order to avoid contamination at the outer cask shell. Layout and safety aspects: All safety relevant Nuclear Island (NI) buildings are designed against design earthquake as well as explosion pressure wave. The protection against Airplane Crash (APC) is realised by civil and layout dispositions. The Reactor Building, the Safeguard Buildings division 2 and 3 and the Fuel Building are protected by concrete structures. The other safety relevant nuclear buildings are protected by geographical separation. Important safety requirements are the further reduction of the probability of severe accidents and the mitigation of such an accident on the plant area. For that, a spreading area for molten corium, a channel from the reactor pit to the spreading area and the In Containment Refuelling Water Storage Tank (IRWST) for flooding and initial cooling of the corium, were implemented in the design of the Reactor Building. Layout results: The following buildings are arranged on a common raft to protect them against design earthquake: Reactor Building (RB), Safeguard Buildings (SAB

  6. DIGITAL ONCOLOGY PATIENT RECORD - HETEROGENEOUS FILE BASED APPROACH

    Directory of Open Access Journals (Sweden)

    Nikolay Sapundzhiev

    2010-12-01

    Full Text Available Introduction: Oncology patients need extensive follow-up and meticulous documentation. The aim of this study was to introduce a simple, platform independent file based system for documentation of diagnostic and therapeutic procedures in oncology patients and test its function.Material and methods: A file-name based system of the type M1M2M3.F2 was introduced, where M1 is a unique identifier for the patient, M2 is the date of the clinical intervention/event, M3 is an identifier for the author of the medical record and F2 is the specific software generated file-name extension.Results: This system is in use at 5 institutions, where a total of 11 persons on 14 different workstations inputted 16591 entries (files for 2370. The merge process was tested on 2 operating systems - when copied together all files sort up as expected by patient, and for each patient in a chronological order, providing a digital cumulative patient record, which contains heterogeneous file formats.Conclusion: The file based approach for storing heterogeneous digital patient related information is an reliable system, which can handle open-source, proprietary, general and custom file formats and seems to be easily scalable. Further development of software for automatic checks of the integrity and searching and indexing of the files is expected to produce a more user-friendly environment

  7. Using Electronic Patient Records to Discover Disease Correlations and Stratify Patient Cohorts

    DEFF Research Database (Denmark)

    Roque, Francisco S.; Jensen, Peter B.; Schmock, Henriette

    2011-01-01

    Electronic patient records remain a rather unexplored, but potentially rich data source for discovering correlations between diseases. We describe a general approach for gathering phenotypic descriptions of patients from medical records in a systematic and non-cohort dependent manner. By extracting...... phenotype information from the free-text in such records we demonstrate that we can extend the information contained in the structured record data, and use it for producing fine-grained patient stratification and disease co-occurrence statistics. The approach uses a dictionary based on the International...

  8. The EPR in a few words: all you need to know about the EPR nuclear reactor

    International Nuclear Information System (INIS)

    2009-01-01

    After a brief presentation of the EPR (European - or Evolutionary - Pressurized Reactor) type nuclear reactor, this paper, proposed by the collective group 'Stop EPR', develops the following points: EPR is as dangerous as other reactors; EPR flouts democracy; France's energy demand do not need the construction of EPRs; the construction of EPRs is not a factor of economical and social development; EPR should not be constructed neither in France nor elsewhere and the present building sites should be cancelled; the EPR will not help France to increase its energy independence and protect itself from oil price increases; choosing the EPR is incompatible with the large investments to be made in energy conservation and renewable energies; the EPR is not a solution to climate change; the VHV line corridor that will starts at Flamanville is not justified and poses risks to the environment and public health

  9. Rapid-scan EPR imaging.

    Science.gov (United States)

    Eaton, Sandra S; Shi, Yilin; Woodcock, Lukas; Buchanan, Laura A; McPeak, Joseph; Quine, Richard W; Rinard, George A; Epel, Boris; Halpern, Howard J; Eaton, Gareth R

    2017-07-01

    In rapid-scan EPR the magnetic field or frequency is repeatedly scanned through the spectrum at rates that are much faster than in conventional continuous wave EPR. The signal is directly-detected with a mixer at the source frequency. Rapid-scan EPR is particularly advantageous when the scan rate through resonance is fast relative to electron spin relaxation rates. In such scans, there may be oscillations on the trailing edge of the spectrum. These oscillations can be removed by mathematical deconvolution to recover the slow-scan absorption spectrum. In cases of inhomogeneous broadening, the oscillations may interfere destructively to the extent that they are not visible. The deconvolution can be used even when it is not required, so spectra can be obtained in which some portions of the spectrum are in the rapid-scan regime and some are not. The technology developed for rapid-scan EPR can be applied generally so long as spectra are obtained in the linear response region. The detection of the full spectrum in each scan, the ability to use higher microwave power without saturation, and the noise filtering inherent in coherent averaging results in substantial improvement in signal-to-noise relative to conventional continuous wave spectroscopy, which is particularly advantageous for low-frequency EPR imaging. This overview describes the principles of rapid-scan EPR and the hardware used to generate the spectra. Examples are provided of its application to imaging of nitroxide radicals, diradicals, and spin-trapped radicals at a Larmor frequency of ca. 250MHz. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. EPR: Some History and Clarification

    Science.gov (United States)

    Fine, Arthur

    2002-04-01

    Locality, separation and entanglement 1930s style. We’ll explore the background to the 1935 paper by Einstein, Podolsky and Rosen, how it was composed, the actual argument of the paper, the principles used, and how the paper was received by Schroedinger, and others.We’ll also look at Bohr’s response: the extent to which Bohr connects with what Einstein was after in EPR and the extent to EPR marks a shift in Bohr’s thinking about the quantum theory.

  11. Some ideas on the EPR

    International Nuclear Information System (INIS)

    2003-01-01

    Facing the debate and controversial between partisans and opponents of the European Pressurized Reactor construction, the SFP energy Group aims to offer some reflexions. In this framework the following topics are discussed: the french nuclear park and its replacement, the energy costs, the nuclear reactors profitability, the generation IV reactors. The paper examines then the EPR technology and its cost to conclude on the advantage of an EPR construction, in the case of an energy policy based on the nuclear. This last point seems to be the real challenge of the problem. (A.L.B.)

  12. EPR in B physics and elsewhere

    International Nuclear Information System (INIS)

    Lipkin, H.J.; Tel Aviv Univ.; Argonne National Lab., IL

    1997-01-01

    The application of Einstein-Podolsky-Rosen correlations in Υ(4s) → B anti B decays to research in CP violation is the first and probably only use of EPR as a technique for research in new physics. Elsewhere highly sophisticated EPR projects question EPR and test its predictions to look for violations of quantum mechanics, hidden variables, Bell''s inequalities, etc

  13. EPR: the nuclear impasse; EPR: l'impasse nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Marillier, F [Association Ecologiste Greenpeace (France)

    2008-07-01

    The questions relative to the climatic change constitute crucial challenges for the next ten years. In this context the author aims to show how the EPR project illustrates the nuclear french ''autism''. He presents and analyzes the international and environmental impacts of this obsolete technology, as a project useless and dangerous. (A.L.B.)

  14. EPR: the nuclear impasse; EPR: l'impasse nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Marillier, F. [Association Ecologiste Greenpeace (France)

    2008-07-01

    The questions relative to the climatic change constitute crucial challenges for the next ten years. In this context the author aims to show how the EPR project illustrates the nuclear french ''autism''. He presents and analyzes the international and environmental impacts of this obsolete technology, as a project useless and dangerous. (A.L.B.)

  15. EPR correlations and EPW distributions

    International Nuclear Information System (INIS)

    Bell, J.S.

    1995-01-01

    In the case of two free spin-zero particles, the wave function originally considered by Einstein, Podolsky and Rosen to exemplify EPR correlations has a non-negative Wigner distribution. This distribution gives an explicitly local account of the correlations. For an irreducible non-locality, more elaborate wave functions are required, with Wigner distributions which are not non-negative. (author)

  16. EPR measurements in irradiated polyacetylene

    International Nuclear Information System (INIS)

    Hola, O.; Foeldesova, M.

    1990-01-01

    The influence of γ-irradiation on the paramagnetic properties of polyacetylene, and the dependence of the EPR spectra on the radiation dose in samples of irradiated polyacetylene were studied. The measurements show that no essential changes of the spin mobility occurred during irradiation. (author) 3 refs.; 2 figs

  17. EPR study of human hair

    Czech Academy of Sciences Publication Activity Database

    Křížová, Jana; Káfuňková, Eva; Stopka, Pavel

    2005-01-01

    Roč. 99, č. 14 (2005), s. 217-218 ISSN 0009-2770 R&D Projects: GA MZd(CZ) NL7567; GA MZd(CZ) NB7377 Institutional research plan: CEZ:AV0Z40320502 Keywords : EPR Subject RIV: CA - Inorganic Chemistry Impact factor: 0.445, year: 2005

  18. Patient access to complex chronic disease records on the Internet

    Directory of Open Access Journals (Sweden)

    Bartlett Cherry

    2012-08-01

    Full Text Available Abstract Background Access to medical records on the Internet has been reported to be acceptable and popular with patients, although most published evaluations have been of primary care or office-based practice. We tested the feasibility and acceptability of making unscreened results and data from a complex chronic disease pathway (renal medicine available to patients over the Internet in a project involving more than half of renal units in the UK. Methods Content and presentation of the Renal PatientView (RPV system was developed with patient groups. It was designed to receive information from multiple local information systems and to require minimal extra work in units. After piloting in 4 centres in 2005 it was made available more widely. Opinions were sought from both patients who enrolled and from those who did not in a paper survey, and from staff in an electronic survey. Anonymous data on enrolments and usage were extracted from the webserver. Results By mid 2011 over 17,000 patients from 47 of the 75 renal units in the UK had registered. Users had a wide age range (90 yrs but were younger and had more years of education than non-users. They were enthusiastic about the concept, found it easy to use, and 80% felt it gave them a better understanding of their disease. The most common reason for not enrolling was being unaware of the system. A minority of patients had security concerns, and these were reduced after enrolling. Staff responses were also strongly positive. They reported that it aided patient concordance and disease management, and increased the quality of consultations with a neutral effect on consultation length. Neither patient nor staff responses suggested that RPV led to an overall increase in patient anxiety or to an increased burden on renal units beyond the time required to enrol each patient. Conclusions Patient Internet access to secondary care records concerning a complex chronic disease is feasible and popular

  19. Patient access to complex chronic disease records on the Internet.

    Science.gov (United States)

    Bartlett, Cherry; Simpson, Keith; Turner, A Neil

    2012-08-06

    Access to medical records on the Internet has been reported to be acceptable and popular with patients, although most published evaluations have been of primary care or office-based practice. We tested the feasibility and acceptability of making unscreened results and data from a complex chronic disease pathway (renal medicine) available to patients over the Internet in a project involving more than half of renal units in the UK. Content and presentation of the Renal PatientView (RPV) system was developed with patient groups. It was designed to receive information from multiple local information systems and to require minimal extra work in units. After piloting in 4 centres in 2005 it was made available more widely. Opinions were sought from both patients who enrolled and from those who did not in a paper survey, and from staff in an electronic survey. Anonymous data on enrollment and usage were extracted from the webserver. By mid 2011 over 17,000 patients from 47 of the 75 renal units in the UK had registered. Users had a wide age range (90 yrs) but were younger and had more years of education than non-users. They were enthusiastic about the concept, found it easy to use, and 80% felt it gave them a better understanding of their disease. The most common reason for not enrolling was being unaware of the system. A minority of patients had security concerns, and these were reduced after enrolling. Staff responses were also strongly positive. They reported that it aided patient concordance and disease management, and increased the quality of consultations with a neutral effect on consultation length. Neither patient nor staff responses suggested that RPV led to an overall increase in patient anxiety or to an increased burden on renal units beyond the time required to enroll each patient. Patient Internet access to secondary care records concerning a complex chronic disease is feasible and popular, providing an increased sense of empowerment and understanding, with no

  20. [Problem list in computer-based patient records].

    Science.gov (United States)

    Ludwig, C A

    1997-01-14

    Computer-based clinical information systems are capable of effectively processing even large amounts of patient-related data. However, physicians depend on rapid access to summarized, clearly laid out data on the computer screen to inform themselves about a patient's current clinical situation. In introducing a clinical workplace system, we therefore transformed the problem list-which for decades has been successfully used in clinical information management-into an electronic equivalent and integrated it into the medical record. The table contains a concise overview of diagnoses and problems as well as related findings. Graphical information can also be integrated into the table, and an additional space is provided for a summary of planned examinations or interventions. The digital form of the problem list makes it possible to use the entire list or selected text elements for generating medical documents. Diagnostic terms for medical reports are transferred automatically to corresponding documents. Computer technology has an immense potential for the further development of problem list concepts. With multimedia applications sound and images will be included in the problem list. For hyperlink purpose the problem list could become a central information board and table of contents of the medical record, thus serving as the starting point for database searches and supporting the user in navigating through the medical record.

  1. Use of EPR to Solve Biochemical Problems

    Science.gov (United States)

    Sahu, Indra D.; McCarrick, Robert M.; Lorigan, Gary A.

    2013-01-01

    EPR spectroscopy is a very powerful biophysical tool that can provide valuable structural and dynamic information on a wide variety of biological systems. The intent of this review is to provide a general overview for biochemists and biological researchers on the most commonly used EPR methods and how these techniques can be used to answer important biological questions. The topics discussed could easily fill one or more textbooks; thus, we present a brief background on several important biological EPR techniques and an overview of several interesting studies that have successfully used EPR to solve pertinent biological problems. The review consists of the following sections: an introduction to EPR techniques, spin labeling methods, and studies of naturally occurring organic radicals and EPR active transition metal systems which are presented as a series of case studies in which EPR spectroscopy has been used to greatly further our understanding of several important biological systems. PMID:23961941

  2. Using electronic patient records to discover disease correlations and stratify patient cohorts.

    Directory of Open Access Journals (Sweden)

    Francisco S Roque

    2011-08-01

    Full Text Available Electronic patient records remain a rather unexplored, but potentially rich data source for discovering correlations between diseases. We describe a general approach for gathering phenotypic descriptions of patients from medical records in a systematic and non-cohort dependent manner. By extracting phenotype information from the free-text in such records we demonstrate that we can extend the information contained in the structured record data, and use it for producing fine-grained patient stratification and disease co-occurrence statistics. The approach uses a dictionary based on the International Classification of Disease ontology and is therefore in principle language independent. As a use case we show how records from a Danish psychiatric hospital lead to the identification of disease correlations, which subsequently can be mapped to systems biology frameworks.

  3. Childrens Hospital Integrated Patient Electronic Record System Continuation (CHIPERS)

    Science.gov (United States)

    2015-12-01

    Pediatric  ICU  with  severe  sepsis/shock...traumatic  brain  injury  and  pulmonary  embolus   and  in  both  adult  and   pediatric  patients.  CDS  can  be  a...record,   pediatric  critical  care,  neonatal  intensive  care,  severe  sepsis,  septic  shock   16. SECURITY CLASSIFICATION

  4. EPR-technical codes - a common basis for the EPR

    International Nuclear Information System (INIS)

    Zaiss, W.; Appell, B.

    1997-01-01

    The design and construction of Nuclear Power Plants implies a full set of codes and standards to define the construction rules of components and equipment. Rules are existing and are currently implemented, respectively in France and Germany (mainly RCCs and KTA safety standards). In the frame of the EPR-project, the common objective requires an essential industrial work programme between engineers from both countries to elaborate a common set of codes and regulations. These new industrial rules are called the ETCs (EPR Technical Codes). In the hierarchy the ETCs are - in case of France - on the common level of basic safety rules (RFS), design and construction rules (RCC) and - in Germany - belonging to RSK guidelines and KTA safety standards. A set of six ETCs will be elaborated to cover: safety and process, mechanical components, electrical equipment, instrumentation and control, civil works, fire protection. (orig.)

  5. The Flamanville 3 EPR reactor; Le reacteur EPR Flamanville 3

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    On April 10. 2007, the french government authorized EDF to create on the site of Flamanville ( La Manche) a nuclear base installation containing a pressurized water EPR type reactor. This nuclear reactor, conceived by AREVA NP and EDF, is the first copy of a generation susceptible to replace later, at least partly, the French nuclear reactors at present in operation.Within the framework of its mission of technical support of the Authority of Nuclear Safety ( A.S.N.), the I.R.S.N. widely contributed successively: to define the general objectives of safety assigned to this new generation of pressurized water nuclear reactors; to analyze the options of safety proposed by EDF for the EPR project; To deepen, upstream to the authorization of creation, the evaluation of the step of safety and the measures of conception retained by EDF that have to allow to respect the objectives of safety which were notified to it. (N.C.)

  6. Medical ADP Systems: Automated Medical Records Hold Promise to Improve Patient Care

    Science.gov (United States)

    1991-01-01

    automated medical records. The report discusses the potential benefits that automation could make to the quality of patient care and the factors that impede...information systems, but no organization has fully automated one of the most critical types of information, patient medical records. The patient medical record...its review of automated medical records. GAO’s objectives in this study were to identify the (1) benefits of automating patient records and (2) factors

  7. EPR compared to international requirements (Mainly EUR)

    International Nuclear Information System (INIS)

    Broecker, B.

    1996-01-01

    A number of European Utilities have entered an agreement to write common requirements dedicated to future light water nuclear power plants to be built in Europe. The activities are known under the sign EUR (European Utilities Requirements). EPR, the future European Pressurized water Reactor, is the first installation of this type which will be operational from the year 2000 onwards, must fulfill the European requirements. EPR will serve as a test whether these requirements are realistic and well balanced. At the basic design stage of EPR, this paper concentrates on four main topics: the requirements which are new compared with existing reactors and which put a major challenge to the designer; the requirements today still open and the way they can be met by the EPR or not; the points for which already today the EPR special requirements exceed the EUR; the examples where the design of the EPR has given feedback which has led to a change of the EUR. EPR and EUR are different approaches to the reactor of the future. EUR is a set of requirements which leaves a flexibility to the designer while EPR is a real project which defines the technical solutions. EPR will fulfill the EUR and will at the same time serve as a test whether these requirements are realistic. EPR will also fulfill international requirements with minor changes. (J.S.). 7 figs

  8. Consumers' Perceptions of Patient-Accessible Electronic Medical Records

    Science.gov (United States)

    Vaughon, Wendy L; Czaja, Sara J; Levy, Joslyn; Rockoff, Maxine L

    2013-01-01

    Background Electronic health information (eHealth) tools for patients, including patient-accessible electronic medical records (patient portals), are proliferating in health care delivery systems nationally. However, there has been very limited study of the perceived utility and functionality of portals, as well as limited assessment of these systems by vulnerable (low education level, racial/ethnic minority) consumers. Objective The objective of the study was to identify vulnerable consumers’ response to patient portals, their perceived utility and value, as well as their reactions to specific portal functions. Methods This qualitative study used 4 focus groups with 28 low education level, English-speaking consumers in June and July 2010, in New York City. Results Participants included 10 males and 18 females, ranging in age from 21-63 years; 19 non-Hispanic black, 7 Hispanic, 1 non-Hispanic White and 1 Other. None of the participants had higher than a high school level education, and 13 had less than a high school education. All participants had experience with computers and 26 used the Internet. Major themes were enhanced consumer engagement/patient empowerment, extending the doctor’s visit/enhancing communication with health care providers, literacy and health literacy factors, improved prevention and health maintenance, and privacy and security concerns. Consumers were also asked to comment on a number of key portal features. Consumers were most positive about features that increased convenience, such as making appointments and refilling prescriptions. Consumers raised concerns about a number of potential barriers to usage, such as complex language, complex visual layouts, and poor usability features. Conclusions Most consumers were enthusiastic about patient portals and perceived that they had great utility and value. Study findings suggest that for patient portals to be effective for all consumers, portals must be designed to be easy to read, visually

  9. Impact of patients' access to medical records in occupational medicine.

    Science.gov (United States)

    Krakov, A; Kabaha, N; Azuri, J; Moshe, S

    2018-04-14

    Information technologies offer new ways to engage with patients regarding their health, but no studies have been done in occupational health services (OHS). To examine the advantages and disadvantages of providing written and oral medical information to patients in OHS. In this cross-sectional study, data were retrieved from patients visiting four different OHS during 2014-15 for a fitness for work evaluation. We built a semi-quantitative satisfaction questionnaire, with responses ranging on a Likert scale of 1-5 from very dissatisfied (1) to very satisfied (5). There were 287 questionnaires available for analysis. The number of patients who received detailed oral and written information, which included an explanation of their health condition and of the occupational physician's (OP's) decision, was higher in clinics 1 and 3 compared to clinics 2 and 4 (48 and 38% compared to 21 and 31% respectively, P < 0.05). When patients were provided with detailed oral and written information, they declared having a better understanding (4.3 and 4.4 compared to 3.8 respectively, P < 0.001), a higher level of confidence in their OP (4.4 and 4.3 compared to 3.7 and 4 respectively, P < 0.001), a higher level of satisfaction (4.3 and 4.4 compared to 3.8 respectively, P < 0.001) and a higher sense of control and ability to correct the record (1.8 compared to 1.4 respectively, P < 0.01), compared to patients who received partial information. We recommend sharing detailed oral and written medical information with patients in OHS.

  10. Hydrogen Analyses in the EPR

    International Nuclear Information System (INIS)

    Worapittayaporn, S.; Eyink, J.; Movahed, M.

    2008-01-01

    In severe accidents with core melting large amounts of hydrogen may be released into the containment. The EPR provides a combustible gas control system to prevent hydrogen combustion modes with the potential to challenge the containment integrity due to excessive pressure and temperature loads. This paper outlines the approach for the verification of the effectiveness and efficiency of this system. Specifically, the justification is a multi-step approach. It involves the deployment of integral codes, lumped parameter containment codes and CFD codes and the use of the sigma criterion, which provides the link to the broad experimental data base for flame acceleration (FA) and deflagration to detonation transition (DDT). The procedure is illustrated with an example. The performed analyses show that hydrogen combustion at any time does not lead to pressure or temperature loads that threaten the containment integrity of the EPR. (authors)

  11. Pharmacological and physical vessel modulation strategies to improve EPR-mediated drug targeting to tumors.

    Science.gov (United States)

    Ojha, Tarun; Pathak, Vertika; Shi, Yang; Hennink, Wim E; Moonen, Chrit T W; Storm, Gert; Kiessling, Fabian; Lammers, Twan

    2017-09-15

    The performance of nanomedicine formulations depends on the Enhanced Permeability and Retention (EPR) effect. Prototypic nanomedicine-based drug delivery systems, such as liposomes, polymers and micelles, aim to exploit the EPR effect to accumulate at pathological sites, to thereby improve the balance between drug efficacy and toxicity. Thus far, however, tumor-targeted nanomedicines have not yet managed to achieve convincing therapeutic results, at least not in large cohorts of patients. This is likely mostly due to high inter- and intra-patient heterogeneity in EPR. Besides developing (imaging) biomarkers to monitor and predict EPR, another strategy to address this heterogeneity is the establishment of vessel modulation strategies to homogenize and improve EPR. Over the years, several pharmacological and physical co-treatments have been evaluated to improve EPR-mediated tumor targeting. These include pharmacological strategies, such as vessel permeabilization, normalization, disruption and promotion, as well as physical EPR enhancement via hyperthermia, radiotherapy, sonoporation and phototherapy. In the present manuscript, we summarize exemplary studies showing that pharmacological and physical vessel modulation strategies can be used to improve tumor-targeted drug delivery, and we discuss how these advanced combination regimens can be optimally employed to enhance the (pre-) clinical performance of tumor-targeted nanomedicines. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. EPR dosimetry of irradiated human teeth

    International Nuclear Information System (INIS)

    Rodas Duran, J.E.; Panzeri, H.; Mascarenhas, S.

    1985-01-01

    The determination of the absorbed radiation dose in man may be made by Electron Paramagnetic Resonance (EPR) spectroscopy of dental enamel. We analysed the EPR signals for dental enamel submitted to gamma radiation in doses between 1 Gy and 25 Gy. We conclude that independent of the type of tooth analysed there exists a linear relation between the EPR signals and the absorbed doses. These studies were extended to enamel irradiated with gamma rays and with X rays in doses between 0.1 Gy and 0.6 Gy. The graph of the intensity of the EPR signals as a function of the dose has a slope of 0.22. This calibration may be used to calculate the absorbed dose for humans from a measurement of the EPR signal from small samples of enamel taken from any permanent tooth. Finally we comment on some EPR studies of effects of radiation of milk teeth. (author)

  13. EPR studies of melanin from Cladosporium cladosporioides

    International Nuclear Information System (INIS)

    Pilawa, B.; Buszman, E.; Latocha, M.; Wilczok, T.

    1996-01-01

    Free radical properties of Cladosporium cladosporioides mycelium and melanin, and synthetic eumelanin and pheomelanin were studied by electron paramagnetic resonance method. Single EPR line and complex EPR spectrum with hyperfine splitting were measured for model DOPA-melanin and cysteinyldopa-melanin, respectively. EPR spectra of Cladosporium cladosporioides samples and pheomelanin show the same character. The concentration of paramagnetic centers in melanins isolated from Cladosporium cladosporioides is considerably higher than that of crude mycelium, whereas the EPR line widths are lower for mycelium than for melanin samples. For all analyzed samples the increase of EPR signals intensity with the increase of microwave power, and the decrease of intensities after saturation were observed the low values of microwave power sufficient for EPR lines saturation demonstrate that the spin-lattice relaxation times of unpaired electrons in melanins are long. (author)

  14. Optimizing the user interface of a data entry module for an electronic patient record for cardiac rehabilitation: A mixed method usability approach.

    Science.gov (United States)

    van Engen-Verheul, Mariëtte M; Peute, Linda W P; de Keizer, Nicolette F; Peek, Niels; Jaspers, Monique W M

    2016-03-01

    Cumbersome electronic patient record (EPR) interfaces may complicate data-entry in clinical practice. Completeness of data entered in the EPR determines, among other things, the value of computerized clinical decision support (CCDS). Quantitative usability evaluations can provide insight into mismatches between the system design model of data entry and users' data entry behavior, but not into the underlying causes for these mismatches. Mixed method usability evaluation studies may provide these insights, and thus support generating redesign recommendations for improving an EPR system's data entry interface. To improve the usability of the data entry interface of an EPR system with CCDS in the field of cardiac rehabilitation (CR), and additionally, to assess the value of a mixed method usability approach in this context. Seven CR professionals performed a think-aloud usability evaluation both before (beta-version) and after the redesign of the system. Observed usability problems from both evaluations were analyzed and categorized using Zhang et al.'s heuristic principles of good interface design. We combined the think-aloud usability evaluation of the system's beta-version with the measurement of a new usability construct: users' deviations in action sequence from the system's predefined data entry order sequence. Recommendations for redesign were implemented. We assessed whether the redesign improved CR professionals' (1) task efficacy (with respect to the completeness of data they collected), and (2) task efficiency (with respect to the average number of mouse clicks they needed to complete data entry subtasks). With the system's beta version, 40% of health care professionals' navigation actions through the system deviated from the predefined next system action. The causes for these deviations as revealed by the think-aloud method mostly concerned mismatches between the system design model for data entry action sequences and users expectations of these action

  15. Pharmaceutical applications of in vivo EPR

    International Nuclear Information System (INIS)

    Maeder, K.

    1998-01-01

    The aim of this article is to discuss the applications of in vivo EPR in the field of pharmacy. In addition to direct detection of free radical metabolites and measurement of oxygen, EPR can be used to characterize the mechanisms of drug release from biodegradable polymers. Unique information about drug concentration, the microenvironment (viscosity, polarity, pH) and biodistribution (by localized measurement or EPR Imaging) can be obtained. (author)

  16. EPR-based material modelling of soils

    Science.gov (United States)

    Faramarzi, Asaad; Alani, Amir M.

    2013-04-01

    In the past few decades, as a result of the rapid developments in computational software and hardware, alternative computer aided pattern recognition approaches have been introduced to modelling many engineering problems, including constitutive modelling of materials. The main idea behind pattern recognition systems is that they learn adaptively from experience and extract various discriminants, each appropriate for its purpose. In this work an approach is presented for developing material models for soils based on evolutionary polynomial regression (EPR). EPR is a recently developed hybrid data mining technique that searches for structured mathematical equations (representing the behaviour of a system) using genetic algorithm and the least squares method. Stress-strain data from triaxial tests are used to train and develop EPR-based material models for soil. The developed models are compared with some of the well-known conventional material models and it is shown that EPR-based models can provide a better prediction for the behaviour of soils. The main benefits of using EPR-based material models are that it provides a unified approach to constitutive modelling of all materials (i.e., all aspects of material behaviour can be implemented within a unified environment of an EPR model); it does not require any arbitrary choice of constitutive (mathematical) models. In EPR-based material models there are no material parameters to be identified. As the model is trained directly from experimental data therefore, EPR-based material models are the shortest route from experimental research (data) to numerical modelling. Another advantage of EPR-based constitutive model is that as more experimental data become available, the quality of the EPR prediction can be improved by learning from the additional data, and therefore, the EPR model can become more effective and robust. The developed EPR-based material models can be incorporated in finite element (FE) analysis.

  17. Patient safety in out-of-hours primary care: a review of patient records

    Directory of Open Access Journals (Sweden)

    Wensing Michel

    2010-12-01

    Full Text Available Abstract Background Most patients receive healthcare in primary care settings, but relatively little is known about patient safety. Out-of-hours contacts are of particular importance to patient safety. Our aim was to examine the incidence, types, causes, and consequences of patient safety incidents at general practice cooperatives for out-of-hours primary care and to examine which factors were associated with the occurrence of patient safety incidents. Methods A retrospective study of 1,145 medical records concerning patient contacts with four general practice cooperatives. Reviewers identified records with evidence of a potential patient safety incident; a physician panel determined whether a patient safety incident had indeed occurred. In addition, the panel determined the type, causes, and consequences of the incidents. Factors associated with incidents were examined in a random coefficient logistic regression analysis. Results In 1,145 patient records, 27 patient safety incidents were identified, an incident rate of 2.4% (95% CI: 1.5% to 3.2%. The most frequent incident type was treatment (56%. All incidents had at least partly been caused by failures in clinical reasoning. The majority of incidents did not result in patient harm (70%. Eight incidents had consequences for the patient, such as additional interventions or hospitalisation. The panel assessed that most incidents were unlikely to result in patient harm in the long term (89%. Logistic regression analysis showed that age was significantly related to incident occurrence: the likelihood of an incident increased with 1.03 for each year increase in age (95% CI: 1.01 to 1.04. Conclusion Patient safety incidents occur in out-of-hours primary care, but most do not result in harm to patients. As clinical reasoning played an important part in these incidents, a better understanding of clinical reasoning and guideline adherence at GP cooperatives could contribute to patient safety.

  18. Electron paramagnetic resonance (EPR) in medical dosimetry

    International Nuclear Information System (INIS)

    Schauer, David A.; Iwasaki, Akinori; Romanyukha, Alexander A.; Swartz, Harold M.; Onori, Sandro

    2006-01-01

    This paper describes the fundamentals of electron paramagnetic resonance (EPR) and its application to retrospective measurements of clinically significant doses of ionizing radiation. X-band is the most widely used in EPR dosimetry because it represents a good compromise between sensitivity, sample size and water content in the sample. Higher frequency bands (e.g., W and Q) provide higher sensitivity, but they are also greatly influenced by water content. L and S bands can be used for EPR measurements in samples with high water content but they are less sensitive than X-band. Quality control for therapeutic radiation facilities using X-band EPR spectrometry of alanine is also presented

  19. Skew Projection of Echo-Detected EPR Spectra for Increased Sensitivity and Resolution

    Science.gov (United States)

    Bowman, Michael K.; Krzyaniak, Matthew D.; Cruce, Alex A.; Weber, Ralph T.

    2013-01-01

    The measurement of EPR spectra during pulsed EPR experiments is commonly accomplished by recording the integral of the electron spin echo as the applied magnetic field is stepped through the spectrum. This approach to echo-detected EPR spectral measurement (ED-EPR) limits sensitivity and spectral resolution and can cause gross distortions in the resulting spectra because some of the information present in the electron spin echo is discarded in such measurements. However, Fourier Transformation of echo shapes measured at a series of magnetic field values followed by skew projection onto either a magnetic field or resonance frequency axis can increase both spectral resolution and sensitivity without the need to trade one against the other. Examples of skew-projected spectra with single crystals, glasses and powders show resolution improvements as large as a factor of seven with sensitivity increases of as much as a factor of five. PMID:23644351

  20. Patients, privacy and trust: patients' willingness to allow researchers to access their medical records.

    Science.gov (United States)

    Damschroder, Laura J; Pritts, Joy L; Neblo, Michael A; Kalarickal, Rosemarie J; Creswell, John W; Hayward, Rodney A

    2007-01-01

    The federal Privacy Rule, implemented in the United States in 2003, as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), created new restrictions on the release of medical information for research. Many believe that its restrictions have fallen disproportionately on researchers prompting some to call for changes to the Rule. Here we ask what patients think about researchers' access to medical records, and what influences these opinions. A sample of 217 patients from 4 Veteran Affairs (VA) facilities deliberated in small groups at each location with the opportunity to question experts and inform themselves about privacy issues related to medical records research. After extensive deliberation, these patients were united in their inclination to share their medical records for research. Yet they were also united in their recommendations to institute procedures that would give them more control over whether and how their medical records are used for research. We integrated qualitative and quantitative results to derive a better understanding of this apparent paradox. Our findings can best be presented as answers to questions related to five dimensions of trust: Patients' trust in VA researchers was the most powerful determinant of the kind of control they want over their medical records. More specifically, those who had lower trust in VA researchers were more likely to recommend a more stringent process for obtaining individual consent. Insights on the critical role of trust suggest actions that researchers and others can take to more fully engage patients in research.

  1. Evaluation of the process of recording patient education, consistency of record-keeping with perception, and patient satisfaction after implementing clinical supervision: An embedded evaluation

    Directory of Open Access Journals (Sweden)

    Khorasani Parvaneh

    2016-08-01

    Full Text Available Background and Objective: Currently, patient education has been considered in medical centers. Clinical provision, which is one of the legal tools with training-support dimensions, can evaluate the consistency between the implemented procedures and the planned ones. This study aimed to evaluate the process of recording patient education, consistency of record-keeping with perception, and patient satisfaction after implementing clinical supervision. Materials and Methods: This longitudinal, embedded study was conducted during 2013-2015 in three stages of designing, implementation, and evaluation of the supervision program using randomized convenience sampling on 786 monitoring units (medical records of patients being discharged at Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. In the designing stage, the checklists for supervision of recording patient education and consistency of patient perception with the recorded trainings and the patient satisfaction questionnaire were designed and their valididty and reliability were established. In the implementation stage, structure of the monitoring program was designed with the cooperation of eight supervisors. During 12 months, 2333 checklists and questionnaires were completed at the time of hospital discharge in the evaluation stage. Data analysis was performed in SPSS, version 18, using One-way ANOVA. Results: After 12 months of embedded evaluation, the mean score of recording patient education was 88.5±21.75, and the mean scores of patient satisfaction with the training process and consistency between patients’ perception and the recorded trainings were 47.17±21.48 and 73±25.13, respectively. The mean scores of recording patient training and consistency between patients’ perception and the recorded trainings had an increasing trend (P<0.001, while the mean score of patient satisfaction reduced (P<0.001. Conclusion: The results of clinical supervision during

  2. 42 CFR 2.1 - Statutory authority for confidentiality of drug abuse patient records.

    Science.gov (United States)

    2010-10-01

    ... HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.1 Statutory authority for confidentiality of drug abuse patient records. The restrictions of these regulations upon the disclosure and use of drug abuse patient records were initially authorized by section 408...

  3. Patient-centred care: using online personal medical records in IVF practice.

    NARCIS (Netherlands)

    Tuil, W.S.; Hoopen, A.J. ten; Braat, D.D.M.; Vries Robbé, P.F. de; Kremer, J.A.M.

    2006-01-01

    BACKGROUND: Generic patient-accessible medical records have shown promise in enhancing patient-centred care for patients with chronic diseases. We sought to design, implement and evaluate a patient-accessible medical record specifically for patients undergoing a course of assisted reproduction (IVF

  4. Medical narratives and patient analogs: the ethical implications of electronic patient records.

    Science.gov (United States)

    Kluge, E H

    1999-12-01

    An electronic patient record consists of electronically stored data about a specific patient. It therefore constitutes a data-space. The data may be combined into a patient profile which is relative to a particular specialty as well as phenomenologically unique to the specific professional who constructs the profile. Further, a diagnosis may be interpreted as a path taken by a health care professional with a certain specialty through the data-space relative to the patient profile constructed by that professional. This way of looking at electronic patient records entails certain ethical implications about privacy and accessibility. However, it also permits the construction of artificial intelligence and competence algorithms for health care professionals relative to their specialties.

  5. Patient-Centered Personal Health Record and Portal Implementation Toolkit for Ambulatory Clinics: A Feasibility Study.

    Science.gov (United States)

    Nahm, Eun-Shim; Diblasi, Catherine; Gonzales, Eva; Silver, Kristi; Zhu, Shijun; Sagherian, Knar; Kongs, Katherine

    2017-04-01

    Personal health records and patient portals have been shown to be effective in managing chronic illnesses. Despite recent nationwide implementation efforts, the personal health record and patient portal adoption rates among patients are low, and the lack of support for patients using the programs remains a critical gap in most implementation processes. In this study, we implemented the Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit in a large diabetes/endocrinology center and assessed its preliminary impact on personal health record and patient portal knowledge, self-efficacy, patient-provider communication, and adherence to treatment plans. Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit is composed of Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General, clinic-level resources for clinicians, staff, and patients, and Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit Plus, an optional 4-week online resource program for patients ("MyHealthPortal"). First, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General was implemented, and all clinicians and staff were educated about the center's personal health record and patient portal. Then general patient education was initiated, while a randomized controlled trial was conducted to test the preliminary effects of "MyHealthPortal" using a small sample (n = 74) with three observations (baseline and 4 and 12 weeks). The intervention group showed significantly greater improvement than the control group in patient-provider communication at 4 weeks (t56 = 3.00, P = .004). For other variables, the intervention group tended to show greater improvement; however, the differences were not significant. In this preliminary study, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit showed potential for filling the gap in the current

  6. EPR project construction cost control

    International Nuclear Information System (INIS)

    Duflo, D.; Pouget-Abadie, X.; Dufour, A.; Kauffmann, G.

    2001-01-01

    The EPR project is now managed by EDF in cooperation with the German Utilities. The main engineering activities for this period are related to the preparation of construction project management, deepening of some safety issues, definition of the project technical reference. The EPR project concerns the so-called reference unit, that is an isolated first-off unit, with unit electrical power of about 1500 MW. The construction costs evaluated are those of the nuclear island, the conventional island, site facilities, installation work and the administrative buildings. The EPR project construction cost evaluation method applies to all the equipment installed and commissioned. It requires the availability of a preliminary project detailed enough to identify the bill of quantities. To these quantities are then assigned updated unit prices that are based either on cost bases for similar and recent facilities or taken from request for quotation for similar equipment or result from gains due to contractual conditions benefiting from simplifications in the functional and technical specifications. The input and output data are managed in a model that respects the breakdown on which the evaluation method is based. The structural organization of this method reflects a functional breakdown on the one hand (nuclear island, conventional island, common site elements) and on the other hand a breakdown according to equipment or activity (civil engineering, mechanics, electricity, instrumentation and control). This paper discusses the principle and the method of construction cost evaluation carried out, the cost data base and input and output parameters as well as results and oncoming cost analysis tasks. (author)

  7. EPR of exchange coupled systems

    CERN Document Server

    Bencini, Alessandro

    2012-01-01

    From chemistry to solid state physics to biology, the applications of Electron Paramagnetic Resonance (EPR) are relevant to many areas. This unified treatment is based on the spin Hamiltonian approach and makes extensive use of irreducible tensor techniques to analyze systems in which two or more spins are magnetically coupled. This edition contains a new Introduction by coauthor Dante Gatteschi, a pioneer and scholar of molecular magnetism.The first two chapters review the foundations of exchange interactions, followed by examinations of the spectra of pairs and clusters, relaxation in oligon

  8. EPR investigations on technetium compounds

    International Nuclear Information System (INIS)

    Abram, U.; Munze, R.; Kirmse, R.; Stach, J.

    1986-01-01

    Stimulated by the widespread use of the isotope /sup 99m/Tc in the field of nuclear medicine, there has been a substantial growth of interest in the chemistry of this man-made element. A particular need emerges for analytical methods allowing solution investigations of coordination compounds of technetium with low substance use. Considering these facts, Electron Paramagnetic Resonance Spectroscopy (EPR) appears to be a very suitable method because only very small amounts of the compounds are needed (lower than 1 mg). The resulting spectra give information regarding the valence state, symmetry and bonding properties of the compounds under study

  9. Effect of introduction of electronic patient reporting on the duration of ambulance calls.

    Science.gov (United States)

    Kuisma, Markku; Väyrynen, Taneli; Hiltunen, Tuomas; Porthan, Kari; Aaltonen, Janne

    2009-10-01

    We examined the effect of the change from paper records to the electronic patient records (EPRs) on ambulance call duration. We retrieved call duration times 6 months before (group 1) and 6 months after (group 2) the introduction of EPR. Subgroup analysis of group 2 was fulfilled depending whether the calls were made during the first or last 3 months after EPR introduction. We analyzed 37 599 ambulance calls (17 950 were in group 1 and 19 649 were in group 2). The median call duration in group 1 was 48 minutes and in group 2 was 49 minutes (P = .008). In group 2, call duration was longer during the first 3 months after EPR introduction. In multiple linear regression analysis, urgency category (P introduction was noticed, reflecting adaptation process to a new way of working.

  10. Overview of LBB implementation for the EPR

    International Nuclear Information System (INIS)

    Cauquelin, C.

    1997-01-01

    This paper presents an overview of the use of leak-before-break (LBB) analysis for EPR reactors. EPR is an evolutionary Nuclear Island of the 4 loop x 1500 Mwe class currently in the design phase. Application of LBB to the main coolant lines and resulting design impacts are summarized. Background information on LBB analysis in France and Germany is also presented

  11. Overview of LBB implementation for the EPR

    Energy Technology Data Exchange (ETDEWEB)

    Cauquelin, C.

    1997-04-01

    This paper presents an overview of the use of leak-before-break (LBB) analysis for EPR reactors. EPR is an evolutionary Nuclear Island of the 4 loop x 1500 Mwe class currently in the design phase. Application of LBB to the main coolant lines and resulting design impacts are summarized. Background information on LBB analysis in France and Germany is also presented.

  12. EPR dosimetry with tooth enamel: A review

    International Nuclear Information System (INIS)

    Fattibene, Paola; Callens, Freddy

    2010-01-01

    When tooth enamel is exposed to ionizing radiation, radicals are formed, which can be detected using electron paramagnetic resonance (EPR) techniques. EPR dosimetry using tooth enamel is based on the (presumed) correlation between the intensity or amplitude of some of the radiation-induced signals with the dose absorbed in the enamel. In the present paper a critical review is given of this widely applied dosimetric method. The first part of the paper is fairly fundamental and deals with the main properties of tooth enamel and some of its model systems (e.g., synthetic apatites). Considerable attention is also paid to the numerous radiation-induced and native EPR signals and the radicals responsible for them. The relevant methods for EPR detection, identification and spectrum analyzing are reviewed from a general point of view. Finally, the needs for solid-state modelling and studies of the linearity of the dose response are investigated. The second part is devoted to the practical implementation of EPR dosimetry using enamel. It concerns specific problems of preparation of samples, their irradiation and spectrum acquisition. It also describes how the dosimetric signal intensity and dose can be retrieved from the EPR spectra. Special attention is paid to the energy dependence of the EPR response and to sources of uncertainties. Results of and problems encountered in international intercomparisons and epidemiological studies are also dealt with. In the final section the future of EPR dosimetry with tooth enamel is analyzed.

  13. EPR meeting international safety standards with margin

    International Nuclear Information System (INIS)

    Mazurkiewicz, S.M.; Brauns, J.; Blombach, J.

    2005-01-01

    The EPR provides technology that offers a solution to the market's need for safe, economic power. The EPR was originally developed through a joint effort between Framatome ANP and Siemens by incorporating the best technological features from the French and German nuclear reactor fleets into a cost-competitive product capable of international licensing. As such, the EPR is a global product with commercial units currently being built in Finland at the Olkiluoto site, and planned for France, at the Flamanville site. Framatome ANP has recently proposed four EPR units to China in response to a request for vendor bids. In addition, Framatome ANP has announced their intent to pursue design certification with the United States Nuclear Regulatory Commission (NRC). This paper discusses how EPR's innovative safety philosophy ensures compliance with international safety standards for advanced light-water reactors (ALWRs). (author)

  14. EPR meeting international safety standards with margin

    International Nuclear Information System (INIS)

    Mazurkiewicz, S.M.; Brauns, J.; Blombach, J.

    2005-01-01

    The EPR provides technology that offers a solution to the market's need for safe, economic power. The EPR was originally developed through a joint effort between Framatome ANP and Siemens by incorporating the best technological features from the French and German nuclear reactor fleets into a cost-competitive product capable of international licensing. As such, the EPR is a global product with commercial units currently being built in Finland at the Olkiluoto site, and planned for France, at the Flamanville site. Framatome ANP has recently proposed four EPR units to China in response to a request for vendor bids. In addition, Framatome ANP has announced their intent to pursue design certification in with the United States Nuclear Regulatory Commission (NRC). This paper discusses how EPR's innovative safety philosophy ensures compliance with international safety standards for advanced light-water reactors (ALWRs). (author)

  15. Association between personal health record enrollment and patient loyalty.

    Science.gov (United States)

    Turley, Marianne; Garrido, Terhilda; Lowenthal, Alex; Zhou, Yi Yvonne

    2012-07-01

    To examine the association between patient loyalty, as measured by member retention in the health plan, and access to My Health Manager (MHM), Kaiser Permanente's PHR, which is linked to its electronic health record, KP HealthConnect. We conducted a retrospective cohort observational quality improvement project from the third quarter of 2005 to the fourth quarter of 2008 for approximately 394,000 Kaiser Permanente Northwest members. To control for self-selection bias, we used propensity scores to perform exact 1-to-1 matching without replacement between MHM users and nonusers. We estimated retention rates of the matched data and assessed the association between MHM use and retention versus voluntary termination. We also estimated odds ratios of significant variables impacting member retention. The probability of remaining a member or being involuntarily terminated versus voluntary termination was 96.7% for users (95% confidence interval [CI], 96.6%-96.7%) and 92.2% for nonusers (95% CI, 92.1%-92.4%; P loyalty, retention is critical to healthcare organizations.

  16. Patient-Centered e-Health Record over the Cloud.

    Science.gov (United States)

    Koumaditis, Konstantinos; Themistocleous, Marinos; Vassilacopoulos, George; Prentza, Andrianna; Kyriazis, Dimosthenis; Malamateniou, Flora; Maglaveras, Nicos; Chouvarda, Ioanna; Mourouzis, Alexandros

    2014-01-01

    The purpose of this paper is to introduce the Patient-Centered e-Health (PCEH) conceptual aspects alongside a multidisciplinary project that combines state-of-the-art technologies like cloud computing. The project, by combining several aspects of PCEH, such as: (a) electronic Personal Healthcare Record (e-PHR), (b) homecare telemedicine technologies, (c) e-prescribing, e-referral, e-learning, with advanced technologies like cloud computing and Service Oriented Architecture (SOA), will lead to an innovative integrated e-health platform of many benefits to the society, the economy, the industry, and the research community. To achieve this, a consortium of experts, both from industry (two companies, one hospital and one healthcare organization) and academia (three universities), was set to investigate, analyse, design, build and test the new platform. This paper provides insights to the PCEH concept and to the current stage of the project. In doing so, we aim at increasing the awareness of this important endeavor and sharing the lessons learned so far throughout our work.

  17. A secure and robust password-based remote user authentication scheme using smart cards for the integrated EPR information system.

    Science.gov (United States)

    Das, Ashok Kumar

    2015-03-01

    An integrated EPR (Electronic Patient Record) information system of all the patients provides the medical institutions and the academia with most of the patients' information in details for them to make corrective decisions and clinical decisions in order to maintain and analyze patients' health. In such system, the illegal access must be restricted and the information from theft during transmission over the insecure Internet must be prevented. Lee et al. proposed an efficient password-based remote user authentication scheme using smart card for the integrated EPR information system. Their scheme is very efficient due to usage of one-way hash function and bitwise exclusive-or (XOR) operations. However, in this paper, we show that though their scheme is very efficient, their scheme has three security weaknesses such as (1) it has design flaws in password change phase, (2) it fails to protect privileged insider attack and (3) it lacks the formal security verification. We also find that another recently proposed Wen's scheme has the same security drawbacks as in Lee at al.'s scheme. In order to remedy these security weaknesses found in Lee et al.'s scheme and Wen's scheme, we propose a secure and efficient password-based remote user authentication scheme using smart cards for the integrated EPR information system. We show that our scheme is also efficient as compared to Lee et al.'s scheme and Wen's scheme as our scheme only uses one-way hash function and bitwise exclusive-or (XOR) operations. Through the security analysis, we show that our scheme is secure against possible known attacks. Furthermore, we simulate our scheme for the formal security verification using the widely-accepted AVISPA (Automated Validation of Internet Security Protocols and Applications) tool and show that our scheme is secure against passive and active attacks.

  18. EPR dosimetry - present and future

    International Nuclear Information System (INIS)

    Regulla, D.F.

    1999-01-01

    In the past, IAEA has played a central role in stipulating research and development in EPR high-dose standardisation as well as co-ordinating and organising international dose intercomparison programs, within the Member States of the United Nations from the mid-seventies till today. The future tasks of EPR dosimetry seem to tend towards different subjects such as biomarkers, biological radiation effects, post-accident dose reconstruction in the environment, and retrospective human dosimetry. The latter may be considered a promising tool for epidemiology on the way to re-define radiation risk of man for chronicle radiation exposures, based on e.g. South Ural civil population and radiation workers. There are on-going international activities in the field of standardising high-level dosimetry by the American Standards on Testing and Materials (ASTM), and the International Organisation of Standards (ISO) as well as those of the International Commission on Radiation Units and Measurements (ICRU) considering the establishment of relevant recommendations concerning industrial radiation processing, but also human dose reconstruction. (author)

  19. EPR Dosimetry - Present and Future

    Energy Technology Data Exchange (ETDEWEB)

    Regulla, D.F. [GSF - National Research Centre for Environment and Health, Institute of Radiation Protection, 85764 Neuherberg (Germany)

    1999-07-01

    In the past, IAEA has played a central role in stipulating research and development in EPR high-dose standardisation as well as in coordinating and organising international dose intercomparison programs, within the Member States of the United Nations from the mid-seventies till today. The future tasks of EPR dosimetry seem to tend towards different subjects such as bio markers, biological radiation effects, post-accident dose reconstruction in the environment, and retrospective human dosimetry. The latter may be considered a promising tool for epidemiology on the way to re-define radiation risk of man for chronicle radiation exposures, based on e.g. South Ural civil population and radiation workers. There are on-going international activities in the field of standardising high-level dosimetry by the American Standards on Testing and Materials (Astm), and by the International Organisation of Standards (ISO). The International Commission on Radiation Units and Measurements (ICRU) is considering the establishment of relevant recommendations concerning industrial radiation processing, but also human dose reconstruction. (Author)

  20. EPR Dosimetry - Present and Future

    International Nuclear Information System (INIS)

    Regulla, D.F.

    1999-01-01

    In the past, IAEA has played a central role in stipulating research and development in EPR high-dose standardisation as well as in coordinating and organising international dose intercomparison programs, within the Member States of the United Nations from the mid-seventies till today. The future tasks of EPR dosimetry seem to tend towards different subjects such as bio markers, biological radiation effects, post-accident dose reconstruction in the environment, and retrospective human dosimetry. The latter may be considered a promising tool for epidemiology on the way to re-define radiation risk of man for chronicle radiation exposures, based on e.g. South Ural civil population and radiation workers. There are on-going international activities in the field of standardising high-level dosimetry by the American Standards on Testing and Materials (Astm), and by the International Organisation of Standards (ISO). The International Commission on Radiation Units and Measurements (ICRU) is considering the establishment of relevant recommendations concerning industrial radiation processing, but also human dose reconstruction. (Author)

  1. Alanine-EPR as a transfer standard dosimetry system for low energy X radiation

    International Nuclear Information System (INIS)

    Khoury, H.J.; Silva, E.J. da; Mehta, K.; Barros, V.S. de; Asfora, V.K.; Guzzo, P.L.; Parker, A.G.

    2015-01-01

    The purpose of this paper is to evaluate the use of alanine-EPR as a transfer standard dosimetry system for low energy X radiation, such as that in RS-2400, which operates in the range from 25 to 150 kV and 2 to 45 mA. Two types of alanine dosimeters were investigated. One is a commercial alanine pellets from Aérial-Centre de Ressources Technologiques, France and one was prepared in our laboratory (LMRI-DEN/UFPE). The EPR spectra of the irradiated dosimeters were recorded in the Nuclear Energy Department of UFPE, using a Bruker EMX10 EPR spectrometer operating in the X-band. The alanine-EPR dosimetry system was calibrated in the range of 20–220 Gy in this X-ray field, against an ionization chamber calibrated at the relevant X-ray energy with traceability to PTB. The results showed that both alanine dosimeters presented a linear dose response the same sensitivity, when the EPR signal was normalized to alanine mass. The total uncertainty in the measured dose was estimated to be about 3%. The results indicate that it is possible to use the alanine-EPR dosimetry system for validation of a low-energy X ray irradiator, such as RS-2400.

  2. EPR spectra induced by gamma-irradiation of some dry medical herbs

    Science.gov (United States)

    Yordanov, N. D.; Lagunov, O.; Dimov, K.

    2009-04-01

    The radiation-induced EPR spectra in some medical herbs are reported. The samples studied are: (i) leaves of nettle, common balm, peppermint and thyme; (ii) stalks of common balm, thyme, milfoil, yarrow and marigold; (iii) blossoms of yarrow and marigold; (iv) blossoms and leaves of hawthorn and tutsan; and (v) roots of common valerian, nettle, elecampane (black and white), restharrows and carlina. Before irradiation all samples exhibit one weak anisotropic singlet EPR line with effective g-value of 2.0050±0.0002. The radiation-induced spectra fall into three groups. EPR spectra of irradiated blossoms of yarrow and marigold, stalks of common balm, thyme, tutsan and yarrow as well as roots of common valerian, nettle and elecampane (black and white) show "cellulose-like" EPR spectrum typical for irradiated plants. It is characterized by one intense central line with g=2.0050±0.0005 and two weak satellite lines situated ca. 30 G left and right to it. EPR spectra of gamma-irradiated restharrows and carlina are complex. They may be represented by one triplet corresponding to the "cellulose-like" EPR spectrum, one relatively intense singlet, situated in the center of the spectrum, and five weak additional satellite lines left and right to the center. The last spectrum was assigned as "carbohydrate-like" type. Only one intense EPR singlet with g=2.0048±0.0005 was recorded after irradiation of leaves of nettle and common balm. The lifetime of the radiation-induced EPR spectra was followed for a period of 3 months.

  3. EPR spectra induced by gamma-irradiation of some dry medical herbs

    International Nuclear Information System (INIS)

    Yordanov, N.D.; Lagunov, O.; Dimov, K.

    2009-01-01

    The radiation-induced EPR spectra in some medical herbs are reported. The samples studied are: (i) leaves of nettle, common balm, peppermint and thyme; (ii) stalks of common balm, thyme, milfoil, yarrow and marigold; (iii) blossoms of yarrow and marigold; (iv) blossoms and leaves of hawthorn and tutsan; and (v) roots of common valerian, nettle, elecampane (black and white), restharrows and carlina. Before irradiation all samples exhibit one weak anisotropic singlet EPR line with effective g-value of 2.0050±0.0002. The radiation-induced spectra fall into three groups. EPR spectra of irradiated blossoms of yarrow and marigold, stalks of common balm, thyme, tutsan and yarrow as well as roots of common valerian, nettle and elecampane (black and white) show 'cellulose-like' EPR spectrum typical for irradiated plants. It is characterized by one intense central line with g=2.0050±0.0005 and two weak satellite lines situated ca. 30 G left and right to it. EPR spectra of gamma-irradiated restharrows and carlina are complex. They may be represented by one triplet corresponding to the 'cellulose-like' EPR spectrum, one relatively intense singlet, situated in the center of the spectrum, and five weak additional satellite lines left and right to the center. The last spectrum was assigned as 'carbohydrate-like' type. Only one intense EPR singlet with g=2.0048±0.0005 was recorded after irradiation of leaves of nettle and common balm. The lifetime of the radiation-induced EPR spectra was followed for a period of 3 months

  4. EPR spectra induced by gamma-irradiation of some dry medical herbs

    Energy Technology Data Exchange (ETDEWEB)

    Yordanov, N.D. [Laboratory EPR, Institute of Catalysis, Bulgarian Academy of Sciences, 1113 Sofia (Bulgaria)], E-mail: ndyepr@bas.bg; Lagunov, O. [Laboratory EPR, Institute of Catalysis, Bulgarian Academy of Sciences, 1113 Sofia (Bulgaria); Dimov, K. [Institute of Cryobiology and Food technology, 1162 Sofia (Bulgaria)

    2009-04-15

    The radiation-induced EPR spectra in some medical herbs are reported. The samples studied are: (i) leaves of nettle, common balm, peppermint and thyme; (ii) stalks of common balm, thyme, milfoil, yarrow and marigold; (iii) blossoms of yarrow and marigold; (iv) blossoms and leaves of hawthorn and tutsan; and (v) roots of common valerian, nettle, elecampane (black and white), restharrows and carlina. Before irradiation all samples exhibit one weak anisotropic singlet EPR line with effective g-value of 2.0050{+-}0.0002. The radiation-induced spectra fall into three groups. EPR spectra of irradiated blossoms of yarrow and marigold, stalks of common balm, thyme, tutsan and yarrow as well as roots of common valerian, nettle and elecampane (black and white) show 'cellulose-like' EPR spectrum typical for irradiated plants. It is characterized by one intense central line with g=2.0050{+-}0.0005 and two weak satellite lines situated ca. 30 G left and right to it. EPR spectra of gamma-irradiated restharrows and carlina are complex. They may be represented by one triplet corresponding to the 'cellulose-like' EPR spectrum, one relatively intense singlet, situated in the center of the spectrum, and five weak additional satellite lines left and right to the center. The last spectrum was assigned as 'carbohydrate-like' type. Only one intense EPR singlet with g=2.0048{+-}0.0005 was recorded after irradiation of leaves of nettle and common balm. The lifetime of the radiation-induced EPR spectra was followed for a period of 3 months.

  5. The use of nationwide on-line prescription records improves the drug history in hospitalized patients

    DEFF Research Database (Denmark)

    Glintborg, Bente; Poulsen, Henrik E; Dalhoff, Kim P

    2008-01-01

    What is already known about this subject: Structured medication interviews improve the medication history upon hospitalization. Pharmacy records are valid lists of the prescribed medications available to individual patients. In Denmark, treating doctors now have access to their patients' pharmacy...... records through a real-time online electronic database What this study adds: Omission errors are frequent among hospitalized patients despite structured drug interviews and home visits. Pharmacy records may be used to minimize patients' recall bias and improve the medication lists....

  6. Characterization of beer flavour stability (EPR - spin trapping)

    International Nuclear Information System (INIS)

    Stasko, A.; Liptakova, M.; Malik, F.

    1999-01-01

    The beer flavour stability is coupled with free radical degradation processes. Probably, aldehydes produced during the brewery but also generated by stalling are responsible for beer flavour as well as for its breaking down. The storing beer at the lower temperatures and in the dark place inhibits, and otherwise the rising temperature and illumination accelerate the rate of such radical processes. Beers contain naturally occurring radical scavengers - antioxidants which inhibit such unwanted reactions. Then depleting of scavengers results in the breaking down of the beer stability. EPR spin trapping technique was used as monitor such processes and for characterising so the flavour stability of beer. The probe was temperated at 60 grad C in the cavity of EPR spectrometer in the presence of spin trapping agent, N-tert.-butyl-α-phenyl nitrone (PBN) and EPR spectra were recorded for few hours. After beer antioxidants become depleted, free radicals formed by the beer degradation are scavenged by PBN spin trap and this point is characterised with a dramatically increased concentration of the free radicals trapped

  7. Thermal induced EPR signals in tooth enamel

    International Nuclear Information System (INIS)

    Fattibene, P.; Aragno, D.; Onori, S.; Pressello, M.C.

    2000-01-01

    Electron paramagnetic resonance (EPR) spectroscopy was used to detect the effects of temperature on powdered human tooth enamel, not irradiated in the laboratory. Samples were heated at temperature between 350 and 450, at 600 and at 1000 deg. C, for different heating times, between 6 min and 39 h. Changes in the EPR spectra were detected, with the formation of new signals. Possible correlation between the changes in EPR spectra and modifications in the enamel and in the mineral phase of bone detected with other techniques is discussed. The implications for dosimetric applications of signals induced by overheating due to mechanical friction during sample preparation are underlined

  8. Nitrosyl hemoglobins: EPR above 80 K

    Energy Technology Data Exchange (ETDEWEB)

    Wajnberg, E.; Bemski, G.; El-Jaick, L.J.; Alves, O.C.

    1995-03-01

    The EPR spectra of nitrosyl hemoglobin and myoglobin in different conditions (native, denatured and lyophilized), as well as of hematin-NO were obtained in the temperature range of 80 K-280 K. There is a substantial and reversible.decrease of the areas of the EPR spectra of all the hemoglobin samples above 150 K. The interpretation of the results implies the existence of two conformational states in thermal equilibrium only one of which is EPR detectable. Thermodynamical parameters are determined for the hexa and penta-coordinated cases. (author). 25 refs, 3 figs.

  9. Nitrosyl hemoglobins: EPR above 80 K

    International Nuclear Information System (INIS)

    Wajnberg, E.; Bemski, G.; El-Jaick, L.J.; Alves, O.C.

    1995-03-01

    The EPR spectra of nitrosyl hemoglobin and myoglobin in different conditions (native, denatured and lyophilized), as well as of hematin-NO were obtained in the temperature range of 80 K-280 K. There is a substantial and reversible.decrease of the areas of the EPR spectra of all the hemoglobin samples above 150 K. The interpretation of the results implies the existence of two conformational states in thermal equilibrium only one of which is EPR detectable. Thermodynamical parameters are determined for the hexa and penta-coordinated cases. (author). 25 refs, 3 figs

  10. EPR ohmic heating energy storage

    International Nuclear Information System (INIS)

    Heck, F.M.; Stillwagon, R.E.; King, E.I.

    1977-01-01

    The Ohmic Heating (OH) Systems for all the Experimental Power Reactor (EPR) designs to date have all used temporary energy storage to assist in providing the OH current charge required to build up the plasma current. The energies involved (0.8 x 10 9 J to 1.9 x 10 9 J) are so large as to make capacitor storage impractical. Two alternative approaches are homopolar dc generators and ac generators. Either of these can be designed for pulse duty and can be made to function in a manner similar to a capacitor in the OH circuit and are therefore potential temporary energy storage devices for OH systems for large tokamaks. This study compared total OH system costs using homopolar and ac generators to determine their relative merits. The total system costs were not significantly different for either type of machine. The added flexibility and the lower maintenance of the ac machine system make it the more attractive approach

  11. From planning to realisation of an electronic patient record.

    Science.gov (United States)

    Krämer, T; Rapp, R; Krämer, K-L

    1999-03-01

    The high complex requirements on information and information flow in todays hospitals can only be accomplished by the use of modern Information Systems (IS). In order to achieve this, the Stiftung Orthopädische Universitätsklinik has carried out first the Project "Strategic Informations System Planning" in 1993. Then realizing the neccessary infrastructure (network; client-server) from 1993 to 1997, and finally started the introduction of modern IS (SAP R/3 and IXOS-Archive) in the clinical area. One of the approved goal was the replacement of the paper medical record by an up-to-date electronical medical record. In this article the following three topics will be discussed: the difference between the up-to-date electronical medical record and the electronically archived finished cases, steps performed by our clinic to realize the up-to-date electronical medical record and the problems occured during this process.

  12. [From planning to realization of an electronic patient record].

    Science.gov (United States)

    Krämer, T; Rapp, R; Krämer, K L

    1999-03-01

    The high complex requirements on information and information flow in todays hospitals can only be accomplished by the use of modern Information Systems (IS). In order to achieve this, the Stiftung Orthopädische Universitätsklinik has carried out first the Project "Strategic Informations System Planning" in 1993. Then realizing the necessary infrastructure (network; client-server) from 1993 to 1997, and finally started the introduction of modern IS (SAP R/3 and IXOS-Archive) in the clinical area. One of the approved goal was the replacement of the paper medical record by an up-to-date electronical medical record. In this article the following three topics will be discussed: the difference between the up-to-date electronical medical record and the electronically archived finished cases, steps performed by our clinic to realize the up-to-date electronical medical record and the problems occurred during this process.

  13. Record linkage for pharmacoepidemiological studies in cancer patients.

    Science.gov (United States)

    Herk-Sukel, Myrthe P P van; Lemmens, Valery E P P; Poll-Franse, Lonneke V van de; Herings, Ron M C; Coebergh, Jan Willem W

    2012-01-01

    An increasing need has developed for the post-approval surveillance of (new) anti-cancer drugs by means of pharmacoepidemiology and outcomes research in the area of oncology. To create an overview that makes researchers aware of the available database linkages in Northern America and Europe which facilitate pharmacoepidemiology and outcomes research in cancer patients. In addition to our own database, i.e. the Eindhoven Cancer Registry (ECR) linked to the PHARMO Record Linkage System, we considered database linkages between a population-based cancer registry and an administrative healthcare database that at least contains information on drug use and offers a longitudinal perspective on healthcare utilization. Eligible database linkages were limited to those that had been used in multiple published articles in English language included in Pubmed. The HMO Cancer Research Network (CRN) in the US was excluded from this review, as an overview of the linked databases participating in the CRN is already provided elsewhere. Researchers who had worked with the data resources included in our review were contacted for additional information and verification of the data presented in the overview. The following database linkages were included: the Surveillance, Epidemiology, and End-Results-Medicare; cancer registry data linked to Medicaid; Canadian cancer registries linked to population-based drug databases; the Scottish cancer registry linked to the Tayside drug dispensing data; linked databases in the Nordic Countries of Europe: Norway, Sweden, Finland and Denmark; and the ECR-PHARMO linkage in the Netherlands. Descriptives of the included database linkages comprise population size, generalizability of the population, year of first data availability, contents of the cancer registry, contents of the administrative healthcare database, the possibility to select a cancer-free control cohort, and linkage to other healthcare databases. The linked databases offer a longitudinal

  14. Homogeneity and EPR metrics for assessment of regular grids used in CW EPR powder simulations.

    Science.gov (United States)

    Crăciun, Cora

    2014-08-01

    CW EPR powder spectra may be approximated numerically using a spherical grid and a Voronoi tessellation-based cubature. For a given spin system, the quality of simulated EPR spectra depends on the grid type, size, and orientation in the molecular frame. In previous work, the grids used in CW EPR powder simulations have been compared mainly from geometric perspective. However, some grids with similar homogeneity degree generate different quality simulated spectra. This paper evaluates the grids from EPR perspective, by defining two metrics depending on the spin system characteristics and the grid Voronoi tessellation. The first metric determines if the grid points are EPR-centred in their Voronoi cells, based on the resonance magnetic field variations inside these cells. The second metric verifies if the adjacent Voronoi cells of the tessellation are EPR-overlapping, by computing the common range of their resonance magnetic field intervals. Beside a series of well known regular grids, the paper investigates a modified ZCW grid and a Fibonacci spherical code, which are new in the context of EPR simulations. For the investigated grids, the EPR metrics bring more information than the homogeneity quantities and are better related to the grids' EPR behaviour, for different spin system symmetries. The metrics' efficiency and limits are finally verified for grids generated from the initial ones, by using the original or magnetic field-constraint variants of the Spherical Centroidal Voronoi Tessellation method. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Homogeneity and EPR metrics for assessment of regular grids used in CW EPR powder simulations

    Science.gov (United States)

    Crăciun, Cora

    2014-08-01

    CW EPR powder spectra may be approximated numerically using a spherical grid and a Voronoi tessellation-based cubature. For a given spin system, the quality of simulated EPR spectra depends on the grid type, size, and orientation in the molecular frame. In previous work, the grids used in CW EPR powder simulations have been compared mainly from geometric perspective. However, some grids with similar homogeneity degree generate different quality simulated spectra. This paper evaluates the grids from EPR perspective, by defining two metrics depending on the spin system characteristics and the grid Voronoi tessellation. The first metric determines if the grid points are EPR-centred in their Voronoi cells, based on the resonance magnetic field variations inside these cells. The second metric verifies if the adjacent Voronoi cells of the tessellation are EPR-overlapping, by computing the common range of their resonance magnetic field intervals. Beside a series of well known regular grids, the paper investigates a modified ZCW grid and a Fibonacci spherical code, which are new in the context of EPR simulations. For the investigated grids, the EPR metrics bring more information than the homogeneity quantities and are better related to the grids’ EPR behaviour, for different spin system symmetries. The metrics’ efficiency and limits are finally verified for grids generated from the initial ones, by using the original or magnetic field-constraint variants of the Spherical Centroidal Voronoi Tessellation method.

  16. Identifying Patients for Clinical Studies from Electronic Health Records: TREC 2012 Medical Records Track at OHSU

    Science.gov (United States)

    2012-11-01

    report_text:infectious OR report_text:meningitis OR report_text:cefdinir OR report_text:encephalitis OR report_text:"brain abscess " OR...sertraline|zyprexa|olanza pine" 178 Patients with metastatic breast cancer ((report_text:metast* OR discharge_icd_codes_tx:196* OR...report_text:"metastatic breast cancer" 179 Patients taking atypical antipsychotics without a diagnosis schizophrenia or bipolar depression

  17. New loophole for the EPR paradox

    OpenAIRE

    Feldmann, Michel

    1999-01-01

    We exhibit a classical model free from any paradox which exactly simulates the spin EPR test. We conclude that Bell's inequality violation is a strictly classical phenomenon, contrary to a general belief.

  18. Changes to criminal records checks used to safeguard vulnerable patients.

    Science.gov (United States)

    Griffith, Richard; Tengnah, Cassam

    2012-07-01

    The Protection of Freedoms Act 2012 is introducing changes to the Criminal Records Bureau (CRB) checks carried out on those people who work with vulnerable groups. The new law is the coalition Government's response to the criticism of the Safeguarding Vulnerable Group Act 2006. It will merge the CRB and Independent Safeguarding Authority into a new Disclosure and Barring Service and will enhance the rights of applicants to challenge the CRB's right to disclose non-conviction information as part of an enhanced criminal records check. In the first of two articles on the Protection of Freedoms Act 2012, Richard Griffith and Cassam Tengnah discuss the current framework for disclosing criminal records and the impact of the changes on district nurses applying for new posts.

  19. Improving Patient Safety With the Military Electronic Health Record

    National Research Council Canada - National Science Library

    Charles, Marie-Jocelyne; Harmon, Bart J; Jordan, Pamela S

    2005-01-01

    The United States Department of Defense (DoD) has transformed health care delivery in its use of information technology to automate patient data documentation, leading to improvements in patient safety...

  20. DANBIO-powerful research database and electronic patient record

    DEFF Research Database (Denmark)

    Hetland, Merete Lund

    2011-01-01

    an overview of the research outcome and presents the cohorts of RA patients. The registry, which is approved as a national quality registry, includes patients with RA, PsA and AS, who are followed longitudinally. Data are captured electronically from the source (patients and health personnel). The IT platform...... as an electronic patient 'chronicle' in routine care, and at the same time provides a powerful research database....

  1. Spin entanglement, decoherence and Bohm's EPR paradox

    OpenAIRE

    Cavalcanti, E. G.; Drummond, P. D.; Bachor, H. A.; Reid, M. D.

    2007-01-01

    We obtain criteria for entanglement and the EPR paradox for spin-entangled particles and analyse the effects of decoherence caused by absorption and state purity errors. For a two qubit photonic state, entanglement can occur for all transmission efficiencies. In this case, the state preparation purity must be above a threshold value. However, Bohm's spin EPR paradox can be achieved only above a critical level of loss. We calculate a required efficiency of 58%, which appears achievable with cu...

  2. Perspectives of shaped pulses for EPR spectroscopy

    Science.gov (United States)

    Spindler, Philipp E.; Schöps, Philipp; Kallies, Wolfgang; Glaser, Steffen J.; Prisner, Thomas F.

    2017-07-01

    This article describes current uses of shaped pulses, generated by an arbitrary waveform generator, in the field of EPR spectroscopy. We show applications of sech/tanh and WURST pulses to dipolar spectroscopy, including new pulse schemes and procedures, and discuss the more general concept of optimum-control-based pulses for applications in EPR spectroscopy. The article also describes a procedure to correct for experimental imperfections, mostly introduced by the microwave resonator, and discusses further potential applications and limitations of such pulses.

  3. Applications of EPR in radiation research

    CERN Document Server

    Lund, Anders

    2014-01-01

    Applications of EPR in Radiation Research is a multi-author contributed volume presented in eight themes: I. Elementary radiation processes (in situ and low temperature radiolysis, quantum solids); II: Solid state radiation chemistry (crystalline, amorphous and heterogeneous systems); III: Biochemistry, biophysics and biology applications (radicals in biomaterials, spin trapping, free-radical-induced DNA damage); IV: Materials science (polymeric and electronic materials, materials for treatment of nuclear waste, irradiated food); V: Radiation metrology (EPR-dosimetry, retrospective and medical

  4. EPR Spectroscopy in Environmental Lichen-Indication

    Science.gov (United States)

    Bondarenko, P. V.; Nguyet, Le Thi Bich; Zhuravleva, S. E.; Trukhan, E. M.

    2017-09-01

    The paramagnetic properties of lichens were investigated using EPR spectroscopy and Xanthoria parietina (L.) Th. Fr. as a case study. It was found that the concentration of paramagnetic centers in lichen thalli increased as the air-pollution level increased. Possible formation mechanisms of the paramagnetic centers in lichens were discussed. The efficiency of using EPR spectroscopy to study lichens as environmental quality indicators was demonstrated.

  5. EPR of alanine irradiated by neutrons

    International Nuclear Information System (INIS)

    Pivovarov, S.P.; Seredavina, T.A.; Zhdanov, S.V.; Mul'gin, S.I.; Zhakparov, R.K.

    2001-01-01

    In the work the first results of EPR studies of alanine, irradiated with diverse doses at neutron cyclotron generator different conditions and on the critical reactor stand are presented. A dose linearity dependence of EPR signal is observing, the methods of γ-background contribution separation are discussed. Obtain results is giving the basis to recommendation of alanine as an effective detector irradiation. However it is demanded the farther study on clarification of radiation sensitivity value dependence on the neutron energy spectrum form

  6. Maternity patients' access to their electronic medical records: use and perspectives of a patient portal.

    Science.gov (United States)

    Megan Forster, Megan; Dennison, Kerrie; Callen, Joanne; Andrew, Andrew; Westbrook, Johanna I

    Patients have been able to access clinical information from their paper-based health records for a number of years. With the advent of Electronic Medical Records (EMRs) access to this information can now be achieved online using a secure electronic patient portal. The purpose of this study was to investigate maternity patients' use and perceptions of a patient portal developed at the Mater Mothers' Hospital in Brisbane, Australia. A web-based patient portal, one of the first developed and deployed in Australia, was introduced on 26 June 2012. The portal was designed for maternity patients booked at Mater Mothers' Hospital, as an alternative to the paper-based Pregnancy Health Record. Through the portal, maternity patients are able to complete their hospital registration form online and obtain current health information about their pregnancy (via their EMR), as well as access a variety of support tools to use during their pregnancy such as tailored public health advice. A retrospective cross-sectional study design was employed. Usage statistics were extracted from the system for a one year period (1 July 2012 to 30 June 2013). Patients' perceptions of the portal were obtained using an online survey, accessible by maternity patients for two weeks in February 2013 (n=80). Descriptive statistics were employed to analyse the data. Between July 2012 and June 2013, 10,892 maternity patients were offered a patient portal account and access to their EMR. Of those 6,518 created one (60%; 6,518/10,892) and 3,104 went on to request access to their EMR (48%; 3,104/6,518). Of these, 1,751 had their access application granted by 30 June 2013. The majority of maternity patients submitted registration forms online via the patient portal (56.7%). Patients could view their EMR multiple times: there were 671 views of the EMR, 2,781 views of appointment schedules and 135 birth preferences submitted via the EMR. Eighty survey responses were received from EMR account holders, (response

  7. Improving stroke patients' care: a patient held record is not enough

    Directory of Open Access Journals (Sweden)

    Lampe Fiona

    2001-03-01

    Full Text Available Abstract Background Stroke patients' care in hospital tends to be poorly organised, with poor communication and a lack of information being frequent sources of complaint. The purpose of this study was to evaluate whether a patient-held record (PHR would result in greater patient satisfaction and better care planning for stroke patients. Methods A time series control (6 months - intervention (8 months - control (6 months was used among London teaching hospital general medical and geriatric medicine inpatient wards. All stroke patients admitted to the wards during the intervention phase received a PHR and were instructed in its use. Demographic, stroke severity, social factors and outcomes were collected from all stroke patients during all phases of the study. Results Of 252 stroke patients aged 46 to 98 years entered into the study, by six months after admission 118 (46.8% had died. PHR and control group patients were well matched in terms of socio-demographic characteristics and pre-stroke ability. At six months after admission, 119 (97% patients responded to the questionnaire. Just over half (56%, 13 of intervention group patients recalled receiving a PHR. Of those patients, 59% reported reading the PHR, 27% had lost their PHR, and two-thirds said they had difficulties encouraging staff to write in the PHR. Half felt that possession of the PHR was more trouble than it was worth. PHR group patients were more satisfied with the recovery they had made (79% vs. 59%, p=0.04, but felt less able to talk to staff about their problems (61% vs. 82%, p=0.02. PHR group patients reported receiving fewer explanations about their condition (18% vs. 33%, p=0.12 and treatment (26% vs. 45%, p=0.07, and were more afraid of asking doctors questions (21% vs. 4%, p=0.01 than controls. PHR group patients were no better prepared for hospital discharge than control group patients, and both groups were ill-informed about services and benefits that might have helped

  8. DANBIO-powerful research database and electronic patient record

    DEFF Research Database (Denmark)

    Hetland, Merete Lund

    2011-01-01

    is based on open-source software. Via a unique personal identification code, linkage with various national registers is possible for research purposes. Since the year 2000, more than 10,000 patients have been included. The main focus of research has been on treatment efficacy and drug survival. Compared...... an overview of the research outcome and presents the cohorts of RA patients. The registry, which is approved as a national quality registry, includes patients with RA, PsA and AS, who are followed longitudinally. Data are captured electronically from the source (patients and health personnel). The IT platform...... with RA patients, who were on conventional treatment with DMARDs, the patients who started biological treatment were younger, had longer disease duration, higher disease activity, tried more DMARDs and received more prednisolone. Also, more patients on biological therapy were seropositive and had erosive...

  9. Advances in Probes and Methods for Clinical EPR Oximetry

    Science.gov (United States)

    Hou, Huagang; Khan, Nadeem; Jarvis, Lesley A.; Chen, Eunice Y.; Williams, Benjamin B.; Kuppusamy, Periannan

    2015-01-01

    EPR oximetry, which enables reliable, accurate, and repeated measurements of the partial pressure of oxygen in tissues, provides a unique opportunity to investigate the role of oxygen in the pathogenesis and treatment of several diseases including cancer, stroke, and heart failure. Building on significant advances in the in vivo application of EPR oximetry for small animal models of disease, we are developing suitable probes and instrumentation required for use in human subjects. Our laboratory has established the feasibility of clinical EPR oximetry in cancer patients using India ink, the only material presently approved for clinical use. We now are developing the next generation of probes, which are both superior in terms of oxygen sensitivity and biocompatibility including an excellent safety profile for use in humans. Further advances include the development of implantable oxygen sensors linked to an external coupling loop for measurements of deep-tissue oxygenations at any depth, overcoming the current limitation of 10 mm. This paper presents an overview of recent developments in our ability to make meaningful measurements of oxygen partial pressures in human subjects under clinical settings. PMID:24729217

  10. Patients Reading Their Medical Records: Differences in Experiences and Attitudes between Regular and Inexperienced Readers

    Science.gov (United States)

    Huvila, Isto; Daniels, Mats; Cajander, Åsa; Åhlfeldt, Rose-Mharie

    2016-01-01

    Introduction: We report results of a study of how ordering and reading of printouts of medical records by regular and inexperienced readers relate to how the records are used, to the health information practices of patients, and to their expectations of the usefulness of new e-Health services and online access to medical records. Method: The study…

  11. Factors influencing recording of drug misuse in primary care: a qualitative study of GPs in England.

    Science.gov (United States)

    Davies-Kershaw, Hilary; Petersen, Irene; Nazareth, Irwin; Stevenson, Fiona

    2018-04-01

    Drug misuse is a serious public health problem. Evidence from previous epidemiological studies show that GPs are recording drug misuse in electronic patient records (EPR). However, although the recording trends are similar to national surveys, recording rates are much lower. To explore the factors that influence GPs to record drug misuse in the EPR, and to gain a clearer understanding of the gap between the amount of drug misuse recorded in primary care and that in national surveys and other studies. A semi-structured qualitative interview study of GPs working in general practices across England. Purposive sampling was employed to recruit 12 GPs, both with and without a special interest in drug misuse, from across England. Semi-structured face-to-face interviews were conducted to consider whether and why GPs record drug misuse, which methods GPs use for recording, GPs' actions if a patient asks for the information not to be recorded, and GPs' actions if they think a patient misuses drugs but does not disclose the information. Resulting data were analysed using a combination of inductive and deductive thematic analysis. The complexity of asking about drug misuse preceded GPs' decision to record. They described how the context of the general practice protocols, interaction between GP and patient, and the questioning process affected whether, how, and in which circumstances they asked about drug use. This led to GPs making a clinical decision on whether, who, and how to record in the EPR. When making decisions about whether or not to record drug misuse, GPs face complex choices. Aside from their own views, they reported feelings of pressure from the general practice environment in which they worked and their clinical commissioning group, as well as government policies. © British Journal of General Practice 2018.

  12. Development of the electronic patient record system based on problem oriented system.

    Science.gov (United States)

    Uto, Yumiko; Iwaanakuchi, Takashi; Muranaga, Fuminori; Kumamoto, Ichiro

    2013-01-01

    In Japan, POS (problem oriented system) is recommended in the clinical guideline. Therefore, the records are mainly made by SOAP. We developed a system mainly with a function which enabled our staff members of all kinds of professions including doctors to enter the patients' clinical information as an identical record, regardless if they were outpatients or inpatients, and to observe the contents chronologically. This electric patient record system is called "e-kanja recording system". On this system, all staff members in the medical team can now share the same information. Moreover, the contents can be reviewed by colleagues; the quality of records has been improved as it is evaluated by the others.

  13. Barriers to retrieving patient information from electronic health record data: failure analysis from the TREC Medical Records Track.

    Science.gov (United States)

    Edinger, Tracy; Cohen, Aaron M; Bedrick, Steven; Ambert, Kyle; Hersh, William

    2012-01-01

    Secondary use of electronic health record (EHR) data relies on the ability to retrieve accurate and complete information about desired patient populations. The Text Retrieval Conference (TREC) 2011 Medical Records Track was a challenge evaluation allowing comparison of systems and algorithms to retrieve patients eligible for clinical studies from a corpus of de-identified medical records, grouped by patient visit. Participants retrieved cohorts of patients relevant to 35 different clinical topics, and visits were judged for relevance to each topic. This study identified the most common barriers to identifying specific clinic populations in the test collection. Using the runs from track participants and judged visits, we analyzed the five non-relevant visits most often retrieved and the five relevant visits most often overlooked. Categories were developed iteratively to group the reasons for incorrect retrieval for each of the 35 topics. Reasons fell into nine categories for non-relevant visits and five categories for relevant visits. Non-relevant visits were most often retrieved because they contained a non-relevant reference to the topic terms. Relevant visits were most often infrequently retrieved because they used a synonym for a topic term. This failure analysis provides insight into areas for future improvement in EHR-based retrieval with techniques such as more widespread and complete use of standardized terminology in retrieval and data entry systems.

  14. Deep Patient: An Unsupervised Representation to Predict the Future of Patients from the Electronic Health Records

    Science.gov (United States)

    Miotto, Riccardo; Li, Li; Kidd, Brian A.; Dudley, Joel T.

    2016-05-01

    Secondary use of electronic health records (EHRs) promises to advance clinical research and better inform clinical decision making. Challenges in summarizing and representing patient data prevent widespread practice of predictive modeling using EHRs. Here we present a novel unsupervised deep feature learning method to derive a general-purpose patient representation from EHR data that facilitates clinical predictive modeling. In particular, a three-layer stack of denoising autoencoders was used to capture hierarchical regularities and dependencies in the aggregated EHRs of about 700,000 patients from the Mount Sinai data warehouse. The result is a representation we name “deep patient”. We evaluated this representation as broadly predictive of health states by assessing the probability of patients to develop various diseases. We performed evaluation using 76,214 test patients comprising 78 diseases from diverse clinical domains and temporal windows. Our results significantly outperformed those achieved using representations based on raw EHR data and alternative feature learning strategies. Prediction performance for severe diabetes, schizophrenia, and various cancers were among the top performing. These findings indicate that deep learning applied to EHRs can derive patient representations that offer improved clinical predictions, and could provide a machine learning framework for augmenting clinical decision systems.

  15. Incorporating Personal Health Records into the Disease Management of Rural Heart Failure Patients

    Science.gov (United States)

    Baron, Karen Parsley

    2012-01-01

    Personal Health Records (PHRs) allow patients to access and in some cases manage their own health records. Their potential benefits include access to health information, enhanced asynchronous communication between patients and clinicians, and convenience of online appointment scheduling and prescription refills. Potential barriers to PHR use…

  16. Integrating phenotypic data from electronic patient records with molecular level systems biology

    DEFF Research Database (Denmark)

    Brunak, Søren

    2011-01-01

    Electronic patient records remain a rather unexplored, but potentially rich data source for discovering correlations between diseases. We describe a general approach for gathering phenotypic descriptions of patients from medical records in a systematic and non-cohort dependent manner. By extracti...... Classification of Disease ontology and is therefore in principle language independent. As a use case we show how records from a Danish psychiatric hospital lead to the identification of disease correlations, which subsequently are mapped to systems biology frameworks....

  17. EPR dosimetry for actual and suspected overexposures during radiotherapy treatments in Poland

    International Nuclear Information System (INIS)

    Trompier, F.; Sadlo, J.; Michalik, J.; Stachowicz, W.; Mazal, A.; Clairand, I.; Rostkowska, J.; Bulski, W.; Kulakowski, A.; Sluszniak, J.; Gozdz, S.; Wojcik, A.

    2007-01-01

    EPR dosimetry on bone samples was recently used for actual and suspected overexposures during radiotherapy treatments performed in Poland. In 2001 five breast-cancer patients undergoing radiotherapy in the Bialystok Oncology Center, Poland, were overexposed. The overexposure was due to a defective safety interlock and an obsolete safety system of the linear accelerator. For the three most exposed patients, pieces of rib bones removed during surgical reconstruction of the chest wall and skin transplantation allowed an estimation of the accident doses by electron paramagnetic resonance (EPR) spectrometry. The doses delivered during the accident were as high as 60-80 Gy. In 2005, a patient treated in Kielce Holy Cross Cancer Center exhibited similar deep necroses of the chest wall but 6 years following a 'standard upper mantel fields' radiotherapy for Hodgkin's disease. In order to investigate the possible late effect of an overexposure as necrosis origin, the delivered dose was afterward estimated by EPR dosimetry performed on a rib sample

  18. The Third International Intercomparison on EPR Tooth Dosimetry: Part 2, final analysis

    International Nuclear Information System (INIS)

    Wieser, A.; Debuyst, R.; Fattibene, P.; Meghzifene, A.; Onori, S.; Bayankin, S. N.; Brik, A.; Bugay, A.; Chumak, V.; Ciesielski, B.; Hoshi, M.; Imata, H.; Ivannikov, A.; Ivanov, D.; Junczewska, M.; Miyazawa, C.; Penkowski, M.; Pivovarov, S.; Romanyukha, A.; Romanyukha, L.; Schauer, D.; Scherbina, O.; Schultka, K.; Sholom, S.; Skvortsov, V.; Stepanenko, V.; Thomas, J. A.; Tielewuhan, E.; Toyoda, S.; Trompier, F.

    2006-01-01

    The objective of the Third International Intercomparison on EPR Tooth Dosimetry was to evaluate laboratories performing tooth enamel dosimetry <300 mGy. Final analysis of results included a correlation analysis between features of laboratory dose reconstruction protocols and dosimetry performance. Applicability of electron paramagnetic resonance (EPR) tooth dosimetry at low dose was shown at two applied dose levels of 79 and 176 mGy. Most (9 of 12) laboratories reported the dose to be within 50 mGy of the delivered dose of 79 mGy, and 10 of 12 laboratories reported the dose to be within 100 mGy of the delivered dose of 176 mGy. At the high-dose tested (704 mGy) agreement within 25% of the delivered dose was found in 10 laboratories. Features of EPR dose reconstruction protocols that affect dosimetry performance were found to be magnetic field modulation amplitude in EPR spectrum recording, EPR signal model in spectrum deconvolution and duration of latency period for tooth enamel samples after preparation. (authors)

  19. Copper ESEEM and HYSCORE through ultra-wideband chirp EPR spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Segawa, Takuya F.; Doll, Andrin; Pribitzer, Stephan; Jeschke, Gunnar, E-mail: gjeschke@ethz.ch [ETH Zurich, Laboratory of Physical Chemistry, Vladimir-Prelog-Weg 2, CH-8093 Zurich (Switzerland)

    2015-07-28

    The main limitation of pulse electron paramagnetic resonance (EPR) spectroscopy is its narrow excitation bandwidth. Ultra-wideband (UWB) excitation with frequency-swept chirp pulses over several hundreds of megahertz overcomes this drawback. This allows to excite electron spin echo envelope modulation (ESEEM) from paramagnetic copper centers in crystals, whereas up to now, only ESEEM of ligand nuclei like protons or nitrogens at lower frequencies could be detected. ESEEM spectra are recorded as two-dimensional correlation experiments, since the full digitization of the electron spin echo provides an additional Fourier transform EPR dimension. Thus, UWB hyperfine-sublevel correlation experiments generate a novel three-dimensional EPR-correlated nuclear modulation spectrum.

  20. Positive effects of electronic patient records on three clinical activities

    DEFF Research Database (Denmark)

    Hertzum, Morten; Simonsen, Jesper

    2008-01-01

    records prior to the trial period. The data comprise measurements from 11 team conferences, 7 ward rounds, and 10 nursing handovers. Results: During team conferences the clinicians experienced a reduction on five of six subscales of mental workload, and the physicians experienced an overall reduction...... in mental workload. The physician in charge also experienced increased clarity about the importance of and responsibilities for work tasks, and reduced mental workload during ward rounds. During nursing handovers the nurses experienced fewer missing pieces of information and fewer messages to pass on after...

  1. Cancer patients' attitudes and experiences of online access to their electronic medical records: A qualitative study.

    Science.gov (United States)

    Rexhepi, Hanife; Åhlfeldt, Rose-Mharie; Cajander, Åsa; Huvila, Isto

    2018-06-01

    Patients' access to their online medical records serves as one of the cornerstones in the efforts to increase patient engagement and improve healthcare outcomes. The aim of this article is to provide in-depth understanding of cancer patients' attitudes and experiences of online medical records, as well as an increased understanding of the complexities of developing and launching e-Health services. The study result confirms that online access can help patients prepare for doctor visits and to understand their medical issues. In contrast to the fears of many physicians, the study shows that online access to medical records did not generate substantial anxiety, concerns or increased phone calls to the hospital.

  2. Informed use of patients' records on trusted health care services.

    Science.gov (United States)

    Sahama, Tony; Miller, Evonne

    2011-01-01

    Health care is an information-intensive business. Sharing information in health care processes is a smart use of data enabling informed decision-making whilst ensuring. the privacy and security of patient information. To achieve this, we propose data encryption techniques embedded Information Accountability Framework (IAF) that establishes transitions of the technological concept, thus enabling understanding of shared responsibility, accessibility, and efficient cost effective informed decisions between health care professionals and patients. The IAF results reveal possibilities of efficient informed medical decision making and minimisation of medical errors. Of achieving this will require significant cultural changes and research synergies to ensure the sustainability, acceptability and durability of the IAF.

  3. [Electronic versus paper-based patient records: a cost-benefit analysis].

    Science.gov (United States)

    Neubauer, A S; Priglinger, S; Ehrt, O

    2001-11-01

    The aim of this study is to compare the costs and benefits of electronic, paperless patient records with the conventional paper-based charts. Costs and benefits of planned electronic patient records are calculated for a University eye hospital with 140 beds. Benefit is determined by direct costs saved by electronic records. In the example shown, the additional benefits of electronic patient records, as far as they can be quantified total 192,000 DM per year. The costs of the necessary investments are 234,000 DM per year when using a linear depreciation over 4 years. In total, there are additional annual costs for electronic patient records of 42,000 DM. Different scenarios were analyzed. By increasing the time of depreciation to 6 years, the cost deficit reduces to only approximately 9,000 DM. Increased wages reduce the deficit further while the deficit increases with a loss of functions of the electronic patient record. However, several benefits of electronic records regarding research, teaching, quality control and better data access cannot be easily quantified and would greatly increase the benefit to cost ratio. Only part of the advantages of electronic patient records can easily be quantified in terms of directly saved costs. The small cost deficit calculated in this example is overcompensated by several benefits, which can only be enumerated qualitatively due to problems in quantification.

  4. EPR Dosimetry for ageing effect in NPP

    International Nuclear Information System (INIS)

    Choi, Hoon; Lim, Young Ki; Kim, Jong Seog; Jung, Sun Chul

    2005-01-01

    As one of the retrospective dosimetry method, EPR spectroscopy has been studied by many research up to theses days. As a dosimeter for EPR spectroscopy, Alanine is already a well known dosimeter in the field of radiation therapy and dose assessment in radiological accident by its characteristics as good linearity in a wide range of energy level and extremely low signal fading on time. Through technical document of IAEA, the EPR dosimetry method using alanine sample was published in 2000 after research by coordinated project on management of ageing of in-containment I and C cables. Although alanine sample is regarded as a good EPR dosimeter like above ageing assessment field, actually the assessment of radiation should be done at least for two fuel cycles, because of its relatively low irradiation environment in almost all spots in power plant. So, for getting more accurate detection value of radiation, another material is tested for being put in simultaneously inside the power plant with alanine. The test result for lithium formate monohydrate (HCO 2 LiH 2 0) was presented below for checking its possibility for being applied as EPR dosimeter for this project

  5. Self-reported stressors among patients with Exhaustion Disorder: an exploratory study of patient records

    Science.gov (United States)

    2014-01-01

    Background Several researchers imply that both work-related and non-work-related stress exposure are likely to contribute to stress-related mental illness. Yet empirical studies investigating both domains seem to be limited, particularly in a clinical population. The purpose of this study was to a) explore which stressors (non-work and work-related) are reported as important for the onset of illness by patients seeking medical care for stress-related exhaustion and b) explore the prevalence of each stressor and examine whether the pattern differs between men and women. Methods This is an exploratory mixed method study, comprising patients at a specialist outpatient stress clinic. Information from medical records of 20 patients was initially used in a first qualitative step to construct the instrument, using a combination of a conventional content analysis and a directed content analysis. In the second phase patient records from 50 men and 50 women were selected and coded in accordance with the coding instrument. Frequency statistics were calculated for all stressors. Results A total of 24 categories of stressors (11 related to work and 13 related to private life) were identified in the first qualitative step. A median of four stressors, usually both work and non-work-related was reported by the patients. The most common stressors were 1) quantitative demands at work, 2) private relational conflicts and 3) emotional demands at work. Conclusions Work demands are, by far, the most prevalent stressor, followed by relational problems in private life. The pattern was similar for women and men, with a slight difference in the distribution between work and non-work stressors. Men and women also show similar patterns when comparing the occurrence of each stressor. Slight differences were seen, in particular with regard to managerial responsibility that was reported by 6% of the women compared to 36% of the men. One important practical implication of this study is that

  6. Improving Patient Safety With the Military Electronic Health Record

    Science.gov (United States)

    2005-01-01

    Consolidated Health Informatics (CHI) project, one of the 24 electronic government ( eGov ) Internet- based technology initiatives supporting the president’s...United States Department of Defense (DoD) has transformed health care delivery in its use of information technology to automate patient data...use throughout the Federal Government . The importance of standards in EHR systems was further recognized in an IOM report, which stated, “Electronic

  7. Magnetic, catalytic, EPR and electrochemical studies on binuclear ...

    Indian Academy of Sciences (India)

    Magnetic, catalytic, EPR and electrochemical studies on binuclear copper(II) complexes ... to the oxidation of 3,5-di--butylcatechol to the corresponding quinone. ... EPR spectral studies in methanol solvent show welldefined four hyperfine ...

  8. Characterization of the factors having an influence on the evolution of the EPR signal of irradiated alanine

    International Nuclear Information System (INIS)

    Feaugas-Le-Berre, Valerie

    1999-01-01

    EPR/alanine dosimetry has been used by the LNHB (Laboratoire National Henri Becquerel) since many years for applied metrology. This technic is based on the measurement of the EPR signal of the free radicals induced in alanine by irradiation. The aim of this work is to characterize the factors having an influence on the evolution of the amplitude of the EPR signal of irradiated alanine to limit the uncertainties on the determination of the absorbed dose. The first step of this work has been the choice of the dosimeter. A bibliographic study completed by experiments on the response of alanine isomers to the dose and on its stability with time has lead us to choose L-α-alanine powder as dosimeter. The influence of the recording parameter of the spectrometer on the characteristics of the EPR spectrum has then been studied. This has enabled us to optimize the recording conditions of EPR spectra. As the angular anisotropy of the EPR signal limits the measurements reproducibility, an experimental protocol has been defined to solve this problem. The repeatability of the measurements has been enhanced by modifying the spectrometer and using an internal standard constituted of single crystals of CuSO 4 .5H 2 O. As the amplitude of the EPR signal is sensitive to the measurement temperature, a method of normalization of the results to 20 C has been determined. We have studied the influence of an irradiation parameter and of environmental parameters. We have shown that the EPR signal amplitude increases with irradiation temperature. The EPR signal amplitude and its evolution vary strongly with storage conditions (temperature and moisture) of the dosimeter before and after irradiation. The presence of moisture in alanine powder leads to a loss of signal amplitude. The dosimeters exposition to light also entails a loss of amplitude. Oxygen does not influence the EPR spectrum of alanine. We have noticed that the EPR signal amplitude of samples stored in absence of moisture

  9. An Improved and Secure Anonymous Biometric-Based User Authentication with Key Agreement Scheme for the Integrated EPR Information System.

    Science.gov (United States)

    Jung, Jaewook; Kang, Dongwoo; Lee, Donghoon; Won, Dongho

    2017-01-01

    Nowadays, many hospitals and medical institutes employ an authentication protocol within electronic patient records (EPR) services in order to provide protected electronic transactions in e-medicine systems. In order to establish efficient and robust health care services, numerous studies have been carried out on authentication protocols. Recently, Li et al. proposed a user authenticated key agreement scheme according to EPR information systems, arguing that their scheme is able to resist various types of attacks and preserve diverse security properties. However, this scheme possesses critical vulnerabilities. First, the scheme cannot prevent off-line password guessing attacks and server spoofing attack, and cannot preserve user identity. Second, there is no password verification process with the failure to identify the correct password at the beginning of the login phase. Third, the mechanism of password change is incompetent, in that it induces inefficient communication in communicating with the server to change a user password. Therefore, we suggest an upgraded version of the user authenticated key agreement scheme that provides enhanced security. Our security and performance analysis shows that compared to other related schemes, our scheme not only improves the security level, but also ensures efficiency.

  10. An Improved and Secure Anonymous Biometric-Based User Authentication with Key Agreement Scheme for the Integrated EPR Information System.

    Directory of Open Access Journals (Sweden)

    Jaewook Jung

    Full Text Available Nowadays, many hospitals and medical institutes employ an authentication protocol within electronic patient records (EPR services in order to provide protected electronic transactions in e-medicine systems. In order to establish efficient and robust health care services, numerous studies have been carried out on authentication protocols. Recently, Li et al. proposed a user authenticated key agreement scheme according to EPR information systems, arguing that their scheme is able to resist various types of attacks and preserve diverse security properties. However, this scheme possesses critical vulnerabilities. First, the scheme cannot prevent off-line password guessing attacks and server spoofing attack, and cannot preserve user identity. Second, there is no password verification process with the failure to identify the correct password at the beginning of the login phase. Third, the mechanism of password change is incompetent, in that it induces inefficient communication in communicating with the server to change a user password. Therefore, we suggest an upgraded version of the user authenticated key agreement scheme that provides enhanced security. Our security and performance analysis shows that compared to other related schemes, our scheme not only improves the security level, but also ensures efficiency.

  11. An Improved and Secure Anonymous Biometric-Based User Authentication with Key Agreement Scheme for the Integrated EPR Information System

    Science.gov (United States)

    Kang, Dongwoo; Lee, Donghoon; Won, Dongho

    2017-01-01

    Nowadays, many hospitals and medical institutes employ an authentication protocol within electronic patient records (EPR) services in order to provide protected electronic transactions in e-medicine systems. In order to establish efficient and robust health care services, numerous studies have been carried out on authentication protocols. Recently, Li et al. proposed a user authenticated key agreement scheme according to EPR information systems, arguing that their scheme is able to resist various types of attacks and preserve diverse security properties. However, this scheme possesses critical vulnerabilities. First, the scheme cannot prevent off-line password guessing attacks and server spoofing attack, and cannot preserve user identity. Second, there is no password verification process with the failure to identify the correct password at the beginning of the login phase. Third, the mechanism of password change is incompetent, in that it induces inefficient communication in communicating with the server to change a user password. Therefore, we suggest an upgraded version of the user authenticated key agreement scheme that provides enhanced security. Our security and performance analysis shows that compared to other related schemes, our scheme not only improves the security level, but also ensures efficiency. PMID:28046075

  12. Investigation of radical locations in various sesame seeds by CW EPR and 9-GHz EPR imaging.

    Science.gov (United States)

    Nakagawa, K; Hara, H

    2015-01-01

    We investigated the location of radical in various sesame seeds using continuous-wave (CW) electron paramagnetic resonance (EPR) and 9-GHz EPR imaging. CW EPR detected persistent radicals (single line) for various sesame seeds. The EPR linewidth of black sesame seeds was narrower than that of the irradiated white sesame seeds. A very small signal was detected for the white sesame seeds. Two-dimensional (2D) imaging using a 9-GHz EPR imager showed that radical locations vary for various sesame seeds. The paramagnetic species in black sesame seeds were located on the seed coat (skin) and in the hilum region. The signal with the highest intensity was obtained from the hilum part. A very low-intensity image was observed for the white sesame seeds. In addition, the 2D imaging of the irradiated white sesame seeds showed that free radicals were located throughout the entire seed. For the first time, CW EPR and 9-GHz EPR imaging showed the exact location of radical species in various sesame seeds.

  13. Some physico-technical aspects of the new generation of self-calibrated alanine/EPR dosimeter and results from the international intercomparison trial

    International Nuclear Information System (INIS)

    Yordanov, N.D.; Gancheva, V.

    2000-01-01

    Some physico-technical parameters of the self-calibrated alanine/EPR dosimeters are described. Principally, this new type of solid state/EPR dosimeter contains radiation sensitive diamagnetic material (in the present case, alanine), some quantity of EPR active, but radiation insensitive, substance (for example, Mn 2+ /MgO) playing roles of an internal standard and a binding material. Thus with this dosimeter the EPR spectra of alanine and the internal standard Mn 2+ are recorded simultaneously and the dose response is represented as a ratio of EPR signal intensities of alanine versus Mn 2+ as a function of absorbed dose. As a result, the data of the present study have shown that there is practically no interference of the dosimeter EPR response (expressed as the ratio I alanine /I Mn ) from the way of preparation (homogeneity), behavior after irradiation (fading of EPR signals with time, influence of different meteorological conditions) as well as specific spectrometer setting conditions. These dosimeters show satisfactory reproducibility of preparation and reading as well as stability on keeping. Thus, fulfilling the described physico-technical data of this type of dosimeters, the reproducibility of the readings is significantly improved particularly when intercomparison among different laboratories is performed. This conclusion is confirmed by independent studies of the described self-calibrated alanine/EPR dosimeters in several laboratories in Europe. Results of which are also reported. (author)

  14. Computational and instrumental methods in EPR

    CERN Document Server

    Bender, Christopher J

    2006-01-01

    Computational and Instrumental Methods in EPR Prof. Bender, Fordham University Prof. Lawrence J. Berliner, University of Denver Electron magnetic resonance has been greatly facilitated by the introduction of advances in instrumentation and better computational tools, such as the increasingly widespread use of the density matrix formalism. This volume is devoted to both instrumentation and computation aspects of EPR, while addressing applications such as spin relaxation time measurements, the measurement of hyperfine interaction parameters, and the recovery of Mn(II) spin Hamiltonian parameters via spectral simulation. Key features: Microwave Amplitude Modulation Technique to Measure Spin-Lattice (T1) and Spin-Spin (T2) Relaxation Times Improvement in the Measurement of Spin-Lattice Relaxation Time in Electron Paramagnetic Resonance Quantitative Measurement of Magnetic Hyperfine Parameters and the Physical Organic Chemistry of Supramolecular Systems New Methods of Simulation of Mn(II) EPR Spectra: Single Cryst...

  15. EPR spectra of some irradiated polycrystalline perrhenate

    International Nuclear Information System (INIS)

    Zaitseva, N.G.; Constantinescu, M.; Georgescu, R.; Constantinescu, O.

    1978-10-01

    An EPR study of the paramagnetic centers formed by γ, electron and neutron irradiation of the NaReO 4 and KReO 4 was made. In the EPR spectra of the powder samples irradiated γ, with electrons and neutrons, the presence of three types of paramagnetic centers was observed. From the EPR parameters, the centers were attributed to the ReOsub(4)sup(.), ReOsub(3)sup(.) and ReOsub(2)sup(.) radicals respectively. The lower intensity of the spectra observed by KReO 4 samples irradiation showed a higher radioresistance of the KReO 4 than that of NaReO 4 . A radiolitical scheme taking into account the paramagnetic centers formation was proposed. (author)

  16. Relativistic Nonlocality and the EPR Paradox

    Science.gov (United States)

    Chamberlain, Thomas

    2014-03-01

    The exact violation of Bell's Inequalities is obtained with a local realistic model for spin. The model treats one particle that comprises a quantum ensemble and simulates the EPR data one coincidence at a time as a product state. Such a spin is represented by operators σx , iσy ,σz in its body frame rather than the usual set of σX ,σY ,σZ in the laboratory frame. This model, assumed valid in the absence of a measuring probe, contains both quantum polarizations and coherences. Each carries half the EPR correlation, but only half can be measured using coincidence techniques. The model further predicts the filter angles that maximize the spin correlation in EPR experiments.

  17. Pressurized water reactors: the EPR project

    International Nuclear Information System (INIS)

    Py, J.P.; Yvon, M.

    2007-01-01

    EPR (originally 'European pressurized water reactor', and now 'evolutionary power reactor') is a model of reactor initially jointly developed by French and German engineers which fulfills the particular safety specifications of both countries but also the European utility requirements jointly elaborated by the main European power companies under the initiative of Electricite de France (EdF). Today, two EPR-based reactors are under development: one is under construction in Finland and the other, Flamanville 3 (France), received its creation permit decree on April 10, 2007. This article presents, first, the main objectives of the EPR, and then, describes the Flamanville 3 reactor: reactor type and general conditions, core and conditions of operation, primary and secondary circuits with their components, main auxiliary and recovery systems, man-machine interface and instrumentation and control system, confinement and serious accidents, arrangement of buildings. (J.S.)

  18. Spin entanglement, decoherence and Bohm's EPR paradox.

    Science.gov (United States)

    Cavalcanti, E G; Drummond, P D; Bachor, H A; Reid, M D

    2009-10-12

    We obtain criteria for entanglement and the EPR paradox for spin-entangled particles and analyse the effects of decoherence caused by absorption and state purity errors. For a two qubit photonic state, entanglement can occur for all transmission efficiencies. In this case, the state preparation purity must be above a threshold value. However, Bohm's spin EPR paradox can be achieved only above a critical level of loss. We calculate a required efficiency of 58%, which appears achievable with current quantum optical technologies. For a macroscopic number of particles prepared in a correlated state, spin entanglement and the EPR paradox can be demonstrated using our criteria for efficiencies eta > 1/3 and eta > 2/3 respectively. This indicates a surprising insensitivity to loss decoherence, in a macroscopic system of ultra-cold atoms or photons.

  19. EPR and development of quantum electronics

    International Nuclear Information System (INIS)

    Manenkov, A A

    2011-01-01

    A role of electron paramagnetic resonance in development of quantum electronics is discussed. Basic principles and history of masers are briefly described. Spin-levels of paramagnetic ions in crystals as a very suitable object for active media of solid-state masers (called as EPR-masers) and physical processes in EPR-masers (population inversion of energy states) are analyzed. This analysis demonstrates a significant role of relaxation processes in multi-level spin-systems for efficient maser action. In this context peculiarities of spin-lattice and spin-spin cross relaxation processes in multi-level systems are analyzed. Development of EPR-masers and their application in radioastronomy and far-space communication systems are briefly described.

  20. EPR of impurity ions in disordered solids

    International Nuclear Information System (INIS)

    Kliava, J.

    1986-01-01

    The state of the art in the EPR spectroscopy of disordered solids is reviewed and theoretical aspects of the EPR shape in disordered systems are discussed. Emphasis is placed on the concept of the joint probability density of the spin Hamiltonian parameters. A survey of experimental data is provided on distributions of spin Hamiltonian parametes obtained using computer simulation techniques. A quantitative information is given on the short-range ordering in disordered materials available from EPR studies. A procedure of extracting such type of data which consists in a transformation from the distribution of the spin Hamiltonian parameters to that of atomic coordinates in the surrounding of a paramagnetic center is outlined. Numerical estimates of the degree of continuous disorder are reviewed

  1. Patient experiences with full electronic access to health records and clinical notes through the My HealtheVet Personal Health Record Pilot: qualitative study.

    Science.gov (United States)

    Woods, Susan S; Schwartz, Erin; Tuepker, Anais; Press, Nancy A; Nazi, Kim M; Turvey, Carolyn L; Nichol, W Paul

    2013-03-27

    Full sharing of the electronic health record with patients has been identified as an important opportunity to engage patients in their health and health care. The My HealtheVet Pilot, the initial personal health record of the US Department of Veterans Affairs, allowed patients and their delegates to view and download content in their electronic health record, including clinical notes, laboratory tests, and imaging reports. A qualitative study with purposeful sampling sought to examine patients' views and experiences with reading their health records, including their clinical notes, online. Five focus group sessions were conducted with patients and family members who enrolled in the My HealtheVet Pilot at the Portland Veterans Administration Medical Center, Oregon. A total of 30 patients enrolled in the My HealtheVet Pilot, and 6 family members who had accessed and viewed their electronic health records participated in the sessions. Four themes characterized patient experiences with reading the full complement of their health information. Patients felt that seeing their records positively affected communication with providers and the health system, enhanced knowledge of their health and improved self-care, and allowed for greater participation in the quality of their care such as follow-up of abnormal test results or decision-making on when to seek care. While some patients felt that seeing previously undisclosed information, derogatory language, or inconsistencies in their notes caused challenges, they overwhelmingly felt that having more, rather than less, of their health record information provided benefits. Patients and their delegates had predominantly positive experiences with health record transparency and the open sharing of notes and test results. Viewing their records appears to empower patients and enhance their contributions to care, calling into question common provider concerns about the effect of full record access on patient well-being. While shared

  2. The Electronic Health Record Objective Structured Clinical Examination: Assessing Student Competency in Patient Interactions While Using the Electronic Health Record.

    Science.gov (United States)

    Biagioli, Frances E; Elliot, Diane L; Palmer, Ryan T; Graichen, Carla C; Rdesinski, Rebecca E; Ashok Kumar, Kaparaboyna; Galper, Ari B; Tysinger, James W

    2017-01-01

    Because many medical students do not have access to electronic health records (EHRs) in the clinical environment, simulated EHR training is necessary. Explicitly training medical students to use EHRs appropriately during patient encounters equips them to engage patients while also attending to the accuracy of the record and contributing to a culture of information safety. Faculty developed and successfully implemented an EHR objective structured clinical examination (EHR-OSCE) for clerkship students at two institutions. The EHR-OSCE objectives include assessing EHR-related communication and data management skills. The authors collected performance data for students (n = 71) at the first institution during academic years 2011-2013 and for students (n = 211) at the second institution during academic year 2013-2014. EHR-OSCE assessment checklist scores showed that students performed well in EHR-related communication tasks, such as maintaining eye contact and stopping all computer work when the patient expresses worry. Findings indicated student EHR skill deficiencies in the areas of EHR data management including medical history review, medication reconciliation, and allergy reconciliation. Most students' EHR skills failed to improve as the year progressed, suggesting that they did not gain the EHR training and experience they need in clinics and hospitals. Cross-institutional data comparisons will help determine whether differences in curricula affect students' EHR skills. National and institutional policies and faculty development are needed to ensure that students receive adequate EHR education, including hands-on experience in the clinic as well as simulated EHR practice.

  3. Can EPR non-locality be geometrical?

    International Nuclear Information System (INIS)

    Ne'eman, Y.

    1995-01-01

    The presence in Quantum Mechanics of non-local correlations is one of the two fundamentally non-intuitive features of that theory. The non-local correlations themselves fall into two classes: EPR and Geometrical. The non-local characteristics of the geometrical type are well-understood and are not suspected of possibly generating acausal features, such as faster-than-light propagation of information. This has especially become true since the emergence of a geometrical treatment for the relevant gauge theories, i.e. Fiber Bundle geometry, in which the quantum non-localities are seen to correspond to pure homotopy considerations. This aspect is reviewed in section 2. Contrary-wise, from its very conception, the EPR situation was felt to be paradoxical. It has been suggested that the non-local features of EPR might also derive from geometrical considerations, like all other non-local characteristics of QM. In[7], one of the authors was able to point out several plausibility arguments for this thesis, emphasizing in particular similarities between the non-local correlations provided by any gauge field theory and those required by the preservation of the quantum numbers of the original EPR state-vector, throughout its spatially-extended mode. The derivation was, however, somewhat incomplete, especially because of the apparent difference between, on the one hand, the closed spatial loops arising in the analysis of the geometrical non-localities, from Aharonov-Bohm and Berry phases to magnetic monopoles and instantons, and on the other hand, in the EPR case, the open line drawn by the positions of the two moving decay products of the disintegrating particle. In what follows, the authors endeavor to remove this obstacle and show that as in all other QM non-localities, EPR is somehow related to closed loops, almost involving homotopy considerations. They develop this view in section 3

  4. Using the Electronic Medical Record to Enhance Physician-Nurse Communication Regarding Patients' Discharge Status.

    Science.gov (United States)

    Driscoll, Molly; Gurka, David

    2015-01-01

    The fast-paced environment of hospitals contributes to communication failures between health care providers while impacting patient care and patient flow. An effective mechanism for sharing patients' discharge information with health care team members is required to improve patient throughput. The communication of a patient's discharge plan was identified as crucial in alleviating patient flow delays at a tertiary care, academic medical center. By identifying the patients who were expected to be discharged the following day, the health care team could initiate discharge preparations in advance to improve patient care and patient flow. The patients' electronic medical record served to convey dynamic information regarding the patients' discharge status to the health care team via conditional discharge orders. Two neurosciences units piloted a conditional discharge order initiative. Conditional discharge orders were designed in the electronic medical record so that the conditions for discharge were listed in a dropdown menu. The health care team was trained on the conditional discharge order protocol, including when to write them, how to find them in the patients' electronic medical record, and what actions should be prompted by these orders. On average, 24% of the patients discharged had conditional discharge orders written the day before discharge. The average discharge time for patients with conditional discharge orders decreased by 83 minutes (0.06 day) from baseline. Qualitatively, the health care team reported improved workflows with conditional orders. The conditional discharge orders allowed physicians to communicate pending discharges electronically to the multidisciplinary team. The initiative positively impacted patient discharge times and workflows.

  5. Alanine EPR dosimetry of therapeutic irradiators

    International Nuclear Information System (INIS)

    Bugay, O.; Bartchuk, V.; Kolesnik, S.; Mazin, M.; Gaponenko, H.

    1999-01-01

    The high-dose alanine EPR dosimetry is a very precise method in the dose range 1-100 kGy. The system is used generally as the standard high-dose transfer dosimetry in many laboratories. This is comparatively expensive technique so it is important to use it as a more universal dosimetry system also in the middle and low dose ranges. The problems of the middle-dose alanine dosimetry are discussed and the solution of several problems is proposed. The alanine EPR dosimetry has been applied to the dose measurements of medical irradiators in the Kiev City Oncology Center. (author)

  6. Krótka (prehistoria argumentu EPR

    Directory of Open Access Journals (Sweden)

    Tadeusz Pabjan

    2010-12-01

    Full Text Available The 1935 thought experiment of Einstein, Podolsky and Rosen is one of the most important episodes in the history of the dispute about the correct interpretation of quantum mechanics. The present paper deals with the origin of the EPR paper and discusses some other thought experiments that preceded the formulation of the Einstein-Podolsky-Rosen argument. Special attention is paid to the evolution of a simply photon-box experiment, which was devised by Einstein in 1930 and then modified by him several times before 1935. It is argued that the scheme of the original EPR argument is in fact contained in these few seminal experiments.

  7. Biophysical EPR Studies Applied to Membrane Proteins

    Science.gov (United States)

    Sahu, Indra D; Lorigan, Gary A

    2015-01-01

    Membrane proteins are very important in controlling bioenergetics, functional activity, and initializing signal pathways in a wide variety of complicated biological systems. They also represent approximately 50% of the potential drug targets. EPR spectroscopy is a very popular and powerful biophysical tool that is used to study the structural and dynamic properties of membrane proteins. In this article, a basic overview of the most commonly used EPR techniques and examples of recent applications to answer pertinent structural and dynamic related questions on membrane protein systems will be presented. PMID:26855825

  8. TL and EPR dating: some applications

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, S. [Institute of Physics, University of Sao Paulo, Sao Paulo (Brazil)

    2006-07-01

    The intensity of thermoluminescence light emitted by a crystal is a function of radiation dose. The number of defects or of radicals in a crystal or organic substances is also a function of radiation dose. Since such defects or radicals present EPR signals, the EPR intensity is also a function of radiation dose. These facts are basis for radiation dosimetry and can be applied in dating of archaeological potteries or other materials, as well as in dating geological substances such as sediments, caves speleothemes, animal teeth and bones. Recent investigation on sensitized quartz based dosimeters and dating calcite covering ancient wall painting to find early settlers in Brazil will be presented. (Author)

  9. Holographic EPR Pairs, Wormholes and Radiation

    OpenAIRE

    Chernicoff, Mariano; Güijosa, Alberto; Pedraza, Juan F.

    2013-01-01

    As evidence for the ER=EPR conjecture, it has recently been observed that the string that is holographically dual to an entangled quark-antiquark pair separating with (asymptotically) uniform acceleration has a wormhole on its worldsheet. We point out that a two-sided horizon and a wormhole actually appear for much more generic quark-antiquark trajectories, which is consistent with the fact that the members of an EPR pair need not be permanently out of causal contact. The feature that determi...

  10. Mast-sipping in EPR trademark plants

    International Nuclear Information System (INIS)

    Langenberger, Jan; Schienbein, Marcel; Geier, Roland

    2010-01-01

    For more than 20 years, AREVA applies and develops different sipping techniques to identify fuel assemblies with leaking fuel rods. For the EPR trademark reactors a Mast Sipping System with newest developments will be implemented considering radiation protection and latest standards requirements. The innovative EPR trademark Sipping System differs from previous systems in many ways. One of the main innovations is that all the necessary processes of the Sipping system have been fully digitized. Second, several ALARA design modifications have been implemented to meet the current radiation protection requirements. An additional implementable multilingual assistance program facilitates the handling of the system and helps to prevent incorrect operation. (orig.)

  11. Neonatal Nurses Experience Unintended Consequences and Risks to Patient Safety With Electronic Health Records.

    Science.gov (United States)

    Dudding, Katherine M; Gephart, Sheila M; Carrington, Jane M

    2018-04-01

    In this article, we examine the unintended consequences of nurses' use of electronic health records. We define these as unforeseen events, change in workflow, or an unanticipated result of implementation and use of electronic health records. Unintended consequences experienced by nurses while using electronic health records have been well researched. However, few studies have focused on neonatal nurses, and it is unclear to what extent unintended consequences threaten patient safety. A new instrument called the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire has been validated, and secondary analysis using the tool explored the phenomena among neonatal nurses (N = 40). The purposes of this study were to describe unintended consequences of use of electronic health records for neonatal nurses and to explore relationships between the phenomena and characteristics of the nurse and the electronic health record. The most frequent unintended consequences of electronic health record use were due to interruptions, followed by a heavier workload due to the electronic health record, changes to the workflow, and altered communication patterns. Neonatal nurses used workarounds most often with motivation to better assist patients. Teamwork was moderately related to higher unintended consequences including patient safety risks (r = 0.427, P = .007), system design (r = 0.419, P = .009), and technology barriers (r = 0.431, P = .007). Communication about patients was reduced when patient safety risks were high (r = -0.437, P = .003). By determining the frequency with which neonatal nurses experience unintended consequences of electronic health record use, future research can be targeted to improve electronic health record design through customization, integration, and refinement to support patient safety and better outcomes.

  12. Patients want granular privacy control over health information in electronic medical records.

    Science.gov (United States)

    Caine, Kelly; Hanania, Rima

    2013-01-01

    To assess patients' desire for granular level privacy control over which personal health information should be shared, with whom, and for what purpose; and whether these preferences vary based on sensitivity of health information. A card task for matching health information with providers, questionnaire, and interview with 30 patients whose health information is stored in an electronic medical record system. Most patients' records contained sensitive health information. No patients reported that they would prefer to share all information stored in an electronic medical record (EMR) with all potential recipients. Sharing preferences varied by type of information (EMR data element) and recipient (eg, primary care provider), and overall sharing preferences varied by participant. Patients with and without sensitive records preferred less sharing of sensitive versus less-sensitive information. Patients expressed sharing preferences consistent with a desire for granular privacy control over which health information should be shared with whom and expressed differences in sharing preferences for sensitive versus less-sensitive EMR data. The pattern of results may be used by designers to generate privacy-preserving EMR systems including interfaces for patients to express privacy and sharing preferences. To maintain the level of privacy afforded by medical records and to achieve alignment with patients' preferences, patients should have granular privacy control over information contained in their EMR.

  13. A PRIVACY MANAGEMENT ARCHITECTURE FOR PATIENT-CONTROLLED PERSONAL HEALTH RECORD SYSTEM

    Directory of Open Access Journals (Sweden)

    MD. NURUL HUDA

    2009-06-01

    Full Text Available Patient-controlled personal health record systems can help make health care safer, cheaper, and more convenient by facilitating patients to 1 grant any care provider access to their complete personal health records anytime from anywhere, 2 avoid repeated tests and 3 control their privacy transparently. In this paper, we present the architecture of our Privacy-aware Patient-controlled Personal Health Record (P3HR system through which a patient can view her integrated health history, and share her health information transparently with others (e.g., healthcare providers. Access to the health information of a particular patient is completely controlled by that patient. We also carry out intuitive security and privacy analysis of the P3HR system architecture considering different types of security attacks. Finally, we describe a prototype implementation of the P3HR system that we developed reflecting the special view of Japanese society. The most important advantage of P3HR system over other existing systems is that most likely P3HR system provides complete privacy protection without losing data accuracy. Unlike traditional partially anonymous health records (e.g., using k-anonymity or l-diversity, the health records in P3HR are closer to complete anonymity, and yet preserve data accuracy. Our approach makes it very unlikely that patients could be identified by an attacker from their anonymous health records in the P3HR system.

  14. Negation scope and spelling variation for text-mining of Danish electronic patient records

    DEFF Research Database (Denmark)

    Thomas, Cecilia Engel; Jensen, Peter Bjødstrup; Werge, Thomas

    2014-01-01

    Electronic patient records are a potentially rich data source for knowledge extraction in biomedical research. Here we present a method based on the ICD10 system for text-mining of Danish health records. We have evaluated how adding functionalities to a baseline text-mining tool affected...

  15. Design of the EPR containment

    International Nuclear Information System (INIS)

    Appell, B.; Zaiss, W.

    1996-01-01

    In order to respect the safety objectives set for the EPR (European Pressurized water Reactor), the confinement function must be designed to guard against in the design uncontrolled releases in the environment in all conditions taken into account and to preserve its structural integrity. The concept chosen is a double-wall confinement with technology identical derived from the current French N4 containments and the associated systems ensuring the isolation and the control of leaks. The basic principles aiming to minimize leaks are as follows: no direct leak; state-of-the-art leak tight design of the systems and components passing through the containment building; recovery of potential leaks through the inner wall and the penetration sleeves in the inter-wall space; recovery in the peripheral buildings; and specific measures if necessary. The inner wall is a prestressed concrete shell (55 tendons cables arranged in two horizontal layers and a vertical layer for the barrel) without liner, of free volume 90000 m 3 , an internal diameter of 48 m and 1.3 m thickness. The free volume is chosen so as to rule out the risk of global detonation and the use of catalytic recombiners limits the risk of hydrogen explosion. The design pressure (6.5 bar abs) and temperature of the inner wall are defined for a given volume by the set of three conditions: Pee-4 conditions such as LOCA or SLB, global deflagration of hydrogen and core melt scenario. The rate of leakage in accident conditions from the inner wall must not be higher than 1% per day. The chosen concept must enable satisfactory leak tightness to be preserved for beyond design conditions in order to have margins and to guard against phenomenological uncertainties. The possibility of adding an internal composite liner is being studied. A large scale mockup is being built to validate the hypothesis and methods of leak rates of the inner wall and for the performance testing of the composite liner. The outer wall, made of

  16. EPR and optical absorption studies of Cr3+ ions in potassium sodium dl-tartrate tetrahydrate

    International Nuclear Information System (INIS)

    Kripal, Ram; Singh, Pragya; Shukla, Santwana

    2011-01-01

    EPR spectra of Cr 3+ ions doped in potassium sodium dl-tartrate tetrahydrate single crystals are recorded at 77 K. The spin Hamiltonian and zero field parameters g, |D| and |E| are measured from the resonance lines obtained at various rotations of the magnetic field. The values obtained are: g x =1.9257±0.0002, g y =1.9720±0.0002, g z =2.0102±0.0002, |D|=313±2 (x10 -4 ) cm -1 and |E|=101±2 (x10 -4 ) cm -1 . From the results of EPR study, the site symmetry of Cr 3+ ion in the crystal is discussed. The optical absorption at room temperature is also studied. From the observed band positions, the crystal field splitting parameter (D q ) and the Racah inter-electronic repulsion parameters (B and C) are evaluated. The bonding parameters are obtained by correlating optical and EPR data and the nature of bonding in the crystal is discussed. -- Research Highlights: → EPR spectra of Cr 3+ ions doped in potassium sodium dl-tartrate tetrahydrate single crystals are done at 77 K. → The spin Hamiltonian and zero field parameters g, |D| and |E| are measured. From the results of EPR study, the site symmetry of Cr 3+ ion in the crystal is discussed. → The optical absorption at room temperature is also studied and the crystal field splitting parameter (D q ) as well as the Racah inter-electronic repulsion parameters (B and C) is evaluated. → The bonding parameters are obtained by correlating optical and EPR data and the nature of bonding in the crystal is discussed.

  17. Privacy preservation and information security protection for patients' portable electronic health records.

    Science.gov (United States)

    Huang, Lu-Chou; Chu, Huei-Chung; Lien, Chung-Yueh; Hsiao, Chia-Hung; Kao, Tsair

    2009-09-01

    As patients face the possibility of copying and keeping their electronic health records (EHRs) through portable storage media, they will encounter new risks to the protection of their private information. In this study, we propose a method to preserve the privacy and security of patients' portable medical records in portable storage media to avoid any inappropriate or unintentional disclosure. Following HIPAA guidelines, the method is designed to protect, recover and verify patient's identifiers in portable EHRs. The results of this study show that our methods are effective in ensuring both information security and privacy preservation for patients through portable storage medium.

  18. Patients Know Best: Qualitative Study on How Families Use Patient-Controlled Personal Health Records

    Science.gov (United States)

    Schneider, Hanna; Hill, Susan

    2016-01-01

    Background Self-management technologies, such as patient-controlled electronic health records (PCEHRs), have the potential to help people manage and cope with disease. Objective This study set out to investigate patient families’ lived experiences of working with a PCEHR. Methods We conducted a semistructured qualitative field study with patient families and clinicians at a children’s hospital in the UK that uses a PCEHR (Patients Know Best). All families were managing the health of a child with a serious chronic condition, who was typically under the care of multiple clinicians. As data gathering and analysis progressed, it became clear that while much of the literature assumes that patients are willing and waiting to take more responsibility for and control over their health management (eg, with PCEHRs), only a minority of participants in our study responded in this way. Their experiences with the PCEHR were diverse and strongly shaped by their coping styles. Theory on coping identifies a continuum of coping styles, from approach to avoidance oriented, and proposes that patients’ information needs depend on their style. Results We identified 3 groups of patient families and an outlier, distinguished by their coping style and their PCEHR use. We refer to the outlier as controlling (approach oriented, highly motivated to use PCEHR), and the 3 groups as collaborating (approach oriented, motivated to use PCEHR), cooperating (avoidance oriented, less motivated to use PCEHR), and avoiding (very avoidance oriented, not motivated to use PCEHR). Conclusions The PCEHR met the needs of controller and collaborators better than the needs of cooperators and avoiders. We draw on the Self-Determination Theory to propose ways in which a PCEHR design might better meet the needs of avoidance-oriented users. Further, we highlight the need for families to also relinquish control at times, and propose ways in which PCEHR design might support a better distribution of control

  19. Individualized music played for agitated patients with dementia: analysis of video-recorded sessions.

    Science.gov (United States)

    Ragneskog, H; Asplund, K; Kihlgren, M; Norberg, A

    2001-06-01

    Many nursing home patients with dementia suffer from symptoms of agitation (e.g. anxiety, shouting, irritability). This study investigated whether individualized music could be used as a nursing intervention to reduce such symptoms in four patients with severe dementia. The patients were video-recorded during four sessions in four periods, including a control period without music, two periods where individualized music was played, and one period where classical music was played. The recordings were analysed by systematic observations and the Facial Action Coding System. Two patients became calmer during some of the individualized music sessions; one patient remained sitting in her armchair longer, and the other patient stopped shouting. For the two patients who were most affected by dementia, the noticeable effect of music was minimal. If the nursing staff succeed in discovering the music preferences of an individual, individualized music may be an effective nursing intervention to mitigate anxiety and agitation for some patients.

  20. Bridging the Gap Between the Social and the Technical: The Enrolment of Socio-Technical Information Architects to Cope with the Two-Level Model of EPR Systems.

    Science.gov (United States)

    Pedersen, Rune

    2017-01-01

    This is a project proposal derived from an urge to re-define the governance of ICT in healthcare towards regional and national standardization of the patient pathways. The focus is on a two-levelled approach for governing EPR systems where the clinicians' model structured variables and patient pathways. The overall goal is a patient centric EPR portfolio. This paper define and enlighten the need for establishing the socio- technical architect role necessary to obtain the capabilities of a modern structured EPR system. Clinicians are not capable to moderate between the technical and the clinical.

  1. NESG EPR Journal.cdr

    African Journals Online (AJOL)

    Tosin Bashir

    improvements in manufacturing and trade activities, which ... Product (GDP) recorded a slight improvement within the period ... tenor of the forward sales cycle from 180 days to 30 days ... decrease in Foreign Direct Investment (FDI) and other ...

  2. MDEP Common Position No EPR-01 - Common positions on the EPR instrumentation and controls design

    International Nuclear Information System (INIS)

    2010-01-01

    The purpose of the EPR Working Group (EPRWG) of the Multinational Design Evaluation Program (MDEP) is to identify common positions among the regulators reviewing the EPR Instrumentation and Controls (I and C) Systems in order to: 1. Promote understanding of each country 's regulatory decisions and basis for the decisions, 2. Enhance communication among the members and with external stakeholders, 3. Identify areas where harmonization and convergence of regulations, standards, and guidance can be achieved or improved, and 4. Supports standardization of new reactor designs. Since January 2008, the EPR I and C Technical Expert Subgroup (TESG) members met five times to exchange information regarding their country 's review of the EPR I and C design. The EPR I and C TESG consists of regulators from China, Canada, Finland, France, the United Kingdom, and the United States. The information exchange includes presentation of each country 's review status and technical issues, sharing of guidance documents, and sharing of regulatory decision documents. The TESG focused on the following four core areas of the EPR I and C design: 1. I and C System Independence (particularly for data communications), 2. Level of Defense and Diversity (back-up systems), 3. Qualification/quality of digital platforms, 4. Categorization/classification of systems and functions. As meetings were conducted, some areas were emphasized more depending on the significance of the issues for each country. During the TESG interactions, it became apparent that there were aspects of the EPR design where the countries had common agreement. On November 2, 2009, three of the subgroup countries, France, Finland and the United Kingdom, issued a joint regulatory position on the EPR I and C design as result of the 'Groupe Permanent' meeting in France. This statement of common positions expands upon that joint regulatory position

  3. PADS (Patient Archiving and Documentation System): a computerized patient record with educational aspects.

    Science.gov (United States)

    Hohnloser, J H; Pürner, F

    1992-01-01

    Rapid acquisition and analysis of information in an Intensive Care Unit (ICU) setting is essential, even more so the documentation of the decision making process which has vital consequences for the lives of ICU patients. We describe an Ethernet based local area network (LAN) with clinical workstations (Macintosh fx, ci). Our Patient Archiving and Documentation System (PADS) represents a computerized patient record presently used in a university hospitals' ICU. Taking full advantage of the Macintosh based graphical user interface (GUI) our system enables nurses and doctors to perform the following tasks: admission, medical history taking, physical examination, generation of problem lists and follow up notes, access to laboratory data and reports, semiautomatic generation of a discharge summary including full word processor capabilities. Furthermore, the system offers rapid, consistent and complete automatic encoding of diagnoses following the International Classification of Disease (ICD; WHO, [1]). For educational purposes the user can also view disease entities or complications related to the diagnoses she/he encoded. The system has links to other educational programs such as cardiac auscultation. A MEDLINE literature search through a CD-ROM based system can be performed without exiting the system; also, CD-ROM based medical textbooks can be accessed as well. Commercially available Macintosh programs can be integrated in the system without existing the main program thus enabling users to customize their working environment. Additional options include automatic background monitoring of users learning behavior, analyses and graphical display of numerous epidemiological and health care related problems. Furthermore, we are in the process of integrating sound and digital video in our system. This system represents one in a line of modular departmental models which will eventually be integrated to form a decentralized Hospital Information System (HIS).

  4. Polymer therapeutics and the EPR effect.

    Science.gov (United States)

    Maeda, Hiroshi

    History of the EPR (enhanced permeability and retention) effect is discussed, which goes back to the analyses of molecular pathology in bacterial infection and edema (extravasation) formation. The first mediator we found for extravasation was bradykinin. Later on, were found nitric oxide and superoxide, then formation of peroxynitrite, that activates procollagenase. In this inflammatory setting many other vascular mediators are involved that are also common to cancer vasculature. Obviously cancer vasculature is defective architechtally, and this makes macromolecular drugs more permeable through the vascular wall. The importance of this pathophysiological event of EPR effect can be applied to macromolecular drug-delivery, or tumor selective delivery, which takes hours to achieve in the primary as well as metastatic tumors, not to mention of the inflamed tissues. The retention of the EPR means that such drugs will be retained in tumor tissues more than days to weeks. This was demonstrated initially, and most dramatically, using SMANCS, a protein-polymer conjugated-drug dissolved in lipid contrast medium (Lipiodol) by administering intraarterially. For disseminating the EPR concept globally, or in the scientific community, Professor Ruth Duncan played a key role at the early stage, as she worked extensively on polymer- therapeutics, and knew its importance.

  5. Teaching the EPR Paradox at High School?

    Science.gov (United States)

    Pospiech, Gesche

    1999-01-01

    Argues the importance of students at university and in the final years of high school gaining an appreciation of the principles of quantum mechanics. Presents the EPR gedanken experiment (thought experiment) as a method of teaching the principles of quantum mechanics. (Author/CCM)

  6. EPR: outlines of research and development

    International Nuclear Information System (INIS)

    Anon.

    1996-01-01

    The articles give an overview of the research and development presently under way for the future pressurized water reactors to be constructed in Europe, and particularly the French and German EPR (European Pressurized Reactor). Such an analysis deals essentially with respect to the pressurized water reactors now in operation. (author)

  7. EPR-dosimetry of ionizing radiation

    Science.gov (United States)

    Popova, Mariia; Vakhnin, Dmitrii; Tyshchenko, Igor

    2017-09-01

    This article discusses the problems that arise during the radiation sterilization of medical products. It is propose the solution based on alanine EPR-dosimetry. The parameters of spectrometer and methods of absorbed dose calculation are given. In addition, the problems that arise during heavy particles irradiation are investigated.

  8. Investigation of EPR signals on tooth enamel

    Energy Technology Data Exchange (ETDEWEB)

    Pavlenko, A; Mironova-Ulmane, N; Polakov, M; Riekstina, D [Institute of Solid State Physics, University of Latvia, Riga (Latvia)

    2007-12-15

    Calcified tissues are involved in continues metabolic process in human organism exchanging a number of chemical elements with environment. The rate of biochemical reactions is tissue dependent and the slowest one at the tooth enamel, the most mineralized tissue of human organism. The long time stability and unique chemical composition make tooth enamel suitable for number of application. The assessment of individual radiation dose by Electron Paramagnetic Resonance (EPR) and evaluations of elemental composition by Instrumentation Neutron Activation Analysis (INAA) are the well known procedures where properties of tooth enamel intensively used. The current work is focused on investigation of EPR signals and determination of chemical composition on several teeth samples having different origin. The EPR spectra and INAA element content of milk tooth, caries tooth, and paradantose tooth have been compared to each other. The results showed that the intensity of EPR signal is much higher for the caries tooth than the for paradantose tooth that is in agreement with depleted Ca content.

  9. EPR application in medicine and biology

    Czech Academy of Sciences Publication Activity Database

    Stopka, Pavel; Křížová, Jana; Káfuňková, Eva

    2005-01-01

    Roč. 99, č. 14 (2005), s. 190-192 ISSN 0009-2770 R&D Projects: GA MZd(CZ) NB7377; GA MZd(CZ) NL7567 Institutional research plan: CEZ:AV0Z40320502 Keywords : EPR application Subject RIV: CA - Inorganic Chemistry Impact factor: 0.445, year: 2005

  10. Zavoisky and the Discovery of EPR

    Indian Academy of Sciences (India)

    IAS Admin

    moved to Kazan. In 1926, after finishing the nine-year secondary ... year student, he got a patent for an invention. Zavoisky was ... Early Attempts at NMR and Interruption by World War II ... band modulation) and, in some cases, he did not even apply the constant ... was awarded the Lenin Prize for the discovery of EPR. In the.

  11. The EPR detection of radiation treated foodstuffs

    International Nuclear Information System (INIS)

    Stachowicz, W.; Burlinska, G.; Michalik, J.; Ostrowski, K.; Dziedzic-Goclawska, A.

    1993-01-01

    The short paper by a Polish study group describes the results of the use of Electron Paramagnetic Resonance (EPR) Spectroscopy in the detection of irradiation to food. Pultry, fresh-water fish and sea fish as well as various fruits and yellow boletus are dealt with in some detail. (VHE) [de

  12. Embedding online patient record access in UK primary care: a survey of stakeholder experiences.

    Science.gov (United States)

    Pagliari, Claudia; Shand, Tim; Fisher, Brian

    2012-05-01

    To explore the integration of online patient Record Access within UK Primary Care, its perceived impacts on workload and service quality, and barriers to implementation. Mixed format survey of clinicians, administrators and patients. Telephone interviews with non-users. Primary care centres within NHS England that had offered online record access for the preceding year. Of the 57 practices initially agreeing to pilot the system, 32 had adopted it and 16 of these returned questionnaires. The 42 individual respondents included 14 practice managers, 15 clinicians and 13 patients. Follow-up interviews were conducted with one participant from 15 of the 25 non-adopter practices. Most professionals believed that the system is easy to integrate within primary care; while most patients found it easy to integrate within their daily lives. Professionals perceived no increase in the volume of patient queries or clinical consultations as a result of Record Access; indeed some believed that these had decreased. Most clinicians and patients believed that the service had improved mutual trust, communication, patients' health knowledge and health behaviour. Inhibiting factors included concerns about security, liability and resource requirements. Non-adoption was most frequently attributed to competing priorities, rather than negative beliefs about the service. Record access has an important role to play in supporting patient-focused healthcare policies in the UK and may be easily accommodated within existing services. Additional materials to facilitate patient recruitment, inform system set-up processes, and assure clinicians of their legal position are likely to encourage more widespread adoption.

  13. Assessment of performance parameters for EPR dosimetry with tooth enamel

    International Nuclear Information System (INIS)

    Wieser, A.; Fattibene, P.; Shishkina, E.A.; Ivanov, D.V.; De Coste, V.; Guettler, A.; Onori, S.

    2008-01-01

    In the framework of a comparison between three laboratories, electron paramagnetic resonance (EPR) signal-to-dose response curves were measured for sets of 30 tooth enamel samples and the variance of EPR measurements in dependence on absorbed dose was evaluated, in nine combinations of laboratory of sample preparation and EPR evaluation, respectively. As a test for benchmarking of EPR evaluation, the parameters 'critical dose' and 'limit of detection' were proposed as performance parameters following definitions from chemical-metrology, and a model function was suggested for analytical formulation of the dependence of the variance of EPR measurement on absorbed dose. First estimates of limits of detection by weighted and unweighted fitting resulted in the range 101-552 and 67-561 mGy, respectively, and were generally larger with weighted than with unweighted fitting. Indication was found for the influence of methodology of sample preparation and applied EPR measurement parameters on performance of EPR dosimetry with tooth enamel

  14. “Nothing About Me Without Me”: An Interpretative Review of Patient Accessible Electronic Health Records

    Science.gov (United States)

    Callahan, Ryan; Sevdalis, Nick; Mayer, Erik K; Darzi, Ara

    2015-01-01

    Background Patient accessible electronic health records (PAEHRs) enable patients to access and manage personal clinical information that is made available to them by their health care providers (HCPs). It is thought that the shared management nature of medical record access improves patient outcomes and improves patient satisfaction. However, recent reviews have found that this is not the case. Furthermore, little research has focused on PAEHRs from the HCP viewpoint. HCPs include physicians, nurses, and service providers. Objective We provide a systematic review of reviews of the impact of giving patients record access from both a patient and HCP point of view. The review covers a broad range of outcome measures, including patient safety, patient satisfaction, privacy and security, self-efficacy, and health outcome. Methods A systematic search was conducted using Web of Science to identify review articles on the impact of PAEHRs. Our search was limited to English-language reviews published between January 2002 and November 2014. A total of 73 citations were retrieved from a series of Boolean search terms including “review*” with “patient access to records”. These reviews went through a novel scoring system analysis whereby we calculated how many positive outcomes were reported per every outcome measure investigated. This provided a way to quantify the impact of PAEHRs. Results Ten reviews covering chronic patients (eg, diabetes and hypertension) and primary care patients, as well as HCPs were found but eight were included for the analysis of outcome measures. We found mixed outcomes across both patient and HCP groups, with approximately half of the reviews showing positive changes with record access. Patients believe that record access increases their perception of control; however, outcome measures thought to create psychological concerns (such as patient anxiety as a result of seeing their medical record) are still unanswered. Nurses are more likely than

  15. Imaging informatics-based multimedia ePR system for data management and decision support in rehabilitation research

    Science.gov (United States)

    Wang, Ximing; Verma, Sneha; Qin, Yi; Sterling, Josh; Zhou, Alyssa; Zhang, Jeffrey; Martinez, Clarisa; Casebeer, Narissa; Koh, Hyunwook; Winstein, Carolee; Liu, Brent

    2013-03-01

    With the rapid development of science and technology, large-scale rehabilitation centers and clinical rehabilitation trials usually involve significant volumes of multimedia data. Due to the global aging crisis, millions of new patients with age-related chronic diseases will produce huge amounts of data and contribute to soaring costs of medical care. Hence, a solution for effective data management and decision support will significantly reduce the expenditure and finally improve the patient life quality. Inspired from the concept of the electronic patient record (ePR), we developed a prototype system for the field of rehabilitation engineering. The system is subject or patient-oriented and customized for specific projects. The system components include data entry modules, multimedia data presentation and data retrieval. To process the multimedia data, the system includes a DICOM viewer with annotation tools and video/audio player. The system also serves as a platform for integrating decision-support tools and data mining tools. Based on the prototype system design, we developed two specific applications: 1) DOSE (a phase 1 randomized clinical trial to determine the optimal dose of therapy for rehabilitation of the arm and hand after stroke.); and 2) NEXUS project from the Rehabilitation Engineering Research Center(RERC, a NIDRR funded Rehabilitation Engineering Research Center). Currently, the system is being evaluated in the context of the DOSE trial with a projected enrollment of 60 participants over 5 years, and will be evaluated by the NEXUS project with 30 subjects. By applying the ePR concept, we developed a system in order to improve the current research workflow, reduce the cost of managing data, and provide a platform for the rapid development of future decision-support tools.

  16. Evaluating the Risk of Re-identification of Patients from Hospital Prescription Records.

    Science.gov (United States)

    Emam, Khaled El; Dankar, Fida K; Vaillancourt, Régis; Roffey, Tyson; Lysyk, Mary

    2009-07-01

    Pharmacies often provide prescription records to private research firms, on the assumption that these records are de-identified (i.e., identifying information has been removed). However, concerns have been expressed about the potential that patients can be re-identified from such records. Recently, a large private research firm requested prescription records from the Children's Hospital of Eastern Ontario (CHEO), as part of a larger effort to develop a database of hospital prescription records across Canada. To evaluate the ability to re-identify patients from CHEO'S prescription records and to determine ways to appropriately de-identify the data if the risk was too high. The risk of re-identification was assessed for 18 months' worth of prescription data. De-identification algorithms were developed to reduce the risk to an acceptable level while maintaining the quality of the data. The probability of patients being re-identified from the original variables and data set requested by the private research firm was deemed quite high. A new de-identified record layout was developed, which had an acceptable level of re-identification risk. The new approach involved replacing the admission and discharge dates with the quarter and year of admission and the length of stay in days, reporting the patient's age in weeks, and including only the first character of the patient's postal code. Additional requirements were included in the data-sharing agreement with the private research firm (e.g., audit requirements and a protocol for notification of a breach of privacy). Without a formal analysis of the risk of re-identification, assurances of data anonymity may not be accurate. A formal risk analysis at one hospital produced a clinically relevant data set that also protects patient privacy and allows the hospital pharmacy to explicitly manage the risks of breach of patient privacy.

  17. Body posture recognition and turning recording system for the care of bed bound patients.

    Science.gov (United States)

    Hsiao, Rong-Shue; Mi, Zhenqiang; Yang, Bo-Ru; Kau, Lih-Jen; Bitew, Mekuanint Agegnehu; Li, Tzu-Yu

    2015-01-01

    This paper proposes body posture recognition and turning recording system for assisting the care of bed bound patients in nursing homes. The system continuously detects the patient's body posture and records the length of time for each body posture. If the patient remains in the same body posture long enough to develop pressure ulcers, the system notifies caregivers to change the patient's body posture. The objective of recording is to provide the log of body turning for querying of patients' family members. In order to accurately detect patient's body posture, we developed a novel pressure sensing pad which contains force sensing resistor sensors. Based on the proposed pressure sensing pad, we developed a bed posture recognition module which includes a bed posture recognition algorithm. The algorithm is based on fuzzy theory. The body posture recognition algorithm can detect the patient's bed posture whether it is right lateral decubitus, left lateral decubitus, or supine. The detected information of patient's body posture can be then transmitted to the server of healthcare center by the communication module to perform the functions of recording and notification. Experimental results showed that the average posture recognition accuracy for our proposed module is 92%.

  18. Dreams and nightmares: practical and ethical issues for patients and physicians using personal health records.

    Science.gov (United States)

    Wynia, Matthew; Dunn, Kyle

    2010-01-01

    Electronic health records for patients, personal health records (PHRs), have become increasingly popular among policy makers and purchasers, but uptake among patients and physicians has been relatively slow. PHRs have varying uses that might make them more or less appealing to different stakeholders. The three core uses for PHRs - promoting communication, data use, and patient responsibility - each raises a set of potential practical and financial dilemmas. But some ethical concerns are also at play, some of which are rarely recognized as values-based barriers to the use of PHRs. Recognizing these ethical issues, and addressing them explicitly in PHR design and policy making, would help PHRs to achieve their promise.

  19. An analysis of electronic health record-related patient safety incidents.

    Science.gov (United States)

    Palojoki, Sari; Mäkelä, Matti; Lehtonen, Lasse; Saranto, Kaija

    2017-06-01

    The aim of this study was to analyse electronic health record-related patient safety incidents in the patient safety incident reporting database in fully digital hospitals in Finland. We compare Finnish data to similar international data and discuss their content with regard to the literature. We analysed the types of electronic health record-related patient safety incidents that occurred at 23 hospitals during a 2-year period. A procedure of taxonomy mapping served to allow comparisons. This study represents a rare examination of patient safety risks in a fully digital environment. The proportion of electronic health record-related incidents was markedly higher in our study than in previous studies with similar data. Human-computer interaction problems were the most frequently reported. The results show the possibility of error arising from the complex interaction between clinicians and computers.

  20. A shared computer-based problem-oriented patient record for the primary care team.

    Science.gov (United States)

    Linnarsson, R; Nordgren, K

    1995-01-01

    1. INTRODUCTION. A computer-based patient record (CPR) system, Swedestar, has been developed for use in primary health care. The principal aim of the system is to support continuous quality improvement through improved information handling, improved decision-making, and improved procedures for quality assurance. The Swedestar system has evolved during a ten-year period beginning in 1984. 2. SYSTEM DESIGN. The design philosophy is based on the following key factors: a shared, problem-oriented patient record; structured data entry based on an extensive controlled vocabulary; advanced search and query functions, where the query language has the most important role; integrated decision support for drug prescribing and care protocols and guidelines; integrated procedures for quality assurance. 3. A SHARED PROBLEM-ORIENTED PATIENT RECORD. The core of the CPR system is the problem-oriented patient record. All problems of one patient, recorded by different members of the care team, are displayed on the problem list. Starting from this list, a problem follow-up can be made, one problem at a time or for several problems simultaneously. Thus, it is possible to get an integrated view, across provider categories, of those problems of one patient that belong together. This shared problem-oriented patient record provides an important basis for the primary care team work. 4. INTEGRATED DECISION SUPPORT. The decision support of the system includes a drug prescribing module and a care protocol module. The drug prescribing module is integrated with the patient records and includes an on-line check of the patient's medication list for potential interactions and data-driven reminders concerning major drug problems. Care protocols have been developed for the most common chronic diseases, such as asthma, diabetes, and hypertension. The patient records can be automatically checked according to the care protocols. 5. PRACTICAL EXPERIENCE. The Swedestar system has been implemented in a

  1. Can audio recording of outpatient consultations improve patients recall and understanding?

    DEFF Research Database (Denmark)

    Wolderslund, Maiken

    of the dialogue between the patient and the clinician via the telephone in the consultation room. By dialing a dedicated number, patients can get access to an audio recording of their consultation by entering their social security number along with a PIN. The primary objective of this study is to determine......Introduction Information provided in an outpatient consultation concerns medication, diagnostic tests, treatment and rehabilitation, all of which are crucial knowledge with regards to patient compliance, decision making and general patient satisfaction. Despite good communication skills among...... clinicians, the communication is challenged by the fact that patients tend to forget or misunderstand parts of the information given. Thus we have designed a study which gives the patients a possibility to hear their consultation again. An Interactive Voice Response platform enables an audio recording...

  2. EPR studies of free radicals decay and survival in gamma irradiated aminoglycoside antibiotics: sisomicin, tobramycin and paromomycin.

    Science.gov (United States)

    Wilczyński, Sławomir; Pilawa, Barbara; Koprowski, Robert; Wróbel, Zygmunt; Ptaszkiewicz, Marta; Swakoń, Jan; Olko, Paweł

    2012-02-14

    Radiation sterilization technology is more actively used now that any time because of its many advantages. Gamma radiation has high penetrating power, relatively low chemical reactivity and causes small temperature rise. But on the other hand radiosterilization can lead to radiolytic products appearing, in example free radicals. Free radicals in radiative sterilized sisomicin, tobramycin and paromomycin were studied by electron paramagnetic resonance (EPR) spectroscopy. Dose of gamma irradiation of 25kGy was used. Concentrations and properties of free radicals in irradiated antibiotics were studied. EPR spectra were recorded for samples stored in air and argon. For gamma irradiated antibiotics strong EPR lines were recorded. One- and two-exponential functions were fitted to experimental points during testing and researching of time influence of the antibiotics storage to studied parameters of EPR lines. Our study of free radicals in radiosterilized antibiotics indicates the need for characterization of medicinal substances prior to sterilization process using EPR values. We propose the concentration of free radicals and other spectroscopic parameters as useful factors to select the optimal type of sterilization for the individual drug. The important parameters are i.a. the τ time constants and K constants of exponential functions. Time constants τ give us information about the speed of free radicals concentration decrease in radiated medicinal substances. The constant K(0) shows the free radicals concentration in irradiated medicament after long time of storage. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. Lack of recording of systemic lupus erythematosus in the death certificates of lupus patients.

    Science.gov (United States)

    Calvo-Alén, J; Alarcón, G S; Campbell, R; Fernández, M; Reveille, J D; Cooper, G S

    2005-09-01

    To determine to what extent the diagnosis of systemic lupus erythematosus (SLE) in deceased lupus patients is under-reported in death certificates, and the patient characteristics associated with such an occurrence. The death certificates of 76 of the 81 deceased SLE patients from two US lupus cohorts (LUMINA for Lupus in Minorities: Nature vs Nurture and CLU for Carolina Lupus Study), including 570 and 265 patients, respectively, were obtained from the Offices of Vital Statistics of the states where the patients died (Alabama, Georgia, North Carolina, South Carolina, Tennessee and Texas). Both cohorts included patients with SLE as per the American College of Rheumatology criteria, aged > or =16 yr, and disease duration at enrolment of < or =5 yr. The median duration of follow-up in each cohort at the time of these analyses ranged from 38.1 to 53.0 months. Standard univariable analyses were performed comparing patients with SLE recorded anywhere in the death certificate and those without it. A multivariable logistic regression model was performed to identify the variables independently associated with not recording SLE in death certificates. In 30 (40%) death certificates, SLE was not recorded anywhere in the death certificate. In univariable analyses, older age was associated with lack of recording of SLE in death certificates [mean age (standard deviation) 50.9 (15.6) years and 39.1 (18.6) yr among those for whom SLE was omitted and included on the death certificates, respectively, P = 0.005]. Patients without health insurance, those dying of a cardiovascular event and those of Caucasian ethnicity were also more likely to be in the non-recorded group. In the multivariable analysis, variables independently associated with not recording SLE as cause of death were older age [odds ratio = (95% confidence interval) 1.043 (1.005-1.083 per yr increase); P = 0.023] and lack of health insurance [4.649 (1.152-18.768); P = 0.031]. A high proportion of SLE diagnoses are not

  4. Model compounds of humic acid and oxovanadium cations. Potentiometric titration and EPR spectroscopy studies

    Directory of Open Access Journals (Sweden)

    Mercê Ana Lucia Ramalho

    1999-01-01

    Full Text Available The stability constants and the isotropic EPR parameters Ao (hyperfine splitting constant and g o (g value were obtained by potentiometric titrations and EPR spectroscopy, respectively, of 85%v/v aqueous solutions of model compounds of humic acids - salicylic acid (SALA - and both nitrohumic acids, a laboratory artifact - nitrosalicylic acids, 3-nitrosalicylic acid (3-NSA, 5-nitrosalicylic acid (5-NSA and 3,5-dinitrosalicylic acid (3,5-DNSA and oxovanadium cations. It was possible to record EPR spectra of those model compounds and the ion VO2+ (V(IV, and the stability constants were obtained from a solution of VO3+ (V(V, the values for the logarithms of the stability constants ranging from 12.77 ± 0.04 to 7.06 ± 0.05 for the species ML, and from 9.90 ±0.04 to 4.06 ± 0.05 for the species ML2 according to the decrease in the acidity of the carboxylic and the hydroxyl groups in the aromatic ring of the model compounds studied as the -NO2 substituents were added. Species distribution diagrams were also obtained for the equilibria studied. The EPR parameters showed that as the logarithm of the overall stability constants increase, g o values also increase, while Ao values show a tendency to decrease.

  5. Longitudinal analysis on utilization of medical document management system in a hospital with EPR implementation.

    Science.gov (United States)

    Kuwata, Shigeki; Yamada, Hitomi; Park, Keunsik

    2011-01-01

    Document management systems (DMS) have widespread in major hospitals in Japan as a platform to digitize the paper-based records being out of coverage by EPR. This study aimed to examine longitudinal trends of actual use of DMS in a hospital in which EPR had been in operation, which would be conducive to planning the further information management system in the hospital. Degrees of utilization of electronic documents and templates with DMS were analyzed based on data extracted from a university-affiliated hospital with EPR. As a result, it was found that the number of electronic documents as well as scanned documents circulating at the hospital tended to increase. The result indicated that replacement of paper-based documents with electronic documents did not occur. Therefore it was anticipated that the need for DMS would continue to increase in the hospital. The methods used this study to analyze the trend of DMS utilization would be applicable to other hospitals with with a variety of DMS implementation, such as electronic storage by scanning documents or paper preservation that is compatible with EPR.

  6. Designing a patient-centered personal health record to promote preventive care

    Directory of Open Access Journals (Sweden)

    Krist Alex H

    2011-11-01

    Full Text Available Abstract Background Evidence-based preventive services offer profound health benefits, yet Americans receive only half of indicated care. A variety of government and specialty society policy initiatives are promoting the adoption of information technologies to engage patients in their care, such as personal health records, but current systems may not utilize the technology's full potential. Methods Using a previously described model to make information technology more patient-centered, we developed an interactive preventive health record (IPHR designed to more deeply engage patients in preventive care and health promotion. We recruited 14 primary care practices to promote the IPHR to all adult patients and sought practice and patient input in designing the IPHR to ensure its usability, salience, and generalizability. The input involved patient usability tests, practice workflow observations, learning collaboratives, and patient feedback. Use of the IPHR was measured using practice appointment and IPHR databases. Results The IPHR that emerged from this process generates tailored patient recommendations based on guidelines from the U.S. Preventive Services Task Force and other organizations. It extracts clinical data from the practices' electronic medical record and obtains health risk assessment information from patients. Clinical content is translated and explained in lay language. Recommendations review the benefits and uncertainties of services and possible actions for patients and clinicians. Embedded in recommendations are self management tools, risk calculators, decision aids, and community resources - selected to match patient's clinical circumstances. Within six months, practices had encouraged 14.4% of patients to use the IPHR (ranging from 1.5% to 28.3% across the 14 practices. Practices successfully incorporated the IPHR into workflow, using it to prepare patients for visits, augment health behavior counseling, explain test results

  7. EPR in characterization of seeds paramagnetic species

    International Nuclear Information System (INIS)

    Luiz, A.P.C.; Mauro, M.F.F.L.; Portugal, K.O.; Barbana, V.M.; Guedes, C.L.B.; Mauro, E. di; Carneiro, C.E.A.; Zaia, D.A.M.; Prete, C.E.C.

    2011-01-01

    Full text. In Brazil, since 1970s, renewable fuel programs has been developed in order to replace petroleum. Today a program that has been discussed is the bio diesel, which intend to replace diesel fuel, fossil oil, to bio diesel, renewal fuel. As seeds are the basis for production of oil and consequently processed into bio diesel, the goal of this work is to characterize and compare paramagnetic species present in the seeds by Electron Paramagnetic Resonance (EPR). Samples used in this study were seeds of sorghum, barley, corn, peanuts, soy beans, cotton, wheat, oats, mustard, rice, sunflower and turnip. Some paramagnetic species present in soil was also investigated as goethite (FeOOH), hematite (Fe 2 O 3 ), magnetite (Fe 3 O 4 ), and ferrihydrite (Fe 5 HO 8 · 4H 2 O), since, these species present in appreciable quantities in the soil can be present in the seeds and analyzed for comparison. The characterization of these species is essential to understand the EPR seeds spectra. Each sample is placed in a thin quartz tube 4 mm in diameter, and it is inserted into the cavity of the spectrometer at room temperature, at low temperature (77 K) and variable temperature using liquid nitrogen flow and hot flow through a compressor air. It was used as standard Mg O:Mn 2+ , which is also inserted into the cavity. Shortly after the potency is regulated, frequency, amplitude and sweep the field. The spectroscopic analysis by EPR X-band (∼ 9:5GHz), were performed at the Fluorescence and Electron Paramagnetic Resonance Laboratory, Exact Sciences Center, State University of Londrina, Parana state, Brazil, through an EPR spectrometer JEOL brand (JES-PE-3X). In the EPR spectra, spectroscopic factor or g factor and line width were determined in paramagnetic species. Studies from several seeds with EPR technique detected in all of them presence of same complex of Fe 3+ present in the goethite at g ∼ 2, and in the seeds exist free radicals at g = 2:004, at room temperature

  8. EPR in characterization of seeds paramagnetic species

    Energy Technology Data Exchange (ETDEWEB)

    Luiz, A.P.C.; Mauro, M.F.F.L.; Portugal, K.O.; Barbana, V.M.; Guedes, C.L.B.; Mauro, E. di; Carneiro, C.E.A.; Zaia, D.A.M.; Prete, C.E.C. [Universidade Estadual de Londrina (UEL), PR (Brazil)

    2011-07-01

    Full text. In Brazil, since 1970s, renewable fuel programs has been developed in order to replace petroleum. Today a program that has been discussed is the bio diesel, which intend to replace diesel fuel, fossil oil, to bio diesel, renewal fuel. As seeds are the basis for production of oil and consequently processed into bio diesel, the goal of this work is to characterize and compare paramagnetic species present in the seeds by Electron Paramagnetic Resonance (EPR). Samples used in this study were seeds of sorghum, barley, corn, peanuts, soy beans, cotton, wheat, oats, mustard, rice, sunflower and turnip. Some paramagnetic species present in soil was also investigated as goethite (FeOOH), hematite (Fe{sub 2}O{sub 3}), magnetite (Fe{sub 3}O{sub 4}), and ferrihydrite (Fe{sub 5}HO{sub 8} {center_dot} 4H{sub 2}O), since, these species present in appreciable quantities in the soil can be present in the seeds and analyzed for comparison. The characterization of these species is essential to understand the EPR seeds spectra. Each sample is placed in a thin quartz tube 4 mm in diameter, and it is inserted into the cavity of the spectrometer at room temperature, at low temperature (77 K) and variable temperature using liquid nitrogen flow and hot flow through a compressor air. It was used as standard Mg O:Mn{sup 2+}, which is also inserted into the cavity. Shortly after the potency is regulated, frequency, amplitude and sweep the field. The spectroscopic analysis by EPR X-band ({approx} 9:5GHz), were performed at the Fluorescence and Electron Paramagnetic Resonance Laboratory, Exact Sciences Center, State University of Londrina, Parana state, Brazil, through an EPR spectrometer JEOL brand (JES-PE-3X). In the EPR spectra, spectroscopic factor or g factor and line width were determined in paramagnetic species. Studies from several seeds with EPR technique detected in all of them presence of same complex of Fe{sup 3+} present in the goethite at g {approx} 2, and in the seeds

  9. Meeting the health information needs of prostate cancer patients using personal health records.

    Science.gov (United States)

    Pai, H H; Lau, F; Barnett, J; Jones, S

    2013-12-01

    There is interest in the use of health information technology in the form of personal health record (phr) systems to support patient needs for health information, care, and decision-making, particularly for patients with distressing, chronic diseases such as prostate cancer (pca). We sought feedback from pca patients who used a phr. For 6 months, 22 pca patients in various phases of care at the BC Cancer Agency (bcca) were given access to a secure Web-based phr called provider, which they could use to view their medical records and use a set of support tools. Feedback was obtained using an end-of-study survey on usability, satisfaction, and concerns with provider. Site activity was recorded to assess usage patterns. Of the 17 patients who completed the study, 29% encountered some minor difficulties using provider. No security breaches were known to have occurred. The two most commonly accessed medical records were laboratory test results and transcribed doctor's notes. Of survey respondents, 94% were satisfied with the access to their medical records, 65% said that provider helped to answer their questions, 77% felt that their privacy and confidentiality were preserved, 65% felt that using provider helped them to communicate better with their physicians, 83% found new and useful information that they would not have received by talking to their health care providers, and 88% said that they would continue to use provider. Our results support the notion that phrs can provide cancer patients with timely access to their medical records and health information, and can assist in communication with health care providers, in knowledge generation, and in patient empowerment.

  10. Sharing Annotated Audio Recordings of Clinic Visits With Patients-Development of the Open Recording Automated Logging System (ORALS): Study Protocol.

    Science.gov (United States)

    Barr, Paul J; Dannenberg, Michelle D; Ganoe, Craig H; Haslett, William; Faill, Rebecca; Hassanpour, Saeed; Das, Amar; Arend, Roger; Masel, Meredith C; Piper, Sheryl; Reicher, Haley; Ryan, James; Elwyn, Glyn

    2017-07-06

    Providing patients with recordings of their clinic visits enhances patient and family engagement, yet few organizations routinely offer recordings. Challenges exist for organizations and patients, including data safety and navigating lengthy recordings. A secure system that allows patients to easily navigate recordings may be a solution. The aim of this project is to develop and test an interoperable system to facilitate routine recording, the Open Recording Automated Logging System (ORALS), with the aim of increasing patient and family engagement. ORALS will consist of (1) technically proficient software using automated machine learning technology to enable accurate and automatic tagging of in-clinic audio recordings (tagging involves identifying elements of the clinic visit most important to patients [eg, treatment plan] on the recording) and (2) a secure, easy-to-use Web interface enabling the upload and accurate linkage of recordings to patients, which can be accessed at home. We will use a mixed methods approach to develop and formatively test ORALS in 4 iterative stages: case study of pioneer clinics where recordings are currently offered to patients, ORALS design and user experience testing, ORALS software and user interface development, and rapid cycle testing of ORALS in a primary care clinic, assessing impact on patient and family engagement. Dartmouth's Informatics Collaboratory for Design, Development and Dissemination team, patients, patient partners, caregivers, and clinicians will assist in developing ORALS. We will implement a publication plan that includes a final project report and articles for peer-reviewed journals. In addition to this work, we will regularly report on our progress using popular relevant Tweet chats and online using our website, www.openrecordings.org. We will disseminate our work at relevant conferences (eg, Academy Health, Health Datapalooza, and the Institute for Healthcare Improvement Quality Forums). Finally, Iora Health, a

  11. Beyond the computer-based patient record: re-engineering with a vision.

    Science.gov (United States)

    Genn, B; Geukers, L

    1995-01-01

    In order to achieve real benefit from the potential offered by a Computer-Based Patient Record, the capabilities of the technology must be applied along with true re-engineering of healthcare delivery processes. University Hospital recognizes this and is using systems implementation projects, such as the catalyst, for transforming the way we care for our patients. Integration is fundamental to the success of these initiatives and this must be explicitly planned against an organized systems architecture whose standards are market-driven. University Hospital also recognizes that Community Health Information Networks will offer improved quality of patient care at a reduced overall cost to the system. All of these implementation factors are considered up front as the hospital makes its initial decisions on to how to computerize its patient records. This improves our chances for success and will provide a consistent vision to guide the hospital's development of new and better patient care.

  12. The use of electronic patient records for medical research: conflicts and contradictions.

    Science.gov (United States)

    Stevenson, Fiona

    2015-03-29

    The use of electronic patient records for medical research is extremely topical. The Clinical Practice Research Datalink (CRPD), the English NHS observational data and interventional research service, was launched in April 2012. The CPRD has access to, and facilities to link, many healthcare related datasets. The CPRD is partially based on learning from the Health Research Support Service (HRSS), which was used to test the technical and practical aspects of downloading and linking electronic patient records for research. Questions around the feasibility and acceptability of implementing and integrating the processes necessary to enable electronic patient records to be used for the purposes of research remain. Focus groups and interviews were conducted with a total of 50 patients and 7 staff from the two English GP practices involved in piloting the HRSS, supplemented with 11 interviews with key stakeholders. Emergent themes were mapped on to the constructs of normalization process theory (NPT) to consider the ways in which sense was made of the work of implementing and integrating the HRSS. The NPT analysis demonstrated a lack of commitment to, and engagement with, the HRSS on the part of patients, whilst the commitment of doctors and practice staff was to some extent mitigated by concerns about issues of governance and consent, particularly in relation to downloading electronic patient records with associated identifiers. Although the CPRD is presented as a benign, bureaucratic process, perceptions by patients and staff of inherent contradictions with centrally held values of information governance and consent in downloading and linking electronic patient records for research remains a barrier to implementation. It is likely that conclusions reached about the problems of balancing the contradictions inherent in sharing what can be perceived as a private resource for the public good are globally transferrable.

  13. Is patient confidentiality compromised with the electronic health record?: a position paper.

    Science.gov (United States)

    Wallace, Ilse M

    2015-02-01

    In order for electronic health records to fulfill their expected benefits, protection of privacy of patient information is key. Lack of trust in confidentiality can lead to reluctance in disclosing all relevant information, which could have grave consequences. This position paper contemplates whether patient confidentiality is compromised by electronic health records. The position that confidentiality is compromised was supported by the four bioethical principles and argued that despite laws and various safeguards to protect patients' confidentiality, numerous data breaches have occurred. The position that confidentiality is not compromised was supported by virtue ethics and a utilitarian viewpoint and argued that safeguards keep information confidential and the public feels relatively safe with the electronic health record. The article concludes with an ethically superior position that confidentiality is compromised with the electronic health record. Although organizational and governmental ways of enhancing the confidentiality of patient information within the electronic health record facilitate confidentiality, the ultimate responsibility of maintaining confidentiality rests with the individual end-users and their ethical code of conduct. The American Nurses Association Code of Ethics for nurses calls for nurses to be watchful with data security in electronic communications.

  14. The patients' active role in managing a personal electronic health record: a qualitative analysis.

    Science.gov (United States)

    Baudendistel, Ines; Winkler, Eva; Kamradt, Martina; Brophy, Sarah; Längst, Gerda; Eckrich, Felicitas; Heinze, Oliver; Bergh, Bjoern; Szecsenyi, Joachim; Ose, Dominik

    2015-09-01

    The complexity of illness and cross-sectoral health care pose challenges for patients with colorectal cancer and their families. Within a patient-centered care paradigm, it is vital to give patients the opportunity to play an active role. Prospective users' attitudes regarding the patients' role in the context of a patient-controlled electronic health record (PEPA) were explored. A qualitative study across regional health care settings and health professions was conducted. Overall, 10 focus groups were performed collecting views of 3 user groups: patients with colorectal cancer (n = 12) and representatives from patient support groups (n = 2), physicians (n = 17), and other health care professionals (HCPs) (n = 16). Data were audio- and videotaped, transcribed verbatim and thematically analyzed using qualitative content analysis. The patients' responsibility as a gatekeeper and access manager was at the center of the focus group discussions, although HCPs addressed aspects that would limit patients taking an active role (e.g., illness related issues). Despite expressed concerns, PEPAs possibility to enhance personal responsibility was seen in all user groups. Giving patients an active role in managing a personal electronic health record is an innovative patient-centered approach, although existing restraints have to be recognized. To enhance user adoption and advance PEPAs potential, key user needs have to be addressed.

  15. Full cycle rapid scan EPR deconvolution algorithm.

    Science.gov (United States)

    Tseytlin, Mark

    2017-08-01

    Rapid scan electron paramagnetic resonance (RS EPR) is a continuous-wave (CW) method that combines narrowband excitation and broadband detection. Sinusoidal magnetic field scans that span the entire EPR spectrum cause electron spin excitations twice during the scan period. Periodic transient RS signals are digitized and time-averaged. Deconvolution of absorption spectrum from the measured full-cycle signal is an ill-posed problem that does not have a stable solution because the magnetic field passes the same EPR line twice per sinusoidal scan during up- and down-field passages. As a result, RS signals consist of two contributions that need to be separated and postprocessed individually. Deconvolution of either of the contributions is a well-posed problem that has a stable solution. The current version of the RS EPR algorithm solves the separation problem by cutting the full-scan signal into two half-period pieces. This imposes a constraint on the experiment; the EPR signal must completely decay by the end of each half-scan in order to not be truncated. The constraint limits the maximum scan frequency and, therefore, the RS signal-to-noise gain. Faster scans permit the use of higher excitation powers without saturating the spin system, translating into a higher EPR sensitivity. A stable, full-scan algorithm is described in this paper that does not require truncation of the periodic response. This algorithm utilizes the additive property of linear systems: the response to a sum of two inputs is equal the sum of responses to each of the inputs separately. Based on this property, the mathematical model for CW RS EPR can be replaced by that of a sum of two independent full-cycle pulsed field-modulated experiments. In each of these experiments, the excitation power equals to zero during either up- or down-field scan. The full-cycle algorithm permits approaching the upper theoretical scan frequency limit; the transient spin system response must decay within the scan

  16. Steering, Entanglement, Nonlocality, and the EPR Paradox

    Science.gov (United States)

    Wiseman, Howard; Jones, Steve; Andrew, Doherty

    2007-06-01

    The concept of steering was introduced by Schroedinger in 1935 as a generalization of the EPR paradox for arbitrary pure bipartite entangled states and arbitrary measurements by one party. Until now, it has never been rigorously defined, so it has not been known (for example) what mixed states are steerable (that is, can be used to exhibit steering). We provide an operational definition, from which we prove (by considering Werner states and Isotropic states) that steerable states are a strict subset of the entangled states, and a strict superset of the states that can exhibit Bell-nonlocality. For arbitrary bipartite Gaussian states we derive a linear matrix inequality that decides the question of steerability via Gaussian measurements, and we relate this to the original EPR paradox.

  17. The long way to the EPR

    International Nuclear Information System (INIS)

    Berke, C.

    1997-01-01

    At the joint conference organized by the German Kerntechnische Gesellschaft (KTG) e.V. and the French Societe Francaise d'Energie Nucleaire (SFEN) in Cologne, the announcement was made on October 20, 1997 that Jean Claude Leny will be appointed Honorary Member of KTG. For reasons of ill health the new honorary member was prevented from attending the conference. In his place, Claus Berke sketched the history of the European Pressurized Water Reactor (EPR) and presented an overview of nuclear development in France and in Germany. Developing one standard reactor model in the primary objective of German-French cooperation in reactor development. The EPR is to replace the present nuclear generating units in France and Germany after the end of their planned service life, and is to be marketed as a standard export line. (orig.) [de

  18. EPR becomes reality at Finland's Olkiluoto 3

    International Nuclear Information System (INIS)

    Gueldner, R.; Giese, U.

    2005-01-01

    The EPR is a third-generation pressurized water reactor (PWR). Its development was started in 1992 by Framatome and Siemens within a Franco-German partnership. Since 2001 this work has been continued by Framatome ANP, which was formed when the two companies merged their nuclear businesses. The French company AREVA, world market leader in nuclear technology, holds a 66% share in Framatome ANP, with Siemens owning 34%. From the very start, development of the EPR was focused on improving plant safety and economics even further. The new reactor development was jointly financed together with the leading power utilities of both countries. The first steps towards realization of an EPR nuclear power plant were taken at Olkiluoto, Finland in 2004, consisting of initial preparation of the construction site. By mid-February 2005 the local municipality - Eurajoki - had issued a construction permit, and the Finnish Government a construction license pursuant to the Finnish Nuclear Energy Act. This had been preceded by a preliminary safety assessment prepared by the Finnish Radiation and Nuclear Safety Authority (STUK) for the Finnish Ministry of Trade and Industry in which STUK verified that it did not see any safety-related issues opposing issuance of the nuclear construction license. STUK emphasized that the evolutionary design of the EPR had been further improved by AREVA compared to the previous product lines. Concreting work began this spring and the unit will start commercial operation in 2009. Construction of an EPR has also been given the political go-ahead in France. According to the utility Electricite de France (EDF) the new reactor will be built as a forerunner of a later series at the site of Flamanville in Normandy. Construction is scheduled to begin in 2007. An EPR nuclear power plant has a rated electric capacity of around 1600 MW, depending on specific site conditions. Being the product of intense bilateral cooperation the EPR combines the technological

  19. A theoretical interpretation of EPR and ENDOR

    International Nuclear Information System (INIS)

    Matos, M.O.M. de.

    1975-08-01

    To interpret the EPR and ENDOR results of the U 2 center in SrF 2 , two wavefunctions are proposed to describe the unpaired electron of the defect. Use is made of two different models in order to obtain the wavefunctions: the Heitler-London and that of molecular orbitals models. The Pauli repulsion (overlap of wavefunctions) is discussed as well as covalency mechanisms and their influence in the calculation of the hyperfine constants due to magnetic interaction of the unpaired electron and the magnetic nucleus of the cristal. A small amount of covalency between the ground state of the interstitial Hydrogen atom and the 2p shell of the F - ions of the first cristaline shell is introduced fenomenologically in the molecular orbitals model. Both methods are discussed by comparing the theoretical calculations of the hyperfine constants with the measured experimental values obtained with the EPR and ENDOR techniques. (Author) [pt

  20. Holographic EPR pairs, wormholes and radiation

    Science.gov (United States)

    Chernicoff, Mariano; Güijosa, Alberto; Pedraza, Juan F.

    2013-10-01

    As evidence for the ER = EPR conjecture, it has recently been observed that the string that is holographically dual to an entangled quark-antiquark pair separating with (asymptotically) uniform acceleration has a wormhole on its worldsheet. We point out that a two-sided horizon and a wormhole actually appear for much more generic quark-antiquark trajectories, which is consistent with the fact that the members of an EPR pair need not be permanently out of causal contact. The feature that determines whether the causal structure of the string worldsheet is trivial or not turns out to be the emission of gluonic radiation by the dual quark and antiquark. In the strongly-coupled gauge theory, it is only when radiation is emitted that one obtains an unambiguous separation of the pair into entangled subsystems, and this is what is reflected on the gravity side by the existence of the worldsheet horizon.

  1. Multisite EPR oximetry from multiple quadrature harmonics.

    Science.gov (United States)

    Ahmad, R; Som, S; Johnson, D H; Zweier, J L; Kuppusamy, P; Potter, L C

    2012-01-01

    Multisite continuous wave (CW) electron paramagnetic resonance (EPR) oximetry using multiple quadrature field modulation harmonics is presented. First, a recently developed digital receiver is used to extract multiple harmonics of field modulated projection data. Second, a forward model is presented that relates the projection data to unknown parameters, including linewidth at each site. Third, a maximum likelihood estimator of unknown parameters is reported using an iterative algorithm capable of jointly processing multiple quadrature harmonics. The data modeling and processing are applicable for parametric lineshapes under nonsaturating conditions. Joint processing of multiple harmonics leads to 2-3-fold acceleration of EPR data acquisition. For demonstration in two spatial dimensions, both simulations and phantom studies on an L-band system are reported. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Pragmatic Randomized, Controlled Trial of Patient Navigators and Enhanced Personal Health Records in CKD.

    Science.gov (United States)

    Navaneethan, Sankar D; Jolly, Stacey E; Schold, Jesse D; Arrigain, Susana; Nakhoul, Georges; Konig, Victoria; Hyland, Jennifer; Burrucker, Yvette K; Dann, Priscilla Davis; Tucky, Barbara H; Sharp, John; Nally, Joseph V

    2017-09-07

    Patient navigators and enhanced personal health records improve the quality of health care delivered in other disease states. We aimed to develop a navigator program for patients with CKD and an electronic health record-based enhanced personal health record to disseminate CKD stage-specific goals of care and education. We also conducted a pragmatic randomized clinical trial to compare the effect of a navigator program for patients with CKD with enhanced personal health record and compare their combination compared with usual care among patients with CKD stage 3b/4. Two hundred and nine patients from six outpatient clinics (in both primary care and nephrology settings) were randomized in a 2×2 factorial design into four-study groups: ( 1 ) enhanced personal health record only, ( 2 ) patient navigator only, ( 3 ) both, and ( 4 ) usual care (control) group. Primary outcome measure was the change in eGFR over a 2-year follow-up period. Secondary outcome measures included acquisition of appropriate CKD-related laboratory measures, specialty referrals, and hospitalization rates. Median age of the study population was 68 years old, and 75% were white. At study entry, 54% of patients were followed by nephrologists, and 88% were on renin-angiotensin system blockers. After a 2-year follow-up, rate of decline in eGFR was similar across the four groups ( P =0.19). Measurements of CKD-related laboratory parameters were not significantly different among the groups. Furthermore, referral for dialysis education and vascular access placement, emergency room visits, and hospitalization rates were not statistically significant different between the groups. We successfully developed a patient navigator program and an enhanced personal health record for the CKD population. However, there were no differences in eGFR decline and other outcomes among the study groups. Larger and long-term studies along with cost-effectiveness analyses are needed to evaluate the role of patient navigators

  3. Spectra processing at tooth enamel dosimetry: Analytical description of EPR spectrum at different microwave power

    International Nuclear Information System (INIS)

    Tieliewuhan, E.; Ivannikov, A.; Zhumadilov, K.; Nalapko, M.; Tikunov, D.; Skvortsov, V.; Stepanenko, V.; Toyoda, S.; Tanaka, K.; Endo, S.; Hoshi, M.

    2006-01-01

    Variation of the electron paramagnetic resonance (EPR) spectrum of the human tooth enamel recorded at different microwave power is investigated. The analytical models describing the native and the radiation-induced signals in the enamel are proposed, which fit the experimental spectra in wide range of microwave power. These models are designed to use for processing the spectra of irradiated enamel at determination of the absorbed dose from the intensity of the radiation-induced signal

  4. Teichmuller Space Resolution of the EPR Paradox

    Science.gov (United States)

    Winterberg, Friedwardt

    2013-04-01

    The mystery of Newton's action-at-a-distance law of gravity was resolved by Einstein with Riemann's non-Euclidean geometry, which permitted the explanation of the departure from Newton's law for the motion of Mercury. It is here proposed that the similarly mysterious non-local EPR-type quantum correlations may be explained by a Teichmuller space geometry below the Planck length, for which an experiment for its verification is proposed.

  5. Steering, Entanglement, Nonlocality, and the EPR Paradox

    OpenAIRE

    Wiseman, H. M.; Jones, S. J.; Doherty, A. C.

    2006-01-01

    The concept of steering was introduced by Schrodinger in 1935 as a generalization of the EPR paradox for arbitrary pure bipartite entangled states and arbitrary measurements by one party. Until now, it has never been rigorously defined, so it has not been known (for example) what mixed states are steerable (that is, can be used to exhibit steering). We provide an operational definition, from which we prove (by considering Werner states and Isotropic states) that steerable states are a strict ...

  6. Seventy Years of the EPR Paradox

    Science.gov (United States)

    Kupczynski, Marian

    2006-11-01

    In spite of the fact that statistical predictions of quantum theory (QT) can only be tested if large amount of data is available a claim has been made that QT provides the most complete description of an individual physical system. Einstein's opposition to this claim and the paradox he presented in the article written together with Podolsky and Rosen in 1935 inspired generations of physicists in their quest for better understanding of QT. Seventy years after EPR article it is clear that without deep understanding of the character and limitations of QT one may not hope to find a meaningful unified theory of all physical interactions, manipulate qubits or construct a quantum computer.. In this paper we present shortly the EPR paper, the discussion, which followed it and Bell inequalities (BI). To avoid various paradoxes we advocate purely statistical contextual interpretation (PSC) of QT. According to PSC a state vector is not an attribute of a single electron, photon, trapped ion or quantum dot. A value of an observable assigned to a physical system has only a meaning in a context of a particular physical experiment PSC does not provide any mental space-time picture of sub phenomena. The EPR paradox is avoided because the reduction of the state vector in the measurement process is a passage from a description of the whole ensemble of the experimental results to a particular sub-ensemble of these results. We show that the violation of BI is neither a proof of the completeness of QT nor of its non-locality. Therefore we rephrase the EPR question and ask whether QT is "predictably "complete or in other words does it provide the complete description of experimental data. To test the "predictable completeness" it is not necessary to perform additional experiments it is sufficient to analyze more in detail the existing experimental data by using various non-parametric purity tests and other specific statistical tools invented to study the fine structure the time-series.

  7. Seventy Years of the EPR Paradox

    OpenAIRE

    Kupczynski, Marian

    2007-01-01

    In spite of the fact that statistical predictions of quantum theory (QT) can only be tested if large amount of data is available a claim has been made that QT provides the most complete description of an individual physical system. Einstein's opposition to this claim and the paradox he presented in the article written together with Podolsky and Rosen in 1935 inspired generations of physicists in their quest for better understanding of QT. Seventy years after EPR article it is clear that witho...

  8. Is the EPR paradox really a paradox?

    OpenAIRE

    Tartaglia, A.

    1998-01-01

    The EPR paradox and the meaning of the Bell inequality are discussed. It is shown that considering the quantum objects as carrying with them ''instruction kits'' telling them what to do when meeting a measurement apparatus any paradox disappears. In this view the quantum state is characterized by the prescribed behaviour rather than by the specific value a parameter assumes as a result of an interaction.

  9. Should the EPR be financed by industrialists?

    International Nuclear Information System (INIS)

    Jemain, A.

    2005-01-01

    As a reciprocal arrangement, the industrialists should be invited to contribute to the financing of the new generation reactor EPR (European pressurized reactor) which will be built in Flamanville (Manche, France). In exchange to their financial participation, the industrialists will receive the contractual warranty of stable electricity prices during 10 to 15 years periods. This short paper presents the opposite opinion of two representative of French industries concerning this proposal. Short paper. (J.S.)

  10. EPR Test with Photons and Kaons Analogies

    CERN Document Server

    Gisin, Nicolas

    2001-01-01

    We present a unified formalism describing EPR test using spin 1/2 particles, photons and kaons. This facilitates the comparison between existing experiments using photons and kaons. It underlines the similarities between birefringence and polarization dependent losses that affects experiments using optical fibers and mixing and decay that are intrinsic to the kaons. We also discuss the limitation these two characteristics impose on the testing of Bell's inequality.

  11. On Popper's new EPR-Experiment

    International Nuclear Information System (INIS)

    Bedford, D.; Selleri, F.

    1985-01-01

    It is scientifically reasonable to search for particular statistical ensembles to which the standard quantum rules (like Heisenberg relations) do not apply: these rules would instead be applicable to more general statistical ensembles (which might be called ''standard quantum ensembles''). Along these lines, Popper has recently proposed what he calls ''a new version of the EPR experiment'' in which the Copenhagen and statistical interpretations of quantum mechanics apparently lead to distinguishably different predictions

  12. Self-testing through EPR-steering

    International Nuclear Information System (INIS)

    Šupić, Ivan; Hoban, Matty J

    2016-01-01

    The verification of quantum devices is an important aspect of quantum information, especially with the emergence of more advanced experimental implementations of quantum computation and secure communication. Within this, the theory of device-independent robust self-testing via Bell tests has reached a level of maturity now that many quantum states and measurements can be verified without direct access to the quantum systems: interaction with the devices is solely classical. However, the requirements for this robust level of verification are daunting and require high levels of experimental accuracy. In this paper we discuss the possibility of self-testing where we only have direct access to one part of the quantum device. This motivates the study of self-testing via EPR-steering, an intermediate form of entanglement verification between full state tomography and Bell tests. Quantum non-locality implies EPR-steering so results in the former can apply in the latter, but we ask what advantages may be gleaned from the latter over the former given that one can do partial state tomography? We show that in the case of self-testing a maximally entangled two-qubit state, or ebit, EPR-steering allows for simpler analysis and better error tolerance than in the case of full device-independence. On the other hand, this improvement is only a constant improvement and (up to constants) is the best one can hope for. Finally, we indicate that the main advantage in self-testing based on EPR-steering could be in the case of self-testing multi-partite quantum states and measurements. For example, it may be easier to establish a tensor product structure for a particular party’s Hilbert space even if we do not have access to their part of the global quantum system. (paper)

  13. The Finnish EPR dependent on a bridge

    International Nuclear Information System (INIS)

    Dupin, L.

    2010-01-01

    A new conflict has emerged between the main contractor Areva and its client TVO, the Finnish energy group. The qualification of a handling bridge has delayed the OL3 project of third EPR reactor at Olkiluoto, Finland. The disagreement concerns the testing procedure and may induce a two year delay in the completion of the project which is now planned for 2012 instead of 2010 initially. (J.S.)

  14. The EPR operators are trained on simulator

    International Nuclear Information System (INIS)

    Maincent, G.

    2009-01-01

    Three years before the EPR reactor of Flamanville (Normandie, France) is generating its very first kilowatt hours, Electricite de France has started to train its teams on a simulator which reproduces the man-machine interface of the future nuclear power plant. The simulator used is an evolutive tool specific to the Flamanville reactor and capable to test about 20 different accidental situations. (J.S.)

  15. EPR in non-doped irradiated polyacetylene

    International Nuclear Information System (INIS)

    Hola, O.; Stasko, A.; Foeldesova, M.

    1993-01-01

    The influence of γ-irradiation on the paramagnetic properties of non-doped polyacetylene at low and high radiation doses has been studied and summarized. The dependence of the EPR spectra on the radiation dose in irradiated polyacetylene has been measured. No essential changes of the spin mobility as a consequence of irradiation were observed. The measurements of spin concentration confirm the high resistivity of non-doped polyacetylene to radiation. (author) 9 refs

  16. Electronic health record use, intensity of hospital care, and patient outcomes.

    Science.gov (United States)

    Blecker, Saul; Goldfeld, Keith; Park, Naeun; Shine, Daniel; Austrian, Jonathan S; Braithwaite, R Scott; Radford, Martha J; Gourevitch, Marc N

    2014-03-01

    Previous studies have suggested that weekend hospital care is inferior to weekday care and that this difference may be related to diminished care intensity. The purpose of this study was to determine whether a metric for measuring intensity of hospital care based on use of the electronic health record was associated with patient-level outcomes. We performed a cohort study of hospitalizations at an academic medical center. Intensity of care was defined as the hourly number of provider accessions of the electronic health record, termed "electronic health record interactions." Hospitalizations were categorized on the basis of the mean difference in electronic health record interactions between the first Friday and the first Saturday of hospitalization. We used regression models to determine the association of these categories with patient outcomes after adjusting for covariates. Electronic health record interactions decreased from Friday to Saturday in 77% of the 9051 hospitalizations included in the study. Compared with hospitalizations with no change in Friday to Saturday electronic health record interactions, the relative lengths of stay for hospitalizations with a small, moderate, and large decrease in electronic health record interactions were 1.05 (95% confidence interval [CI], 1.00-1.10), 1.11 (95% CI, 1.05-1.17), and 1.25 (95% CI, 1.15-1.35), respectively. Although a large decrease in electronic health record interactions was associated with in-hospital mortality, these findings were not significant after risk adjustment (odds ratio 1.74, 95% CI, 0.93-3.25). Intensity of inpatient care, measured by electronic health record interactions, significantly diminished from Friday to Saturday, and this decrease was associated with length of stay. Hospitals should consider monitoring and correcting temporal fluctuations in care intensity. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Improving patient-centered communication while using an electronic health record: Report from a curriculum evaluation.

    Science.gov (United States)

    Fogarty, Colleen T; Winters, Paul; Farah, Subrina

    2016-05-01

    Researchers and clinicians are concerned about the impact of electronic health record use and patient-centered communication. Training about patient-centered clinical communication skills with the electronic health record may help clinicians adapt and remain patient-centered. We developed an interactive workshop eliciting challenges and opportunities of working with the electronic health record in clinical practice, introduction of specific patient-centered behaviors and mindful practice techniques, and video demonstrating contrasts in common behavior and "better practices." One hundred thirty-nine resident physicians and faculty supervisors in five residency training programs at the University of Rochester Medical Center participated in the workshops. Participants were asked to complete an 11-item survey of behaviors related to their use of the electronic health record prior to training and after attending training. We used paired t-tests to assess changes in self-reported behavior from pre-intervention to post-intervention. We trained 139 clinicians in the workshops; 110 participants completed the baseline assessment and 39 completed both the baseline and post-intervention assessment. Data from post-curriculum respondents found a statistically significant increase in "I told the patient when turning my attention from the patient to the computer," from 60% of the time prior to the training to 70% of the time after. Data from our program evaluation demonstrated improvement in one communication behavior. Sample size limited the detection of other changes; further research should investigate effective training techniques for patient-centered communication while using the electronic health record. © The Author(s) 2016.

  18. ISS protocol for EPR tooth dosimetry

    International Nuclear Information System (INIS)

    Onori, S.; Aragno, D.; Fattibene, P.; Petetti, E.; Pressello, M.C.

    2000-01-01

    The accuracy in Electron Paramagnetic Resonance (EPR) dose reconstruction with tooth enamel is affected by sample preparation, dosimetric signal amplitude evaluation and unknown dose estimate. Worldwide efforts in the field of EPR dose reconstruction with tooth enamel are focused on the optimization of the three mentioned steps in dose assessment. In the present work, the protocol implemented at ISS in the framework of the European Community Nuclear Fission Safety project 'Dose Reconstruction' is presented. A combined mechanical-chemical procedure for ground enamel sample preparation is used. The signal intensity evaluation is carried out with powder spectra simulation program. Finally, the unknown dose is evaluated individually for each sample with the additive dose method. The unknown dose is obtained by subtracting a mean native dose from the back-extrapolated dose. As an example of the capability of the ISS protocol in unknown dose evaluation, the results obtained in the framework of the 2nd International Intercomparison on EPR tooth enamel dosimetry are reported

  19. Active or passive systems? The EPR approach

    International Nuclear Information System (INIS)

    Bonhomme, N.; Py, J.P.

    1996-01-01

    In attempting to review how EPR is contemplated to meet requirements applicable to future nuclear power plants, the authors indicate where they see the markets and the corresponding unit sizes for the EPR which is a generic key factor for competitiveness. There are no reason in industrialized countries, other than USA (where the investment and amortizing practices under control by Public Utility Commission are quite particular), not to build future plants in the 1000 to 1500 MWe range. Standardization, which has been actively applied all along the French program and for the Konvoi plants, does not prevent evolution and allows to concentrate large engineering effort in smooth realization of plants and achieve actual construction and commissioning without significant delays. In order to contribute to public trust renewal, a next generation of power reactors should be fundamentally less likely to incur serious accidents. To reach this goal the best of passive and active systems must be considered without forgetting that the most important source of knowledge is construction and operating experience. Criteria to assess passive systems investigated for possible implementation in the EPR, such as simplicity of design, impact on plant operation, safety and cost, are discussed. Examples of the principal passive systems investigated are described and reasons why they have been dropped after screening through the criteria are given. (author). 11 figs

  20. Comparative study of some new EPR dosimeters

    International Nuclear Information System (INIS)

    Alzimami, K.S.; Maghraby, Ahmed M.; Bradley, D.A.

    2014-01-01

    Investigations have been made of four new radiation dosimetry EPR candidates from the same family of materials: sulfamic acid, sulfanillic acid, homotaurine, and taurine. Mass energy attenuation coefficients, mass stopping power values and the time dependence of the radiation induced radicals are compared. Also investigated are the microwave saturation behavior and the effect of applied modulation amplitude on both peak-to-peak line width (W PP ) and peak-to-peak signal height (H PP ). The dosimeters are characterized by simple spectra and stable radiation-induced radicals over reasonable durations, especially in taurine dosimeters. Sulfamic acid dosimeters possessed the highest sensitivity followed by taurine and homotaurine and sulfanillic. - Highlights: ► Several EPR dosimeters were suggested based on SO 3 − radical. ► Taurine, homotaurine, sulfanilic, and sulfamic acid all possess simple EPR spectra. ► Dosimeters were compared to each other in terms of the dosimetric point of view. ► Energy dependence curves of the selected dosimeters were compared to eachother

  1. Active or passive systems? The EPR approach

    Energy Technology Data Exchange (ETDEWEB)

    Bonhomme, N [Nuclear Power International, Cedex (France); Py, J P [FRAMATOME, Cedex (France)

    1996-12-01

    In attempting to review how EPR is contemplated to meet requirements applicable to future nuclear power plants, the authors indicate where they see the markets and the corresponding unit sizes for the EPR which is a generic key factor for competitiveness. There are no reason in industrialized countries, other than USA (where the investment and amortizing practices under control by Public Utility Commission are quite particular), not to build future plants in the 1000 to 1500 MWe range. Standardization, which has been actively applied all along the French program and for the Konvoi plants, does not prevent evolution and allows to concentrate large engineering effort in smooth realization of plants and achieve actual construction and commissioning without significant delays. In order to contribute to public trust renewal, a next generation of power reactors should be fundamentally less likely to incur serious accidents. To reach this goal the best of passive and active systems must be considered without forgetting that the most important source of knowledge is construction and operating experience. Criteria to assess passive systems investigated for possible implementation in the EPR, such as simplicity of design, impact on plant operation, safety and cost, are discussed. Examples of the principal passive systems investigated are described and reasons why they have been dropped after screening through the criteria are given. (author). 11 figs.

  2. Factors influencing EPR dosimetry in fingernails

    International Nuclear Information System (INIS)

    Dubner, D.L.; Spinella, M.R.; Bof, E.

    2010-01-01

    The technique based on the detection of ionizing radiation induced radicals by EPR in tooth enamel is an established method for the dosimetry of exposed persons in radiological emergencies. Dosimetry based on EPR spectral analysis of fingernail clippings, currently under development, has the practical advantage of the easier sample collection. A limiting factor is that overlapping the radiation induced signal (RIS), fingernails have shown the presence of two mechanically induced signals, called MIS1 and MIS2, due to elastic and plastic deformation respectively, at the time of fingernails cutting. With a water treatment, MIS1 is eliminated while MIS2 is considerably reduced. The calibration curves needed for radiation accident dosimetry should have 'universal' characteristics, ie. Represent the variability that can be found in different individuals. Early studies were directed to the analysis of factors affecting the development of such universal calibration curves. The peak to peak amplitude of the signal before and after the water treatment as well as the effect of size and number of clippings were studied. Furthermore, the interpersonal and intrapersonal variability were analyzed. Taking into account these previous studies, the optimal conditions for measurement were determined and EPR spectra of samples irradiated at different doses were used for the developing of dose-response curves. This paper presents the analysis of the results.(authors) [es

  3. Overcoming barriers to implementing patient-reported outcomes in an electronic health record: a case report.

    Science.gov (United States)

    Harle, Christopher A; Listhaus, Alyson; Covarrubias, Constanza M; Schmidt, Siegfried Of; Mackey, Sean; Carek, Peter J; Fillingim, Roger B; Hurley, Robert W

    2016-01-01

    In this case report, the authors describe the implementation of a system for collecting patient-reported outcomes and integrating results in an electronic health record. The objective was to identify lessons learned in overcoming barriers to collecting and integrating patient-reported outcomes in an electronic health record. The authors analyzed qualitative data in 42 documents collected from system development meetings, written feedback from users, and clinical observations with practice staff, providers, and patients. Guided by the Unified Theory on the Adoption and Use of Information Technology, 5 emergent themes were identified. Two barriers emerged: (i) uncertain clinical benefit and (ii) time, work flow, and effort constraints. Three facilitators emerged: (iii) process automation, (iv) usable system interfaces, and (v) collecting patient-reported outcomes for the right patient at the right time. For electronic health record-integrated patient-reported outcomes to succeed as useful clinical tools, system designers must ensure the clinical relevance of the information being collected while minimizing provider, staff, and patient burden. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Retrospective individual dosimetry using EPR of tooth enamel

    International Nuclear Information System (INIS)

    Skvortzo, V.; Ivannikov, A.; Stepanenko, V.; Wieser, A.; Bougai, A.; Brick, A.; Chumak, V.; Radchuk, V.; Repin, V.; Kirilov, V.

    1996-01-01

    The results of joint investigations (in the framework of ECP-10 program) aimed on the improvement of the sensitivity and accuracy of the procedure of dose measurement using tooth enamel EPR spectroscopy are presented. It is shown, what the sensitivity of method may be increased using special physical-chemical procedure of the enamel samples treatment, which leads to the reducing of EPR signal of organic components in enamel. Tooth diseases may have an effect on radiation sensitivity of enamel. On the basis of statistical analysis of the results of more then 2000 tooth enamel samples measurements it was shown, what tooth enamel EPR spectroscopy gives opportunity to register contribution into total dose, which is caused by natural environmental radiation and by radioactive contamination. EPR response of enamel to ultraviolet exposure is investigated and possible influences to EPR dosimetry is discussed. The correction factors for EPR dosimetry in real radiation fields are estimated

  5. Use of the Frank sequence in pulsed EPR

    DEFF Research Database (Denmark)

    Tseitlin, Mark; Quine, Richard W.; Eaton, Sandra S.

    2011-01-01

    The Frank polyphase sequence has been applied to pulsed EPR of triarylmethyl radicals at 256MHz (9.1mT magnetic field), using 256 phase pulses. In EPR, as in NMR, use of a Frank sequence of phase steps permits pulsed FID signal acquisition with very low power microwave/RF pulses (ca. 1.5m......W in the application reported here) relative to standard pulsed EPR. A 0.2mM aqueous solution of a triarylmethyl radical was studied using a 16mm diameter cross-loop resonator to isolate the EPR signal detection system from the incident pulses. Keyword: Correlation spectroscopy,Multi-pulse EPR,Low power pulses,NMR,EPR...

  6. Classifying Normal and Abnormal Status Based on Video Recordings of Epileptic Patients

    Directory of Open Access Journals (Sweden)

    Jing Li

    2014-01-01

    Full Text Available Based on video recordings of the movement of the patients with epilepsy, this paper proposed a human action recognition scheme to detect distinct motion patterns and to distinguish the normal status from the abnormal status of epileptic patients. The scheme first extracts local features and holistic features, which are complementary to each other. Afterwards, a support vector machine is applied to classification. Based on the experimental results, this scheme obtains a satisfactory classification result and provides a fundamental analysis towards the human-robot interaction with socially assistive robots in caring the patients with epilepsy (or other patients with brain disorders in order to protect them from injury.

  7. Investigating the recording and accuracy of fluid balance monitoring in critically ill patients

    Directory of Open Access Journals (Sweden)

    Annette Diacon

    2014-11-01

    Full Text Available Background. The accurate assessment of fluid balance data collected during physical assessment as well as during monitoring and record-keeping forms an essential part of the baseline patient information that guides medical and nursing interventions aimed at achieving physiological stability in patients. An informal audit of 24-hour fluid balance records in a local intensive care unit (ICU showed that seven out of ten fluid balance calculations were incorrect.Objective. To identify and describe current clinical nursing practice in fluid balance monitoring and measurement accuracy in ICUs, conducted as part of a broader study in partial fulfilment of a Master of Nursing degree.Methods. A quantitative approach utilising a descriptive, exploratory study design was applied. An audit of 103 ICU records was conducted to establish the current practices and accuracy in recording of fluid balance monitoring. Data were collected using a purpose-designed tool based on relevant literature and practice experience. Results. Of the original recorded fluid balance calculations, 79% deviated by more than 50 mL from the audited calculations. Further­more, a significant relationship was shown between inaccurate fluid balance calculation and administration of diuretics (p=0.01. Conclusion. The majority of fluid balance records were incorrectly calculated.

  8. When and How Should Clinicians Share Details from a Health Record with Patients with Mental Illness?

    Science.gov (United States)

    Thom, Robyn P; Farrell, Helen M

    2017-03-01

    Stigma associated with mental illness-a public health crisis-is perpetuated by the language used to describe and document it. Psychiatric pathology and how it can be perceived among clinicians contribute to the marginalization of patients, which exacerbates their vulnerability. Clinical documentation of mental illness has long been mired in pejorative language that perpetuates negative assumptions about those with mental illness. Although patients have the legal right to view their health record, sharing mental health notes with patients remains a sensitive issue, largely due to clinicians' fears that review of this content might cause harm, specifically psychiatric destabilization. However, the ethical principles of justice, beneficence, and autonomy as well as nonmaleficence must be considered by clinicians in determining when and how to share psychiatric details from a health record with their patients. © 2017 American Medical Association. All Rights Reserved.

  9. Confirmation of a second EPR to be built at Penly

    International Nuclear Information System (INIS)

    Anon.

    2009-01-01

    The French government has made public its decision to launch the construction of a second EPR in France. This EPR is planned to be built on the Penly site (northern region of France). EDF will manage this project but other investors like GDF-Suez are invited to participate. The construction works are planned to begin in 2012 for a commissioning in 2017. This reactor will be the fifth EPR being built in the world. (A.C.)

  10. Corridor consultations and the medical microbiological record: is patient safety at risk?

    Science.gov (United States)

    Heard, S R; Roberts, C; Furrows, S J; Kelsey, M; Southgate, L

    2003-01-01

    The performance procedures of the General Medical Council are aimed at identifying seriously deficient performance in a doctor. The performance procedures require the medical record to be of a standard that enables the next doctor seeing the patient to give adequate care based on the available information. Setting standards for microbiological record keeping has proved difficult. Over one fifth of practising medical microbiologists (including virologists) in the UK (139 of 676) responded to a survey undertaken by the working group developing the performance procedures for microbiology, to identify current practice and to develop recommendations for agreement within the profession about the standards of the microbiological record. The cumulative frequency for the surveyed recording methods used indicated that at various times 65% (90 of 139) of respondents used a daybook, 62% (86 of 139) used the back of the clinical request card, 57% (79 of 139) used a computer record, and 22% (30 of 139) used an index card system to record microbiological advice, suggesting wide variability in relation to how medical microbiologists maintain clinical records. PMID:12499432

  11. The EPR investigation of tooth enamel for measurements of tooth enamel for measurements of absorbed gamma doses of people irradiated in Chernobyl accident

    International Nuclear Information System (INIS)

    Baran, N.P.; Barchuk, V.I.; Bar'yakhtar, V.G.; Bugaj, A.A.; Koval', G.N.; Maksimenko, V.M.; Berezhnoj, A.B.; Zakharash, M.P.; AN Ukrainskoj SSR, Kiev

    1993-01-01

    The EPR spectra of the tooth enamel of Chernobyl 'liquidators' were investigated. A lot of people were engaged in work at the Chernobyl area after the accident in 1986. A part of them is under regular medical control at the Ukrainian security service hospital. When patients lose the teeth for some reasons the EPR spectra of radiation centers in tooth enamel caused by emergency gamma radiation were investigated. The measurement of the intensities of the EPR spectra give the real individual absorbed doses of gamma radiation which are much higher than the official values registered in the medical cards of liquidators

  12. Two-dimensional 220 MHz Fourier transform EPR imaging

    International Nuclear Information System (INIS)

    Placidi, Giuseppe; Brivati, John A.; Alecci, Marcello; Testa, Luca; Sotgiu, Antonello

    1998-01-01

    In the last decade radiofrequency continuous-wave EPR spectrometers have been developed to detect and localize free radicals in vivo. Only recently, pulsed radiofrequency EPR spectrometers have been described for imaging applications with small samples. In the present work, we show the first two-dimensional image obtained at 220 MHz on a large phantom (40 ml) that simulates typical conditions of in vivo EPR imaging. This pulsed EPR apparatus has the potential to make the time required for three-dimensional imaging compatible with the biological half-life of normally used paramagnetic probes. (author)

  13. Identification of gamma-irradiated fruit juices by EPR spectroscopy

    International Nuclear Information System (INIS)

    Aleksieva, K.I.; Dimov, K.G.; Yordanov, N.D.

    2014-01-01

    The results of electron paramagnetic resonance (EPR) study on commercially available juices from various fruits and different fruit contents: 25%, 40%, 50%, and 100%, homemade juices, nectars and concentrated fruit syrups, before and after gamma-irradiation are reported. In order to remove water from non- and irradiated samples all juices and nectars were filtered; the solid residue was washed with alcohol and dried at room temperature. Only concentrated fruit syrups were dried for 60 min at 40 °C in a standard laboratory oven. All samples under study show a singlet EPR line with g=2.0025 before irradiation with exception of concentrated fruit syrups, which are EPR silent. Irradiation of juice samples gives rise to complex EPR spectra which gradually transferred to “cellulose-like” EPR spectrum from 25% to 100% fruit content. Concentrated fruit syrups show typical “sugar-like“ spectra due to added saccharides. All EPR spectra are characteristic and can prove radiation treatment. The fading kinetics of radiation-induced EPR signals were studied for a period of 60 days after irradiation. - Highlights: • The EPR analysis of juices, nectars and syrups proves that the sample has been irradiated. • Two sample preparation procedures were used. • The stability of the radiation induced EPR signals was studied over 2 months. • Application of European standards can be extended for irradiated juices and syrups

  14. The six P’s of the next step in electronic patient records in the Netherlands

    NARCIS (Netherlands)

    Michel-Verkerke, Margreet B.; Stegwee, Robert A.; Spil, Antonius A.M.

    2015-01-01

    The objective of this study was to evaluate a decade of Electronic Patient Record development. During the study a second question was added: How to take the next step in the Netherlands? This paper describes the developments but the main results create a framework for the future situation. The USE

  15. 42 CFR 2.2 - Statutory authority for confidentiality of alcohol abuse patient records.

    Science.gov (United States)

    2010-10-01

    ... HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction.... (B) To qualified personnel for the purpose of conducting scientific research, management audits, financial audits, or program evaluation, but such personnel may not identify, directly or indirectly, any...

  16. Continuous event recorders did not affect anxiety or quality of life in patients with palpitations

    NARCIS (Netherlands)

    Hoefman, Emmy; Boer, Kimberly R.; van Weert, Henk C. P. M.; Reitsma, Johannes B.; Koster, Rudolf W.; Bindels, Patrick J. P.

    2007-01-01

    OBJECTIVES: Palpitations can generate feelings of anxiety and decrease quality of life (QoL) due to fear of a cardiac abnormality. Continuous event recorders (CERs) have proven to be successful in diagnosing causes of palpitations but may affect patient QoL and anxiety. The aim is to determine

  17. Design of a consumer health record for supporting the patient-centered management of chronic diseases.

    NARCIS (Netherlands)

    de Clerq, P.A.; Hasman, A.; Wolffenbuttel, B.H.R.

    2001-01-01

    : Medinfo 2001;10(Pt 2):1445-9 Related Articles, Books, LinkOut Design of a consumer health record for supporting the patient-centered management of chronic diseases. de Clercq PA, Hasman A, Wolffenbuttel BH. Department of Medical Informatics, University of Maastricht, Maastricht, The Netherlands.

  18. Wireless connection of continuous glucose monitoring system to the electronic patient record

    Science.gov (United States)

    Murakami, Alexandre; Gutierrez, Marco A.; Lage, Silvia G.; Rebelo, Marina S.; Granja, Luiz A. R.; Ramires, Jose A. F.

    2005-04-01

    The control of blood sugar level (BSL) at near-normal levels has been documented to reduce both acute and chronic complications of diabetes mellitus. Recent studies suggested, the reduction of mortality in a surgical intensive care unit (ICU), when the BSL are maintained at normal levels. Despite of the benefits appointed by these and others clinical studies, the strict BSL control in critically ill patients suffers from some difficulties: a) medical staff need to measure and control the patient"s BSL using blood sample at least every hour. This is a complex and time consuming task; b) the inaccuracy of standard capillary glucose monitoring (fingerstick) in hypotensive patients and, if frequently used to sample arterial or venous blood, may lead to excess phlebotomy; c) there is no validated procedure for continuously monitoring of BSL levels. This study used the MiniMed CGMS in ill patients at ICU to send, in real-time, BSL values to a Web-Based Electronic Patient Record. The BSL values are parsed and delivered through a wireless network as an HL7 message. The HL7 messages with BSL values are collected, stored into the Electronic Patient Record and presented into a bed-side monitor at the ICU together with other relevant patient information.

  19. Analysis of free text in electronic health records for identification of cancer patient trajectories

    DEFF Research Database (Denmark)

    Jensen, Kasper; Soguero-Ruiz, Cristina; Mikalsen, Karl Oyvind

    2017-01-01

    With an aging patient population and increasing complexity in patient disease trajectories, physicians are often met with complex patient histories from which clinical decisions must be made. Due to the increasing rate of adverse events and hospitals facing financial penalties for readmission......, there has never been a greater need to enforce evidence-led medical decision-making using available health care data. In the present work, we studied a cohort of 7,741 patients, of whom 4,080 were diagnosed with cancer, surgically treated at a University Hospital in the years 2004-2012. We have developed...... a methodology that allows disease trajectories of the cancer patients to be estimated from free text in electronic health records (EHRs). By using these disease trajectories, we predict 80% of patient events ahead in time. By control of confounders from 8326 quantified events, we identified 557 events...

  20. Locations of radical species in black pepper seeds investigated by CW EPR and 9GHz EPR imaging.

    Science.gov (United States)

    Nakagawa, Kouichi; Epel, Boris

    2014-10-15

    In this study, noninvasive 9GHz electron paramagnetic resonance (EPR)-imaging and continuous wave (CW) EPR were used to investigate the locations of paramagnetic species in black pepper seeds without further irradiation. First, lithium phthalocyanine (LiPC) phantom was used to examine 9GHz EPR imaging capabilities. The 9GHz EPR-imager easily resolved the LiPC samples at a distance of ∼2mm. Then, commercially available black pepper seeds were measured. We observed signatures from three different radical species, which were assigned to stable organic radicals, Fe(3+), and Mn(2+) complexes. In addition, no EPR spectral change in the seed was observed after it was submerged in distilled H2O for 1h. The EPR and spectral-spatial EPR imaging results suggested that the three paramagnetic species were mostly located at the seed surface. Fewer radicals were found inside the seed. We demonstrated that the CW EPR and 9GHz EPR imaging were useful for the determination of the spatial distribution of paramagnetic species in various seeds. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Atrial fibrillation detected by external loop recording for seven days or two-day simultaneous Holter recording: A comparison in patients with ischemic stroke or transient ischemic attack.

    Science.gov (United States)

    Sejr, Michala Herskind; Nielsen, Jens Cosedis; Damgaard, Dorte; Sandal, Birgitte Forsom; May, Ole

    Atrial fibrillation (AF) is the most common cardiac cause of ischemic stroke and transient ischemic attack (IS/TIA). To compare the diagnostic value of seven-day external loop recording (ELR) and two-day Holter recording for detecting AF after IS/TIA. 191 IS/TIA patients without AF history. Endpoint was AF >30s. We started two-day Holter recording and seven-day ELR simultaneously. Seven-day ELR and two-day Holter recording detected the same three AF patients. ELR detected another six patients with AF adjudicated by cardiologists, four detections after Holter (3 vs. 7, p=0.125) and two false-positive detections during Holter. Seven-day ELR automatically classified 50/191 patients (26%) with AF, but only 7/50 (14%) were confirmed as AF by cardiologists. Seven-day ELR did not detect significantly more patients with AF than two-day Holter recording. 86% of patients with ELR-classified AF were false positives, indicating a poor performance of the automatic AF detection algorithm used. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Honoring Dental Patients' Privacy Rule Right of Access in the Context of Electronic Health Records.

    Science.gov (United States)

    Ramoni, Rachel B; Asher, Sheetal R; White, Joel M; Vaderhobli, Ram; Ogunbodede, Eyitope O; Walji, Muhammad F; Riedy, Christine; Kalenderian, Elsbeth

    2016-06-01

    A person's right to access his or her protected health information is a core feature of the U.S. Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. If the information is stored electronically, covered entities must be able to provide patients with some type of machine-readable, electronic copy of their data. The aim of this study was to understand how academic dental institutions execute the Privacy Rule's right of access in the context of electronic health records (EHRs). A validated electronic survey was distributed to the clinical deans of 62 U.S. dental schools during a two-month period in 2014. The response rate to the survey was 53.2% (N=33). However, three surveys were partially completed, and of the 30 completed surveys, the 24 respondents who reported using axiUm as the EHR at their dental school clinic were the ones on which the results were based (38.7% of total schools at the time). Of the responses analyzed, 86% agreed that clinical modules should be considered part of a patient's dental record, and all agreed that student teaching-related modules should not. Great variability existed among these clinical deans as to whether administrative and financial modules should be considered part of a patient record. When patients request their records, close to 50% of responding schools provide the information exclusively on paper. This study found variation among dental schools in their implementation of the Privacy Rule right of access, and although all the respondents had adopted EHRs, a large number return records in paper format.

  3. Investigating the Extent to Which Patients Should Control Access to Patient Records for Research: A Deliberative Process Using Citizens’ Juries

    Science.gov (United States)

    Bozentko, Kyle; Clement, Sarah; Hunn, Amanda; Hassan, Lamiece; Norris, Ruth; Oswald, Malcolm; Peek, Niels

    2018-01-01

    Background The secondary use of health data for research raises complex questions of privacy and governance. Such questions are ill-suited to opinion polling where citizens must choose quickly between multiple-choice answers based on little information. Objective The aim of this project was to extend knowledge about what control informed citizens would seek over the use of health records for research after participating in a deliberative process using citizens’ juries. Methods Two 3-day citizens’ juries, of 17 citizens each, were convened to reflect UK national demographics from 355 eligible applicants. Each jury addressed the mission “To what extent should patients control access to patient records for secondary use?” Jurors heard from and questioned 5 expert witnesses (chosen either to inform the jury, or to argue for and against the secondary use of data), interspersed with structured opportunities to deliberate among themselves, including discussion and role-play. Jurors voted on a series of questions associated with the jury mission, giving their rationale. Individual views were polled using questionnaires at the beginning and at end of the process. Results At the end of the process, 33 out of 34 jurors voted in support of the secondary use of data for research, with 24 wanting individuals to be able to opt out, 6 favoring opt in, and 3 voting that all records should be available without any consent process. When considering who should get access to data, both juries had very similar rationales. Both thought that public benefit was a key justification for access. Jury 1 was more strongly supportive of sharing patient records for public benefit, whereas jury 2 was more cautious and sought to give patients more control. Many jurors changed their opinion about who should get access to health records: 17 people became more willing to support wider information sharing of health data for public benefit, whereas 2 moved toward more patient control over

  4. Contribution of Harold M. Swartz to In Vivo EPR and EPR Dosimetry.

    Science.gov (United States)

    Gallez, Bernard

    2016-12-01

    In 2015, we are celebrating half a century of research in the application of Electron Paramagnetic Resonance (EPR) as a biodosimetry tool to evaluate the dose received by irradiated people. During the EPR Biodose 2015 meeting, a special session was organized to acknowledge the pioneering contribution of Harold M. (Hal) Swartz in the field. The article summarizes his main contribution in physiology and medicine. Four emerging themes have been pursued continuously along his career since its beginning: (1) radiation biology; (2) oxygen and oxidation; (3) measuring physiology in vivo; and (4) application of these measurements in clinical medicine. The common feature among all these different subjects has been the use of magnetic resonance techniques, especially EPR. In this article, you will find an impressionist portrait of Hal Swartz with the description of the 'making of' this pioneer, a time-line perspective on his career with the creation of three National Institutes of Health-funded EPR centers, a topic-oriented perspective on his career with a description of his major contributions to Science, his role as a mentor and his influence on his academic children, his active role as founder of scientific societies and organizer of scientific meetings, and the well-deserved international recognition received so far. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Contribution of Harold M. Swartz to In Vivo EPR and EPR Dosimetry

    International Nuclear Information System (INIS)

    Gallez, Bernard

    2016-01-01

    In 2015, we are celebrating half a century of research in the application of Electron Paramagnetic Resonance (EPR) as a biodosimetry tool to evaluate the dose received by irradiated people. During the EPR Biodose 2015 meeting, a special session was organized to acknowledge the pioneering contribution of Harold M. (Hal) Swartz in the field. The article summarizes his main contribution in physiology and medicine. Four emerging themes have been pursued continuously along his career since its beginning: (1) radiation biology; (2) oxygen and oxidation; (3) measuring physiology in vivo; and (4) application of these measurements in clinical medicine. The common feature among all these different subjects has been the use of magnetic resonance techniques, especially EPR. In this article, you will find an impressionist portrait of Hal Swartz with the description of the 'making of' this pioneer, a time-line perspective on his career with the creation of three National Institutes of Health-funded EPR centers, a topic-oriented perspective on his career with a description of his major contributions to Science, his role as a mentor and his influence on his academic children, his active role as founder of scientific societies and organizer of scientific meetings, and the well-deserved international recognition received so far. (author)

  6. Improving Self-Care of Patients with Chronic Disease using Online Personal Health Record

    Directory of Open Access Journals (Sweden)

    Amol Wagholikar

    2012-09-01

    Full Text Available Background Effective management of chronic diseases such as prostate cancer is important. Research suggests a tendency to use self-care treatment options such as over-the-counter (OTC complementary medications among prostate cancer patients. The current trend in patient-driven recording of health data in an online Personal Health Record (PHR presents an opportunity to develop new data-driven approaches for improving prostate cancer patient care. However, the ability of current online solutions to share patients’ data for better decision support is limited. An informatics approach may improve online sharing of self-care interventions among these patients. It can also provide better evidence to support decisions made during their self-managed care.Aims To identify requirements for an online system and describe a new case-based reasoning (CBR method for improving self-care of advanced prostate cancer patients in an online PHR environment. Method A non-identifying online survey was conducted to understand self-care patterns among prostate cancer patients and to identify requirements for an online information system. The pilot study was carried out between August 2010 and December 2010. A case-base of 52 patients was developed. Results The data analysis showed self-care patterns among the prostate cancer patients. Selenium (55% was the common complementary supplement used by the patients. Paracetamol (about 45% was the commonly used OTC by the patients. Conclusion The results of this study specified requirements for an online case-based reasoning information system. The outcomes of this study are being incorporated in design of the proposed Artificial Intelligence (AI driven patient journey browser system. A basic version of the proposed system is currently being considered for implementation.

  7. EPR: what has it taught us

    International Nuclear Information System (INIS)

    Stapp, H.P.

    1985-05-01

    This symposium commemorating the fiftieth anniversary of the paper of Einstein, Podolsky, and Rosen is a fitting place to review what that work and its sequels have taught us. Prima facie, the EPR paper appears to have been exceedingly counter-productive for the following reasons: (1) The work was quickly rebutted by Bohr, and this rebuttal was apparently accepted by most workers in the field. (2) Scientists who adopted the position advocated by Bohr have produced, in the intervening fifty years, a marvelous body of useful theory, whereas those following the course suggested by EPR have produced nothing of any certified practical value. (3) It has been shown by Bell that the conclusion reached by EPR is incompatible with their assumptions. Chemists and physicists have recently begun to examine the behavior of quantum mechanical systems that are very small, yet large enough to influence their environment in ways that appreciably modify their own behavior, vis-a-vis the behavior they would have if isolated. Because these systems are neither small enough to be treated as isolated (or as residing in a classically described environment) between preparation and detection, nor large enough to be treated classically, they do not conform to the format demanded by the Copenhagen interpretation. Indeed, the behavior of these systems depends on ontological considerations that were irrelevant in the situations covered by the Copenhagen interpretation, and that were systematically ignored in that interpretation. Scientists now face the task of enlarging the scope of quantum theory to cover these new situations, and comparing the empirical consequences of various ontological assumptions. 17 refs

  8. Characterizing EPR-mediated passive drug targeting using contrast-enhanced functional ultrasound imaging.

    Science.gov (United States)

    Theek, Benjamin; Gremse, Felix; Kunjachan, Sijumon; Fokong, Stanley; Pola, Robert; Pechar, Michal; Deckers, Roel; Storm, Gert; Ehling, Josef; Kiessling, Fabian; Lammers, Twan

    2014-05-28

    The Enhanced Permeability and Retention (EPR) effect is extensively used in drug delivery research. Taking into account that EPR is a highly variable phenomenon, we have here set out to evaluate if contrast-enhanced functional ultrasound (ceUS) imaging can be employed to characterize EPR-mediated passive drug targeting to tumors. Using standard fluorescence molecular tomography (FMT) and two different protocols for hybrid computed tomography-fluorescence molecular tomography (CT-FMT), the tumor accumulation of a ~10 nm-sized near-infrared-fluorophore-labeled polymeric drug carrier (pHPMA-Dy750) was evaluated in CT26 tumor-bearing mice. In the same set of animals, two different ceUS techniques (2D MIOT and 3D B-mode imaging) were employed to assess tumor vascularization. Subsequently, the degree of tumor vascularization was correlated with the degree of EPR-mediated drug targeting. Depending on the optical imaging protocol used, the tumor accumulation of the polymeric drug carrier ranged from 5 to 12% of the injected dose. The degree of tumor vascularization, determined using ceUS, varied from 4 to 11%. For both hybrid CT-FMT protocols, a good correlation between the degree of tumor vascularization and the degree of tumor accumulation was observed, within the case of reconstructed CT-FMT, correlation coefficients of ~0.8 and p-values of EPR, and potentially also to pre-select patients likely to respond to passively tumor-targeted nanomedicine treatments. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Identification of Patient Safety Risks Associated with Electronic Health Records: A Software Quality Perspective.

    Science.gov (United States)

    Virginio, Luiz A; Ricarte, Ivan Luiz Marques

    2015-01-01

    Although Electronic Health Records (EHR) can offer benefits to the health care process, there is a growing body of evidence that these systems can also incur risks to patient safety when developed or used improperly. This work is a literature review to identify these risks from a software quality perspective. Therefore, the risks were classified based on the ISO/IEC 25010 software quality model. The risks identified were related mainly to the characteristics of "functional suitability" (i.e., software bugs) and "usability" (i.e., interface prone to user error). This work elucidates the fact that EHR quality problems can adversely affect patient safety, resulting in errors such as incorrect patient identification, incorrect calculation of medication dosages, and lack of access to patient data. Therefore, the risks presented here provide the basis for developers and EHR regulating bodies to pay attention to the quality aspects of these systems that can result in patient harm.

  10. The PHARMS (Patient Held Active Record of Medication Status) feasibility study: a research proposal.

    LENUS (Irish Health Repository)

    Walsh, Elaine

    2018-01-08

    Medication errors are a major source of preventable morbidity, mortality and cost and many occur at the times of hospital admission and discharge. Novel interventions (such as new methods of recording medication information and conducting medication reconciliation) are required to facilitate accurate transfer of medication information. With existing evidence supporting the use of information technology and the patient representing the one constant in the care process, an electronic patient held medication record may provide a solution. This study will assess the feasibility of introducing a patient held electronic medication record in primary and secondary care using the Consolidated Framework for Implementation Research (CFIR).This feasibility study is a mixed method study of community dwelling older adult patients admitted to an urban secondary care facility comprising a non-randomised intervention and qualitative interviews with key stakeholders. Outcomes of interest include clinical outcomes and process evaluation.This study will yield insights pertaining to feasibility, acceptability and participation for a more definitive evaluation of the intervention. The study also has the potential to contribute to knowledge of implementation of technology in a healthcare context and to the broader area of implementation science.

  11. Self-Reported Interview-Assisted Diet Records Underreport Energy Intake in Maintenance Hemodialysis Patients.

    Science.gov (United States)

    Shapiro, Bryan B; Bross, Rachelle; Morrison, Gillian; Kalantar-Zadeh, Kamyar; Kopple, Joel D

    2015-07-01

    Studies suggest that maintenance hemodialysis (MHD) patients report dietary energy intakes (EIs) that are lower than what is actually ingested. Data supporting this conclusion have several important limitations. The present study introduces a novel approach of assessing underreporting of EI in MHD patients. Comparisons of EI of free-living MHD patients determined from food records to their measured energy needs. Metabolic research ward. Thirteen clinically stable MHD patients with unchanging weights whose EI was assessed by dietitian interview-assisted 3-day food records. EI was compared with (1) patients' resting energy expenditure (REE), measured by indirect calorimetry, and estimated total energy expenditure (TEE) and (2) patients' dietary energy requirements (DER) measured while patients underwent nitrogen balance studies and consumed a constant energy diet in a research ward for a mean duration of 89.5 days. DER was calculated as the actual EI during the research study corrected for changes in body fat and lean body mass measured by Dual X-Ray Absorptiometry. Underreporting of EI was determined by an EI:REE ratio <1.27 and an EI:TEE ratio or EI:DEE ratio <1.0. Seven of the 13 MHD patients studied were male. Patient's ages were 47.7 ± standard deviation 9.7 years; body mass index averaged 25.4 ± 2.8 kg/m2, and dialysis vintage was 53.3 ± 37.1 months. The EI:REE ratio (1.03 ± 0.23) was significantly less than the cutoff value for underreporting of 1.27 (P = .001); 12 of 13 patients had EI:REE ratios <1.27. The mean EI:TEE ratio was significantly less than the cutoff value of 1.0 (0.73 ± 0.17, P < .0001), and 12 MHD patients had EI:TEE ratios <1.0. The EI:DER ratio was also <1.0 (0.83 ± 0.25, P = .012), and 10 MHD had EI:DER ratios <1.0. Dietitian interview-assisted diet records by MHD patients substantially underestimate the patient's dietary EI. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  12. Modified automatic R-peak detection algorithm for patients with epilepsy using a portable electrocardiogram recorder.

    Science.gov (United States)

    Jeppesen, J; Beniczky, S; Fuglsang Frederiksen, A; Sidenius, P; Johansen, P

    2017-07-01

    Earlier studies have shown that short term heart rate variability (HRV) analysis of ECG seems promising for detection of epileptic seizures. A precise and accurate automatic R-peak detection algorithm is a necessity in a real-time, continuous measurement of HRV, in a portable ECG device. We used the portable CE marked ePatch® heart monitor to record the ECG of 14 patients, who were enrolled in the videoEEG long term monitoring unit for clinical workup of epilepsy. Recordings of the first 7 patients were used as training set of data for the R-peak detection algorithm and the recordings of the last 7 patients (467.6 recording hours) were used to test the performance of the algorithm. We aimed to modify an existing QRS-detection algorithm to a more precise R-peak detection algorithm to avoid the possible jitter Qand S-peaks can create in the tachogram, which causes error in short-term HRVanalysis. The proposed R-peak detection algorithm showed a high sensitivity (Se = 99.979%) and positive predictive value (P+ = 99.976%), which was comparable with a previously published QRS-detection algorithm for the ePatch® ECG device, when testing the same dataset. The novel R-peak detection algorithm designed to avoid jitter has very high sensitivity and specificity and thus is a suitable tool for a robust, fast, real-time HRV-analysis in patients with epilepsy, creating the possibility for real-time seizure detection for these patients.

  13. A computerised out-patient medical records programme based on the Summary Time-Oriented Record (STOR) System.

    Science.gov (United States)

    Cheong, P Y; Goh, L G; Ong, R; Wong, P K

    1992-12-01

    Advances in microcomputer hardware and software technology have made computerised outpatient medical records practical. We have developed a programme based on the Summary Time-Oriented Record (STOR) system which complements existing paper-based record keeping. The elements of the Problem Oriented Medical Record (POMR) System are displayed in two windows within one screen, namely, the SOAP (Subjective information, Objective information, Assessments and Plans) elements in the Reason For Encounter (RFE) window and the problem list with outcomes in the Problem List (PL) window. Context sensitive child windows display details of plans of management in the RFE window and clinical notes in the PL window. The benefits of such innovations to clinical decision making and practice based research and its medico-legal implications are discussed.

  14. NHS England Patient Online - Patient Access to their Medical Record in General Practice

    Directory of Open Access Journals (Sweden)

    Jana Dale

    2015-10-01

    Patient Online can be promoted quickly and successfully when the clear evidence demonstrates it reduces workload. Its implementation will then result in the improved patient care and changes in behaviour necessary for the NHS National Information Board “Personalised Health and Care 2020” Implementation.

  15. EPR spin trapping of protein radicals

    DEFF Research Database (Denmark)

    Davies, Michael Jonathan; Hawkins, Clare Louise

    2004-01-01

    Electron paramagnetic resonance (EPR) spin trapping was originally developed to aid the detection of low-molecular-mass radicals formed in chemical systems. It has subsequently found widespread use in biology and medicine for the direct detection of radical species formed during oxidative stress...... tumbling radicals are often broad and relatively poor in distinctive features, a number of techniques have been developed that allow a wealth of information to be obtained about the nature, site, and reactions of such radicals. This article summarizes recent developments in this area and reviews selected...... examples of radical formation on proteins....

  16. Ethical Implications of the Electronic Health Record: In the Service of the Patient.

    Science.gov (United States)

    Sulmasy, Lois Snyder; López, Ana María; Horwitch, Carrie A

    2017-08-01

    Electronic health records (EHRs) provide benefits for patients, physicians, and clinical teams, but also raise ethical questions. Navigating how to provide care in the digital age requires an assessment of the impact of the EHR on patient care and the patient-physician relationship. EHRs should facilitate patient care and, as an essential component of that care, support the patient-physician relationship. Billing, regulatory, research, documentation, and administrative functions determined by the operational requirements of health care systems, payers, and others have resulted in EHRs that are better able to satisfy such external functions than to ensure that patient care needs are met. The profession has a responsibility to identify and address this mismatch. This position paper by the American College of Physicians (ACP) Ethics, Professionalism and Human Rights Committee does not address EHR design, user variability, meaningful use, or coding requirements and other government and payer mandates per se; these issues are discussed in detail in ACP's Clinical Documentation policy. This paper focuses on EHRs and the patient-physician relationship and patient care; patient autonomy, privacy and confidentiality; and professionalism, clinical reasoning and training. It explores emerging ethical challenges and concerns for and raised by physicians across the professional lifespan, whose ongoing input is crucial to the development and use of information technology that truly serves patients.

  17. Patient-centered communication in the era of electronic health records: What does the evidence say?

    Science.gov (United States)

    Rathert, Cheryl; Mittler, Jessica N; Banerjee, Sudeep; McDaniel, Jennifer

    2017-01-01

    Patient-physician communication is essential for patient-centered health care. Physicians are concerned that electronic health records (EHRs) negatively affect communication with patients. This study identified a framework for understanding communication functions that influence patient outcomes. We then conducted a systematic review of the literature and organized it within the framework to better understand what is known. A comprehensive search of three databases (CINAHL, Medline, PsycINFO) yielded 41 articles for analysis. Results indicated that EHR use improves capture and sharing of certain biomedical information. However, it may interfere with collection of psychosocial and emotional information, and therefore may interfere with development of supportive, healing relationships. Patient access to the EHR and messaging functions may improve communication, patient empowerment, engagement, and self-management. More rigorous examination of EHR impacts on communication functions and their influences on patient outcomes is imperative for achieving patient-centered care. By focusing on the role of communication functions on patient outcomes, future EHRs can be developed to facilitate care. Training alone is likely to be insufficient to address disruptions to communication processes. Processes must be improved, and EHRs must be developed to capture useful data without interfering with physicians' and patients' abilities to effectively communicate. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Enabling Patient Control of Personal Electronic Health Records Through Distributed Ledger Technology.

    Science.gov (United States)

    Cunningham, James; Ainsworth, John

    2017-01-01

    The rise of distributed ledger technology, initiated and exemplified by the Bitcoin blockchain, is having an increasing impact on information technology environments in which there is an emphasis on trust and security. Management of electronic health records, where both conformation to legislative regulations and maintenance of public trust are paramount, is an area where the impact of these new technologies may be particularly beneficial. We present a system that enables fine-grained personalized control of third-party access to patients' electronic health records, allowing individuals to specify when and how their records are accessed for research purposes. The use of the smart contract based Ethereum blockchain technology to implement this system allows it to operate in a verifiably secure, trustless, and openly auditable environment, features crucial to health information systems moving forward.

  19. E-PR technologies in political party activities

    OpenAIRE

    Tereshchuk Vitaliy Ivanovych

    2016-01-01

    The article discusses the role of the Internet as an important communicative tool in the field of political PR. The article reviews the characteristics of PR-activities on the Internet and the features of e-PR in the political sphere. Particular attention is paid to the system of political party’s e-PR tools.

  20. EPR study on tomatoes before and after gamma-irradiation

    International Nuclear Information System (INIS)

    Aleksieva, K.; Georgieva, L.; Tzvetkova, E.; Yordanov, N.D.

    2009-01-01

    The results from the EPR studies on fresh, air-dried and lyophilized tomato samples before and after gamma-irradiation are reported. Before irradiation fresh and air-dried tomatoes exhibit one singlet EPR line characterized with common g-factor of 2.0048±0.0005, whereas freeze-dried tomato does not show any EPR spectrum. After irradiation, a typical 'cellulose-like' triplet EPR spectrum appears in all samples, attributed to cellulose free radicals, generated by gamma-irradiation. It consists of intense central line with g=2.0048±0.0005 and two weak satellite lines separated ca. 3 mT left and right of it. In air-dried and lyophilized tomatoes the 'cellulose-like' EPR spectrum is superimposed by an additional partly resolved carbohydrate spectrum. Fading measurements of the radiation-induced EPR signals indicate that the intensity of the EPR spectra of air-dried and freeze-dried tomato are reduced to about 50% after 50 days, whereas those of fresh irradiated tomatoes kept at 4 o C fade completely in 15 days. The reported results unambiguously show that the presence of two satellite lines in the EPR 'cellulose-like' spectra of tomato samples can be used for identification of radiation processing.

  1. EPR and NMR spectroscopy on spin-labeled proteins

    NARCIS (Netherlands)

    Finiguerra, Michelina Giuseppina

    2011-01-01

    Spin labeling and electron paramagnetic resonance (EPR) have been employed to study structure and dynamics of proteins. The surface polarity of four single cysteine mutants of the Zn-azurin in frozen solution were studied using 275 GHz EPR (J-band), with the advantage compared to 9 GHz (X-band) and

  2. Case Studies in e-RPL and e-PR

    Science.gov (United States)

    Cameron, Roslyn; Miller, Allison

    2014-01-01

    The use of ePortfolios for recognition of prior learning (e-RPL) and for professional recognition (e-PR) is slowly gaining in popularity in the VET sector however their use is sporadic across educational sectors, disciplines, educational institutions and professions. Added to this is an array of purposes and types of e-RPL and e-PR models and…

  3. Properties of the ammonium tartrate/EPR dosimeter

    International Nuclear Information System (INIS)

    Yordanov, N.D.; Gancheva, V.

    2004-01-01

    The EPR response of γ-irradiated ammonium tartrate on the absorbed dose of γ-rays up to 22 kGy as well as the changes in the shape of the EPR spectrum upon applied modulation amplitude and microwave power are reported. Also the possibility to use ammonium tartrate together with Mn 2+ magnetically diluted in MgO as an internal reference material is evaluated. The influence of the microwave power and the modulation amplitude on their dose response is investigated. The results show that the radiation-induced EPR spectrum of ammonium tartrate, obtained at a low microwave power is complex consisting several patterns and is more easily saturated than the Mn 2+ EPR spectrum. In this case the following settings of the EPR parameters are recommended: H mod ≤0.05 mT and 10≤P MW ≤13 mW. Using these parameters the dosimeters can be considered for use in intercomparisons

  4. On the annealing of the EPR dislocation signal in silicon

    International Nuclear Information System (INIS)

    Zolotukhin, M.N.; Kveder, V.V.; Osip'yan, Yu.A.

    1981-01-01

    The annealing kinetics of the (EPR) dislocation signal (D-centers) in silicon is studied. The disappearance of the dislocation EPR signal as a result of annealing is ascribed to rearrangement of the nuclei of the partial dislocations accompanied by pairwise ''closing'' of the broken bonds in the S=0 state. The height of the energy barrier for the rearrangement process is approximately 2 eV. A residual ''nonannealing'' EPR signal is observed in strongly deformed silicon crystals. It resembles an isotropic line with a width approximately 7.5 Oe and a g-factor approximately 2.006. It is suggested that the respective EPR centers (O-centers) are similar to the EPR centers in amorphic silicon [ru

  5. Costing the EPR Project Using the Real Options Method

    International Nuclear Information System (INIS)

    Epaulard, Anne; Gallon, Stephane

    2001-01-01

    Real options theory makes it possible to cost investments which offer flexibility but whose returns are uncertain, such as the construction in 2000 of an EPR prototype; this prototype will enable the European pressurised-water reactor (EPR) to be used to renew EDF's nuclear power stations in 2020 (flexibility) but its economic worth will then depend on the cost of the competing gas-fired power plants (uncertain return). Options theory shows that investing in EPR technology in 2000 provides sufficient flexibility in 2020 to be considered cost-effective, even though use of EPRs is unlikely by that date. The investment made in 2000 to develop EPR technology therefore actually plays the part of an option or, in other words, insurance (against the risk of high gas prices)

  6. Record High US Measles Cases: Patient Vaccination, Clinical Assessment and Management

    Centers for Disease Control (CDC) Podcasts

    This podcast is an overview of the Clinician Outreach and Communication Activity (COCA) Call: Record High US Measles Cases: Patient Vaccination, Clinical Assessment and Management. In May 2014, the United States recorded the largest number of reported measles cases since 1994 and the number continues to rise. Most cases reported have been acquired in the U.S. and are associated with importations from countries where measles is still common. This highly contagious, acute viral illness spreads quickly in unvaccinated populations once reaching the U.S. The recent measles outbreaks highlight the importance of maintaining high vaccination coverage in the U.S. and ensuring age-appropriate vaccination for international travelers. During this COCA call, clinicians will learn the status of measles in the U.S. and CDC vaccination recommendations and guidelines for patient assessment and management.

  7. Feasibility of utilizing a commercial eye tracker to assess electronic health record use during patient simulation.

    Science.gov (United States)

    Gold, Jeffrey Allen; Stephenson, Laurel E; Gorsuch, Adriel; Parthasarathy, Keshav; Mohan, Vishnu

    2016-09-01

    Numerous reports describe unintended consequences of electronic health record implementation. Having previously described physicians' failures to recognize patient safety issues within our electronic health record simulation environment, we now report on our use of eye and screen-tracking technology to understand factors associated with poor error recognition during an intensive care unit-based electronic health record simulation. We linked performance on the simulation to standard eye and screen-tracking readouts including number of fixations, saccades, mouse clicks and screens visited. In addition, we developed an overall Composite Eye Tracking score which measured when, where and how often each safety item was viewed. For 39 participants, the Composite Eye Tracking score correlated with performance on the simulation (p = 0.004). Overall, the improved performance was associated with a pattern of rapid scanning of data manifested by increased number of screens visited (p = 0.001), mouse clicks (p = 0.03) and saccades (p = 0.004). Eye tracking can be successfully integrated into electronic health record-based simulation and provides a surrogate measure of cognitive decision making and electronic health record usability. © The Author(s) 2015.

  8. EAP recordings in ineraid patients--correlations with psychophysical measures and possible implications for patient fitting.

    Science.gov (United States)

    Zimmerling, Martin J; Hochmair, Erwin S

    2002-04-01

    Objective measurements can be helpful for cochlear implant fitting of difficult populations, as for example very young children. One method, the recording of the electrically evoked compound action potential (EAP), measures the nerve recruitment in the cochlea in response to stimulation through the implant. For coding strategies implemented at a moderate stimulation rate of 250 pps per channel, useful correlations between EAP data and psychophysical data have been already found. With new systems running at higher rates, it is important to check these correlations again. This study investigates the correlations between psychophysical data and EAP measures calculated from EAP amplitude growth functions. EAP data were recorded in 12 Ineraid subjects. Additionally, behavioral thresholds (THR) and maximum acceptable loudness levels (MAL) were determined for stimulation rates of 80 pps and 2,020 pps for each electrode. Useful correlations between EAP data and psychophysical data were found at the low stimulation rate (80 pps). However, at the higher stimulation rate (2,020 pps) correlations were not significant. They were improved substantially, however, by introducing a factor that corrected for disparities due to temporal integration. Incorporation of this factor, which controls for the influence of the stimulation rate on the threshold, improved the correlations between EAP measures recorded at 80 pps and psychophysical MALs measured at 2,020 pps to better than r = 0.70. EAP data as such can only be used to predict behavioral THRs or MCLs at low stimulation rates. To cope with temporal integration effects at higher stimulation rates, EAP data must be rate corrected. The introduction of a threshold-rate-factor is a promising way to achieve that goal. Further investigations need to be performed.

  9. Unreliable patient identification warrants ABO typing at admission to check existing records before transfusion.

    Science.gov (United States)

    Ferrera-Tourenc, V; Lassale, B; Chiaroni, J; Dettori, I

    2015-06-01

    This study describes patient identification errors leading to transfusional near-misses in blood issued by the Alps Mediterranean French Blood Establishment (EFSAM) to Marseille Public Hospitals (APHM) over an 18-month period. The EFSAM consolidates 14 blood banks in southeast France. It supplies 149 hospitals and maintains a centralized database on ABO types used at all area hospitals. As an added precaution against incompatible transfusion, the APHM requires ABO testing at each admission regardless of whether the patient has an ABO record. The study goal was to determine if admission testing was warranted. Discrepancies between ABO type determined by admission testing and records in the centralized database were investigated. The root cause for each discrepancy was classified as specimen collection or patient admission error. Causes of patient admission events were further subclassified as namesake (name similarity) or impersonation (identity fraud). The incidence of ABO discrepancies was 1:2334 including a 1:3329 incidence of patient admission events. Impersonation was the main cause of identity events accounting for 90.3% of cases. The APHM's ABO control policy prevented 19 incompatible transfusions. In relation to the 48,593 packed red cell units transfused, this would have corresponded to a risk of 1:2526. Collecting and storing ABO typing results in a centralized database is an essential public health tool. It allows crosschecking of current test results with past records and avoids redundant testing. However, as patient identification remains unreliable, ABO typing at each admission is still warranted to prevent transfusion errors. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  10. Implementation of computer-based patient records in primary care: the societal health economic effects.

    OpenAIRE

    Arias-Vimárlund, V.; Ljunggren, M.; Timpka, T.

    1996-01-01

    OBJECTIVE: Exploration of the societal health economic effects occurring during the first year after implementation of Computerised Patient Records (CPRs) at Primary Health Care (PHC) centres. DESIGN: Comparative case studies of practice processes and their consequences one year after CPR implementation, using the constant comparison method. Application of transaction-cost analyses at a societal level on the results. SETTING: Two urban PHC centres under a managed care contract in Ostergötland...

  11. Integrating clinical theory and practice in an epilepsy-specific electronic patient record.

    LENUS (Irish Health Repository)

    Breen, Patricia

    2009-01-01

    This study\\'s objective was to assess the usability of the epilepsy history module of the electronic patient record, developed at Beaumont Hospital, and to identify opportunities for improvement. Observation, interview and document analysis methods were used. Results indicated that the module was useable but the design did not work as well in practice as anticipated by theory. The next iteration of the module included identified enhancements; this iteration is currently in use.

  12. Pediatric patients on ketogenic diet undergoing general anesthesia-a medical record review.

    Science.gov (United States)

    Soysal, Elif; Gries, Heike; Wray, Carter

    2016-12-01

    To identify guidelines for anesthesia management and determine whether general anesthesia is safe for pediatric patients on ketogenic diet (KD). Retrospective medical record review. Postoperative recovery area. All pediatric patients who underwent general anesthesia while on KD between 2009 and 2014 were reviewed. We identified 24 patients who underwent a total of 33 procedures. All children were on KD due to intractable epilepsy. The age of patients ranged from 1 to 15 years. General anesthesia for the scheduled procedures. Patients' demographics, seizure history, type of procedure; perioperative blood chemistry, medications including the anesthesia administered, and postoperative complications. Twenty-four patients underwent a total of 33 procedures. The duration of KD treatment at the time of general anesthesia ranged from 4 days to 8 years. Among the 33 procedures, 3 patients had complications that could be attributable to KD and general anesthesia. A 9-year-old patient experienced increased seizures on postoperative day 0. An 8-year-old patient with hydropcephalus developed metabolic acidosis on postoperative day 1, and a 7-year-old patient's procedure was complicated by respiratory distress and increased seizure activity in the postanesthesia care unit. This study showed that it is relatively safe for children on KD to undergo general anesthesia. The 3 complications attributable to general anesthesia were mild, and the increased seizure frequencies in 2 patients returned back to baseline in 24 hours. Although normal saline is considered more beneficial than lactated Ringer's solution in patients on KD, normal saline should also be administered carefully because of the risk of exacerbating patients' metabolic acidosis. One should be aware of the potential change of the ketogenic status due to drugs given intraoperatively. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Identifying patients with hypertension: a case for auditing electronic health record data.

    Science.gov (United States)

    Baus, Adam; Hendryx, Michael; Pollard, Cecil

    2012-01-01

    Problems in the structure, consistency, and completeness of electronic health record data are barriers to outcomes research, quality improvement, and practice redesign. This nonexperimental retrospective study examines the utility of importing de-identified electronic health record data into an external system to identify patients with and at risk for essential hypertension. We find a statistically significant increase in cases based on combined use of diagnostic and free-text coding (mean = 1,256.1, 95% CI 1,232.3-1,279.7) compared to diagnostic coding alone (mean = 1,174.5, 95% CI 1,150.5-1,198.3). While it is not surprising that significantly more patients are identified when broadening search criteria, the implications are critical for quality of care, the movement toward the National Committee for Quality Assurance's Patient-Centered Medical Home program, and meaningful use of electronic health records. Further, we find a statistically significant increase in potential cases based on the last two or more blood pressure readings greater than or equal to 140/90 mm Hg (mean = 1,353.9, 95% CI 1,329.9-1,377.9).

  14. Realization of a universal patient identifier for electronic medical records through biometric technology.

    Science.gov (United States)

    Leonard, D C; Pons, Alexander P; Asfour, Shihab S

    2009-07-01

    The technology exists for the migration of healthcare data from its archaic paper-based system to an electronic one, and, once in digital form, to be transported anywhere in the world in a matter of seconds. The advent of universally accessible healthcare data has benefited all participants, but one of the outstanding problems that must be addressed is how the creation of a standardized nationwide electronic healthcare record system in the United States would uniquely identify and match a composite of an individual's recorded healthcare information to an identified individual patients out of approximately 300 million people to a 1:1 match. To date, a few solutions to this problem have been proposed that are limited in their effectiveness. We propose the use of biometric technology within our fingerprint, iris, retina scan, and DNA (FIRD) framework, which is a multiphase system whose primary phase is a multilayer consisting of these four types of biometric identifiers: 1) fingerprint; 2) iris; 3) retina scan; and 4) DNA. In addition, it also consists of additional phases of integration, consolidation, and data discrepancy functions to solve the unique association of a patient to their medical data distinctively. This would allow a patient to have real-time access to all of their recorded healthcare information electronically whenever it is necessary, securely with minimal effort, greater effectiveness, and ease.

  15. Deploying the advanced U.S. EPR

    International Nuclear Information System (INIS)

    Hagan, C.

    2007-01-01

    As electricity demand, clean air concerns and energy prices increase in the U.S., interest in new nuclear reactors is also on the rise. These factors - along with decades of outstanding performance of the nation's existing nuclear fleet - have contributed to a favorable market for new nuclear power in the U.S. Although no U.S. company has declared it actually will buy and build new reactors, many have actively expressed their interest through investment and regulatory interaction. The timing is also right for new reactors in terms of public perception, government policy and acceptance of the investment community. Amid this environment, the U.S. commercial power industry recently has begun pursuing new nuclear generation in earnest. AREVA, whose ongoing global market analyses indicated the need for additional baseload nuclear generation in the U.S., chose to license its EPR design to meet that need. This article will discuss the American market landscape for new nuclear and how AREVA is approaching it, present an overview of the company's U.S. EPR technology, and provide an update on the regulatory status of the design and deployment schedule. (orig.)

  16. Protecting the privacy of individual general practice patient electronic records for geospatial epidemiology research.

    Science.gov (United States)

    Mazumdar, Soumya; Konings, Paul; Hewett, Michael; Bagheri, Nasser; McRae, Ian; Del Fante, Peter

    2014-12-01

    General practitioner (GP) practices in Australia are increasingly storing patient information in electronic databases. These practice databases can be accessed by clinical audit software to generate reports that inform clinical or population health decision making and public health surveillance. Many audit software applications also have the capacity to generate de-identified patient unit record data. However, the de-identified nature of the extracted data means that these records often lack geographic information. Without spatial references, it is impossible to build maps reflecting the spatial distribution of patients with particular conditions and needs. Links to socioeconomic, demographic, environmental or other geographically based information are also not possible. In some cases, relatively coarse geographies such as postcode are available, but these are of limited use and researchers cannot undertake precision spatial analyses such as calculating travel times. We describe a method that allows researchers to implement meaningful mapping and spatial epidemiological analyses of practice level patient data while preserving privacy. This solution has been piloted in a diabetes risk research project in the patient population of a practice in Adelaide. The method offers researchers a powerful means of analysing geographic clinic data in a privacy-protected manner. © 2014 Public Health Association of Australia.

  17. [Electronic medical records: Evolution of physician-patient relationship in the Primary Care clinic].

    Science.gov (United States)

    Pérez-Santonja, T; Gómez-Paredes, L; Álvarez-Montero, S; Cabello-Ballesteros, L; Mombiela-Muruzabal, M T

    2017-04-01

    The introduction of electronic medical records and computer media in clinics, has influenced the physician-patient relationship. These modifications have many advantages, but there is concern that the computer has become too important, going from a working tool to the centre of our attention during the clinical interview, decreasing doctor interaction with the patient. The objective of the study was to estimate the percentage of time that family physicians spend on computer media compared to interpersonal communication with the patient, and whether this time is modified depending on different variables such as, doctor's age or reason for the consultation. An observational and descriptive study was conducted for 10 weeks, with 2 healthcare centres involved. The researchers attended all doctor- patient interviews, recording the patient time in and out of the consultation. Each time the doctor fixed his gaze on computer media the time was clocked. A total of 436 consultations were collected. The doctors looked at the computer support a median 38.33% of the total duration of an interview. Doctors of 45 years and older spent more time fixing their eyes on computer media (P<.05). Family physicians used almost 40% of the consultation time looking at computer media, and depends on age of physician, number of queries, and number of medical appointments. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Electronic medical records and communication with patients and other clinicians: are we talking less?

    Science.gov (United States)

    O'Malley, Ann S; Cohen, Genna R; Grossman, Joy M

    2010-04-01

    Commercial electronic medical records (EMRs) both help and hinder physician interpersonal communication--real-time, face-to-face or phone conversations--with patients and other clinicians, according to a new Center for Studying Health System Change (HSC) study based on in-depth interviews with clinicians in 26 physician practices. EMRs assist real-time communication with patients during office visits, primarily through immediate access to patient information, allowing clinicians to talk with patients rather than search for information from paper records. For some clinicians, however, aspects of EMRs pose a distraction during visits. Moreover, some indicated that clinicians may rely on EMRs for information gathering and transfer at the expense of real-time communication with patients and other clinicians. Given time pressures already present in many physician practices, EMR and office-work flow modifications could help ensure that EMRs advance care without compromising interpersonal communication. In particular, policies promoting EMR adoption should consider incorporating communication-skills training for medical trainees and clinicians using EMRs.

  19. The Impact of Health Literacy on a Patient's Decision to Adopt a Personal Health Record

    Science.gov (United States)

    Noblin, Alice M.; Wan, Thomas T. H.; Fottler, Myron

    2012-01-01

    Health literacy is a concept that describes a patient's ability to understand materials provided by physicians or other providers. Several factors, including education level, income, and age, can influence health literacy. Research conducted at one medical practice in Florida indicated that in spite of the patients’ relatively low education level, the majority indicated a broad acceptance of personal health record (PHR) technology. The key variable explaining patient willingness to adopt a PHR was the patient's health literacy as measured by the eHealth Literacy Scale (eHEALS). Adoption and use rates may also depend on the availability of office staff for hands-on training as well as assistance with interpretation of medical information. It is hoped that technology barriers will disappear over time, and usefulness of the information will promote increased utilization of PHRs. Patient understanding of the information remains a challenge that must be overcome to realize the full potential of PHRs. PMID:23209454

  20. Increased patient communication using a process supplementing an electronic medical record.

    Science.gov (United States)

    Garvey, Thomas D; Evensen, Ann E

    2015-02-01

    Importance: Patients with cervical cytology abnormalities may require surveillance for many years, which increases the risk of management error, especially in clinics with multiple managing clinicians. National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PCMH) certification requires tracking of abnormal results and communicating effectively with patients. The purpose of this study was to determine whether a computer-based tracking system that is not embedded in the electronic medical record improves (1) accurate and timely communication of results and (2) patient adherence to follow-up recommendations. Design: Pre/post study using data from 2005-2012. Intervention implemented in 2008. Data collected via chart review for at least 18 months after index result. Participants: Pre-intervention: all women (N = 72) with first abnormal cytology result from 2005-2007. Post-intervention: all women (N = 128) with first abnormal cytology result from 2008-2010. Patients were seen at a suburban, university-affiliated, family medicine residency clinic. Intervention: Tracking spreadsheet reviewed monthly with reminders generated for patients not in compliance with recommendations. Main Outcome and Measures: (1) rates of accurate and timely communication of results and (2) rates of patient adherence to follow-up recommendations. Intervention decreased absent or erroneous communication from clinician to patient (6.4% pre- vs 1.6% post-intervention [P = 0.04]), but did not increase patient adherence to follow-up recommendations (76.1% pre- vs 78.0% post-intervention [ P= 0.78]). Use of a spreadsheet tracking system improved communication of abnormal results to patients, but did not significantly improve patient adherence to recommended care. Although the tracking system complies with NCQA PCMH requirements, it was insufficient to make meaningful improvements in patient-oriented outcomes.

  1. Patients' online access to their electronic health records and linked online services: a systematic interpretative review.

    Science.gov (United States)

    de Lusignan, Simon; Mold, Freda; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Gronlund, Toto Anne; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Barker, Fiona; Ellis, Beverley; Koczan, Phil; Arvanitis, Theodoros N; McCarthy, Mary; Jones, Simon; Rafi, Imran

    2014-09-08

    To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Primary care. A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of access to a wider group of patients. A1 SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO

  2. A technique to stabilize record bases for Gothic arch tracings in patients with implant-retained complete dentures.

    Science.gov (United States)

    Raigrodski, A J; Sadan, A; Carruth, P L

    1998-12-01

    Clinicians have long expressed concern about the accuracy of the Gothic arch tracing for recording centric relation in edentulous patients. With the use of dental implants to assist in retaining complete dentures, the problem of inaccurate recordings, made for patients without natural teeth, can be significantly reduced. This article presents a technique that uses healing abutments to stabilize the record bases so that an accurate Gothic arch tracing can be made.

  3. A dozen useful tips on how to minimise the influence of sources of error in quantitative electron paramagnetic resonance (EPR) spectroscopy-A review

    International Nuclear Information System (INIS)

    Mazur, Milan

    2006-01-01

    The principal and the most important error sources in quantitative electron paramagnetic resonance (EPR) measurements arising from sample-associated factors are the influence of the variation of the sample material (dielectric constant), sample size and shape, sample tube wall thickness, and sample orientation and positioning within the microwave cavity on the EPR signal intensity. Variation in these parameters can cause significant and serious errors in the primary phase of quantitative EPR analysis (i.e., data acquisition). The primary aim of this review is to provide useful suggestions, recommendations and simple procedures to minimise the influence of such primary error sources in quantitative EPR measurements. According to the literature, as well as results obtained in our EPR laboratory, the following are recommendations for samples, which are compared in quantitative EPR studies: (i) the shape of all samples should be identical; (ii) the position of the sample/reference in the cavity should be identical; (iii) a special alignment procedure for precise sample positioning within the cavity should be adopted; (iv) a special/consistent procedure for sample packing for a powder material should be used; (v) the wall thickness of sample tubes should be identical; (vi) the shape and wall thickness of quartz Dewars, where used, should be identical; (vii) where possible a double TE 104 cavity should be used in quantitative EPR spectroscopy; (viii) the dielectric properties of unknown and standard samples should be as close as possible; (ix) sample length less than double the cavity length should be used; (x) the optimised sample geometry for the X-band cavity is a 30 mm-length capillary with i.d. less then 1.5 mm; (xi) use of commercially distributed software for post-recording spectra manipulation is a basic necessity; and (xii) the sample and laboratory temperature should be kept constant during measurements. When the above recommendations and procedures were used

  4. The organization of information in electronic patient record under the perspective of usability recommendations: proposition of organization of information.

    Directory of Open Access Journals (Sweden)

    Tatiana Tissa Kawakami

    2017-10-01

    Full Text Available Introduction: Among the various areas of studies, health information is highlighted in this study. More specifically, the patient's electronic medical records and issues related to it’s informational organization and usability. Objectives: suggest Usability recommendations applicable to the Electronic Patient Record. More specifically, identify, according to the specialized literature, recommendations of Usability, as well as to develop a checklist with recommendations of Usability for the Electronic Patient Record. Methodology: the study’s basic purpose is the theoretical nature. The deductive method of documental delimitation was chosen. Results: elaboration of checklist with recommendations of Usability for Electronic Patient Records. Conclusion: Usability recommendations can be used to improve electronic patient records. However, it should be noted that knowledge in the scope of Information Science should be considered and summed up, since a great deal of content related to Usability refers to operational and visual aspects of the interface, not clearly or directly contemplating the issues related to information.

  5. Patient Perceptions of Electronic Medical Record Use by Faculty and Resident Physicians: A Mixed Methods Study.

    Science.gov (United States)

    Lee, Wei Wei; Alkureishi, Maria A; Ukabiala, Obioma; Venable, Laura Ruth; Ngooi, Samantha S; Staisiunas, Daina D; Wroblewski, Kristen E; Arora, Vineet M

    2016-11-01

    While concerns remain regarding Electronic Medical Records (EMR) use impeding doctor-patient communication, resident and faculty patient perspectives post-widespread EMR adoption remain largely unexplored. We aimed to describe patient perspectives of outpatient resident and faculty EMR use and identify positive and negative EMR use examples to promote optimal utilization. This was a prospective mixed-methods study. Internal medicine faculty and resident patients at the University of Chicago's primary care clinic participated in the study. In 2013, one year after EMR implementation, telephone interviews were conducted with patients using open-ended and Likert style questions to elicit positive and negative perceptions of EMR use by physicians. Interview transcripts were analyzed qualitatively to develop a coding classification. Satisfaction with physician EMR use was examined using bivariate statistics. In total, 108 interviews were completed and analyzed. Two major themes were noted: (1) Clinical Functions of EMR and (2) Communication Functions of EMR; as well as six subthemes: (1a) Clinical Care (i.e., clinical efficiency), (1b) Documentation (i.e., proper record keeping and access), (1c) Information Access, (1d) Educational Resource, (2a) Patient Engagement and (2b) Physical Focus (i.e., body positioning). Overall, 85 % (979/1154) of patient perceptions of EMR use were positive, with the majority within the "Clinical Care" subtheme (n = 218). Of negative perceptions, 66 % (115/175) related to the "Communication Functions" theme, and the majority of those related to the "Physical Focus" subtheme (n = 71). The majority of patients (90 %, 95/106) were satisfied with physician EMR use: 59 % (63/107) reported the computer had a positive effect on their relationship and only 7 % (8/108) reported the EMR made it harder to talk with their doctors. Despite concerns regarding EMRs impeding doctor-patient communication, patients reported largely positive

  6. Data mining in bone marrow transplant records to identify patients with high odds of survival.

    Science.gov (United States)

    Taati, Babak; Snoek, Jasper; Aleman, Dionne; Ghavamzadeh, Ardeshir

    2014-01-01

    Patients undergoing a bone marrow stem cell transplant (BMT) face various risk factors. Analyzing data from past transplants could enhance the understanding of the factors influencing success. Records up to 120 measurements per transplant procedure from 1751 patients undergoing BMT were collected (Shariati Hospital). Collaborative filtering techniques allowed the processing of highly sparse records with 22.3% missing values. Ten-fold cross-validation was used to evaluate the performance of various classification algorithms trained on predicting the survival status. Modest accuracy levels were obtained in predicting the survival status (AUC = 0.69). More importantly, however, operations that had the highest chances of success were shown to be identifiable with high accuracy, e.g., 92% or 97% when identifying 74 or 31 recipients, respectively. Identifying the patients with the highest chances of survival has direct application in the prioritization of resources and in donor matching. For patients where high-confidence prediction is not achieved, assigning a probability to their survival odds has potential applications in probabilistic decision support systems and in combination with other sources of information.

  7. Signal averaging technique for noninvasive recording of late potentials in patients with coronary artery disease

    Science.gov (United States)

    Abboud, S.; Blatt, C. M.; Lown, B.; Graboys, T. B.; Sadeh, D.; Cohen, R. J.

    1987-01-01

    An advanced non invasive signal averaging technique was used to detect late potentials in two groups of patients: Group A (24 patients) with coronary artery disease (CAD) and without sustained ventricular tachycardia (VT) and Group B (8 patients) with CAD and sustained VT. Recorded analog data were digitized and aligned using a cross correlation function with fast Fourier transform schema, averaged and band pass filtered between 60 and 200 Hz with a non-recursive digital filter. Averaged filtered waveforms were analyzed by computer program for 3 parameters: (1) filtered QRS (fQRS) duration (2) interval between the peak of the R wave peak and the end of fQRS (R-LP) (3) RMS value of last 40 msec of fQRS (RMS). Significant change was found between Groups A and B in fQRS (101 -/+ 13 msec vs 123 -/+ 15 msec; p < .0005) and in R-LP vs 52 -/+ 11 msec vs 71-/+18 msec, p <.002). We conclude that (1) the use of a cross correlation triggering method and non-recursive digital filter enables a reliable recording of late potentials from the body surface; (2) fQRS and R-LP durations are sensitive indicators of CAD patients susceptible to VT.

  8. Toward a full understanding of the EPR effect in primary and metastatic tumors as well as issues related to its heterogeneity.

    Science.gov (United States)

    Maeda, Hiroshi

    2015-08-30

    The enhanced permeability and retention (EPR) effect of solid tumors as seen with nanomedicines and macromolecular drugs is well known. However, many researchers appear to lack a full understanding of this effect. The effect varies depending on a patient's pathological and physiological characteristics and clinical condition. When a patient's systolic blood pressure is low side of about 90mmHg instead of 120-130mmHg, the hydrodynamic force pushing blood from the luminal side of a vessel into tumor tissue becomes significantly low, which results in a low EPR. Also, a vascular embolism in a tumor may impede blood flow and the EPR. Here, I describe the background of the EPR effect, heterogeneity of this effect, physiological and pathological factors affecting the effect, the EPR effect in metastatic tumors, artifacts of the EPR effect with micellar and liposomal drugs, problems of macromolecular drug stability and drug release, and access to target sites. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Bridging the digital divide: mobile access to personal health records among patients with diabetes.

    Science.gov (United States)

    Graetz, Ilana; Huang, Jie; Brand, Richard J; Hsu, John; Yamin, Cyrus K; Reed, Mary E

    2018-01-01

    Some patients lack regular computer access and experience a digital divide that causes them to miss internet-based health innovations. The diffusion of smartphones has increased internet access across the socioeconomic spectrum, and increasing the channels through which patients can access their personal health records (PHRs) could help bridge the divide in PHR use. We examined PHR use through a computer-based Web browser or mobile device. Cross-sectional historical cohort analysis. Among adult patients in the diabetes registry of an integrated healthcare delivery system, we studied the devices used to access their PHR during 2016. Among 267,208 patients with diabetes, 68.1% used the PHR in 2016; 60.6% of all log-ins were via computer and 39.4% were via mobile device. Overall, 63.9% used it from both a computer and mobile device, 29.6% used only a computer, and 6.5% used only a mobile device. After adjustment, patients who were black, Hispanic, or Asian; lived in lower socioeconomic status (SES) neighborhoods; or had lower engagement were all significantly more likely to use the PHR only from a mobile device (P digital divide in computer use, disproportionately reaching racial/ethnic minorities and lower SES patients. Nonetheless, even with a mobile-optimized and app-accessible PHR, differences in PHR use by race/ethnicity and SES remain. Continued efforts are needed to increase equitable access to PHRs among patients with chronic conditions.

  10. Ageing effect in nanocrystalline TiCx/C studied by EPR

    International Nuclear Information System (INIS)

    Guskos, N.; Typek, J.; Bodziony, T.; Zolnierkiewicz, G.; Maryniak, M.; Biedunkiewicz, A.

    2009-01-01

    TiC/C nanocrystalline material: titanium carbide TiC dispersed in a carbon matrix has been prepared by a nonhydrolytic sol-gel process. Temperature dependence of the electron paramagnetic resonance (EPR) spectra of this material has been studied in the 3.5-120 K range. Two very different EPR lines have been recorded in fresh sample at temperatures below 120 K arising from the Ti(III) complex (broad and asymmetric line) and conduction electrons (very narrow line). In the same aged sample (1 year old) the magnetic anisotropy of Ti(III) line has increased while a narrow line attributed to conduction electrons has vanished. The existence of the paramagnetic centers connected with trivalent titanium ions could the result of disordering processes. The increase of anisotropy in Ti(III) line could be connected with the oxidation processes. The temperature dependence of the integrated intensity of the broad line revealed the presence of titanium antiferromagnetic dimers. The disappearance of a narrow EPR line suggests that the oxidation process (ageing effect) could influence also the electrical properties of titanium carbide

  11. The role and benefits of accessing primary care patient records during unscheduled care: a systematic review.

    Science.gov (United States)

    Bowden, Tom; Coiera, Enrico

    2017-09-22

    The purpose of this study was to assess the impact of accessing primary care records on unscheduled care. Unscheduled care is typically delivered in hospital Emergency Departments. Studies published to December 2014 reporting on primary care record access during unscheduled care were retrieved. Twenty-two articles met inclusion criteria from a pool of 192. Many shared electronic health records (SEHRs) were large in scale, servicing many millions of patients. Reported utilization rates by clinicians was variable, with rates >20% amongst health management organizations but much lower in nation-scale systems. No study reported on clinical outcomes or patient safety, and no economic studies of SEHR access during unscheduled care were available. Design factors that may affect utilization included consent and access models, SEHR content, and system usability and reliability. Despite their size and expense, SEHRs designed to support unscheduled care have been poorly evaluated, and it is not possible to draw conclusions about any likely benefits associated with their use. Heterogeneity across the systems and the populations they serve make generalization about system design or performance difficult. None of the reviewed studies used a theoretical model to guide evaluation. Value of Information models may be a useful theoretical approach to design evaluation metrics, facilitating comparison across systems in future studies. Well-designed SEHRs should in principle be capable of improving the efficiency, quality and safety of unscheduled care, but at present the evidence for such benefits is weak, largely because it has not been sought.

  12. Novel screen printed electrode set for routine EEG recordings in patients with altered mental status.

    Science.gov (United States)

    Myllymaa, Sami; Lepola, Pasi; Hukkanen, Taina; Oun, Andre; Mervaala, Esa; Toyras, Juha; Lappalainen, Reijo; Myllymaa, Katja

    2013-01-01

    There is a growing need for an easy to use screening tool for the assessment of brain's electrical function in patients with altered mental status (AMS). The purpose of this study is to give a brief overview of the state-of-the-art in electrode technology, and to present a novel sub-hairline electrode set developed in our research group. Screen-printing technology was utilized to construct the electrode set consisting of ten electroencephalography (EEG) electrodes, two electrooculography (EOG) electrodes, two ground electrodes and two reference electrodes. Electrical characteristics of hydrogel-coated silver ink electrodes were found adequate for clinical EEG recordings as assessed by electrical impedance spectroscopy (EIS). The skin-electrode impedances remain stable and low enough at least two days enabling high-quality long-term recordings. Due to the proper material selection, thin ink layers and detachable zero insertion force (ZIF) - connector, electrode was observed to be CT- and MRI-compatible allowing imaging without removing the electrodes. Pilot EEG recordings gave very promising results and an on-going clinical trial with larger number of patients will show the true feasibility of this approach.

  13. EPR design features to mitigate severe accident challenges

    International Nuclear Information System (INIS)

    Mazurkiewicz, S.M.; Fischer, M.; Bittermann, D.

    2005-01-01

    The EPR, an evolutionary pressurized water reactor (PWR), is a 4300-4500 MWth that incorporates proven technology within an optimized configuration to enhance safety. EPR was originally developed through a joint effort between Framatome ANP and Siemens by incorporating the best technological features from the French and German nuclear reactor fleets into a cost-competitive product. Commercial EPR units are currently being built in Finland at the Olkiluoto site, and planned for France at the Flamanville site. In recent months, Framatome ANP announced their intention to market the EPR units to China in response to a request for vendor bids as well as their intent to pursue design certification in the United States under 10CFR52. The EPR safety philosophy is based on a deterministic consideration of defense-in-depth complemented by probabilistic analyses. Not only is the EPR designed to prevent and mitigate design basis accidents (DBAs), it employs an extra level of safety associated with severe accident response. Therefore, as a design objective, features are included to ensure that radiological consequences are limited such that the need for stringent counter measures, such as evacuation and relocation of the nearby population, can be reasonably excluded. This paper discusses some of the innovative features of the EPR to address severe accident challenges. (author)

  14. The EPR - technology for the 3rd Millennium

    International Nuclear Information System (INIS)

    Bernstrauch, O.

    2000-01-01

    The Basic Design of the European Pressurized Water Reactor (EPR) was completed 1997 , the Basic Design Optimization Phase 1998 and the Detailed Design Phase will start in the near future. With these milestones, a new generation of PWRs is moving forward. Most of all, this is another story of a successful Franco-German cooperation. It is a rundown of the history of the EPR, before a decision is made to launch the lead-unit construction. The EPR project was launched in 1992 by Nuclear Power International (NPI), a joint company of FRAMATOME and Siemens KWU, supported by EDF and nine German electric utilities. Each step of the development of the EPR was harmonized with the Nuclear Safety Authorities both in France and Germany to reach an early approval. The EPR integrates the latest technological advances, especially in safety and operational aspects and comprises more than 30 years operating experience. Thus, the EPR combines the qualities of its predecessors, the French N4 and the German Konvoi. Presently, Siemens KWU and FRAMATOME are preparing the detailed design phase and the following construction and commissioning phase. The decision to build an EPR is not yet made either by the German electric utilities or by EdF, but it will be expected within the next months as a strong statement to follow the nuclear way and to ensure the know-how transfer. (author)

  15. Identification of gamma-irradiated fruit juices by EPR spectroscopy

    Science.gov (United States)

    Aleksieva, K. I.; Dimov, K. G.; Yordanov, N. D.

    2014-10-01

    The results of electron paramagnetic resonance (EPR) study on commercially available juices from various fruits and different fruit contents: 25%, 40%, 50%, and 100%, homemade juices, nectars and concentrated fruit syrups, before and after gamma-irradiation are reported. In order to remove water from non- and irradiated samples all juices and nectars were filtered; the solid residue was washed with alcohol and dried at room temperature. Only concentrated fruit syrups were dried for 60 min at 40 °C in a standard laboratory oven. All samples under study show a singlet EPR line with g=2.0025 before irradiation with exception of concentrated fruit syrups, which are EPR silent. Irradiation of juice samples gives rise to complex EPR spectra which gradually transferred to "cellulose-like" EPR spectrum from 25% to 100% fruit content. Concentrated fruit syrups show typical "sugar-like" spectra due to added saccharides. All EPR spectra are characteristic and can prove radiation treatment. The fading kinetics of radiation-induced EPR signals were studied for a period of 60 days after irradiation.

  16. Web technology for emergency medicine and secure transmission of electronic patient records.

    Science.gov (United States)

    Halamka, J D

    1998-01-01

    The American Heritage dictionary defines the word "web" as "something intricately contrived, especially something that ensnares or entangles." The wealth of medical resources on the World Wide Web is now so extensive, yet disorganized and unmonitored, that such a definition seems fitting. In emergency medicine, for example, a field in which accurate and complete information, including patients' records, is urgently needed, more than 5000 Web pages are available today, whereas fewer than 50 were available in December 1994. Most sites are static Web pages using the Internet to publish textbook material, but new technology is extending the scope of the Internet to include online medical education and secure exchange of clinical information. This article lists some of the best Web sites for use in emergency medicine and then describes a project in which the Web is used for transmission and protection of electronic medical records.

  17. One positive impact of health care reform to physicians: the computer-based patient record.

    Science.gov (United States)

    England, S P

    1993-11-01

    The health care industry is an information-dependent business that will require a new generation of health information systems if successful health care reform is to occur. We critically need integrated clinical management information systems to support the physician and related clinicians at the direct care level, which in turn will have linkages with secondary users of health information such as health payors, regulators, and researchers. The economic dependence of health care industry on the CPR cannot be underestimated, says Jeffrey Ritter. He sees the U.S. health industry as about to enter a bold new age where our records are electronic, our computers are interconnected, and our money is nothing but pulses running across the telephone lines. Hence the United States is now in an age of electronic commerce. Clinical systems reform must begin with the community-based patient chart, which is located in the physician's office, the hospital, and other related health care provider offices. A community-based CPR and CPR system that integrates all providers within a managed care network is the most logical step since all health information begins with the creation of a patient record. Once a community-based CPR system is in place, the physician and his or her clinical associates will have a common patient record upon which all direct providers have access to input and record patient information. Once a community-level CPR system is in place with a community provider network, each physician will have available health information and data processing capability that will finally provide real savings in professional time and effort. Lost patient charts will no longer be a problem. Data input and storage of health information would occur electronically via transcripted text, voice, and document imaging. All electronic clinical information, voice, and graphics could be recalled at any time and transmitted to any terminal location within the health provider network. Hence

  18. Expanded HIV Testing Strategy Leveraging the Electronic Medical Record Uncovers Undiagnosed Infection Among Hospitalized Patients.

    Science.gov (United States)

    Felsen, Uriel R; Cunningham, Chinazo O; Heo, Moonseong; Futterman, Donna C; Weiss, Jeffrey M; Zingman, Barry S

    2017-05-01

    Routine HIV testing of hospitalized patients is recommended, but few strategies to expand testing in the hospital setting have been described. We assessed the impact of an electronic medical record (EMR) prompt on HIV testing for hospitalized patients. We performed a pre-post study at 3 hospitals in the Bronx, NY. We compared the proportion of admissions of patients 21-64 years old with an HIV test performed, characteristics of patients tested, and rate of new HIV diagnoses made by screening while an EMR prompt recommending HIV testing was inactive vs. active. The prompt appeared for patients with no previous HIV test or a high-risk diagnosis after their last HIV test. Among 36,610 admissions while the prompt was inactive, 9.5% had an HIV test performed. Among 18,943 admissions while the prompt was active, 21.8% had an HIV test performed. Admission while the prompt was active was associated with increased HIV testing among total admissions [adjusted odds ratio (aOR) 2.78, 95% confidence interval (CI): 2.62 to 2.96], those without a previous HIV test (aOR 4.03, 95% CI: 3.70 to 4.40), and those with a previous negative test (aOR 1.52, 95% CI: 1.37 to 1.68) (P diversification of patients tested, and an increase in diagnoses made by screening.

  19. Einstein and the Quantum: The Secret Life of EPR

    Science.gov (United States)

    Fine, Arthur

    2006-05-01

    Locality, separation and entanglement -- 1930s style. Starting with Solvay 1927, we'll explore the background to the 1935 paper by Einstein, Podolsky and Rosen: how it was composed, the actual argument and principles used, and how the paper was received by Schroedinger, and others. We'll also look at Bohr's response: the extent to which Bohr connects with what Einstein was after in EPR and the extent to which EPR marks a shift in Bohr's thinking about the quantum theory. Time permitting, we will contrast EPR with Bell's theorem.

  20. EPR trademark project delivery. The value of experience

    International Nuclear Information System (INIS)

    Leverenz, Ruediger

    2013-01-01

    We are building the EPR trademark reactor fleet. Together. With four EPR trademark projects under construction in the world, AREVA has unrivalled experience in the delivery of large-scale nuclear projects, including more than a thousand lessons learned captured from Olkiluoto 3 and Flamanville 3 projects. This book of knowledge as well as the return of experience of AREVA's and EDF's teams are now being fully leveraged on ongoing projects, especially on Flamanville 3 and Taishan, and will be incorporated in all future EPR TM projects.

  1. Comparison of electronic health record system functionalities to support the patient recruitment process in clinical trials.

    Science.gov (United States)

    Schreiweis, Björn; Trinczek, Benjamin; Köpcke, Felix; Leusch, Thomas; Majeed, Raphael W; Wenk, Joachim; Bergh, Björn; Ohmann, Christian; Röhrig, Rainer; Dugas, Martin; Prokosch, Hans-Ulrich

    2014-11-01

    Reusing data from electronic health records for clinical and translational research and especially for patient recruitment has been tackled in a broader manner since about a decade. Most projects found in the literature however focus on standalone systems and proprietary implementations at one particular institution often for only one singular trial and no generic evaluation of EHR systems for their applicability to support the patient recruitment process does yet exist. Thus we sought to assess whether the current generation of EHR systems in Germany provides modules/tools, which can readily be applied for IT-supported patient recruitment scenarios. We first analysed the EHR portfolio implemented at German University Hospitals and then selected 5 sites with five different EHR implementations covering all major commercial systems applied in German University Hospitals. Further, major functionalities required for patient recruitment support have been defined and the five sample EHRs and their standard tools have been compared to the major functionalities. In our analysis of the site's hospital information system environments (with four commercial EHR systems and one self-developed system) we found that - even though no dedicated module for patient recruitment has been provided - most EHR products comprise generic tools such as workflow engines, querying capabilities, report generators and direct SQL-based database access which can be applied as query modules, screening lists and notification components for patient recruitment support. A major limitation of all current EHR products however is that they provide no dedicated data structures and functionalities for implementing and maintaining a local trial registry. At the five sites with standard EHR tools the typical functionalities of the patient recruitment process could be mostly implemented. However, no EHR component is yet directly dedicated to support research requirements such as patient recruitment. We

  2. EPR TOOTH DOSIMETRY OF SNTS AREA INHABITANTS.

    Science.gov (United States)

    Sholom, Sergey; Desrosiers, Marc; Bouville, André; Luckyanov, Nicholas; Chumak, Vadim; Simon, Steven L

    2007-07-01

    The determination of external dose to teeth of inhabitants of settlements near the Semipalatinsk Nuclear Test Site (SNTS) was conducted using the EPR dosimetry technique to assess radiation doses associated with exposure to radioactive fallout from the test site. In this study, tooth doses have been reconstructed for 103 persons with all studied teeth having been formed before the first nuclear test in 1949. Doses above those received from natural background radiation, termed "accident doses", were found to lie in the range from zero to approximately 2 Gy, with one exception, a dose for one person from Semipalatinsk city was approximately 9 Gy. The variability of reconstructed doses within each of the settlements demonstrated heterogeneity of the deposited fallout as well as variations in lifestyle. The village mean external gamma doses for residents of nine[ settlements were in the range from a few tens of mGy to approximately 100 mGy.

  3. EPR tooth dosimetry of SNTS area inhabitants

    Energy Technology Data Exchange (ETDEWEB)

    Sholom, Sergey [Scientific Center for Radiation Medicine, Melnikova str., 53, Kiev (Ukraine); Desrosiers, Marc [Ionizing Radiation Division, National Institute of Standards and Technology, Gaithersburg, MD (United States); Bouville, Andre; Luckyanov, Nicholas [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Boulevard, Bethesda, MD (United States); Chumak, Vadim [Scientific Center for Radiation Medicine, Melnikova str., 53, Kiev (Ukraine); Simon, Steven L. [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Boulevard, Bethesda, MD (United States)], E-mail: ssimon@mail.nih.gov

    2007-07-15

    The determination of external dose to teeth of inhabitants of settlements near the Semipalatinsk Nuclear Test Site (SNTS) was conducted using the EPR dosimetry technique to assess radiation doses associated with exposure to radioactive fallout from the test site. In this study, tooth doses have been reconstructed for 103 persons with all studied teeth having been formed before the first nuclear test in 1949. Doses above those received from natural background radiation, termed 'accident doses', were found to lie in the range from zero to approximately 2 Gy, with one exception, a dose for one person from Semipalatinsk city was approximately 9 Gy. The variability of reconstructed doses within each of the settlements demonstrated heterogeneity of the deposited fallout as well as variations in lifestyle. The village mean external gamma doses for residents of nine settlements were in the range from a few tens of mGy to approximately 100 mGy.

  4. Radiation protection issues for EPR reactor

    International Nuclear Information System (INIS)

    Miniere, D.; Le Guen, B.; Beneteau, Y.; Le Guen, B.

    2008-01-01

    As part of the EPR (European Pressurized Reactor) project being deployed at Flamanville, EDF has pro actively made the decision to focus on radiation protection Radiation Protection aspects right from the start of the design phase, as it has done with nuclear safety. The approach adopted for managing Radiation Protection-significant activities has been to include all involved stakeholders - designers, licensee and contractor companies - in the three successive phases, starting with a survey among workers and designers, followed by a proposal review, and finally ending with the decision-making phase entrusted to an ALARA committee. The Radiation Protection target set by EDF for this new reactor is to engage in an effort of continuous improvement and optimisation, through benchmarking with the best performing plants of the fleet. The collective dose target is currently set at 0.35 Man Sv/year per unit. In addition to other aspects, efforts will focus on shortening the duration of the highest-dose jobs, with a new challenge being set for work performed in the reactor building during normal operations, the aim being to improve plant availability. The plan is for work to be performed 7 days prior to shutting down the reactor and 3 days afterwards, in order to make logistical arrangements for forthcoming jobs. Without this reduction, the estimated drop is currently 4.5% of annual dose. For this purpose, two areas have been set up in the E.P.R.'s reactor building: one no-go area for containing leaks from the primary circuit, and one accessible area for normal operations, separated from the no-go area by purpose-built ventilation equipment and facilities. To offer protection against radioactive flux (neutrons and high energy), Radiation Protection studies have resulted in the installation of a concrete floor and of nuclear shielding at the outlets of primary circuit pipes. Steam generator bunkers and pumps have also been reinforced. All these measures will ensure that the

  5. EPR by AREVA. An evolutionary reactor

    International Nuclear Information System (INIS)

    Horstmann, Marion

    2010-01-01

    The EPR development goals are as follows: 1. Evolutionary design to fully capitalize on the design, construction and operating experience based on the 86 AREVA's PWR operating worldwide; 2. Enhanced Safety compared to operating PWRs: reduce core damage frequency (CDF), accommodate severe accidents with no long-term population effect, Withstand large airplane crash (APC); 3. High availability; 4. Simplified operation and maintenance; and 5. Generation cost at least 10 % lower than 1500 MWe series in operation.The design builds on the achievements of the N4 and Konvoi reactors. The main plant data are tabulated. The PWR structure is shown as an example of the stepwise improvement. Focus of the presentation is on the construction techniques, supply chain, and project delivery. (P.A.)

  6. EPR's energy conversion system. Alstom's solutions

    International Nuclear Information System (INIS)

    Ledermann, P.

    2009-01-01

    ARABELLE steam turbines have been developed by Alstom to be used as the energy conversion system of light water reactors with high output power like the N4 PWR and the EPR. ARABELLE turbines cumulate 200.000 hours of service with a reliability ratio of 99.97 per cent. This series of slides presents the main features of the turbine including: the use of the simple flux, the very large shape of low pressure blades, the technology of welded rotors. The other main equipment like the alternator, the condenser, the moisture separator-reheaters, the circulating pumps that Alstom integrates in the energy conversion system have benefited with technological improvements that are also presented. (A.C.)

  7. EPR design tools. Integrated data processing tools

    International Nuclear Information System (INIS)

    Kern, R.

    1997-01-01

    In all technical areas, planning and design have been supported by electronic data processing for many years. New data processing tools had to be developed for the European Pressurized Water Reactor (EPR). The work to be performed was split between KWU and Framatome and laid down in the Basic Design contract. The entire plant was reduced to a logical data structure; the circuit diagrams and flowsheets of the systems were drafted, the central data pool was established, the outlines of building structures were defined, the layout of plant components was planned, and the electrical systems were documented. Also building construction engineering was supported by data processing. The tasks laid down in the Basic Design were completed as so-called milestones. Additional data processing tools also based on the central data pool are required for the phases following after the Basic Design phase, i.e Basic Design Optimization; Detailed Design; Management; Construction, and Commissioning. (orig.) [de

  8. EPR of CU+2:Mb single crystal

    International Nuclear Information System (INIS)

    Nascimento, O.R.; Ribeiro, S.C.; Bemski, G.

    1976-01-01

    Copper introduced into met-myoglobin crystals occupies various sites as indicated by EPR parameters. CU 2+ (A) is probably liganded to histidine A10, lysine A14 and asparagine GH4 (Banaszak, 1965) and shows super-hyperfine interaction with a single (imidazole) nitrogen. Cu 2+ (B) and Cu 2+ (C) correspond to other anisotropic sites described with lesser details. Cu 2+ (A) exhibits a transition to an isotropic form with a transition temperature of 40.5 0 C. This transition is indicative of a conformational change in myoglobin and could correspond to a motion of A helix away from the GH section. The transition temperature is 7 0 C higher than the previously reported (Atanasov, 1971) one for myoglobin in solution

  9. Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients

    Science.gov (United States)

    Sanz-García, Ancor; Vega-Zelaya, Lorena; Pastor, Jesús; Torres, Cristina V.; Sola, Rafael G.; Ortega, Guillermo J.

    2016-01-01

    Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control seizures. However, a significant minority of patients continues to exhibit post-operative seizures, even in those cases in which the suspected source of seizures has been correctly localized and resected. The protocol presented here combines a clinical procedure routinely employed during the pre-operative evaluation of temporal lobe epilepsy (TLE) patients with a novel technique for network analysis. The method allows for the evaluation of the temporal evolution of mesial network parameters. The bilateral insertion of foramen ovale electrodes (FOE) into the ambient cistern simultaneously records electrocortical activity at several mesial areas in the temporal lobe. Furthermore, network methodology applied to the recorded time series tracks the temporal evolution of the mesial networks both interictally and during the seizures. In this way, the presented protocol offers a unique way to visualize and quantify measures that considers the relationships between several mesial areas instead of a single area. PMID:28060326

  10. Electronic Health Records: An Enhanced Security Paradigm to Preserve Patient's Privacy

    Science.gov (United States)

    Slamanig, Daniel; Stingl, Christian

    In recent years, demographic change and increasing treatment costs demand the adoption of more cost efficient, highly qualitative and integrated health care processes. The rapid growth and availability of the Internet facilitate the development of eHealth services and especially of electronic health records (EHRs) which are promising solutions to meet the aforementioned requirements. Considering actual web-based EHR systems, patient-centric and patient moderated approaches are widely deployed. Besides, there is an emerging market of so called personal health record platforms, e.g. Google Health. Both concepts provide a central and web-based access to highly sensitive medical data. Additionally, the fact that these systems may be hosted by not fully trustworthy providers necessitates to thoroughly consider privacy issues. In this paper we define security and privacy objectives that play an important role in context of web-based EHRs. Furthermore, we discuss deployed solutions as well as concepts proposed in the literature with respect to this objectives and point out several weaknesses. Finally, we introduce a system which overcomes the drawbacks of existing solutions by considering an holistic approach to preserve patient's privacy and discuss the applied methods.

  11. EPR paradox, quantum nonlocality and physical reality

    International Nuclear Information System (INIS)

    Kupczynski, M

    2016-01-01

    Eighty years ago Einstein, Podolsky and Rosen demonstrated that instantaneous reduction of wave function, believed to describe completely a pair of entangled physical systems, led to EPR paradox. The paradox disappears in statistical interpretation of quantum mechanics (QM) according to which a wave function describes only an ensemble of identically prepared physical systems. QM predicts strong correlations between outcomes of measurements performed on different members of EPR pairs in far-away locations. Searching for an intuitive explanation of these correlations John Bell analysed so called local realistic hidden variable models and proved that correlations consistent with these models satisfy Bell inequalities which are violated by some predictions of QM and by experimental data. Several different local models were constructed and inequalities proven. Some eminent physicists concluded that Nature is definitely nonlocal and that it is acting according to a law of nonlocal randomness. According to these law perfectly random, but strongly correlated events, can be produced at the same time in far away locations and a local and causal explanation of their occurrence cannot be given. We strongly disagree with this conclusion and we prove the contrary by analysing in detail some influential finite sample proofs of Bell and CHSH inequalities and so called Quantum Randi Challenges. We also show how one can win so called Bell's game without violating locality of Nature. Nonlocal randomness is inconsistent with local quantum field theory, with standard model in elementary particle physics and with causal laws and adaptive dynamics prevailing in the surrounding us world. The experimental violation of Bell-type inequalities does not prove the nonlocality of Nature but it only confirms a contextual character of quantum observables and gives a strong argument against counterfactual definiteness and against a point of view according to which experimental outcomes are

  12. EPR paradox, quantum nonlocality and physical reality

    Science.gov (United States)

    Kupczynski, M.

    2016-03-01

    Eighty years ago Einstein, Podolsky and Rosen demonstrated that instantaneous reduction of wave function, believed to describe completely a pair of entangled physical systems, led to EPR paradox. The paradox disappears in statistical interpretation of quantum mechanics (QM) according to which a wave function describes only an ensemble of identically prepared physical systems. QM predicts strong correlations between outcomes of measurements performed on different members of EPR pairs in far-away locations. Searching for an intuitive explanation of these correlations John Bell analysed so called local realistic hidden variable models and proved that correlations consistent with these models satisfy Bell inequalities which are violated by some predictions of QM and by experimental data. Several different local models were constructed and inequalities proven. Some eminent physicists concluded that Nature is definitely nonlocal and that it is acting according to a law of nonlocal randomness. According to these law perfectly random, but strongly correlated events, can be produced at the same time in far away locations and a local and causal explanation of their occurrence cannot be given. We strongly disagree with this conclusion and we prove the contrary by analysing in detail some influential finite sample proofs of Bell and CHSH inequalities and so called Quantum Randi Challenges. We also show how one can win so called Bell's game without violating locality of Nature. Nonlocal randomness is inconsistent with local quantum field theory, with standard model in elementary particle physics and with causal laws and adaptive dynamics prevailing in the surrounding us world. The experimental violation of Bell-type inequalities does not prove the nonlocality of Nature but it only confirms a contextual character of quantum observables and gives a strong argument against counterfactual definiteness and against a point of view according to which experimental outcomes are produced

  13. From Task Descriptions via Coloured Petri Nets Towards an Implementation of a New Electronic Patient Record

    DEFF Research Database (Denmark)

    Jørgensen, Jens Bæk; Lassen, Kristian Bisgaard; van der Aalst, Willibrordus Martinus Pancratius

    2008-01-01

    help to validate and elicit requirements. The second CPN model is a Colored Workflow Net (CWN). The CWN is derived from the EUC. Together, the EUC and the CWN are used to close the gap between the given requirements specification and the realization of these requirements with the help of an IT system......We consider a given specification of functional requirements for a new electronic patient record system for Fyn County, Denmark. The requirements are expressed as task descriptions, which are informal descriptions of work processes to be supported. We describe how these task descriptions are used...

  14. Can the use of Electronic Health Records in General Practice reduce hospitalizations for diabetes patients?

    DEFF Research Database (Denmark)

    Kongstad, Line Planck; Mellace, Giovanni; Rose Olsen, Kim

    on Electronic Health Records (EHR) on diabetes patients total hospitalizations, diabetes related hospitalizations and hospitalizations with diabetes and cardiovascular related Ambulatory Care Sentive Conditions (ACSC). We use a rich nationwide panel dataset (2004-2013) with information of stepwise enrolment...... of GPs in the EHR program. As a control group we use GPs who never enrolled. Following the recent literature on causal inference with panel data, we use a standard propensity score matching estimator where we also match on pre-treatment outcomes. This allows controlling for all the unobservable...

  15. System requirements for a computerised patient record information system at a busy primary health care clinic

    Directory of Open Access Journals (Sweden)

    PJ Blignaut

    2001-09-01

    Full Text Available A prototyping approach was used to determine the essential system requirements of a computerised patient record information system for a typical township primary health care clinic. A pilot clinic was identified and the existing manual system and business processes in this clinic was studied intensively before the first prototype was implemented. Interviews with users, incidental observations and analysis of actual data entered were used as primary techniques to refine the prototype system iteratively until a system with an acceptable data set and adequate functionalities were in place. Several non-functional and user-related requirements were also discovered during the prototyping period.

  16. Identification and Fibrosis Staging of Hepatitis C Patients Using the Electronic Medical Record System.

    Science.gov (United States)

    Anand, Vijay; Hyun, Christian; Khan, Qasim M; Hall, Curtis; Hessefort, Norbert; Sonnenberg, Amnon; Fimmel, Claus J

    2016-09-01

    The aim of this study was to noninvasively assess the severity of chronic hepatitis C virus (HCV) in large patient populations. It would be helpful if fibrosis scores could be calculated solely on the basis of data contained in the patients' electronic medical records (EMR). We performed a pilot study to identify all HCV-infected patients in a large health care system, and predict their fibrosis stage on the basis of demographic and laboratory data using common data from their EMR. HCV-infected patients were identified using the EMR. The liver biopsies of 191 HCV patients were graded using the Ishak and Metavir scoring systems. Demographic and laboratory data were extracted from the EMR and used to calculate the aminotransferase to platelet ratio index, Fib-4, Fibrosis Index, Forns, Göteborg University Cirrhosis Index, Lok Index, and Vira-HepC. In total, 869 HCV-infected patients were identified from a population of over 1 million. In the subgroup of patients with liver biopsies, all 7 algorithms were significantly correlated with the fibrosis stage. The degree of correlation was moderate, with correlation coefficients ranging from 0.22 to 0.60. For the detection of advanced fibrosis (Metavir 3 or 4), the areas under the receiver operating characteristic curve ranged from 0.71 to 0.84, with no significant differences between the individual scores. Sensitivities, specificities, and positive and negative predictive values were within the previously reported range. All scores tended to perform better for higher fibrosis stages. Our study demonstrates that HCV-infected patients can be identified and their fibrosis staged using commonly available EMR-based algorithms.

  17. Using electronic patient records to inform strategic decision making in primary care.

    Science.gov (United States)

    Mitchell, Elizabeth; Sullivan, Frank; Watt, Graham; Grimshaw, Jeremy M; Donnan, Peter T

    2004-01-01

    Although absolute risk of death associated with raised blood pressure increases with age, the benefits of treatment are greater in elderly patients. Despite this, the 'rule of halves' particularly applies to this group. We conducted a randomised controlled trial to evaluate different levels of feedback designed to improve identification, treatment and control of elderly hypertensives. Fifty-two general practices were randomly allocated to either: Control (n=19), Audit only feedback (n=16) or Audit plus Strategic feedback, prioritising patients by absolute risk (n=17). Feedback was based on electronic data, annually extracted from practice computer systems. Data were collected for 265,572 patients, 30,345 aged 65-79. The proportion of known hypertensives in each group with BP recorded increased over the study period and the numbers of untreated and uncontrolled patients reduced. There was a significant difference in mean systolic pressure between the Audit plus Strategic and Audit only groups and significantly greater control in the Audit plus Strategic group. Providing patient-specific practice feedback can impact on identification and management of hypertension in the elderly and produce a significant increase in control.

  18. Will electronic personal health records benefit providers and patients in rural America?

    Science.gov (United States)

    Hargreaves, John S

    2010-03-01

    The objective of this study was to educate stakeholders (e.g., providers, patients, insurers, government) in the healthcare industry about electronic personal health records (PHRs) and their potential application in rural America. Extensive research was performed on PHRs through standard literature search, product demonstrations, educational webinars, and fact finding via news releases. Various stakeholders are eager to transform the healthcare industry into the digital age like other industries (i.e., banking, retail). Despite low adoption of PHRs in 2008 (2.7% of U.S. adults), patients are interested in secure messaging and eVisits with their physicians, online appointment scheduling and reminders, and online access to their laboratory and radiology results. Federal agencies (e.g., Health and Human Services, Department of Defense, Veterans Affairs [VA]), popular information technology (IT) vendors (e.g., Google, Microsoft), and large insurers (e.g., Aetna) have energized the industry through pilot programs and new product announcements. It remains to be seen if barriers to adoption, including privacy concerns, lack of interoperability standards and funding, and provider resistance, can be overcome to enable PHRs to become a critical tool in the creation of a more efficient and less costly U.S. healthcare industry. Electronic PHRs hold great promise to enhance access and improve the quality of care provided to patients in rural America. Government, vendors, and insurers should create incentives for providers and patients to implement PHRs. Likewise, patients need to become more aware of PHRs and their ability to improve health outcomes.

  19. Development and daily use of an electronic oncological patient record for the total management of cancer patients: 7 years' experience.

    Science.gov (United States)

    Galligioni, E; Berloffa, F; Caffo, O; Tonazzolli, G; Ambrosini, G; Valduga, F; Eccher, C; Ferro, A; Forti, S

    2009-02-01

    We describe our experience with an electronic oncological patient record (EOPR) for the total management of cancer patients. The web-based EOPR was developed on the basis of a user-centred design including user education and training, followed by continuous assistance; user acceptance was monitored by means of three questionnaires administered after 2 weeks, 6 months and 6 years. The EOPR has been used daily for all in-ward, day hospital and ambulatory clinical activities since July 2000. The most widely appreciated functions are its rapid multipoint access, the self-updated summary of the patients' clinical course, the management of the entire therapeutic programme synchronised with working agendas and oncological teleconsultation. Security and privacy are assured by means of the separate storage of clinical and demographic data, with access protected by login and a password. The questionnaires highlighted appreciation of rapid data retrieval and exchange and the perception of improved quality of care, but also revealed a sense of additional work and a negative impact on doctor-patient relationships. Our EOPR has proved to be effective in the total management of cancer patients. Its user-centred design and flexible web technology have been key factors in its successful implementation and daily use.

  20. The place of SGML and HTML in building electronic patient records.

    Science.gov (United States)

    Pitty, D; Gordon, C; Reeves, P; Capey, A; Vieyra, P; Rickards, T

    1997-01-01

    The authors are concerned that, although popular, SGML (Standard Generalized Markup Language) is only one approach to capturing, storing, viewing and exchanging healthcare information and does not provide a suitable paradigm for solving most of the problems associated with paper based patient record systems. Although a discussion of the relative merits of SGML, HTML (HyperText Markup Language) may be interesting, we feel such a discussion is avoiding the real issues associated with the most appropriate way to model, represent, and store electronic patient information in order to solve healthcare problems, and therefore the medical informatics community should firstly concern itself with these issues. The paper substantiates this viewpoint and concludes with some suggestions of how progress can be made.

  1. A Socio-Technical Analysis of Patient Accessible Electronic Health Records.

    Science.gov (United States)

    Hägglund, Maria; Scandurra, Isabella

    2017-01-01

    In Sweden, and internationally, there is a movement towards increased transparency in healthcare including giving patients online access to their electronic health records (EHR). The purpose of this paper is to analyze the Swedish patient accessible EHR (PAEHR) service using a socio-technical framework, to increase the understanding of factors that influence the design, implementation, adoption and use of the service. Using the Sitting and Singh socio-technical framework as a basis for analyzing the Swedish PAEHR system and its context indicated that there are many stakeholders engaged in these types of services, with different driving forces and incentives that may influence the adoption and usefulness of PAEHR services. The analysis was useful in highlighting important areas that need to be further explored in evaluations of PAEHR services, and can act as a guide when planning evaluations of any PAEHR service.

  2. Electromagnetic Interference in Patients with Implanted Cardioverter-Defibrillators and Implantable Loop Recorders

    Directory of Open Access Journals (Sweden)

    Marcos de Sousa

    2002-07-01

    Full Text Available Modern life exposes us all to an ever-increasing number of potential sources of electromagnetic interference (EMI and patients with Implantable rhythm devices (IRD like pacemakers, implantable cardioverter defibrillators or implantable loop recorders often ask about the use of microwave ovens, walking through airport metal detectors and the use of cellular phones. Electromagnetic interference occurs when electromagnetic waves emitted by one device impede the normal function of another electronic device. The potential for interaction between implanted pacing systems and cardioverter-defibrillators (electromagnetic interference, EMI has been recognized for years.1,2,3,4. It has been shown that EMI can produce clinically significant effects on patients with implanted pacemakers and ICDs. For these reasons the following text discusses the influence of several EMI generating devices on IRD .

  3. Sustains--direct access for the patient to the medical record over the Internet.

    Science.gov (United States)

    Eklund, Benny; Joustra-Enquist, Ingrid

    2004-01-01

    The basic idea of Sustains III is to emulate the Internet banking for Health Care. Instead of an "Internet Bank Account" the user has a "Health Care Account". The user logs in using a One Time Password which is sent to the user's mobile phone as an SMS, three seconds after the PIN code is entered. Thus personal information can be transferred both ways in a secure way, with acceptable privacy. The user can then explore the medical record in detail. Also get full and complete list of prescriptions, lab-result etc. It's also an easy way of exchange written information between the doctor and the patient. So far Sustains has showed that patients are very satisfied and is also beneficial for the physicians.

  4. All together now: findings from a PCORI workshop to align patient-reported outcomes in the electronic health record.

    Science.gov (United States)

    Jensen, Roxanne E; Snyder, Claire F; Basch, Ethan; Frank, Lori; Wu, Albert W

    2016-11-01

    In recent years, patient-reported outcomes have become increasingly collected and integrated into electronic health records. However, there are few cross-cutting recommendations and limited guidance available in this rapidly developing research area. Our goal is to report key findings from a 2013 Patient-Centered Outcomes Research Institute workshop on this topic and a summary of actions that followed from the workshop, and present resulting recommendations that address patient, clinical and research/quality improvement barriers to regular use. These findings provide actionable guidance across research and practice settings to promote and sustain widespread adoption of patient-reported outcomes across patient populations, healthcare settings and electronic health record systems.

  5. Semantic Interoperable Electronic Patient Records: The Unfolding of Consensus based Archetypes.

    Science.gov (United States)

    Pedersen, Rune; Wynn, Rolf; Ellingsen, Gunnar

    2015-01-01

    This paper is a status report from a large-scale openEHR-based EPR project from the North Norway Regional Health Authority encouraged by the unfolding of a national repository for openEHR archetypes. Clinicians need to engage in, and be responsible for the production of archetypes. The consensus processes have so far been challenged by a low number of active clinicians, a lack of critical specialties to reach consensus, and a cumbersome review process (3 or 4 review rounds) for each archetype. The goal is to have several clinicians from each specialty as a backup if one is hampered to participate. Archetypes and their importance for structured data and sharing of information has to become more visible for the clinicians through more sharpened information practice.

  6. Patient preferences toward an interactive e-consent application for research using electronic health records.

    Science.gov (United States)

    Harle, Christopher A; Golembiewski, Elizabeth H; Rahmanian, Kiarash P; Krieger, Janice L; Hagmajer, Dorothy; Mainous, Arch G; Moseley, Ray E

    2017-12-19

    The purpose of this study was to assess patient perceptions of using an interactive electronic consent (e-consent) application when deciding whether or not to grant broad consent for research use of their identifiable electronic health record (EHR) information. For this qualitative study, we conducted a series of 42 think-aloud interviews with 32 adults. Interview transcripts were coded and analyzed using a modified grounded theory approach. We identified themes related to patient preferences, reservations, and mixed attitudes toward consenting electronically; low- and high-information-seeking behavior; and an emphasis on reassuring information, such as data protections and prohibitions against sharing data with pharmaceutical companies. Participants expressed interest in the types of information contained in their EHRs, safeguards protecting EHR data, and specifics on studies that might use their EHR data. This study supports the potential value of interactive e-consent applications that allow patients to customize their consent experience. This study also highlights that some people have concerns about e-consent platforms and desire more detailed information about administrative processes and safeguards that protect EHR data used in research. This study contributes new insights on how e-consent applications could be designed to ensure that patients' information needs are met when seeking consent for research use of health record information. Also, this study offers a potential electronic approach to meeting the new Common Rule requirement that consent documents contain a "concise and focused" presentation of key information followed by more details. © The Author(s) 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  7. Data mining of audiology patient records: factors influencing the choice of hearing aid type

    Science.gov (United States)

    2012-01-01

    Background This paper describes the analysis of a database of over 180,000 patient records, collected from over 23,000 patients, by the hearing aid clinic at James Cook University Hospital in Middlesbrough, UK. These records consist of audiograms (graphs of the faintest sounds audible to the patient at six different pitches), categorical data (such as age, gender, diagnosis and hearing aid type) and brief free text notes made by the technicians. This data is mined to determine which factors contribute to the decision to fit a BTE (worn behind the ear) hearing aid as opposed to an ITE (worn in the ear) hearing aid. Methods From PCA (principal component analysis) four main audiogram types are determined, and are related to the type of hearing aid chosen. The effects of age, gender, diagnosis, masker, mould and individual audiogram frequencies are combined into a single model by means of logistic regression. Some significant keywords are also discovered in the free text fields by using the chi-squared (χ2) test, which can also be used in the model. The final model can act a decision support tool to help decide whether an individual patient should be offered a BTE or an ITE hearing aid. Results The final model was tested using 5-fold cross validation, and was able to replicate the decisions of audiologists whether to fit an ITE or a BTE hearing aid with precision in the range 0.79 to 0.87. Conclusions A decision support system was produced to predict the type of hearing aid which should be prescribed, with an explanation facility explaining how that decision was arrived at. This system should prove useful in providing a "second opinion" for audiologists. PMID:22595091

  8. Software for evaluation of EPR-dosimetry performance

    International Nuclear Information System (INIS)

    Shishkina, E.A.; Timofeev, Yu.S.; Ivanov, D.V.

    2014-01-01

    Electron paramagnetic resonance (EPR) with tooth enamel is a method extensively used for retrospective external dosimetry. Different research groups apply different equipment, sample preparation procedures and spectrum processing algorithms for EPR dosimetry. A uniform algorithm for description and comparison of performances was designed and implemented in a new computer code. The aim of the paper is to introduce the new software 'EPR-dosimetry performance'. The computer code is a user-friendly tool for providing a full description of method-specific capabilities of EPR tooth dosimetry, from metrological characteristics to practical limitations in applications. The software designed for scientists and engineers has several applications, including support of method calibration by evaluation of calibration parameters, evaluation of critical value and detection limit for registration of radiation-induced signal amplitude, estimation of critical value and detection limit for dose evaluation, estimation of minimal detectable value for anthropogenic dose assessment and description of method uncertainty. (authors)

  9. A sub-Kelvin cryogen-free EPR system.

    Science.gov (United States)

    Melhuish, Simon J; Stott, Chloe; Ariciu, Ana-Maria; Martinis, Lorenzo; McCulloch, Mark; Piccirillo, Lucio; Collison, David; Tuna, Floriana; Winpenny, Richard

    2017-09-01

    We present an EPR instrument built for operation at Q band below 1K. Our cryogen-free Dewar integrates with a commercial electro-magnet and bridge. A description of the cryogenic and RF systems is given, along with the adaptations to the standard EPR experiment for operation at sub-Kelvin temperatures. As a first experiment, the EPR spectra of powdered Cr 12 O 9 (OH) 3 [Formula: see text] were measured. The sub-Kelvin EPR spectra agree well with predictions, and the performance of the sub-Kelvin system at 5K is compared to that of a commercial spectrometer. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  10. Trichloroethylene Radicals: An EPR/SPIN Trapping Study

    National Research Council Canada - National Science Library

    Steel-Goodwin, Linda

    1995-01-01

    .... As part of the process to develop environmental and health effects criteria for base clean-up the initial radicals produced by TCE were studied by electron paramagnetic resonance spectroscopy (EPR...

  11. Reconfiguring Cooperative Work by Visualizing EPR on Large Projected Screens

    DEFF Research Database (Denmark)

    Simonsen, Jesper

    Simonsen, J. (2006): Reconfiguring Cooperative Work by Visualizing EPR on Large Projected Screens, Paper presented at the PDC 2006 workshop on: Reconfiguring Healthcare: Issues in Computer Supported Cooperative Work in Healthcare Environments. Participatory Design Conference, Trento, Italy, August...

  12. EPR and NMR detection of transient radicals and reaction products

    International Nuclear Information System (INIS)

    Trifunac, A.D.

    1981-01-01

    Magnetic resonance methods in radiation chemistry are illustrated. The most recent developments in pulsed EPR and NMR studies in pulse radiolysis are outlined with emphasis on the study of transient radicals and their reaction products. 12 figures

  13. EPR spectroscopy of complex biological iron-sulfur systems.

    Science.gov (United States)

    Hagen, Wilfred R

    2018-02-21

    From the very first discovery of biological iron-sulfur clusters with EPR, the spectroscopy has been used to study not only purified proteins but also complex systems such as respiratory complexes, membrane particles and, later, whole cells. In recent times, the emphasis of iron-sulfur biochemistry has moved from characterization of individual proteins to the systems biology of iron-sulfur biosynthesis, regulation, degradation, and implications for human health. Although this move would suggest a blossoming of System-EPR as a specific, non-invasive monitor of Fe/S (dys)homeostasis in whole cells, a review of the literature reveals limited success possibly due to technical difficulties in adherence to EPR spectroscopic and biochemical standards. In an attempt to boost application of System-EPR the required boundary conditions and their practical applications are explicitly and comprehensively formulated.

  14. EPR-based distance measurements at ambient temperature.

    Science.gov (United States)

    Krumkacheva, Olesya; Bagryanskaya, Elena

    2017-07-01

    Pulsed dipolar (PD) EPR spectroscopy is a powerful technique allowing for distance measurements between spin labels in the range of 2.5-10.0nm. It was proposed more than 30years ago, and nowadays is widely used in biophysics and materials science. Until recently, PD EPR experiments were limited to cryogenic temperatures (TEPR as well as other approaches based on EPR (e.g., relaxation enhancement; RE). In this paper, we review the features of PD EPR and RE at ambient temperatures, in particular, requirements on electron spin phase memory time, ways of immobilization of biomolecules, the influence of a linker between the spin probe and biomolecule, and future opportunities. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Experimental EPR-steering using Bell-local states

    Science.gov (United States)

    Saunders, D. J.; Jones, S. J.; Wiseman, H. M.; Pryde, G. J.

    2010-11-01

    The concept of `steering' was introduced in 1935 by Schrödinger as a generalization of the EPR (Einstein-Podolsky-Rosen) paradox. It has recently been formalized as a quantum-information task with arbitrary bipartite states and measurements, for which the existence of entanglement is necessary but not sufficient. Previous experiments in this area have been restricted to an approach that followed the original EPR argument in considering only two different measurement settings per side. Here we demonstrate experimentally that EPR-steering occurs for mixed entangled states that are Bell local (that is, that cannot possibly demonstrate Bell non-locality). Unlike the case of Bell inequalities, increasing the number of measurement settings beyond two-we use up to six-significantly increases the robustness of the EPR-steering phenomenon to noise.

  16. Decomposition of spectra in EPR dosimetry using the matrix method

    International Nuclear Information System (INIS)

    Sholom, S.V.; Chumak, V.V.

    2003-01-01

    The matrix method of EPR spectra decomposition is developed and adapted for routine application in retrospective EPR dosimetry with teeth. According to this method, the initial EPR spectra are decomposed (using methods of matrix algebra) into several reference components (reference matrices) that are specific for each material. Proposed procedure has been tested on the example of tooth enamel. Reference spectra were a spectrum of an empty sample tube and three standard signals of enamel (two at g=2.0045, both for the native signal and one at g perpendicular =2.0018, g parallel =1.9973 for the dosimetric signal). Values of dosimetric signals obtained using the given method have been compared with data obtained by manual manipulation of spectra, and good coincidence was observed. This allows considering the proposed method as potent for application in routine EPR dosimetry

  17. EPR of radiation defects in lithium-oxyfluoride glass ceramics

    Energy Technology Data Exchange (ETDEWEB)

    Fedotovs, A; Rogulis, U; Sarakovskis, A; Dimitrocenko, L, E-mail: andris-f@navigator.l [Institute of Solid State Physics, University of Latvia, Kengaraga st. 8, LV-1063, Riga (Latvia)

    2010-11-01

    We studied oxyfluoride composites based on lithium silicate glasses with yttrium fluorides and rare-earth dopants. The electron paramagnetic resonance (EPR) has been used to obtain information about radiation induced defects in these materials. Spectra have been measured before and after X-ray irradiation at room temperature and at liquid nitrogen temperature. Fluoride crystallites within samples were created by means of thermal treatment at specific temperatures. EPR spectra of radiation induced defects in oxyfluoride glass ceramics, in which crystallites have not been yet created, show no explicit hfs interaction of fluorine nuclei. However, in glass ceramics, which already contains fluoride crystallites, the hfs characteristic to fluorine nuclei appears in the EPR spectra. EPR hyperfine structure could be explained within a model of an F-type centre in YF{sub 3} crystalline phase.

  18. EPR of radiation defects in lithium-oxyfluoride glass ceramics

    Science.gov (United States)

    Fedotovs, A.; Rogulis, U.; Sarakovskis, A.; Dimitrocenko, L.

    2010-11-01

    We studied oxyfluoride composites based on lithium silicate glasses with yttrium fluorides and rare-earth dopants. The electron paramagnetic resonance (EPR) has been used to obtain information about radiation induced defects in these materials. Spectra have been measured before and after X-ray irradiation at room temperature and at liquid nitrogen temperature. Fluoride crystallites within samples were created by means of thermal treatment at specific temperatures. EPR spectra of radiation induced defects in oxyfluoride glass ceramics, in which crystallites have not been yet created, show no explicit hfs interaction of fluorine nuclei. However, in glass ceramics, which already contains fluoride crystallites, the hfs characteristic to fluorine nuclei appears in the EPR spectra. EPR hyperfine structure could be explained within a model of an F-type centre in YF3 crystalline phase.

  19. Reconstructing Bohr's Reply to EPR in Algebraic Quantum Theory

    Science.gov (United States)

    Ozawa, Masanao; Kitajima, Yuichiro

    2012-04-01

    Halvorson and Clifton have given a mathematical reconstruction of Bohr's reply to Einstein, Podolsky and Rosen (EPR), and argued that this reply is dictated by the two requirements of classicality and objectivity for the description of experimental data, by proving consistency between their objectivity requirement and a contextualized version of the EPR reality criterion which had been introduced by Howard in his earlier analysis of Bohr's reply. In the present paper, we generalize the above consistency theorem, with a rather elementary proof, to a general formulation of EPR states applicable to both non-relativistic quantum mechanics and algebraic quantum field theory; and we clarify the elements of reality in EPR states in terms of Bohr's requirements of classicality and objectivity, in a general formulation of algebraic quantum theory.

  20. The double-edged sword of electronic health records: implications for patient disclosure.

    Science.gov (United States)

    Campos-Castillo, Celeste; Anthony, Denise L

    2015-04-01

    Electronic health record (EHR) systems are linked to improvements in quality of care, yet also privacy and security risks. Results from research studies are mixed about whether patients withhold personal information from their providers to protect against the perceived EHR privacy and security risks. This study seeks to reconcile the mixed findings by focusing on whether accounting for patients' global ratings of care reveals a relationship between EHR provider-use and patient non-disclosure. A nationally representative sample from the 2012 Health Information National Trends Survey was analyzed using bivariate and multivariable logit regressions to examine whether global ratings of care suppress the relationship between EHR provider-use and patient non-disclosure. 13% of respondents reported having ever withheld information from a provider because of privacy/security concerns. Bivariate analysis showed that withholding information was unrelated to whether respondents' providers used an EHR. Multivariable analysis showed that accounting for respondents' global ratings of care revealed a positive relationship between having a provider who uses an EHR and withholding information. After accounting for global ratings of care, findings suggest that patients may non-disclose to providers to protect against the perceived EHR privacy and security risks. Despite evidence that EHRs inhibit patient disclosure, their advantages for promoting quality of care may outweigh the drawbacks. Clinicians should leverage the EHR's value in quality of care and discuss patients' privacy concerns during clinic visits, while policy makers should consider how to address the real and perceived privacy and security risks of EHRs. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Chronic pain among patients with opioid use disorder: Results from electronic health records data.

    Science.gov (United States)

    Hser, Yih-Ing; Mooney, Larissa J; Saxon, Andrew J; Miotto, Karen; Bell, Douglas S; Huang, David

    2017-06-01

    To examine the prevalence of comorbid chronic pain among patients with opioid use disorder (OUD) and to compare other comorbidities (substance use disorder (SUD), mental health disorders, health/disease conditions) among patients in four categories: no chronic pain (No Pain), OUD prior to pain (OUD First), OUD and pain at the same time (Same Time), or pain condition prior to OUD (Pain First). Using an electronic health record (EHR) database from 2006-2015, the study assessed 5307 adult patients with OUD in a large healthcare system; 35.6% were No Pain, 9.7% were OUD First, 14.9% were Same Time, and 39.8% were Pain First. Most OUD patients (64.4%) had chronic pain conditions, and among them 61.8% had chronic pain before their first OUD diagnosis. Other SUDs occurred more frequently among OUD First patients than among other groups in terms of alcohol (33.4% vs. 25.4% for No Pain, 20.7% for Same Time, and 20.3% for Pain First), cocaine (19.0%, vs. 13.8%, 9.4%, 7.1%), and alcohol or drug-induced disorders. OUD First patients also had the highest rates of HIV (4.7%) and hepatitis C virus (HCV; 28.2%) among the four groups. Pain First patients had the highest rates of mental disorder (81.7%), heart disease (72.0%), respiratory disease (68.4%), sleep disorder (41.8%), cancer (23.4%), and diabetes (19.3%). The alarming high rates of chronic pain conditions occurring before OUD and the associated severe mental health and physical health conditions require better models of assessment and coordinated care plans to address these complex medical conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Identifying primary care patients at risk for future diabetes and cardiovascular disease using electronic health records

    Directory of Open Access Journals (Sweden)

    Shrader Peter

    2009-09-01

    Full Text Available Abstract Background Prevention of diabetes and coronary heart disease (CHD is possible but identification of at-risk patients for targeting interventions is a challenge in primary care. Methods We analyzed electronic health record (EHR data for 122,715 patients from 12 primary care practices. We defined patients with risk factor clustering using metabolic syndrome (MetS characteristics defined by NCEP-ATPIII criteria; if missing, we used surrogate characteristics, and validated this approach by directly measuring risk factors in a subset of 154 patients. For subjects with at least 3 of 5 MetS criteria measured at baseline (2003-2004, we defined 3 categories: No MetS (0 criteria; At-risk-for MetS (1-2 criteria; and MetS (≥ 3 criteria. We examined new diabetes and CHD incidence, and resource utilization over the subsequent 3-year period (2005-2007 using age-sex-adjusted regression models to compare outcomes by MetS category. Results After excluding patients with diabetes/CHD at baseline, 78,293 patients were eligible for analysis. EHR-defined MetS had 73% sensitivity and 91% specificity for directly measured MetS. Diabetes incidence was 1.4% in No MetS; 4.0% in At-risk-for MetS; and 11.0% in MetS (p MetS vs No MetS = 6.86 [6.06-7.76]; CHD incidence was 3.2%, 5.3%, and 6.4% respectively (p Conclusion Risk factor clustering in EHR data identifies primary care patients at increased risk for new diabetes, CHD and higher resource utilization.

  3. Record High US Measles Cases: Patient Vaccination, Clinical Assessment and Management

    Centers for Disease Control (CDC) Podcasts

    2014-06-30

    This podcast is an overview of the Clinician Outreach and Communication Activity (COCA) Call: Record High US Measles Cases: Patient Vaccination, Clinical Assessment and Management. In May 2014, the United States recorded the largest number of reported measles cases since 1994 and the number continues to rise. Most cases reported have been acquired in the U.S. and are associated with importations from countries where measles is still common. This highly contagious, acute viral illness spreads quickly in unvaccinated populations once reaching the U.S. The recent measles outbreaks highlight the importance of maintaining high vaccination coverage in the U.S. and ensuring age-appropriate vaccination for international travelers. During this COCA call, clinicians will learn the status of measles in the U.S. and CDC vaccination recommendations and guidelines for patient assessment and management.  Created: 6/30/2014 by : National Center for Immunization and Respiratory Diseases; Division of Viral Diseases; Healthcare Preparedness Activity (HPA); Office of Public Health Preparedness and Response (OPHPR).   Date Released: 6/30/2014.

  4. Towards iconic language for patient records, drug monographs, guidelines and medical search engines.

    Science.gov (United States)

    Lamy, Jean-Baptiste; Duclos, Catherine; Hamek, Saliha; Beuscart-Zéphir, Marie-Catherine; Kerdelhué, Gaetan; Darmoni, Stefan; Favre, Madeleine; Falcoff, Hector; Simon, Christian; Pereira, Suzanne; Serrot, Elisabeth; Mitouard, Thierry; Hardouin, Etienne; Kergosien, Yannick; Venot, Alain

    2010-01-01

    Practicing physicians have limited time for consulting medical knowledge and records. We have previously shown that using icons instead of text to present drug monographs may allow contraindications and adverse effects to be identified more rapidly and more accurately. These findings were based on the use of an iconic language designed for drug knowledge, providing icons for many medical concepts, including diseases, antecedents, drug classes and tests. In this paper, we describe a new project aimed at extending this iconic language, and exploring the possible applications of these icons in medicine. Based on evaluators' comments, focus groups of physicians and opinions of academic, industrial and associative partners, we propose iconic applications related to patient records, for example summarizing patient conditions, searching for specific clinical documents and helping to code structured data. Other applications involve the presentation of clinical practice guidelines and improving the interface of medical search engines. These new applications could use the same iconic language that was designed for drug knowledge, with a few additional items that respect the logic of the language.

  5. Most advanced HTP fuel assembly design for EPR

    International Nuclear Information System (INIS)

    Francillon, Eric; Kiehlmann, Horst-Dieter

    2006-01-01

    End 2003, the Finnish electricity utility Teollisuuden Voima Oy (TVO) signed the contract for building an EPR in Olkiluoto (Finland). Mid 2004, the French electricity utility EDF selected an EPR to be built in France. In 2005, Framatome ANP, an AREVA and Siemens company, announced that they will be pursuing a design certification in the U.S. The EPR development is based on the latest PWR product lines of former Framatome (N4) and Siemens Nuklear (Konvoi). As an introductory part, different aspects of the EPR core characteristics connected to fuel assembly design are presented. It includes means of ensuring reactivity control like hybrid AIC/B4C control rod absorbers and gadolinium as burnable absorber integrated in fuel rods, and specific options for in-core instrumentation, such as Aeroball type instrumentation. Then the design requirements for the EPR fuel assembly are presented in term of very high burnup capacity, rod cladding and fuel assembly reliability. Framatome ANP fuel assembly product characteristics meeting these requirements are then described. EPR fuel assembly design characteristics benefit from the experience feedback of the latest fuel assembly products designed within Framatome ANP, leading to resistance to assembly deformation, high fuel rod restraint and prevention of handling hazards. EPR fuel assembly design features the best components composing the cornerstones of the upgraded family of fuel assemblies that FRAMATOME ANP proposes today. This family is based on a set of common characteristics and associated features, which include the HMP grid as bottom end spacer, the MONOBLOC guide tube and the Robust FUELGUARD as lower tie plate, the use of the M5 Alloy, as cladding and structure material. This fully re-crystallized, ternary Zr-Nb-O alloy produces radically improved in-reactor corrosion, very low hydrogen uptake and growth and an excellent creep behavior, which are described there. EPR fuel assembly description also includes fuel rod

  6. EPR-based distance measurements at ambient temperature

    Science.gov (United States)

    Krumkacheva, Olesya; Bagryanskaya, Elena

    2017-07-01

    Pulsed dipolar (PD) EPR spectroscopy is a powerful technique allowing for distance measurements between spin labels in the range of 2.5-10.0 nm. It was proposed more than 30 years ago, and nowadays is widely used in biophysics and materials science. Until recently, PD EPR experiments were limited to cryogenic temperatures (T biomolecules, the influence of a linker between the spin probe and biomolecule, and future opportunities.

  7. "Community vital signs": incorporating geocoded social determinants into electronic records to promote patient and population health.

    Science.gov (United States)

    Bazemore, Andrew W; Cottrell, Erika K; Gold, Rachel; Hughes, Lauren S; Phillips, Robert L; Angier, Heather; Burdick, Timothy E; Carrozza, Mark A; DeVoe, Jennifer E

    2016-03-01

    Social determinants of health significantly impact morbidity and mortality; however, physicians lack ready access to this information in patient care and population management. Just as traditional vital signs give providers a biometric assessment of any patient, "community vital signs" (Community VS) can provide an aggregated overview of the social and environmental factors impacting patient health. Knowing Community VS could inform clinical recommendations for individual patients, facilitate referrals to community services, and expand understanding of factors impacting treatment adherence and health outcomes. This information could also help care teams target disease prevention initiatives and other health improvement efforts for clinic panels and populations. Given the proliferation of big data, geospatial technologies, and democratization of data, the time has come to integrate Community VS into the electronic health record (EHR). Here, the authors describe (i) historical precedent for this concept, (ii) opportunities to expand upon these historical foundations, and (iii) a novel approach to EHR integration. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Emergency EPR and OSL dosimetry with table vitamins and minerals.

    Science.gov (United States)

    Sholom, S; McKeever, S W S

    2016-12-01

    Several table vitamins, minerals and L-lysine amino acid have been preliminarily tested as potential emergency dosemeters using electron paramagnetic resonance (EPR) and optically stimulated luminescence (OSL) techniques. Radiation-induced EPR signals were detected in samples of vitamin B2 and L-lysine while samples of multivitamins of different brands as well as mineral Mg demonstrated prominent OSL signals after exposure to ionizing radiation doses. Basic dosimetric properties of the radiation-sensitive substances were studied, namely dose response, fading of the EPR or OSL signals and values of minimum measurable doses (MMDs). For EPR-sensitive samples, the EPR signal is converted into units of dose using a linear dose response and correcting for fading using the measured fading dependence. For OSL-sensitive materials, a multi-aliquot, enhanced-temperature protocol was developed to avoid the problem of sample sensitization and to minimize the influence of signal fading. The sample dose in this case is also evaluated using the dose response and fading curves. MMDs of the EPR-sensitive samples were below 2 Gy while those of the OSL-sensitive materials were below 500 mGy as long as the samples are analyzed within 1 week after exposure. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Correlations between the particles in the EPR-paradox

    Energy Technology Data Exchange (ETDEWEB)

    Treder, H.J. (Akademie der Wissenschaften der DDR, Potsdam-Babelsberg. Einstein-Laboratorium fuer Theoretische Physik)

    1984-03-01

    The Einstein-Podolsky-Rosen 'gedanken-experiment' does not imply non-local interactions or an 'action-at-a-distance'. Contrary, the EPR proves the measurements at one particle does not have influences at canonical variables of the other particles if the quantum-mechanical commutation relations are true. But, the EPR implies correlations between the particles which come in by 'subjective knowledge'. These correlations are a priori informations about the relative motion or, complementarily, about the motion of the center of mass. The impression of an action-at-a-distance is produced by the use of usual particle coordinates in the EPR-arrangements. The discussion of the Einstein-Podolsky-Rosen 'gedanken-experiment' (EPR) has been going on over fifty years. Einstein, Podolsky, and Rosen formulated their famous paradox in 1935, and in the discussion between N. Bohr (1935, 1949) and Einstein (1936, 1948); A. Einstein (1948) made his point that the EPR implied an 'action-at-a-distance' for quantum-mechanical particles (without obvious classical interactions). His argument is the starting point for the recent discussion about EPR and causality (see A. Aspect 1981).

  10. Pulsed-High Field/High-Frequency EPR Spectroscopy

    Science.gov (United States)

    Fuhs, Michael; Moebius, Klaus

    Pulsed high-field/high-frequency electron paramagnetic resonance (EPR) spectroscopy is used to disentangle many kinds of different effects often obscured in continuous wave (cw) EPR spectra at lower magnetic fields/microwave frequencies. While the high magnetic field increases the resolution of G tensors and of nuclear Larmor frequencies, the high frequencies allow for higher time resolution for molecular dynamics as well as for transient paramagnetic intermediates studied with time-resolved EPR. Pulsed EPR methods are used for example for relaxation-time studies, and pulsed Electron Nuclear DOuble Resonance (ENDOR) is used to resolve unresolved hyperfine structure hidden in inhomogeneous linewidths. In the present article we introduce the basic concepts and selected applications to structure and mobility studies on electron transfer systems, reaction centers of photosynthesis as well as biomimetic models. The article concludes with an introduction to stochastic EPR which makes use of an other concept for investigating resonance systems in order to increase the excitation bandwidth of pulsed EPR. The limited excitation bandwidth of pulses at high frequency is one of the main limitations which, so far, made Fourier transform methods hardly feasible.

  11. EPR study on non- and gamma-irradiated herbal pills

    International Nuclear Information System (INIS)

    Aleksieva, K.; Lagunov, O.; Dimov, K.; Yordanov, N.D.

    2011-01-01

    The results of EPR studies on herbal pills of marigold, hawthorn, yarrow, common balm, tutsan, nettle and thyme before and after gamma-irradiation are reported. Before irradiation all samples exhibit one weak singlet EPR line with a g-factor of 2.0048±0.0005. After irradiation herbal pills could be separated in two groups according to their EPR spectra. Radiation-induced free radicals in pills of marigold, yarrow, nettle, tutsan and thyme could be attributed mainly to saccharide excipients. Tablets of hawthorn and common balm show 'cellulose-like' EPR spectrum, superimposed on partly resolved carbohydrate spectrum, due to the active part (herb) and inulin, which is present in the pills as an excipient. Fading study of the radiation-induced EPR signals confirms that sugar radicals are more stable than cellulose species. The reported results show that the presence of characteristic EPR spectra of herbal pills due to excipients or active part can be used as unambiguous proof of radiation processing within 35 or more days after irradiation.

  12. EPR study on non- and gamma-irradiated herbal pills

    Energy Technology Data Exchange (ETDEWEB)

    Aleksieva, K., E-mail: katerina_bas@abv.b [Institute of Catalysis, Bulgarian Academy of Sciences, 1113 Sofia (Bulgaria); Lagunov, O. [Institute of Catalysis, Bulgarian Academy of Sciences, 1113 Sofia (Bulgaria); Dimov, K. [Institute of Cryobiology and Food Technologies, 1162 Sofia (Bulgaria); Yordanov, N.D. [Institute of Catalysis, Bulgarian Academy of Sciences, 1113 Sofia (Bulgaria)

    2011-06-15

    The results of EPR studies on herbal pills of marigold, hawthorn, yarrow, common balm, tutsan, nettle and thyme before and after gamma-irradiation are reported. Before irradiation all samples exhibit one weak singlet EPR line with a g-factor of 2.0048{+-}0.0005. After irradiation herbal pills could be separated in two groups according to their EPR spectra. Radiation-induced free radicals in pills of marigold, yarrow, nettle, tutsan and thyme could be attributed mainly to saccharide excipients. Tablets of hawthorn and common balm show 'cellulose-like' EPR spectrum, superimposed on partly resolved carbohydrate spectrum, due to the active part (herb) and inulin, which is present in the pills as an excipient. Fading study of the radiation-induced EPR signals confirms that sugar radicals are more stable than cellulose species. The reported results show that the presence of characteristic EPR spectra of herbal pills due to excipients or active part can be used as unambiguous proof of radiation processing within 35 or more days after irradiation.

  13. EPR study on non- and gamma-irradiated herbal pills

    Science.gov (United States)

    Aleksieva, K.; Lagunov, O.; Dimov, K.; Yordanov, N. D.

    2011-06-01

    The results of EPR studies on herbal pills of marigold, hawthorn, yarrow, common balm, tutsan, nettle and thyme before and after gamma-irradiation are reported. Before irradiation all samples exhibit one weak singlet EPR line with a g-factor of 2.0048±0.0005. After irradiation herbal pills could be separated in two groups according to their EPR spectra. Radiation-induced free radicals in pills of marigold, yarrow, nettle, tutsan and thyme could be attributed mainly to saccharide excipients. Tablets of hawthorn and common balm show "cellulose-like" EPR spectrum, superimposed on partly resolved carbohydrate spectrum, due to the active part (herb) and inulin, which is present in the pills as an excipient. Fading study of the radiation-induced EPR signals confirms that sugar radicals are more stable than cellulose species. The reported results show that the presence of characteristic EPR spectra of herbal pills due to excipients or active part can be used as unambiguous proof of radiation processing within 35 or more days after irradiation.

  14. Exploring the Relationships between the Electronic Health Record System Components and Patient Outcomes in an Acute Hospital Setting

    Science.gov (United States)

    Wiggley, Shirley L.

    2011-01-01

    Purpose: The purpose of this study was to examine the relationship between the electronic health record system components and patient outcomes in an acute hospital setting, given that the current presidential administration has earmarked nearly $50 billion to the implementation of the electronic health record. The relationship between the…

  15. Modeling Patient Treatment With Medical Records: An Abstraction Hierarchy to Understand User Competencies and Needs.

    Science.gov (United States)

    St-Maurice, Justin D; Burns, Catherine M

    2017-07-28

    Health care is a complex sociotechnical system. Patient treatment is evolving and needs to incorporate the use of technology and new patient-centered treatment paradigms. Cognitive work analysis (CWA) is an effective framework for understanding complex systems, and work domain analysis (WDA) is useful for understanding complex ecologies. Although previous applications of CWA have described patient treatment, due to their scope of work patients were previously characterized as biomedical machines, rather than patient actors involved in their own care. An abstraction hierarchy that characterizes patients as beings with complex social values and priorities is needed. This can help better understand treatment in a modern approach to care. The purpose of this study was to perform a WDA to represent the treatment of patients with medical records. The methods to develop this model included the analysis of written texts and collaboration with subject matter experts. Our WDA represents the ecology through its functional purposes, abstract functions, generalized functions, physical functions, and physical forms. Compared with other work domain models, this model is able to articulate the nuanced balance between medical treatment, patient education, and limited health care resources. Concepts in the analysis were similar to the modeling choices of other WDAs but combined them in as a comprehensive, systematic, and contextual overview. The model is helpful to understand user competencies and needs. Future models could be developed to model the patient's domain and enable the exploration of the shared decision-making (SDM) paradigm. Our work domain model links treatment goals, decision-making constraints, and task workflows. This model can be used by system developers who would like to use ecological interface design (EID) to improve systems. Our hierarchy is the first in a future set that could explore new treatment paradigms. Future hierarchies could model the patient as a

  16. Unsupervised ensemble ranking of terms in electronic health record notes based on their importance to patients.

    Science.gov (United States)

    Chen, Jinying; Yu, Hong

    2017-04-01

    Allowing patients to access their own electronic health record (EHR) notes through online patient portals has the potential to improve patient-centered care. However, EHR notes contain abundant medical jargon that can be difficult for patients to comprehend. One way to help patients is to reduce information overload and help them focus on medical terms that matter most to them. Targeted education can then be developed to improve patient EHR comprehension and the quality of care. The aim of this work was to develop FIT (Finding Important Terms for patients), an unsupervised natural language processing (NLP) system that ranks medical terms in EHR notes based on their importance to patients. We built FIT on a new unsupervised ensemble ranking model derived from the biased random walk algorithm to combine heterogeneous information resources for ranking candidate terms from each EHR note. Specifically, FIT integrates four single views (rankers) for term importance: patient use of medical concepts, document-level term salience, word co-occurrence based term relatedness, and topic coherence. It also incorporates partial information of term importance as conveyed by terms' unfamiliarity levels and semantic types. We evaluated FIT on 90 expert-annotated EHR notes and used the four single-view rankers as baselines. In addition, we implemented three benchmark unsupervised ensemble ranking methods as strong baselines. FIT achieved 0.885 AUC-ROC for ranking candidate terms from EHR notes to identify important terms. When including term identification, the performance of FIT for identifying important terms from EHR notes was 0.813 AUC-ROC. Both performance scores significantly exceeded the corresponding scores from the four single rankers (P<0.001). FIT also outperformed the three ensemble rankers for most metrics. Its performance is relatively insensitive to its parameter. FIT can automatically identify EHR terms important to patients. It may help develop future interventions

  17. Care team identification in the electronic health record: A critical first step for patient-centered communication.

    Science.gov (United States)

    Dalal, Anuj K; Schnipper, Jeffrey L

    2016-05-01

    Patient-centered communication is essential to coordinate care and safely progress patients from admission through discharge. Hospitals struggle with improving the complex and increasingly electronic conversation patterns among care team members, patients, and caregivers to achieve effective patient-centered communication across settings. Accurate and reliable identification of all care team members is a precursor to effective patient-centered communication and ideally should be facilitated by the electronic health record. However, the process of identifying care team members is challenging, and team lists in the electronic health record are typically neither accurate nor reliable. Based on the literature and on experience from 2 initiatives at our institution, we outline strategies to improve care team identification in the electronic health record and discuss potential implications for patient-centered communication. Journal of Hospital Medicine 2016;11:381-385. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  18. Leveraging electronic healthcare record standards and semantic web technologies for the identification of patient cohorts.

    Science.gov (United States)

    Fernández-Breis, Jesualdo Tomás; Maldonado, José Alberto; Marcos, Mar; Legaz-García, María del Carmen; Moner, David; Torres-Sospedra, Joaquín; Esteban-Gil, Angel; Martínez-Salvador, Begoña; Robles, Montserrat

    2013-12-01

    The secondary use of electronic healthcare records (EHRs) often requires the identification of patient cohorts. In this context, an important problem is the heterogeneity of clinical data sources, which can be overcome with the combined use of standardized information models, virtual health records, and semantic technologies, since each of them contributes to solving aspects related to the semantic interoperability of EHR data. To develop methods allowing for a direct use of EHR data for the identification of patient cohorts leveraging current EHR standards and semantic web technologies. We propose to take advantage of the best features of working with EHR standards and ontologies. Our proposal is based on our previous results and experience working with both technological infrastructures. Our main principle is to perform each activity at the abstraction level with the most appropriate technology available. This means that part of the processing will be performed using archetypes (ie, data level) and the rest using ontologies (ie, knowledge level). Our approach will start working with EHR data in proprietary format, which will be first normalized and elaborated using EHR standards and then transformed into a semantic representation, which will be exploited by automated reasoning. We have applied our approach to protocols for colorectal cancer screening. The results comprise the archetypes, ontologies, and datasets developed for the standardization and semantic analysis of EHR data. Anonymized real data have been used and the patients have been successfully classified by the risk of developing colorectal cancer. This work provides new insights in how archetypes and ontologies can be effectively combined for EHR-driven phenotyping. The methodological approach can be applied to other problems provided that suitable archetypes, ontologies, and classification rules can be designed.

  19. Leveraging electronic healthcare record standards and semantic web technologies for the identification of patient cohorts

    Science.gov (United States)

    Fernández-Breis, Jesualdo Tomás; Maldonado, José Alberto; Marcos, Mar; Legaz-García, María del Carmen; Moner, David; Torres-Sospedra, Joaquín; Esteban-Gil, Angel; Martínez-Salvador, Begoña; Robles, Montserrat

    2013-01-01

    Background The secondary use of electronic healthcare records (EHRs) often requires the identification of patient cohorts. In this context, an important problem is the heterogeneity of clinical data sources, which can be overcome with the combined use of standardized information models, virtual health records, and semantic technologies, since each of them contributes to solving aspects related to the semantic interoperability of EHR data. Objective To develop methods allowing for a direct use of EHR data for the identification of patient cohorts leveraging current EHR standards and semantic web technologies. Materials and methods We propose to take advantage of the best features of working with EHR standards and ontologies. Our proposal is based on our previous results and experience working with both technological infrastructures. Our main principle is to perform each activity at the abstraction level with the most appropriate technology available. This means that part of the processing will be performed using archetypes (ie, data level) and the rest using ontologies (ie, knowledge level). Our approach will start working with EHR data in proprietary format, which will be first normalized and elaborated using EHR standards and then transformed into a semantic representation, which will be exploited by automated reasoning. Results We have applied our approach to protocols for colorectal cancer screening. The results comprise the archetypes, ontologies, and datasets developed for the standardization and semantic analysis of EHR data. Anonymized real data have been used and the patients have been successfully classified by the risk of developing colorectal cancer. Conclusions This work provides new insights in how archetypes and ontologies can be effectively combined for EHR-driven phenotyping. The methodological approach can be applied to other problems provided that suitable archetypes, ontologies, and classification rules can be designed. PMID:23934950

  20. Distinctive EPR signals provide an understanding of the affinity of bis-(3-hydroxy-4-pyridinonato) copper(II) complexes for hydrophobic environments.

    Science.gov (United States)

    Rangel, Maria; Leite, Andreia; Silva, André M N; Moniz, Tânia; Nunes, Ana; Amorim, M João; Queirós, Carla; Cunha-Silva, Luís; Gameiro, Paula; Burgess, John

    2014-07-07

    In this work we report the synthesis and characterization of a set of 3-hydroxy-4-pyridinone copper(ii) complexes with variable lipophilicity. EPR spectroscopy was used to characterize the structure of copper(ii) complexes in solution, and as a tool to gain insight into solvent interactions. EPR spectra of solutions of the [CuL2] complexes recorded in different solvents reveal the presence of two copper species whose ratio depends on the nature of the solvent. Investigation of EPR spectra in the pure solvents methanol, dimethylsulfoxide, dichloromethane and their 50% (v/v) mixtures with toluene allowed the characterization of two types of copper signals (gzz = 2.30 and gzz = 2.26) whose spin-Hamiltonian parameters are consistent with solvated and non-solvated square-planar copper(ii) complexes. Regarding the potential biological application of ligands and complexes and to get insight into the partition properties in water-membrane interfaces, EPR spectra were also obtained in water-saturated octanol, an aqueous solution buffered at pH = 7.4 and liposome suspensions, for three compounds representative of different hydro-lipophilic balances. Analysis of the EPR spectra obtained in liposomes allowed establishment of the location of the complexes in the water and lipid phases. In view of the results of this work we put forward the use of EPR spectroscopy to assess the affinity of copper(ii) complexes for a hydrophobic environment and also to obtain indirect information about the lipophilicity of the ligands and similar EPR silent complexes.

  1. EPC projects for EPR Flamanville 3 NPP

    International Nuclear Information System (INIS)

    Diaz, J.I.; Polo, J.; Aymerich, E.; Cubian, B.

    2010-01-01

    IBERDROLA Ingenieria y Construccion is carrying out a handful of activities in the EPR Flamanville 3 -FA3 NPP- context since 2007 matching oriented to position the company in the emerging marketplace of new nuclear power plants Generation III+, whose expectation for the next years is highly promising. IBERDROLA Ingenieria y Construccion leads 5 EPC -Engineering, Procurement and Commissioning- projects for FA3 NPP from the Nuclear Island till Sea Water Pumping Station as follows: - Design, procurement. fabrication, installation and testing of 21 shell and tubes heat-exchangers for the nuclear island. 12 out of these 17 HXs are conventional and will be designed according to ASME BPV code Section VIII and have to comply with PED 97/23/CE and ESPN. The remaining 5 HXs are nuclear and will be designed according to ASME BPV code Section III and have also to comply with PED and ESPN. - Design, procurement, fabrication and assembly of 9 demineralizers for different plant systems. Three of these Important To Safety (IPS) equipments have been manufactured according with ASME VIII codes and six of them with EN 13445 code plus additional requirements to comply with PED and final client requirements for nuclear island. - Design, fabrication and installation of qualified travelling water screening filters. The equipments furnished will be two nuclear safety qualified filters and associated equipment (cleaning water system and control system). Additionally some auxiliary devices such as grids, automatic trash rakes and stop gates are included in the contract. - Engineering, procurement, fabrication, erection and commissioning for the condensate treatment plant. This system includes a demineralizer tank, 5 filters, reactive injection mixer, pneumatic and manual valves, piping and instrumentation and control systems. - Engineering, procurement erection and commissioning for the electro-chlorination plant to protect the IPS piping for Condensate Water System for FA3. This system

  2. EPC projects for EPR Flamanville 3 NPP

    Energy Technology Data Exchange (ETDEWEB)

    Diaz, J.I.; Polo, J.; Aymerich, E.; Cubian, B. [Nuclear Generation Department, Iberdrola Ingenieria y Construccion, Avda. Manoteras 20, 28050 Madrid (Spain)

    2010-07-01

    IBERDROLA Ingenieria y Construccion is carrying out a handful of activities in the EPR Flamanville 3 -FA3 NPP- context since 2007 matching oriented to position the company in the emerging marketplace of new nuclear power plants Generation III+, whose expectation for the next years is highly promising. IBERDROLA Ingenieria y Construccion leads 5 EPC -Engineering, Procurement and Commissioning- projects for FA3 NPP from the Nuclear Island till Sea Water Pumping Station as follows: - Design, procurement. fabrication, installation and testing of 21 shell and tubes heat-exchangers for the nuclear island. 12 out of these 17 HXs are conventional and will be designed according to ASME BPV code Section VIII and have to comply with PED 97/23/CE and ESPN. The remaining 5 HXs are nuclear and will be designed according to ASME BPV code Section III and have also to comply with PED and ESPN. - Design, procurement, fabrication and assembly of 9 demineralizers for different plant systems. Three of these Important To Safety (IPS) equipments have been manufactured according with ASME VIII codes and six of them with EN 13445 code plus additional requirements to comply with PED and final client requirements for nuclear island. - Design, fabrication and installation of qualified travelling water screening filters. The equipments furnished will be two nuclear safety qualified filters and associated equipment (cleaning water system and control system). Additionally some auxiliary devices such as grids, automatic trash rakes and stop gates are included in the contract. - Engineering, procurement, fabrication, erection and commissioning for the condensate treatment plant. This system includes a demineralizer tank, 5 filters, reactive injection mixer, pneumatic and manual valves, piping and instrumentation and control systems. - Engineering, procurement erection and commissioning for the electro-chlorination plant to protect the IPS piping for Condensate Water System for FA3. This system

  3. Using Electronic Health Records to Build an Ophthalmologic Data Warehouse and Visualize Patients' Data.

    Science.gov (United States)

    Kortüm, Karsten U; Müller, Michael; Kern, Christoph; Babenko, Alexander; Mayer, Wolfgang J; Kampik, Anselm; Kreutzer, Thomas C; Priglinger, Siegfried; Hirneiss, Christoph

    2017-06-01

    To develop a near-real-time data warehouse (DW) in an academic ophthalmologic center to gain scientific use of increasing digital data from electronic medical records (EMR) and diagnostic devices. Database development. Specific macular clinic user interfaces within the institutional hospital information system were created. Orders for imaging modalities were sent by an EMR-linked picture-archiving and communications system to the respective devices. All data of 325 767 patients since 2002 were gathered in a DW running on an SQL database. A data discovery tool was developed. An exemplary search for patients with age-related macular degeneration, performed cataract surgery, and at least 10 intravitreal (excluding bevacizumab) injections was conducted. Data related to those patients (3 142 204 diagnoses [including diagnoses from other fields of medicine], 720 721 procedures [eg, surgery], and 45 416 intravitreal injections) were stored, including 81 274 optical coherence tomography measurements. A web-based browsing tool was successfully developed for data visualization and filtering data by several linked criteria, for example, minimum number of intravitreal injections of a specific drug and visual acuity interval. The exemplary search identified 450 patients with 516 eyes meeting all criteria. A DW was successfully implemented in an ophthalmologic academic environment to support and facilitate research by using increasing EMR and measurement data. The identification of eligible patients for studies was simplified. In future, software for decision support can be developed based on the DW and its structured data. The improved classification of diseases and semiautomatic validation of data via machine learning are warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Characterizing workflow for pediatric asthma patients in emergency departments using electronic health records.

    Science.gov (United States)

    Ozkaynak, Mustafa; Dziadkowiec, Oliwier; Mistry, Rakesh; Callahan, Tiffany; He, Ze; Deakyne, Sara; Tham, Eric

    2015-10-01

    The purpose of this study was to describe a workflow analysis approach and apply it in emergency departments (EDs) using data extracted from the electronic health record (EHR) system. We used data that were obtained during 2013 from the ED of a children's hospital and its four satellite EDs. Workflow-related data were extracted for all patient visits with either a primary or secondary diagnosis on discharge of asthma (ICD-9 code=493). For each patient visit, eight different a priori time-stamped events were identified. Data were also collected on mode of arrival, patient demographics, triage score (i.e. acuity level), and primary/secondary diagnosis. Comparison groups were by acuity levels 2 and 3 with 2 being more acute than 3, arrival mode (ambulance versus walk-in), and site. Data were analyzed using a visualization method and Markov Chains. To demonstrate the viability and benefit of the approach, patient care workflows were visually and quantitatively compared. The analysis of the EHR data allowed for exploration of workflow patterns and variation across groups. Results suggest that workflow was different for different arrival modes, settings and acuity levels. EHRs can be used to explore workflow with statistical and visual analytics techniques novel to the health care setting. The results generated by the proposed approach could be utilized to help institutions identify workflow issues, plan for varied workflows and ultimately improve efficiency in caring for diverse patient groups. EHR data and novel analytic techniques in health care can expand our understanding of workflow in both large and small ED units. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Organizational strategies for promoting patient and provider uptake of personal health records.

    Science.gov (United States)

    Wells, Susan; Rozenblum, Ronen; Park, Andrea; Dunn, Marie; Bates, David W

    2015-01-01

    To investigate organizational strategies to promote personal health records (PHRs) adoption with a focus on patients with chronic disease. Using semi-structured interviews and a web-based survey, we sampled US health delivery organizations which had implemented PHRs for at least 12 months, were recognized as PHR innovators, and had scored highly in national patient satisfaction surveys. Respondents had lead positions for clinical information systems or high-risk population management. Using grounded theory approach, thematic categories were derived from interviews and coupled with data from the survey. Interviews were conducted with 30 informants from 16 identified organizations. Organizational strategies were directed towards raising patient awareness via multimedia communications, and provider acceptance and uptake. Strategies for providers were grouped into six main themes: organizational vision, governance and policies, work process redesign, staff training, information technology (IT) support, and monitoring and incentives. Successful organizations actively communicated their vision, engaged leaders at all levels, had clear governance, planning, and protocols, set targets, and celebrated achievement. The most effective strategy for patient uptake was through health professional encouragement. No specific outreach efforts targeted patients with chronic disease. Registration and PHR activity was routinely measured but without reference to a denominator population or high risk subpopulations. Successful PHR implementation represents a social change and operational project catalyzed by a technical solution. The key to clinician acceptance is making their work easier. However, organizations will likely not achieve the value they want from PHRs unless they target specific populations and monitor their uptake. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions

  6. How bioethics principles can aid design of electronic health records to accommodate patient granular control.

    Science.gov (United States)

    Meslin, Eric M; Schwartz, Peter H

    2015-01-01

    Ethics should guide the design of electronic health records (EHR), and recognized principles of bioethics can play an important role. This approach was recently adopted by a team of informaticists who are designing and testing a system where patients exert granular control over who views their personal health information. While this method of building ethics in from the start of the design process has significant benefits, questions remain about how useful the application of bioethics principles can be in this process, especially when principles conflict. For instance, while the ethical principle of respect for autonomy supports a robust system of granular control, the principles of beneficence and nonmaleficence counsel restraint due to the danger of patients being harmed by restrictions on provider access to data. Conflict between principles has long been recognized by ethicists and has even motivated attacks on approaches that state and apply principles. In this paper, we show how using ethical principles can help in the design of EHRs by first explaining how ethical principles can and should be used generally, and then by discussing how attention to details in specific cases can show that the tension between principles is not as bad as it initially appeared. We conclude by suggesting ways in which the application of these (and other) principles can add value to the ongoing discussion of patient involvement in their health care. This is a new approach to linking principles to informatics design that we expect will stimulate further interest.

  7. Acoustic analysis of snoring sounds recorded with a smartphone according to obstruction site in OSAS patients.

    Science.gov (United States)

    Koo, Soo Kweon; Kwon, Soon Bok; Kim, Yang Jae; Moon, J I Seung; Kim, Young Jun; Jung, Sung Hoon

    2017-03-01

    Snoring is a sign of increased upper airway resistance and is the most common symptom suggestive of obstructive sleep apnea. Acoustic analysis of snoring sounds is a non-invasive diagnostic technique and may provide a screening test that can determine the location of obstruction sites. We recorded snoring sounds according to obstruction level, measured by DISE, using a smartphone and focused on the analysis of formant frequencies. The study group comprised 32 male patients (mean age 42.9 years). The spectrogram pattern, intensity (dB), fundamental frequencies (F 0 ), and formant frequencies (F 1 , F 2 , and F 3 ) of the snoring sounds were analyzed for each subject. On spectrographic analysis, retropalatal level obstruction tended to produce sharp and regular peaks, while retrolingual level obstruction tended to show peaks with a gradual onset and decay. On formant frequency analysis, F 1 (retropalatal level vs. retrolingual level: 488.1 ± 125.8 vs. 634.7 ± 196.6 Hz) and F 2 (retropalatal level vs. retrolingual level: 1267.3 ± 306.6 vs. 1723.7 ± 550.0 Hz) of retrolingual level obstructions showed significantly higher values than retropalatal level obstruction (p smartphone can be effective for recording snoring sounds.

  8. Usefulness of implantable loop recorder in a patient with syncope during bathing

    Directory of Open Access Journals (Sweden)

    Motohiro Nakao, MD

    2013-02-01

    Full Text Available A 27-year-old man presented to our hospital with a 1-year-hisory of repeated syncope, which particularly occurred while bathing or on a hot day. The head-up tilt test did not induce arrhythmia; however, blood pressure decreased by 39 mm Hg without any symptoms. Given that no bradycardia/tachycardia was induced on electrophysiological study and carotid sinus massage, an implantable loop recorder (ILR was implanted. After 2 months, syncope again occurred during bathing at midnight. Sinus arrest and a maximum ventricular pause of 10.2 s were documented using the ILR. After pacemaker implantation, the patient had not experienced syncope for 14 months.

  9. Olkiluoto 3: Finland has chosen a EPR

    International Nuclear Information System (INIS)

    Brummer, S.

    2003-01-01

    According to the Finn law any nuclear project has to be declared conformed to the general interest of the country by the government and then has to be approved by the parliament. In may 2002 the Finn parliament approved the project of the TVO company: the construction of a new nuclear unit on the Olkiluoto site and the direct and definitive disposal of spent fuels in the granite underground layers of the same site. The project was agreed with 109 votes for and 92 against. In september 2002 an international invitation to tender was launched and 4 companies made proposals: Westinghouse, Atomstroexport, Framatome-ANP and General Electric. Westinghouse withdrew its offer some time later. In october 2003 TVO announced that the unit will be a 1600 MW EPR (European pressurized reactor) built by Framatome-ANP. The construction work will begin in spring 2005 and the unit is scheduled to enter into service in 2009. At that time the contribution of nuclear energy to the Finn energy production will reach 35%. (A.C.)

  10. Pulsed EPR for studying silver clusters

    International Nuclear Information System (INIS)

    Michalik, J.; Wasowicz, T.; Sadlo, J.; Reijerse, E.J.; Kevan, L.

    1996-01-01

    The cationic silver clusters of different nuclearity have been produced by radiolysis of zeolite A and SAPO molecular sieves containing Ag + as exchangeable cations. The pulsed EPR spectroscopy has been applied for studying the local environment of silver cluster in order to understand the mechanism of cluster formation and stabilization. the electron spin echo modulation (ESEM) results on Ag 6 n+ cluster in dehydration zeolite A indicate that the hexameric silver is stabilized only in sodalite cages which are surrounded by α-cages containing no water molecules. Trimeric silver clusters formed in hydrated A zeolites strongly interact with water, thus the paramagnetic center can be considered as a cluster-water adduct. In SAPO-molecular sieves, silver clusters are formed only in the presence of adsorbed alcohol molecules. From ESEM it is determined that Ag 4 n+ in SAPO-42 is stabilized in α cages, where it is directly coordinated by two methanol molecules. Dimeric silver, Ag 2 + in SAPO-5 and SAPO-11 is located in 6-ring channels and interacts with three CH 3 OH molecules, each in different 10 ring or 12 ring channels. The differences of Ag 2 + stability in SAPO-5 and SAPO-11 are also discussed. (Author)

  11. A critical assessment of early warning score records in 168,000 patients

    DEFF Research Database (Denmark)

    Pedersen, Niels Egholm; Rasmussen, Lars Simon; Petersen, John Asger

    2018-01-01

    critically assessed NEWS data recorded over 12 months. This observational study included NEWS records from adult inpatients hospitalized in the Capital Region of Denmark during 2014. Physiological variables and the use of supplementary oxygen (NEWS variables) were recorded. We identified implausible records...

  12. The effect of thermal treatment on radiation-induced EPR signals in tooth enamel

    International Nuclear Information System (INIS)

    Vorona, I.P.; Ishchenko, S.S.; Baran, N.P.

    2005-01-01

    The effect of thermal treatment on the radiation-induced EPR spectrum of tooth enamel was studied. Annealing before sample irradiation was found to increase enamel radiation sensitivity by more than 40%. Depending on the annealing conditions the EPR signals of three supplementary radiation radicals were observed in addition to the main signal caused by CO 2 - radicals. It was found that the presence of these signals in the enamel EPR spectra provides evidence of sample annealing. The possibility of obtaining information about sample history by studying the additional EPR signals is discussed. It can be important to EPR dating and EPR dosimetry

  13. Boron dose determination for BNCT using Fricke and EPR dosimetry

    International Nuclear Information System (INIS)

    Wielopolski, L.; Ciesielski, B.

    1995-01-01

    In Boron Neutron Capture Therapy (BNCT) the dominant dose delivered to the tumor is due to α and 7 Li charged particles resulting from a neutron capture by 10 B and is referred to herein as the boron dose. Boron dose is directly attributable to the following two independent factors, one boron concentration and the neutron capture energy dependent cross section of boron, and two the energy spectrum of the neutrons that interact with boron. The neutron energy distribution at a given point is dictated by the incident neutron energy distribution, the depth in tissue, geometrical factors such as beam size and patient's dimensions. To account for these factors can be accommodated by using Monte Carlo theoretical simulations. However, in conventional experimental BNCT dosimetry, e.g., using TLDs or ionization chambers, it is only possible to estimate the boron dose. To overcome some of the limitations in the conventional dosimetry, modifications in ferrous sulfate dosimetry (Fricke) and Electron Paramagnetic Resonance (EPR) dosimetry in alanine, enable to measure specifically boron dose in a mixed gamma neutron radiation fields. The boron dose, in either of the dosimeters, is obtained as a difference between measurements with boronated and unboronated dosimeters. Since boron participates directly in the measurements, the boron dosimetry reflects the true contribution, integral of the neutron energy spectrum with boron cross section, of the boron dose to the total dose. Both methods are well established and used extensively in dosimetry, they are presented briefly here

  14. A qualitative study of how patients with type 2 diabetes use an electronic stand-alone personal health record.

    Science.gov (United States)

    Fuji, Kevin T; Abbott, Amy A; Galt, Kimberly A

    2015-04-01

    Patient use of personal health records (PHRs) to manage their health information has been proposed to enhance patient knowledge and empower patients to make changes in their self-care behaviors. However, there remains a gap in understanding about patients' actual PHR use behaviors. The purpose of this qualitative study was to explore how patients with type 2 diabetes used a PHR to manage their diabetes-related health information for self-care. Fifty-nine patients with type 2 diabetes were interviewed 3-6 months after receiving initial training on a free-of-charge, Web-based PHR. Interviews were audio-recorded, transcribed, and analyzed using an iterative process of in vivo coding, categorization, and theme development. Nine themes emerged, three of which expressed positive experiences: complete and accessible record; increased awareness; and behavioral changes. The remaining six themes expressed negative experiences: out of sight, out of mind; I would have used it if I were sicker; economic, infrastructure, and computer literacy barriers; lack of patient-provider engagement; double tracking; and privacy and security concerns. Despite some potential positive benefits resulting from PHR use, several barriers inhibited sustained and effective use over time. Provider and patient education about the benefits of PHR use and about the potential for filling in information gaps in the provider-based record is key to engage patients and stimulate PHR adoption and use.

  15. How is adult patient adherence recorded in orthodontists’ clinical notes? A mixed-method case-note study

    Directory of Open Access Journals (Sweden)

    Al Shammary N

    2017-10-01

    Full Text Available Nawaf Al Shammary,1 Koula Asimakopoulou,1 Fraser McDonald,2 Jonathon T Newton,1 Sasha Scambler1 1Division of Population and Patient Health, 2Craniofacial Development and Stem Cell Biology Department, King’s College London Dental Institute, London, UKBackground: Patient adherence in orthodontic treatment is extremely important as it is linked with better treatment outcomes. Despite its importance, however, there is no shared definition of the concept. This makes the recording of adherence-related behaviors in patient notes difficult. The current study explored how, and to what extent adherence is recorded in adult patients’ medical records by orthodontists working in a large National Health Service (NHS London hospital.Materials and methods: A mixed-methods approach was used. A total of 17 clinicians with a mean age of 31 years (SD =4.87 provided N=20 case notes spanning N=324 appointments with patients they judged to be non-adherent. The notes were inspected for evidence of recording of patient adherence using adherence indicators identified in the literature.Results: The term “adherence” did not feature in any notes. The quantitative analysis showed that the three most frequent adherence-related behaviors recorded in notes were “oral hygiene,” “appointment attendance” and “breakages of appliances.” Qualitative analysis not only confirmed these factors but also showed that 1 the clinical aspects of treatment, 2 clinician–patient interaction factors and 3 patient attitudes also featured. This part of the analysis also highlighted inconsistencies across case notes in terms of the amount of information being recorded.Conclusion: Adherence as a term does not feature in the clinical case notes of clinician-identified non-adherent adult patients, while predictors of adherence are recorded with varying degrees of consistency. Keywords: adherence, adults, orthodontic treatment

  16. Kinetics of elimination and distribution in blood and liver of biocompatible ferrofluids based on Fe{sub 3}O{sub 4} nanoparticles: An EPR and XRF study

    Energy Technology Data Exchange (ETDEWEB)

    Gamarra, L.F. [Instituto de Ensino e Pesquisa, Hospital Israelita Albert Einstein, Sao Paulo 05651-901 (Brazil); Instituto de Fisica, Universidade de Sao Paulo, Sao Paulo 05315-970 (Brazil)], E-mail: lgamarra@if.usp.br; Pontuschka, W.M. [Instituto de Fisica, Universidade de Sao Paulo, Sao Paulo 05315-970 (Brazil); Amaro, E. [Instituto de Ensino e Pesquisa, Hospital Israelita Albert Einstein, Sao Paulo 05651-901 (Brazil); Instituto de Radiologia, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-001 (Brazil); Costa-Filho, A.J. [Instituto de Fisica de Sao Carlos, Universidade de Sao Paulo, Sao Carlos 13560-970 (Brazil); Brito, G.E.S. [Instituto de Fisica, Universidade de Sao Paulo, Sao Paulo 05315-970 (Brazil); Vieira, E.D. [Instituto de Fisica de Sao Carlos, Universidade de Sao Paulo, Sao Carlos 13560-970 (Brazil); Carneiro, S.M. [Laboratorio de Biologia Celular, Instituto Butantan, Sao Paulo 05503-900 (Brazil); Escriba, D.M. [Instituto de Fisica, Universidade de Sao Paulo, Sao Paulo 05315-970 (Brazil); Falleiros, A.M.F. [Centro de Ciencias Biologicas, Universidade Estadual de Londrina 86051-990 (Brazil); Salvador, V.L. [Centro de aplicacoes e Lasers, IPEN, Sao Paulo 05508-000 (Brazil)

    2008-05-01

    In this study, we evaluated the biodistribution and the elimination kinetics of a biocompatible magnetic fluid, Endorem{sup TM}, based on dextran-coated Fe{sub 3}O{sub 4} nanoparticles endovenously injected into Winstar rats. The iron content in blood and liver samples was recorded using electron paramagnetic resonance (EPR) and X-ray fluorescence (XRF) techniques. The EPR line intensity at g = 2.1 was found to be proportional to the concentration of magnetic nanoparticles and the best temperature for spectra acquisition was 298 K. Both EPR and XRF analysis indicated that the maximum concentration of iron in the liver occurred 95 min after the ferrofluid administration. The half-life of the magnetic nanoparticles (MNP) in the blood was (11.6 {+-} 0.6) min measured by EPR and (12.6 {+-} 0.6) min determined by XRF. These results indicate that both EPR and XRF are very useful and appropriate techniques for the study of kinetics of ferrofluid elimination and biodistribution after its administration into the organism.

  17. Kinetics of elimination and distribution in blood and liver of biocompatible ferrofluids based on Fe3O4 nanoparticles: An EPR and XRF study

    International Nuclear Information System (INIS)

    Gamarra, L.F.; Pontuschka, W.M.; Amaro, E.; Costa-Filho, A.J.; Brito, G.E.S.; Vieira, E.D.; Carneiro, S.M.; Escriba, D.M.; Falleiros, A.M.F.; Salvador, V.L.

    2008-01-01

    In this study, we evaluated the biodistribution and the elimination kinetics of a biocompatible magnetic fluid, Endorem TM , based on dextran-coated Fe 3 O 4 nanoparticles endovenously injected into Winstar rats. The iron content in blood and liver samples was recorded using electron paramagnetic resonance (EPR) and X-ray fluorescence (XRF) techniques. The EPR line intensity at g = 2.1 was found to be proportional to the concentration of magnetic nanoparticles and the best temperature for spectra acquisition was 298 K. Both EPR and XRF analysis indicated that the maximum concentration of iron in the liver occurred 95 min after the ferrofluid administration. The half-life of the magnetic nanoparticles (MNP) in the blood was (11.6 ± 0.6) min measured by EPR and (12.6 ± 0.6) min determined by XRF. These results indicate that both EPR and XRF are very useful and appropriate techniques for the study of kinetics of ferrofluid elimination and biodistribution after its administration into the organism

  18. Thermodynamic Basis of Electron Transfer in Dihydroorotate Dehydrogenase B from Lactococcus lactis:  Analysis by Potentiometry, EPR Spectroscopy, and ENDOR Spectroscopy

    DEFF Research Database (Denmark)

    Mohnsen, Al-Walid A.; Rigby, Stephen E. J.; Jensen, Kaj Frank

    2004-01-01

    Dihydroorotate dehydrogenase B (DHODB) is a complex iron-sulfur flavoprotein that catalyzes the conversion of dihydroorotate to orotate and the reduction of NAD+. The enzyme is a dimer of heterodimers containing an FMN, an FAD, and a 2Fe-2S center. UV-visible, EPR, and ENDOR spectroscopies have...... similar to those recorded for the blue semiquinone of free flavins in aqueous solution, thus confirming the presence of this species in DHODB. Spectral features observed during EPR spectroscopy of dithionite-reduced DHODB are consistent with the midpoint reduction potentials determined using UV-visible...... spectroscopy and further identify an unusual EPR signal with very small rhombic anisotropy and g values of 2.02, 1.99, and 1.96. This unusual signal is assigned to the formation of a spin interacting state between the FMN semiquinone species and the reduced 2Fe-2S center. Reduction of DHODB using an excess...

  19. The measurement of oxygen in vivo using EPR techniques

    International Nuclear Information System (INIS)

    Swartz, Harold M.; Clarkson, Robert B.

    1998-01-01

    The measurement of pO 2 in vivo using EPR has some features which have already led to very useful applications and this approach is likely to have increasingly wide and effective use. It is based on the effect of oxygen on EPR spectra which provides a sensitive and accurate means to measure pO 2 quantitatively. The development of oxygen-sensitive paramagnetic materials which are very stable, combined with instrumental developments, has been crucial to the in vivo applications of this technique. The physical basis and biological applications of in vivo EPR oximetry are reviewed, with particular emphasis on the use of EPR spectroscopy at 1 GHz using particulate paramagnetic materials for the repetitive and non-invasive measurement of pO 2 in tissues. In vivo EPR has already produced some very useful results which have contributed significantly to solving important biological problems. The characteristics of EPR oximetry which appear to be especially useful are often complementary to existing techniques for measuring oxygen in tissues. These characteristics include the capability of making repeated measurements from the same site, high sensitivity to low levels of oxygen, and non-invasive options. The existing techniques are especially useful for studies in small animals, where the depth of measurements is not an overriding issue. In larger animals and potentially in human subjects, non-invasive techniques seem to be immediately applicable to study phenomena very near the surface (within 10 mm) while invasive techniques have some very promising uses. The clinical uses of EPR oximetry which seem especially promising and likely to be undertaken in the near future are long-term monitoring of the status and response to treatment of peripheral vascular disease and optimizing cancer therapy by enabling it to be modified on the basis of the pO 2 measured in the tumour. (author)

  20. Electronic Health Record Based Algorithm to Identify Patients with Autism Spectrum Disorder.

    Directory of Open Access Journals (Sweden)

    Todd Lingren

    Full Text Available Cohort selection is challenging for large-scale electronic health record (EHR analyses, as International Classification of Diseases 9th edition (ICD-9 diagnostic codes are notoriously unreliable disease predictors. Our objective was to develop, evaluate, and validate an automated algorithm for determining an Autism Spectrum Disorder (ASD patient cohort from EHR. We demonstrate its utility via the largest investigation to date of the co-occurrence patterns of medical comorbidities in ASD.We extracted ICD-9 codes and concepts derived from the clinical notes. A gold standard patient set was labeled by clinicians at Boston Children's Hospital (BCH (N = 150 and Cincinnati Children's Hospital and Medical Center (CCHMC (N = 152. Two algorithms were created: (1 rule-based implementing the ASD criteria from Diagnostic and Statistical Manual of Mental Diseases 4th edition, (2 predictive classifier. The positive predictive values (PPV achieved by these algorithms were compared to an ICD-9 code baseline. We clustered the patients based on grouped ICD-9 codes and evaluated subgroups.The rule-based algorithm produced the best PPV: (a BCH: 0.885 vs. 0.273 (baseline; (b CCHMC: 0.840 vs. 0.645 (baseline; (c combined: 0.864 vs. 0.460 (baseline. A validation at Children's Hospital of Philadelphia yielded 0.848 (PPV. Clustering analyses of comorbidities on the three-site large cohort (N = 20,658 ASD patients identified psychiatric, developmental, and seizure disorder clusters.In a large cross-institutional cohort, co-occurrence patterns of comorbidities in ASDs provide further hypothetical evidence for distinct courses in ASD. The proposed automated algorithms for cohort selection open avenues for other large-scale EHR studies and individualized treatment of ASD.