Designed for those beginning to study linguistics, this is a lively introduction to two key aspects of the structure of language: syntax (the structure of sentences) and morphology (the structure of ...words). It shows students in a step-by-step fashion how to analyze the syntax and morphology of any language, by clearly describing the basic methods and techniques, and providing almost 100 practical exercises based on data from a rich variety of the world's languages. Written in an engaging style and complete with a comprehensive glossary, Exploring Language Structure explains linguistic concepts by using clear analogies from everyday life. It introduces a range of essential topics in syntax and morphology, such as rules, categories, word classes, grammatical relations, multi-clause constructions and typology. Providing a solid foundation in morphology and syntax, this is the perfect introductory text for beginning students, and will fully prepare them for more advanced courses in linguistic analysis.
In BMJ Quality & Safety, Shah et al report their evaluation of the degree to which efforts in the US Veterans Health Administration to reduce electronic health record (EHR)-related information ...overload have achieved their goal.1 Studying the Veterans Health Information System and Technology Architecture (VistA), an internally developed EHR platform used throughout the Department of Veterans Affairs (VA) system, Shah and colleagues report that the median number of mandatory notification types at each VA facility decreased from 15 (IQR 13–19) to 10 (IQR 10–11) preintervention to postintervention, respectively (p<0.001). ...it appears about the time Secretary of Veterans Affairs Robert Wilkie has announced that CPRS is to be replaced with a commercial EHR.2 View Alerts have been a fundamental feature of CPRS since it appeared in 1997 with national rollout in 2000. ...we have to review this new information using tools and interfaces which are often awkward from a usability perspective.
Tungusic is a small family of languages, many of which are endangered. It encompasses approximately twenty languages located in Siberia and northern China. These languages are distributed over an ...enormous area that ranges from the Yenisey River and Xinjiang in the west to the Kamchatka Peninsula and Sakhalin in the east. They extend as far north as the Taimyr Peninsula and, for a brief period, could even be found in parts of Central and Southern China. This book is an attempt to bring researchers from different backgrounds together to provide an open-access publication in English that is freely available to all scholars in the field. The contributions cover all branches of Tungusic and a wide range of linguistic features. Topics include synchronic descriptions, typological comparisons, dialectology, language contact, and diachronic reconstruction. Some of the contributions are based on first-hand data collected during fieldwork, in some cases from the last speakers of a given language.
Following a 2010-2011 pilot intervention in which a limited sample of primary care doctors offered their patients secure Web-based portal access to their office visit notes, the participating sites ...expanded OpenNotes to nearly all clinicians in primary care, medical, and surgical specialty practices.
The aim of this study was to examine the ongoing experiences and perceptions of patients who read ambulatory visit notes written by a broad range of doctors, nurses, and other clinicians.
A total of 3 large US health systems in Boston, Seattle, and rural Pennsylvania conducted a Web-based survey of adult patients who used portal accounts and had at least 1 visit note available in a recent 12-month period. The main outcome measures included patient-reported behaviors and their perceptions concerning benefits versus risks.
Among 136,815 patients who received invitations, 21.68% (29,656/136,815) responded. Of the 28,782 patient respondents, 62.82% (18,081/28,782) were female, 72.90% (20,982/28,782) were aged 45 years or older, 76.94% (22,146/28,782) were white, and 14.30% (4115/28,782) reported fair or poor health. Among the 22,947 who reported reading 1 or more notes, 3 out of 4 reported reading them for 1 year or longer, half reported reading at least 4 notes, and 37.74% (8588/22,753) shared a note with someone else. Patients rated note reading as very important for helping take care of their health (16,354/22,520, 72.62%), feeling in control of their care (15,726/22,515, 69.85%), and remembering the plan of care (14,821/22,516, 65.82%). Few were very confused (737/22,304, 3.3%) or more worried (1078/22,303, 4.83%) after reading notes. About a third reported being encouraged by their clinicians to read notes and a third told their clinicians they had read them. Less educated, nonwhite, older, and Hispanic patients, and individuals who usually did not speak English at home, were those most likely to report major benefits from note reading. Nearly all respondents (22,593/22,947, 98.46%) thought Web-based access to visit notes a good idea, and 62.38% (13,427/21,525) rated this practice as very important for choosing a future provider.
In this first large-scale survey of patient experiences with a broad range of clinicians working in practices in which shared notes are well established, patients find note reading very important for their health management and share their notes frequently with others. Patients are rarely troubled by what they read, and those traditionally underserved in the United States report particular benefit. However, fewer than half of clinicians and patients actively address their shared notes during visits. As the practice continues to spread rapidly in the United States and internationally, our findings indicate that OpenNotes brings benefits to patients that largely outweigh the risks.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Cigarette smoking is strongly associated with major depressive disorder (MDD). However, any genetic etiology of such comorbidity and causal relations is poorly understood, especially at the ...genome-wide level.
In the present in silico research, we analyzed summary data from the genome-wide association study of the Psychiatric Genetic Consortium for MDD (n = 191 005) and UK Biobank for smoking (n = 337 030) by using various biostatistical methods including Bayesian colocalization analysis, LD score regression, variant effect size correlation analysis, and Mendelian randomization (MR).
By adopting a gene prioritization approach, we identified 43 genes shared by MDD and smoking, which were significantly enriched in membrane potential, gamma-aminobutyric acid receptor activity, and retrograde endocannabinoid signaling pathways, indicating that the comorbid mechanisms are involved in the neurotransmitter system. According to linkage disequilibrium score regression, we found a strong positive correlation between MDD and current smoking (rg = 0.365; p = 7.23 × 10-25) and a negative correlation between MDD and former smoking (rg = -0.298; p = 1.59 × 10-24). MR analysis suggested that genetic liability for depression increased smoking.
These findings inform the concomitant conditions of MDD and smoking and support the use of self-medication with smoking to counteract depression.
In response to mounting evidence that use of electronic medical record systems may cause unintended consequences, and even patient harm, the AMIA Board of Directors convened a Task Force on Usability ...to examine evidence from the literature and make recommendations. This task force was composed of representatives from both academic settings and vendors of electronic health record (EHR) systems. After a careful review of the literature and of vendor experiences with EHR design and implementation, the task force developed 10 recommendations in four areas: (1) human factors health information technology (IT) research, (2) health IT policy, (3) industry recommendations, and (4) recommendations for the clinician end-user of EHR software. These AMIA recommendations are intended to stimulate informed debate, provide a plan to increase understanding of the impact of usability on the effective use of health IT, and lead to safer and higher quality care with the adoption of useful and usable EHR systems.
A one-pot protocol for the dearomatizing spirocyclization/cross-coupling of alkyne-tethered indoles/pyrroles is described. Mechanistic studies support a process by which palladium complexes generated ...in situ act as both π-acid and cross-coupling catalysts. Overall, this facilitates an efficient cascade process that enables the simultaneous preparation of synthetically challenging quaternary spirocyclic carbons and tetrasubstituted alkenes in a single operation.
Clinicians face competing pressures of being clinically productive while using imperfect electronic health record (EHR) systems and maximizing face-to-face time with patients. EHR use is increasingly ...associated with clinician burnout and underscores the need for interventions to improve clinicians' experiences. With an aim of addressing this need, we share evidence-based informatics approaches, pragmatic next steps, and future research directions to improve 3 of the highest contributors to EHR burden: (1) documentation, (2) chart review, and (3) inbox tasks. These approaches leverage speech recognition technologies, natural language processing, artificial intelligence, and redesign of EHR workflow and user interfaces. We also offer a perspective on how EHR vendors, healthcare system leaders, and policymakers all play an integral role while sharing responsibility in helping make evidence-based sociotechnical solutions available and easy to use.
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