Background
The current health system in Australia is comprised of both electronic‐ and paper‐based medical records. The Federal Government has approved funding for the development of an individual ...health identifier and a universally adopted online health repository.
Aims
To determine attitudes and beliefs of patients and healthcare workers regarding the use of stored medical information and the personally controlled electronic health record (PCEHR) in selected major hospitals in Victoria.
Methods
Qualitative survey of patients and healthcare workers (n = 600 each group) conducted during 2014 across five major hospitals in Melbourne to measure the awareness, attitudes and barriers to electronic health and the PCEHR.
Results
Of the patients, 93.3% support the concept of a shared electronic healthcare record, 33.7% were aware of the PCEHR and only 11% had registered. The majority of healthcare workers believed that the presence of a shared health record would result in an increased appropriateness of care and patient safety by reducing adverse drug events and improving the timeliness of care provided. However, only 46% of healthcare workers were aware of the PCEHR.
Conclusions
This study provides a baseline evaluation of perceptions surrounding eHealth and PCHER in acute health services in five metropolitan centres. While there appears to be a readiness for adoption of these strategies for healthcare documentation, patients require motivation to register for the PCEHR, and healthcare workers require more information on the potential benefits to them to achieve more timely and efficient care.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Samples of fine particulate matter were collected in a roadway tunnel near Houston, TX over a period of 4 days during two separate sampling periods: one sampling period from 1200 to 1400 local time ...and another sampling period from 1600 to 1800 local time. During the two sampling periods, the tunnel traffic contained roughly equivalent numbers of heavy-duty diesel trucks. However, during the late afternoon sampling period, the tunnel contained twice as many light-duty gasoline-powered vehicles. The effect of this shift in the vehicle fleet affects the overall emission index (grams pollutant emitted per kilogram carbon in fuel) for fine particles and fine particulate elemental carbon. Additionally, this shift in the fraction of diesel vehicles in the tunnel is used to determine if the chemical mass balancing techniques used to track emissions from gasoline-powered and diesel-powered emissions accurately separates these two emission categories. The results show that the chemical mass balancing calculations apportion roughly equal amounts of the particulate matter measured to diesel vehicles between the two periods and attribute almost twice as much particulate matter in the late afternoon sampling period to gasoline vehicles. Both of these results are consistent with the traffic volume of gasoline and diesel vehicles in the tunnel in the two separate periods and validate the ability for chemical mass balancing techniques to separate these two primary sources of fine particles.
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IJS, KILJ, NUK, PNG, UL, UM
This critical review of recent literature questions earlier predictions that photosynthetic productivity of higher plants is vulnerable to increased ultraviolet-B (UV-B) radiation as a result of ...stratospheric ozone (O3) depletion. Direct UV-B-induced inhibition of photosynthetic competence is observed only at high UV-B irradiances and primarily involves the loss of soluble Calvin cycle enzymes and adaxial stomatal closure in amphistomatous plants. However, even under these extreme UV-B exposures, acclimation (e.g. induction of UV-B absorbing flavonoids) can protect the photosynthetic processes. In plants irradiated with UV-B throughout development a reduction in productivity is usually associated with a reduced ability to intercept light (i.e. smaller leaf area) and not an inhibition of photosynthetic competence. Finally, a review of field experiments utilizing realistic UV-B enhancement is made to evaluate whether the mechanisms involved in UV-B-induced depressions of photosynthesis are likely to impact on the photosynthetic productivity of crops and natural vegetation in the future. Predictions of plant responses to O3 depletion are suspect from squarewave irradiance experiments in the field and controlled environments due to the increased sensitivity of plants to UV-B at relatively low photosynthetically-active photon flux densities (PPFD) and ultraviolet-A (UV-A) irradiances. Realistic modulated UV-B irradiances in the field do not appear to have any significant effects on photosynthetic competence or light-interception. It is concluded that O3 depletion and the concurrent rise in UV-B irradiance is not a direct threat to photosynthetic productivity of crops and natural vegetation.
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BFBNIB, NMLJ, NUK, PNG, SAZU, UL, UM, UPUK
The Oregon Coastal Transition Zone (OCTZ) extends several hundred kilometers offshore where shelf flows interact with the northern California Current. A primitive‐equation numerical ocean model is ...used to study the upwelling circulation in this region from 1 May to 1 November 2001. This OCTZ model obtains initial and boundary conditions from a larger‐scale model of the California Current System and forcing from a regional atmospheric model product. The model results are compared with extensive in situ and remotely sensed data, and the model is found to provide a realistic representation of flows both over the shelf and in the broader OCTZ. Simulation of coastal sea level and shelf currents over the complex topography of the central Oregon coast is improved quantitatively relative to previous regional models. A particularly significant qualitative improvement is realistic representation of coastal jet separation and eddy formation offshore of Cape Blanco. Three‐dimensional Lagrangian analysis of water parcel displacement shows that the surface waters inshore of the separated jet are upwelled from near the bottom along the shelf as far north as 45.5°N. A large eddy, which incorporates some of this upwelled water and carries it farther westward, forms offshore in the late summer. Ensemble simulations show a distinction between the strongly deterministic response to wind forcing over the shelf and the more unstable, less predictable jet separation and offshore eddy formation processes in the region near Cape Blanco.
Measurements from a Houston tunnel were used to develop fuel consumption-based emission factors for CO, NO
x
, and non-methane organic compound (NMOC) for on-road gasoline vehicles. The Houston NO
x
...emission factor was at the low range of emission factors reported in previous (primarily pre-1996) tunnel studies while the NMOC emission factor was slightly higher than that reported in the previous tunnel studies.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Relationships between angling effort and fish abundance have critical implications for the resilience and management of recreational fisheries, but these relationships have rarely been assessed ...empirically. Here, angling effort was related to fish abundance in three marine recreational fisheries in Florida, USA, through a suite of regression and time series methods that accounted for socio‐economic and demographic variables. Overall, recreational angling effort was correlated with fish abundance, but further analyses provided little evidence of strong, causal relationships. Lack of strong relationships implies angling effort might increase in the future unrelated to fish abundance, a decoupling that could threaten the viability of fish populations in the absence of unpopular recreational effort limitation. The inability to establish more conclusive relationships between effort and fish abundance should motivate a future focus towards natural or manipulative experiments that may provide more powerful inferences.
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DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
Objectives To determine the proportion of radiographs inconsistent with bronchiolitis in children with typical presentation of bronchiolitis and to compare rates of intended antibiotic therapy before ...radiography versus those given antibiotics after radiography. Study design We conducted a prospective cohort study in a pediatric emergency department of 265 infants aged 2 to 23 months with radiographs showing either airway disease only (simple bronchiolitis), airway and airspace disease (complex bronchiolitis), and inconsistent diagnoses (eg, lobar consolidation). Results The rate of inconsistent radiographs was 2 of 265 cases (0.75%; 95% CI 0-1.8). A total of 246 children (92.8%) had simple radiographs, and 17 radiographs (6.9%) were complex. To identify 1 inconsistent and 1 complex radiograph requires imaging 133 and 15 children, respectively. Of 148 infants with oxygen saturation >92% and a respiratory disease assessment score <10 of 17 points, 143 (96.6%) had a simple radiograph, compared with 102 of 117 infants (87.2%) with higher scores or lower saturation (odds ratio, 3.9; 95% CI, 1.3-14.3). Seven infants (2.6%) were identified for antibiotics pre-radiography; 39 infants (14.7%) received antibiotics post-radiography (95% CI, 8-16). Conclusions Infants with typical bronchiolitis do not need imaging because it is almost always consistent with bronchiolitis. Risk of airspace disease appears particularly low in children with saturation higher than 92% and mild to moderate distress.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
ICU catheter associated urinary tract infection (CAUTI) continues to be one of the most frequent healthcare associated infections. ICU staff felt that the urinary catheter was an important ...intervention for the critical care patient. Staff hesitated to discontinue catheters until ICU discharge, leading to a higher than desired CAUTI rate. Our goal was to decrease overall ICU CAUTI rates per 1000 device days.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
CMS requires facility-Wide inpatient reporting for C. difficile infection (CDI) using the NHSN LabID FacWideIN Module. This proxy measure utilizes lab Results without clinical evaluation, allowing ...for a less labor-intensive method of surveillance. Our 700-bed academic hospital has tracked CDI using the IDSA/SHEA definitions for five years for facility and unit-based rates. We have continued this practice in conjunction with the LabID Module to provide a more sensitive measurement of our control strategies.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
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