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51.
Steven J. Davidson MD MBA Frank L. Zwemer Jr. MD MBA Larry A. Nathanson MD Kenneth N. Sable MD Abu N.G.A. Khan MD MS 《Academic emergency medicine》2004,11(11):1127-1134
Physician-generated emergency department clinical documentation (information obtained from clinician observations and summarized decision processes inclusive of all manner of electronic systems capturing, storing, and presenting clinical documentation) serves four purposes: recording of medical care and communication among providers; payment for hospital and physician; legal defense from medical negligence allegations; and symptom/disease surveillance, public health, and research functions. In the consensus development process described by Handler, these objectives were balanced with the consideration of efficiency, often evaluated as physician time and clinical documentation system costs, in recording the information necessary for their accomplishment. The consensus panel session participants and authors recommend that 1) clinical documentation be electronically retrievable; 2) selection and implementation be evidence-based and grounded on valid metrics (research is needed to identify these metrics); 3) the user interface be crafted to promote clinical excellence through high-quality information collection and efficient charting techniques; 4) the priorities for integration of clinical information be standardized and implemented within enterprises and across health and information systems; 5) systems use accepted standards for bidirectional, real-time clinical data exchange, without limiting the location or number of simultaneous users; 6) systems fully utilize existing electronic sources of specific patient information and general medical knowledge; 7) systems automatically and reliably capture appropriate data that support electronic billing for emergency department services; and 8) systems promote bedside documentation and mobile access. 相似文献
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Seventy-three men and 72 women made lexical decisions to target words that followed sentences constructed so that the last word was a sexual double-entendre. Prime target relatedness, erotic versus nonerotic target, stimulus onset asynchrony, and participant's gender were varied in a between-subjects design. A second analysis that substituted sentence context for prime target relationship also was conducted. Data were collected on the emotionality and social acceptability of priming sentences and target words. Results revealed that, as with previous research on neutral words, prime target relatedness facilitated lexical decisions. Additionally, there was evidence of slowing in making lexical decisions when erotic material was presented or was part of a contextual bias. This delay was accentuated in women. A model that proposes that sexual words evoke a more complex processing sequence is presented. The model suggests that appraisal and checking or editing mechanisms, which are accentuated in women, help explain the phenomenon.
Portions of this work was submitted by the junior author in partial fulfillment of the requirements for Honors in Psychology at Louisiana State University 相似文献
54.
J. J. J. de Sonnaville M. Bouma L. P. Colly W. Devillé D. Wijkel R. J. Heine 《Diabetologia》1997,40(11):1334-1340
Summary In primary care it is difficult to treat the growing number of non-insulin-dependent diabetic (NIDDM) patients according
to (inter)national guidelines. A prospective, controlled cohort study was designed to assess the intermediate term (2 years)
effect of structured NIDDM care in general practice with and without ’diabetes service' support on glycaemic control, cardiovascular
risk factors, general well-being and treatment satisfaction. The ’diabetes service', supervised by a diabetologist, included
a patient registration system, consultation facilities of a dietitian and diabetes nurse educator, and protocolized blood
glucose lowering therapy advice which included home blood glucose monitoring and insulin therapy. In the study group (SG;
22 general practices), 350 known NIDDM patients over 40 years of age (206 women; mean age 65.3 ± SD 11.9; diabetes duration
5.9 ± 5.4 years) were followed for 2 years. The control group (CG; 6 general practices) consisted of 68 patients (28 women;
age 64.6 ± 10.3; diabetes duration 6.3 ± 6.4 years). Mean HbA1 c (reference 4.3–6.1 %) fell from 7.4 to 7.0 % in SG and rose from 7.4 to 7.6 % in CG during follow-up (p = 0.004). The percentage of patients with poor control (HbA1 c > 8.5 %) shifted from 21.4 to 11.7 % in SG, but from 23.5 to 27.9 % in CG (p = 0.008). Good control (HbA1 c < 7.0 %) was achieved in 54.3 % (SG; at entry 43.4 %) and 44.1 % (CG; at entry 54.4 %) (p = 0.013). Insulin therapy was started in 29.7 % (SG) and 8.8 % (CG) of the patients (p = 0.000) with low risk of severe hypoglycaemia (0.019/patient year). Mean levels of total and HDL-cholesterol (SG), triglycerides
(SG) and diastolic blood pressure (SG + CG) and the percentage of smokers (SG) declined significantly, but the prevalence
of these risk factors remained high. General well-being (SG) did not change during intensified therapy. Treatment satisfaction
(SG) tended to improve. Implementation of structured care, including education and therapeutic advice, results in sustained
good glycaemic control in the majority of NIDDM patients in primary care, with low risk of hypoglycaemia. Lowering cardiovascular
risk requires more than reporting results and referral to guidelines. [Diabetologia (1997) 40: 1334–1340]
Received: 5 February 1997 and in revised form: 22 May 1997 相似文献
55.
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? The benefits of informing patients before undergoing surgery or other investigative procedures are clearly demonstrated in the literature. ? This study aimed to determine the amount and type of information given to patients before, during and after undergoing gastroscopy investigations. ? A survey approach incorporating structured interviews and structured observation was utilized. ? There were statistically significant differences between the information acquired by younger and older patients prior to, but not during or after, the procedure. ? Nurses appear to be the most important source of information for older patients while the information leaflet was perceived as the most important source of information for younger patients. 相似文献
57.
58.
This study investigated preferential encoding of threat material in subjects with posttraumatic stress disorder (PTSD) with a modified dot-probe paradigm. This paradigm indexes attentional bias by measuring response latency to name neutral target words that are presented adjacent to or distant from threat words. Motor vehicle accident survivors with PTSD (n = 15), subclinical PTSD (n = 15), and low anxiety (n = 15) were required to name target words that were presented either adjacent to or distant from strong threat, mild threat, positive, and neutral words. PTSD subjects named targets faster when they were in close proximity to mild threat words. Results suggested that PTSD subjects' attention was drawn to the mild threat stimuli and are discussed in the context of network models of PTSD. 相似文献
59.
Douglas N. Johnson Herbert J. Weingartner Paul Andreason David T. George 《Psychopharmacology》1995,121(2):145-149
This study explored whether benzodiazepines selectively affect aspects of attention and/or visual information processing, as they do memory. A cued visual-search paradigm was employed, using normal volunteers and a single dose of triazolam. This paradigm provided for a detailed examination of two aspects of visual attention and information processing: 1) controlled versus automatic attention allocation (via central and peripheral cues), and 2) the extent to which processing an item in a non-cued location affects performance (via cue-validity). Triazolam, compared to placebo, significantly increased response time, and Drug Condition interacted with Cue-Validity but not Cue-Type. Based on these data, we argue that triazolam doesnot affect attention allocation butdoes affect attentional disengagement and/or attention switching mechanisms. 相似文献
60.
我国医院信息系统必走整合之路 总被引:6,自引:1,他引:5
论述了我国医院信息系统(HIS)整合的重要意义和原则,介绍了HIS整合的方法措施以及经验. 相似文献