Protocol for the "Implementation, adoption, and utility of family history in diverse care settings" study.

BACKGROUND: Risk assessment with a thorough family health history is recommended by numerous organizations and is now a required component of the annual physical for Medicare beneficiaries under the Affordable Care Act. However, there are several barriers to incorporating robust risk assessments into routine care. MeTree, a web-based patient-facing health risk assessment tool, was developed with the aim of overcoming these barriers. In order to better understand what factors will be instrumental for broader adoption of risk assessment programs like MeTree in clinical settings, we obtained funding to perform a type III hybrid implementation-effectiveness study in primary care clinics at five diverse healthcare systems. Here, we describe the study's protocol. METHODS/DESIGN: MeTree collects personal medical information and a three-generation family health history from patients on 98 conditions. Using algorithms built entirely from current clinical guidelines, it provides clinical decision support to providers and patients on 30 conditions. All adult patients with an upcoming well-visit appointment at one of the 20 intervention clinics are eligible to participate. Patient-oriented risk reports are provided in real time. Provider-oriented risk reports are uploaded to the electronic medical record for review at the time of the appointment. Implementation outcomes are enrollment rate of clinics, providers, and patients (enrolled vs approached) and their representativeness compared to the underlying population. Primary effectiveness outcomes are the percent of participants newly identified as being at increased risk for one of the clinical decision support conditions and the percent with appropriate risk-based screening. Secondary outcomes include percent change in those meeting goals for a healthy lifestyle (diet, exercise, and smoking). Outcomes are measured through electronic medical record data abstraction, patient surveys, and surveys/qualitative interviews of clinical staff. DISCUSSION: This study evaluates factors that are critical to successful implementation of a web-based risk assessment tool into routine clinical care in a variety of healthcare settings. The result will identify resource needs and potential barriers and solutions to implementation in each setting as well as an understanding potential effectiveness. TRIAL REGISTRATION: NCT01956773.

Matching case history patterns in case-based reasoning

This paper introduces a mechanism for representing and recognizing case history patterns with rich internal temporal aspects. A case history is characterized as a collection of elemental cases as in conventional case-based reasoning systems, together with the corresponding temporal constraints that can be relative and/or with absolute values. A graphical representation for case histories is proposed as a directed, partially weighted and labeled simple graph. In terms of such a graphical representation, an eigen-decomposition graph matching algorithm is proposed for recognizing case history patterns.

An introduction to China's rail transport Part 1: History, present and future of China's railways

In this paper an introduction is given to the history, current situation and future plans of China's railway industry. The history of China's railway is divided into four development phases: the phase in Imperial China, the phase in the Republic of China and the phases before and after the economic rejuvenation of the People's Republic of China. An introduction to the current situation and future plans includes the major projects under construction and development trends of China's railways. The environment of China's railways is also presented. This is the first of two papers on the railway scene in China.

BSHM meetings: BMS History of Mathematics Splinter Group

Introduction to abstracts from papers given at BMS History of Mathematics Splinter Group, held 17 April 2007, in Swansea.

[BSHM meetings] Topics in the history of financial mathematics: early commerce to chaos in modern stock markets

This account provides an overview of the study day, entitled 'Topics in the History of Financial Mathematics: Early commerce to chaos in modern stock markets,' held by the British Society for the History of Mathematics jointly with Gresham College, at Gresham College, London on 25th April 2008. The series of talks explored the development of mathematics and mathematical techniques in a commercial and financial context.

Reality-experiential history documentaries: the Trench (BBC, 2002) and Britain's modern memory of the First World War

Culloden (BBC, 1964) The Great War (BBC, 1964) 1914-18 (BBC/KCET, 1996) Haig: the Unknown Soldier (BBC, 1996) Veterans: the Last Survivors of the Great War (BBC, 1998) 1900s House (Channel 4, 1999) The Western Front (BBC, 1999) History of Britain (BBC, 2000) 1940s House (Channel 4, 2001) The Ship (BBC, 2002) Surviving the Iron Age (BBC, 2001) The Trench (BBC, 2002) Frontier House (Channel 4, 2002) Lad's Army (BBC, 2002) Edwardian Country House (Channel 4, 2002) Spitfire Ace (Channel 4, 2003) World War One in Colour (Channel 5, 2003) 1914: the War Revolution (BBC, 2003) The First World War (Channel 4, 2003) Dunkirk (BBC, 2004) Dunkirk: The Soldier's Story (BBC, 2004) D-Day to Berlin (BBC, 2004) Bad Lad's Army (ITV, 2004) Destination D-Day: Raw Recruits (BBC, 2004) Bomber Crew (Channel 4, 2004) Battlefield Britain (BBC, 2004) The Last Battle (ARTE/ZDF, 2005) Who Do You Think You Are? (BBC, 2004, 2006) The Somme (Channel 4, 2005) [From the Publisher]