Resolution and Quality Issues in 3D Analysis of Inscribed Signs: An Example from Cypro-Minoan Inscriptions

A recurrent demand in many archaeological digital documentation systems is the need for an accurate as possible registration of data. Somehow, contrary to this request, are efforts led by various computer science groups dealing with 3D documentation and focusing on developing fast and cheap solutions to record 3D models of archaeological assets. The aim of the article is to highlight the importance of aligning the 3D documentation strategy to the archaeological aims, by detailing all factors to be considered when deciding on one documentation strategy over another. The archaeological question discussed here, part of the PhD thesis of one of the co-authors (MP), relates to the Cypro-Minoan signatory and its diachronic variability. The 3D geometric characterization of signs and subsequent shape analysis is the method chosen to reach this goal. A major effort to be invested in correctly determining the shape and variability of each sign, is in assuring that the 3D captured shape is as close as possible to the archaeological reality, which is a common problem not only in palaeographical analysis but also in other fields, where features of interest are in the sub-millimetre range. The paper will illustrate how different data acquisition approaches and post-processing steps such as alignment methods and error treatment may distort the visualised result and thus have a negative impact on planned analysis. Thus, it will argue for the importance of more detailed paradata to allow an informed assessment of the reliability of 3D models and it proposes a list of values and decision-making steps that help make the 3D digitization process more robust and verifiable.

Ohio’s Dual Eligible Population: Effects of Program Design and Implementation on Care Management

MyCare Ohio is a prospective blended managed care payment model program tasked to provide comprehensive and coordinated care to Ohio residents who are dully eligible for Medicare and Medicaid. To understand the administration and day-to-day implementation of care management within MyCare Ohio, n=75 interviews with a total of n=331 personnel from Area Agencies on Aging, Managed Care Plans, and service providers were conducted. Interviews were audio recorded, transcribed, and checked for accuracy. Data were analyzed by iterative reviews and deductive coding in Dedoose. Respondents provided insights on how care management activities are affected by program design features (e.g., ability to opt-out of the Medicare component), transitions between acute and long-term care settings, documentation systems and data-sharing, and high numbers of beneficiaries with behavioral health diagnoses. Implications for practice and policy will be discussed.

Quality Indicators for Older Persons’ Transitions in Care: A Systematic Review and Delphi Process

We identified quality indicators (QIs) for care during transitions of older persons (≥ 65 years of age). Through systematic literature review, we catalogued QIs related to older persons’ transitions in care among continuing care settings and between continuing care and acute care settings and back. Through two Delphi survey rounds, experts ranked relevance, feasibility, and scientific soundness of QIs. A steering committee reviewed QIs for their feasible capture in Canadian administrative databases. Our search yielded 326 QIs from 53 sources. A final set of 38 feasible indicators to measure in current practice was included. The highest proportions of indicators were for the emergency department (47%) and the Institute of Medicine (IOM) quality domain of effectiveness (39.5%). Most feasible indicators were outcome indicators. Our work highlights a lack of standardized transition QI development in practice, and the limitations of current free-text documentation systems in capturing relevant and consistent data.

A mathematical model to evaluate return on investment in higher education

Subject. The article assesses the effectiveness of investments in higher education. Objectives. The aim is to assess the performance of investments in higher education for a Master’s student at the Peter the Great St. Petersburg Polytechnic University, in the field of Economics, Business Analyst Specialty. Methods. The methodology, presented in the study, includes three stages. The first assesses the demand for skills, the second assesses how the supply of skills match the demand, and the third – the effectiveness of investments in higher education, based on the developed mathematical model, scenario analysis, and decision tree. Results. We revealed that for a business analyst, the most important categories of skills are project management, decision-making, organizational competencies, communication, and knowledge of corporate software. The most required skills in these categories are the knowledge of business processes, project documentation, systems thinking, teamwork, communication, and well-bred speech. The analysis of correspondence between the competencies required by employers and those acquired in the training process showed that Master’s graduates meet the demand for the position of a business analyst in the labor market by 69%. Conclusions. The evaluation of the effectiveness of investment in higher education for a Master’s student of the Peter the Great St. Petersburg Polytechnic University, in the field of Economics, Business Analyst Specialty, shows that it is more profitable for a Bachelor graduate to continue studying for a Master's degree, rather than go straight to work.

COVID-19 Exposure Tracking Within Public Health & Safety Enterprises:

Where there is limited access to COVID-19 tests, or where the results of such tests have been delayed or even invalidated (e.g., California and Utah), there is a need for scalable alternative approaches—such as a heuristic model or “pregnancy test for COVID-19” that can factor in the time denominator (i.e., duration of symptoms). This paper asks whether infection among these public health and safety agencies is a "canary in the coal mine," litmus test, or microcosm (pick your analogy) for the communities in which they operate. Can COVID-19 infection counts and rates be seen “moving around” communities by examining the virus’s effect on emergency responders themselves? The troubling question of emergency responders becoming “human indicator values” is relevant to maintaining the health of Mobile Medicine (EMS and Fire) personnel, as well as Police, who are an under-attended population, because without them our collective resiliency would crash. It has further implications for policies regarding, and investments, in exposure tracking and contact tracing, PPE acquisition, and mental and physical wellness. Design: We aggregated data from four (4) different EMS documentation systems across twelve (12) states using the MEDIVIEW BEACON Prehospital Health Information Exchange. We then outputted lists of charts containing critical ICD-10 values that had been identified by the WHO, the CDC, and the Los Angeles County Fire Dept. as inclusion criteria for possible signs, symptoms, and clinical impressions of COVID-19. Results: Three important results emergency from this study: (1) a demonstration of frequent exposure to possible COVID-19 infection among Mobile Medical (EMS & Fire) care providers in the states whose data were included; (2) a demonstration of the nervousness of the general population, given that calls for help due to possible COVID-19 based on symptomology exceeded the number of responses with a correlating “provider impression” after an informed clinical assessment; and (3) that this study was empowered by a public-private partnerships between a technology startup and numerous public health and public safety agencies, offers a template for success in rapidly implementing research and development collaborations. Limitations: This study incorporates data from only (a) twelve (12) states, and (b) four (4) Mobile Medical documentation systems. We sought to combat these limitations by ensuring that our sample crosses agencies types, geographies, population demographics, and municipal environments (i.e., rural vs. urban). Conclusions: Other studies have noted that EMS agencies are tasked with transporting the “sickest of the sick.” We found that PPE is particularly essential where the frequency of encounters between potentially—or actually—infected patients is high, because from Los Angeles County to rural Texas, without sufficient protection, public health and public safety agencies have become microcosms of the communities they are meant to protect. Indeed, data from the first six months of the pandemic in the U.S.A. show that intra-departmental spread is one of (if not the) riskiest sources of infection among Mobile Medical professionals.

The Relationship between Nurses’ Training and Perceptions of Electronic Documentation Systems

Electronic documentation systems have been widely implemented in the healthcare field. These systems have become a critical part of the nursing profession. This research examines how nurses’ general computer skills, training, and self-efficacy affect their perceptions of using these systems. A sample of 248 nurses was surveyed to examine their general computer skills, self-efficacy, and training in electronic documentation systems in nursing programs. We propose a model to investigate the extent to which nurses’ computer skills, self-efficacy, and training in electronic documentation influence perceptions of using electronic documentation systems in hospitals. The data supports a mediated model in which general computer skills, self-efficacy, and training influence perceived usefulness through perceived ease of use. The significance of these findings was confirmed through structural equation modeling. As the electronic documentation systems are customized for every organization, our findings suggest value in nurses receiving training to learn these specific systems in the workplace or during their internships. Doing so may improve patient outcomes by ensuring that nurses use the systems consistently and effectively.

TÜRKİYE'DE HEMŞİRELİK BİLİŞİMİ ÜZERİNE YAPILAN ARAŞTIRMALAR: BİR LİTERATÜR İNCELEMESİ

The aim of this study was to investigate which of research on nursing informatics in Turkey. In this descriptive study, the document review technique was used. Studies on nursing informatics in Turkey between the years 2009-2019 were examined. Literature search was conducted in Scholar Google, PUBMED, YÖK Thesis, Science Direct, Ebscohost databases in Turkish and English using the keywords “nursing informatics, informatics”. Of the research articles, 15 were included in the study. All of the studies in the sample were found to be descriptive. In the research results, it has been determined that the use of information technologies in nursing is directed to nursing students, nurses and patients. In the findings, it is seen that in most of the studies examined, questionnaires prepared by the researchers were used, and only seven studies used valid and reliable scales. It has been determined that attitudes towards computer use, the use of information technologies and nurse documentation systems are included in the studies. It was emphasized that the quality and number of studies to be carried out in the fields of education, clinical practice and management with information technologies should be increased.

Examining ‘immunity passports’ from an ethics perspective – ten reasons why they are bad idea

The two panelists will elaborate on 'four practical problems and six ethical objections', which add up to one very bad idea, i.e., the 'immunity passport'. Such an idea is equal to restricting movement on the basis of biology threatens freedom, fairness and public health. Lessons from previous pandemics will be examined in the context of current measures being deployed, assessing practical and ethical aspects. For example, false negatives in people with few antibodies leading to immune individuals being incorrectly labelled as not immune or not having access to testing to demonstrate immunity. Additionally, the case of healthcare workers will be examined considering feasibility of testing, but also in terms of discrimination and stigma. Another aspect to be explored in detail is monitoring and how it erodes privacy, with the main aim of immunity passport controlling movement. Documentation systems are already presenting a serious risk to privacy, with China announcing the QR-code tracking systems is likely to stay in place after the pandemic ends. Access issues to testing can contribute to further discrimination, whereas labelling people on their basis of their COVID19 status would create a new measure of dividing the society to 'immunoprivileged and immonodeprived' people. A labelling particularly disconcerting in the absence of a free, universally available vaccine. Furthermore, Social and financial inequities would be amplified, whereas divisions between nations could be fueled. Already people with HIV are subjected to restrictions on entering, living and working in certain countries with laws that impinge on the rights of those from sexual and gender minorities. Governments should instead invest on pandemic damage limitation - test, trace and isolate, and apps that empower individuals to make safe choices about their own movements should be prioritized. Also, the development, production and global distribution of a vaccine for SARS-CoV-is key. Universal, timely, free access to a vaccination becomes possible could allow for ethical recording of vaccination status in the context of certain activities. Threats to freedom, fairness and public health are inherent to any platform that is designed to segregate society on the basis of biological data. All policies and practices must be guided by a commitment to social justice.

A Fully Collaborative, Noteless Electronic Medical Record Designed to Minimize Information Chaos: Software Design and Feasibility Study (Preprint)

BACKGROUND Clinicians spend large amounts of their workday using electronic medical records (EMRs). Poorly designed documentation systems contribute to the proliferation of out-of-date information, increased time spent on medical records, clinician burnout, and medical errors. Beyond software interfaces, examining the underlying paradigms and organizational structures for clinical information may provide insights into ways to improve documentation systems. In particular, our attachment to the <i>note</i> as the major organizational unit for storing unstructured medical data may be a cause of many of the problems with modern clinical documentation. Notes, as currently understood, systematically incentivize information duplication and information scattering, both within a single clinician’s notes over time and across multiple clinicians’ notes. Therefore, it is worthwhile to explore alternative paradigms for unstructured data organization. OBJECTIVE The aim of this study is to demonstrate the feasibility of building an EMR that does not use notes as the core organizational unit for unstructured data and which is designed specifically to disincentivize information duplication and information scattering. METHODS We used specific design principles to minimize the incentive for users to duplicate and scatter information. By default, the majority of a patient’s medical history remains the same over time, so users should not have to redocument that information. Clinicians on different teams or services mostly share the same medical information, so all data should be collaboratively shared across teams and services (while still allowing for disagreement and nuance). In all cases where a clinician must state that information has remained the same, they should be able to <i>attest</i> to the information without redocumenting it. We designed and built a web-based EMR based on these design principles. RESULTS We built a medical documentation system that does not use notes and instead treats the chart as a single, dynamically updating, and fully collaborative workspace. All information is organized by clinical topic or problem. Version history functionality is used to enable granular tracking of changes over time. Our system is highly customizable to individual workflows and enables each individual user to decide which data should be structured and which should be unstructured, enabling individuals to leverage the advantages of structured templating and clinical decision support as desired without requiring programming knowledge. The system is designed to facilitate real-time, fully collaborative documentation and communication among multiple clinicians. CONCLUSIONS We demonstrated the feasibility of building a non–note-based, fully collaborative EMR system. Our attachment to the <i>note</i> as the only possible atomic unit of unstructured medical data should be reevaluated, and alternative models should be considered.