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Question:

What is the process of developing a clinical information tool to be embedded in the electronic health record of a very large and diverse academic medical center?

Setting:

The development took place at the University of Pittsburgh Health Sciences Library System.

Method:

The clinical information tool developed is a search box with subject tabs to provide quick access to designated full-text information resources. Each subject tab offers a federated search of a different pool of resources. Search results are organized “on the fly” into meaningful categories using clustering technology and are directly accessible from the results page.

Results:

After more than a year of discussion and planning, a clinical information tool was embedded in the academic medical center''s electronic health record.

Conclusion:

The library successfully developed a clinical information tool, called Clinical-e, for use at the point of care. Future development will refine the tool and evaluate its impact and effectiveness.  相似文献   
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The blood-brain barrier (BBB) is a critical structure that serves as the gatekeeper between the central nervous system and the rest of the body. It is the responsibility of the BBB to facilitate the entry of required nutrients into the brain and to exclude potentially harmful compounds; however, this complex structure has remained difficult to model faithfully in vitro. Accurate in vitro models are necessary for understanding how the BBB forms and functions, as well as for evaluating drug and toxin penetration across the barrier. Many previous models have failed to support all the cell types involved in the BBB formation and/or lacked the flow-created shear forces needed for mature tight junction formation. To address these issues and to help establish a more faithful in vitro model of the BBB, we have designed and fabricated a microfluidic device that is comprised of both a vascular chamber and a brain chamber separated by a porous membrane. This design allows for cell-to-cell communication between endothelial cells, astrocytes, and pericytes and independent perfusion of both compartments separated by the membrane. This NeuroVascular Unit (NVU) represents approximately one-millionth of the human brain, and hence, has sufficient cell mass to support a breadth of analytical measurements. The NVU has been validated with both fluorescein isothiocyanate (FITC)-dextran diffusion and transendothelial electrical resistance. The NVU has enabled in vitro modeling of the BBB using all human cell types and sampling effluent from both sides of the barrier.  相似文献   
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The statistical analysis of answer changes (ACs) has uncovered multiple testing irregularities on large‐scale assessments and is now routinely performed at testing organizations. However, AC data has an uncertainty caused by technological or human factors. Therefore, existing statistics (e.g., number of wrong‐to‐right ACs) used to detect examinees with aberrant ACs capitalize on the uncertainty, which may result in a large Type I error. In this article, the information about ACs is used only for the partitioning of administered items into two disjoint subtests: items where ACs did not occur, and items where ACs did occur. A new statistic is based on the difference in performance between these subtests (measured as Kullback–Leibler divergence between corresponding posteriors of latent traits), where, in order to avoid the uncertainty, only final responses are used. One of the subtests can be filtered such that the asymptotic distribution of the statistic is chi‐square with one degree of freedom. In computer simulations, the presented statistic demonstrated a strong robustness to the uncertainty and higher detection rates in contrast to two popular statistics based on wrong‐to‐right ACs.  相似文献   
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Over the Past several years, a new and unprecedented challenge has been thrust upon professionals in the field of Jewish communal service—the development of effective instrumentalities to absorb into the American Jewish community masses of Soviet Jews. Jewish educators have grappled with the difficulties and frustrations of this task along with their colleagues in the other disciplines of Jewish service. Yet if the influx of these new Russian settlers presents the organized Jewish community with unique and seemingly intractable problems, it also offers Jewish educational agencies—and more particularly central Bureaus and Boards of Jewish education—with an unparalleled opportunity to play a leadership role in this orchestrated communal effort. This essay purports to analyze this potential and to describe how one central agency, the Atlanta Bureau of Jewish Education, has endeavored to exploit it.  相似文献   
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Some biological bases of cognitive development   总被引:1,自引:1,他引:0  
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