Indiana University-Purdue University Indianapolis (IUPUI) / Acceptance of PHR by physicians is fundamental as they play important role towards the promotion of PHR adoption by providing the access to the data to be maintained in PHR and also, using the information within the PHR for decision making. Therefore it is important to measure physicians' perspective on usefulness of PHR, and also the value and trust they have in PHR usage. Review of previous researches identifies the lack of availability of a valid survey instrument that can be used to measure physicians' perception on all different aspects of PHR use and acceptance. Using the integrated literature review methodology and Unified Theory of Acceptance and Use of Technology (UTAUT) as a guiding framework, this study was aimed to identify the factors that can be used in the development of comprehensive evaluation instrument to understand physicians' acceptance of PHR. Total 15 articles were selected for literature review and using the content analysis method, 189 undifferentiated data units were extracted from those articles. These data units were then categorized into the four core constructs of UTAUT. ―Other categorization system was also created for the data units that could not be classified into one of the UTAUT core constructs. Among four core UTAUT constructs, Performance Expectancy is found to be the most influential factor in physicians' acceptance of PHR, followed by ―Other factors, Facilitating Condition and Social Influence. Effort expectancy was found to be the least influential. The identified specific factors within each domain can be used to develop a valid survey instrument to measure physicians' perception on PHR.

This document explains the use of different metrics involved with record linkage. There are two forms of record linkage: deterministic and probabilistic. We will focus on probabilistic record linkage used in merging and updating two databases. Record pairs will be compared using character-based and phonetic-based similarity metrics to determine at what level they match. Performance measures are then calculated and Receiver Operating Characteristic (ROC) curves are formed. Finally, an economic model is applied that returns the optimal tolerance level two databases should use to determine a record pair match in order to maximize profit.

Frailty is a multifaceted, geriatric syndrome that is associated with age-related declines in functional reserves resulting in increased risks of in-hospital death, readmissions and discharge to nursing homes. The risks associated with frailty highlights the need for providers to be able to quickly, and accurately, assess someone’s frailty level. Previous studies have shown that bedside clinician assessment is not a reliable or valid way to determine frailty, meaning that a more reliable, valid and concise method is needed. We developed a prediction model using discharge ICD-9/ICD-10 diagnostic codes and other demographic variables to predict Reported Edmonton Frail Scale scores. Participants were from the Baystate Frailty Study, a prospective cohort design study among elderly patients greater than 65 years old who were admitted to a single academic medical center between 2014 and 2016. Three different predictive models were completed utilizing the LASSO approach. The adjusted r-square increased across the three models indicating an increase in the predictive ability of the models. In this study of 762 hospitalized patients over the age of 65 years old, we found that a frailty prediction model that included ICD codes only had a poor prediction ability (adjusted r-square=0.10). The prediction ability improved 2-fold after adding demographic information, a comorbidity score and interaction terms (adjusted r-square=0.26). This study provided additional insights into the development of an automatic frailty assessment, something which is currently missing from clinical care.

Electronic Medical Records (EMRs) are digital versions of paper charts, used to record the treatment of different patients in hospitals. Clinical pathways are used as guidelines for how to treat different diseases, determined by observing outcomes from previous treatments. Sequential pattern mining is a version of data mining where the data mined is organized in sequences. It is a common research topic in data mining with many new variations on existing algorithms being introduced frequently. In a previous report, the sequential pattern mining algorithm PrefixSpan was used to mine patterns in EMRs to verify or suggest new clinical pathways. It was found to only be able to verify pathways partially. One of the reasons stated for this was that PrefixSpan was too inefficient to be able to mine at a low enough support to consider some items. In this report CSpan is used instead, since it is supposed to outperform PrefixSpan by up to two orders of magnitude, in order to improve runtime and thereby address the problems mentioned in the previous work. The results show that CSpan did indeed improve the runtime and the algorithm was able to mine at a lower minimum support. However, the output was only barely improved. / Electronic Medical Records (EMRs) är digitala versioner av behandlingshistoriken för patienter på sjukhus. Clinical pathways används som riktlinjer för hur olika sjukdomar borde behandlas, vilka bestäms genom att observera utkomsten av tidigare behandlingar. Sequential pattern mining är en typ av data mining där datan som behandlas är strukturerad i sekvenser. Det är ett vanligt forskningsområde inom data mining där många nya variationer av existerande algoritmer introduceras frekvent. I en tidigare rapport användes sequential pattern mining algoritmen PrefixSpan på EMRs för att verifiera eller föreslå nya clinical pathways. Den kunde dock endast verifiera pathways delvis. En av anledningarna som nämndes för detta var att PrefixSpan var för ineffektiv för att kunna köras med en tillräckligt låg support för att kunna finna vissa åtgärder i en behandling. I den här rapporten används istället CSpan, eftersom den ska överprestera PrefixSpan med upp till två storleksordningar, för att förbättra körningstiden och därmed adressera problemen som nämns i den tidigare rapporten. Resultaten visar att CSpan förbättrade körningstiden och algoritmen kunde köras med lägre support. Däremot blev utdatan knappt förbättrad.

Bakgrund Sedan en tid tillbaka har webbåtkomst av patientjournalen utvecklats och blivit möjlig för patienterna såväl i Sverige som i flera länder globalt. Sedan tillgången till journalen underlättats för patienterna tar allt fler chansen att läsa i sina journaler. Med bakgrund av detta undersöks patienternas upplevelser och erfarenheter av att läsa sina journaler i denna litteraturstudie.  Syfte Syftet var att belysa vuxna patienters upplevelser av att läsa journalen vid kontakt med hälso- och sjukvården. Metod En icke-systematisk litteraturöversikt genomfördes genom att samla in data och granska 17 vetenskapliga originalartiklar. Artiklarna innefattar varierande typer av studiedesign. Författarna granskade de utvalda originalartiklarna efter Sophiahemmets Högskolas bedömningsunderlag för kvalitetsgranskning, för att sedan analysera artiklarna genom en integrerad analysmetod. Utefter detta presenterades resultatet uppdelat efter tre teman som författarna fann under analysen.  Resultat Genom granskningen upptäcktes tre huvudteman. De teman som upptäcktes då patienternas upplevelser av att läsa sina journaler undersöktes var: Patienternas upplevelse av: patientdelaktighet, av att inhämta, tolka och förstå journalinformation och personcentrering. Under dessa huvudkategorier sågs ett antal subteman. Dessa subteman innefattade patienternas upplevelser av eller kring deltagande, kommunikation, medicinsk terminologi, förståelse, tekniska svårigheter, reaktioner och känslor, partnerskapet, egenmakt och egenvård. Slutsats Enligt studien var patienterna till stor del positiva över tillgången till patientjournalen och ville läsa sina journalanteckningar. Skillnader fanns mellan olika grupper av patienter när det kom till vilka som tyckte sig ha mest nytta av att läsa journalerna. Patienterna upplevde språkbruket och den medicinska terminologin som används i journalen som svårt att förstå. Enligt studien kan en ökad personcentrering och patientdelaktighet, vid och kring journalföringen, leda till positiva erfarenheter hos patienterna såväl som det kan ge minskade risker inom vården. En ökad personcentrering vid journalföring kan även bidra till att stärka patienternas möjligheter till ett högre mått av hälsolitteracitet. / Background For some time now, web access to the medical records has developed and become possible for patients both in Sweden and in several countries globally. Since access to medical records has been made easier for patients, more and more people are taking the chance to read their medical records. Against this background, the patients attitudes and experiences of reading their medical records are examined in this litteraturestudy. Aim The aim was to shed light on adult patients' experience of reading their medical record when in contact with the health care system. Method The authors created a non-systematic literature review by collecting data and reviewing 17 scientific articles. The articles included were of various types. The authors reviewed the selected articles according to Sophiahemmet University's assessment document for quality review and then analyzed the articles through an integrated analysis method. Following this, the results were presented divided according to three themes that the authors found during the analysis. Results Through the review, three main themes were discovered. The themes that were discovered when the patients' experiences of reading their medical records were examined were: The patients' experience of: patient participation, of obtaining, interpreting and understanding medical record information and person-centeredness. Under these main categories, several sub-themes were seen. These sub-themes included the patients' experiences of or around participation, communication, medical terminology, understanding, technical difficulties, reactions and feelings, the partnership, empowerment and self-care. Conclusions According to the study, patients for the most part had positive experiences while reading their medical records and wanted to continue doing so. There were differences between groups of patients when it came to who found that they had the most benefit from reading the medical records. The patients found the language and medical terminology used in the medical record difficult to understand. According to the study, increased person-centredness and patient participation in record keeping can lead to increased positive experiences for patients as well as reduced risks in care. An increased person-centredness in recordkeeping can also contribute to strengthening patients' opportunities for a higher measure of health literacy.

<p>Frenchman's Bay is a shallow coastal lagoon (0.84 km2) located near the eastern limits of the Toronto urban area. Wholesale land clearance in the 1850's and subsequent industrialization and urbanization of the watershed have had severely impacted wetland habitats and degraded sediment and water quality. Prior to implementation of remediation work, a detailed sedimentologic and magnetic property study was conducted to determine the impacts of post-colonial land use changes in Frenchman's Bay. 11 vibrocores (2-4.5m length) were extracted from the lagoon and 3 5 magnetic susceptibility profiles were collected using a probe driven 1-2 m in the lagoon floor. The core lithofacies were logged in detail and magnetic susceptibility (K, x.) and remanence parameters (NRM, SIRM, Bcr) were measured at 2 cm intervals. Magnetic property and lithofacies data were integrated with geochemical analyses (TOC, C03) and 210Pb dating of core in order to reconstruct the lagoon lithostratigraphy and the thickness of the post-colonial 'anthropogenic layer'. </p> <p>The stratigraphic succession in the lagoon consists of a thick upper sequence of marly gyttja and peat-rich silty marls overlying Holocene laminated marls. The postcolonial layer (Unit 1) is recognized as an uppermost high magnetic susceptibility (x = ~200-300 xl0-8 m3/Kg) gyttja layer that extends to 1-1.5 m depth. The base of the unit has a 210Pb age of 1850 (±55.6), corresponding with the main phase of land clearance and onset of industrialization of the harbour. Titanomagnetite, maghemite and magnetite spherules are the primary magnetic minerals, indicating soil erosion and coal burning as the predominant sources of magnetic particles. The underlying Unit 2 consists of peaty marls with abundant plant fragments recording a more extensive marsh. Unit 3 consists of more carbonate-rich laminated sands (magnetic susceptibility x = 6000 x10-8 m3/Kg) deposited in a low energy oligotrophic lagoon. The basal layer (Unit 4) consists of high magnetic susceptibility massive pebbly muds, which record a pre-lagoon phase of higher water levels in post-glacial Lake Iroquois (ca. 13,500 Ka). </p> <p> Isopach mapping of the magnetostratigraphic units clearly identifies that the anthropogenic layer (Unit I; post-1850) is thickest within a central basin which has acted as trap for sediment carried into the lagoon by several streams. The total volume of impacted anthropogenic sediment is estimated at 4 x105 m3. Isopach maps also identify two thin(< 2 m) wedges of sand (9.6 x104 m3) near the north and southern shores of the bay that records periodic overwash and growth of the beach barrier. </p> <p>The major environmental changes in the lagoon since it inception (ca. 2. 7 Ka include: 1. The formation of a shallow coastal embayment following water level rise from a mid-Holocene low-stand in Lake Ontario (Unit 4); 2. Development of a spit and beach barrier by eastward longshore transport (Unit 3); 3. Closure of the lagoon and development of a stabilized marsh habitat with low sedimentation levels (Unit 2); 4. Destruction of marsh habitats and eutrophication of the lagoon coinciding with land clearance (post-1850's) and an increased in the influx of sediments eroded from the catchment area. </p> / Thesis / Master of Science (MS)

In this paper we develop a digital twin based on the new One Record linked data standard. This enables short-term workload prediction for the various partners in the air cargo supply chain without the need for multiple data exchange interfaces. To the best of our knowledge, it is the first research on the potential benefits of One Record. The concept of the digital twin allows for an overarching optimization of operations in the air cargo supply chain without the necessity of full transparency between all the partners.

Cultural heritage institutions, including galleries, libraries, museums, and archives are increasingly digitizing physical items and collecting born-digital items and making these resources available on the Web. Metadata plays a vital role in the discovery and management of these collections. Existing frameworks to identify and address deficiencies in metadata rely heavily on count and data-value based metrics that are calculated over aggregations of descriptive metadata. There has been little research into the use of traditional network analysis to investigate the connections between metadata records based on shared data values in metadata fields such as subject or creator. This study introduces metadata record graphs as a mechanism to generate network-based statistics to support analysis of metadata. These graphs are constructed with the metadata records as the nodes and shared metadata field values as the edges in the network. By analyzing metadata record graphs with algorithms and tools common to the field of network analysis, metadata managers can develop a new understanding of their metadata that is often impossible to generate from count and data-value based statistics alone. This study tested application of metadata record graphs to analysis of metadata collections of increasing size, complexity, and interconnectedness in a series of three related stages. The findings of this research indicate effectiveness of this new method, identify network algorithms that are useful for analyzing descriptive metadata and suggest methods and practices for future implementations of this technique.

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