Sharing of clinical data in a maternity setting: How do paper hand-held records and electronic health records compare for completeness?

Background Historically, the paper hand-held record (PHR) has been used for sharing information between hospital clinicians, general practitioners and pregnant women in a maternity shared-care environment. Recently in alignment with a National e-health agenda, an electronic health record (EHR) was introduced at an Australian tertiary maternity service to replace the PHR for collection and transfer of data. The aim of this study was to examine and compare the completeness of clinical data collected in a PHR and an EHR. Methods We undertook a comparative cohort design study to determine differences in completeness between data collected from maternity records in two phases. Phase 1 data were collected from the PHR and Phase 2 data from the EHR. Records were compared for completeness of best practice variables collected The primary outcome was the presence of best practice variables and the secondary outcomes were the differences in individual variables between the records. Results Ninety-four percent of paper medical charts were available in Phase 1 and 100% of records from an obstetric database in Phase 2. No PHR or EHR had a complete dataset of best practice variables. The variables with significant improvement in completeness of data documented in the EHR, compared with the PHR, were urine culture, glucose tolerance test, nuchal screening, morphology scans, folic acid advice, tobacco smoking, illicit drug assessment and domestic violence assessment (p = 0.001). Additionally the documentation of immunisations (pertussis, hepatitis B, varicella, fluvax) were markedly improved in the EHR (p = 0.001). The variables of blood pressure, proteinuria, blood group, antibody, rubella and syphilis status, showed no significant differences in completeness of recording. Conclusion This is the first paper to report on the comparison of clinical data collected on a PHR and EHR in a maternity shared-care setting. The use of an EHR demonstrated significant improvements to the collection of best practice variables. Additionally, the data in an EHR were more available to relevant clinical staff with the appropriate log-in and more easily retrieved than from the PHR. This study contributes to an under-researched area of determining data quality collected in patient records.

Paper and electronic antenatal records: What do women and health care providers tell us about their use?

The antenatal paper hand-held record (PHR) has been used extensively in general practice (GP) shared-care management of pregnant women, but recently the antenatal electronic health record (EHR) was introduced. This study aimed to examine the experiences of women and health care providers who use the PHR and the EHR, and find out the relative role of these records in the integration of care. Purposive homogenous samples of women and health care providers were interviewed as users of the PHR in phase 1 and the EHR in phase 2 of the study. Qualitative data were collected via interview with women and GPs and focus groups held with hospital health care providers. Interviews were coded manually and analysed using qualitative content analysis. Fifteen women participated in phase 1 and 12 in phase 2. Seventeen GPs participated in phase 1 and 15 in phase 2. Five focus groups with hospital health care providers were conducted in each phase. Results were categorised into four themes: 1. Record purpose; 2. Perception of the record; 3. Content of the record, and; 4. Sharing information in the record. Both women and health care providers were familiar with the PHR, but identified that some information was missing or not utilised well, and reported underuse of the EHR. The study identified continued widespread use of the PHR and several issues concerning the use of the EHR. An improvement in the strategic implementation of the EHR is suggested as a mechanism to facilitate its wider adoption.

From maternity paper hand-held records to electronic health records: What do women tell us about their use?

The paper hand-held record (PHR) has been used extensively in general practice (GP) shared care management of pregnant women, and recently, the first Mater Shared Electronic Health Record (MSEHR) was introduced. The aim of this qualitative study was to examine women’s experiences using the records and the contribution of the records to integrate care. At the 36-week antenatal visit in a maternity tertiary centre clinic, women were identified as a user of either the PHR or the MSEHR and organised into Phase 1 and Phase 2 studies respectively. Fifteen women were interviewed in Phase 1 and 12 women in Phase 2. Semi-structured interviews were used for data collection, and analysed using qualitative content analysis. Four main themes were identified: (1) purpose of the record; (2) perceptions of the record; (3) content of the record, and; (4) sharing the record. Findings indicate that the PHR is a well-liked maternity tool. The findings also indicate there is under-usage of the MSEHR due to health-care providers failing to follow up and discuss the option of using the electronic health record option or if a woman has completed the log-in process. This paper adds to an already favourable body of knowledge about the use of the PHR. It is recommended that continued implementation of the MSEHR be undertaken to facilitate its use.

Document timespan normalisation and understanding temporality for clinical records search

Previous qualitative research has highlighted that temporality plays an important role in relevance for clinical records search. In this study, an investigation is undertaken to determine the effect that the timespan of events within a patient record has on relevance in a retrieval scenario. In addition, based on the standard practise of document length normalisation, a document timespan normalisation model that specifically accounts for timespans is proposed. Initial analysis revealed that in general relevant patient records tended to cover a longer timespan of events than non-relevant patient records. However, an empirical evaluation using the TREC Medical Records track supports the opposite view that shorter documents (in terms of timespan) are better for retrieval. These findings highlight that the role of temporality in relevance is complex and how to effectively deal with temporality within a retrieval scenario remains an open question.

Response to: Electronic health records and healthcare identifiers : legislation discussion paper

Public submission # 029 to a Australian federal parliamentary committee considering proposed legislative changes to the Commonwealth's Healthcare Identifiers Act 2010 and the Personally Controlled Electronic Health Records Act 2012.

Shariah perspective on marriage contract and practice in contemporary Muslim societies

Forced marriages are worldwide phenomena and also exist in Pakistani society. It involves the lack of free and full consent of at least one of the parties to a marriage. Mostly, females are victims of forced marriages. It is prevalent in the name of religion in many Muslim countries; however, it is purely a traditional and cultural phenomenon which has nothing to do with religion. Forced marriages are different from arranged marriages in which both parties freely consent to enter into marriage contract and they have no objection on the choice of partner selected by their parents. This study will highlights different forms of forced marriages in Pakistani society.

First records of the papaya strain of Papaya ringspot virus (PRSV-P) in French Polynesia and the Cook Islands

The papaya strain of Papaya ringspot virus (PRSV-P), the cause of papaya ringspot disease, was confirmed in French Polynesia and the Cook Islands by double antibody sandwich enzyme linked immunosorbent assay (DAS-ELISA). In French Polynesia, the virus has probably been on the islands of Tahiti and Moorea for several years, but appears not to have spread to eight other islands. In contrast, PRSV-P has only recently appeared in the Cook Islands and is now the subject of an eradication campaign.

Classification and rating of strong-motion earthquake records

Ninety-two strong-motion earthquake records from the California region, U.S.A., have been statistically studied using principal component analysis in terms of twelve important standardized strong-motion characteristics. The first two principal components account for about 57 per cent of the total variance. Based on these two components the earthquake records are classified into nine groups in a two-dimensional principal component plane. Also a unidimensional engineering rating scale is proposed. The procedure can be used as an objective approach for classifying and rating future earthquakes.

Additional records of the rock shrimp, Sicyonia australiensis Hanamura & Wadley, 1998 (Decapoda, Sicyoniidae) from eastern Australia, western central Pacific

This paper reports on the collection of S. australiensis from the continental shelf off southern Queensland, easter Australia, in the western Central Pacific, documenting for the first time the occurrence of the species outside of eastern Bass Strait.

New records of the River Shark Glyphis (Carcharhinidae) reported from Cape York Peninsula, northern Australia

The distribution of the river shark Glyphis in northern Australia is extended with new records of occurrence in the Gulf of Carpentaria and a reassessment of historical survey data from Cape York Peninsula. Nine new specimens of Glyphis sp. A were collected in 2005 from the Weipa region on the Queensland coast of the Gulf of Carpentaria. A re-examination of archival records from 1978-86 marine and estuarine fish surveys in the Gulf of Carpentaria and along the northern Queensland East Coast allowed a further nineteen Glyphis specimens to be identified. Combined this gives twenty-eight new records of Glyphis specimens from the coasts of Cape York Peninsula, Queensland. Common habitat characteristics for all captures were turbid, shallow, fast running tidal water in the upper reaches of coastal rivers. The substrate was generally muddy and the rivers lined with mangrove. In all surveys the representation of Glyphis was low, being less than 1% of the total shark captures historically and 0.002 sharks 50 m net hour-1 in Weipa 2005. The size range captured was 1000-1800 mm total length historically and 705-1200 mm total length from Weipa 2005, with none recorded as sexually mature. Diagnostic characteristics of the Weipa specimens, identified as Glyphis sp. A, were: lower jaw teeth protruding and "spear-like"; second dorsal fin greater than half the height of the first dorsal fin; the snout relatively short and fleshy in the lateral view; pectoral fin ventral surface black in colouration; the precaudal vertebral count between 118 and 123; and the total vertebral count between 204 and 209.

Use of part records in Merino breeding programs - The inheritance of wool growth and fibre traits during different times of the year to determine their value in Merino breeding programs

Fibre diameter can vary dramatically along a wool staple, especially in the Mediterranean environment of southern Australia with its dry summers and abundance of green feed in spring. Other research results have shown a very low phenotypic correlation between fibre diameter grown between seasons. Many breeders use short staples to measure fibre diameter for breeding purposes and also to promote animals for sale. The effectiveness of this practice is determined by the relative response to selection by measuring fibre traits on a full 12 months wool staple as compared to measuring them only on part of a staple. If a high genetic correlation exists between the part record and the full record, then using part records may be acceptable to identify genetically superior animals. No information is available on the effectiveness of part records. This paper investigated whether wool growth and fibre diameter traits of Merino wool grown at different times of the year in a Mediterranean environment, are genetically the same trait, respectively. The work was carried out on about 7 dyebanded wool sections/animal.year, on ewes from weaning to hogget age, in the Katanning Merino resource flocks over 6 years. Relative clean wool growth of the different sections had very low heritability estimates of less than 0.10, and they were phenotypically and genetically poorly correlated with 6 or 12 months wool growth. This indicates that part record measurement of clean wool growth of these sections will be ineffective as indirect selection criteria to improve wool growth genetically. Staple length growth as measured by the length between dyebands, would be more effective with heritability estimates of between 0.20 and 0.30. However, these measurements were shown to have a low genetic correlation with wool grown for 12 months which implies that these staple length measurements would only be half as efficient as the wool weight for 6 or 12 months to improve total clean wool weight. Heritability estimates of fibre diameter, coefficient of variation of fibre diameter and fibre curvature were relatively high and were genetically and phenotypically highly correlated across sections. High positive phenotypic and genetic correlations were also found between fibre diameter, coefficient of variation of fibre diameter and fibre curvature of the different sections and similar measurements for wool grown over 6 or 12 months. Coefficient of variation of fibre diameter of the sections also had a moderate negative phenotypic and genetic correlation with staple strength of wool staples grown over 6 months indicating that coefficient of variation of fibre diameter of any section would be as good an indirect selection criterion to improve stable strength as coefficient of variation of fibre diameter for wool grown over 6 or 12 months. The results indicate that fibre diameter, coefficient of variation of fibre diameter and fibre curvature of wool grown over short periods of time have virtually the same heritability as that of wool grown over 12 months, and that the genetic correlation between fibre diameter, coefficient of variation of fibre diameter and fibre curvature on part and on full records is very high (rg > 0.85). This indicates that fibre diameter, coefficient of variation of fibre diameter and fibre curvature on part records can be used as selection criteria to improve these traits. However, part records of greasy and clean wool growth would be much less efficient than fleece weight for wool grown over 6 or 12 months because of the low heritability of part records and the low genetic correlation between these traits on part records and on wool grown for 12 months.

Reproduction of Richard Dehmel reading with his wife Ida Dehmel nee Auerbach sitting across from him, early in their marriage; Parkstrasse, Hamburg Portraits; Couples

Verso: Erste Wohnung Parkstrasse Fruehzeit der Ehe 1901

Karl Gottschalk and Elisbeth nee Steinfeld with their son Rudolf Gottschalk (later Grahame) and son Fritz Gottschalk (Levy) of Lisbeth's first marriage.

Rudolf Gottschalk (later Grahame) on right; Fritz Gottschalk (Levy) on left

Karl Gottschalk and Elisbeth nee Steinfeld with their son Rudolf Gottschalk (later Grahame) and son Fritz Gottschalk (Levy) of Lisbeth's first marriage.

Rudolf Gottschalk (later Grahame) on right; Fritz Gottschalk (Levy) on left

A review of Taenaris Hubner (Lepidoptera: Nymphalidae: Amathusiinae) in Queensland, together with first Australian records for T. myops kirschi Staudinger and Elymnias agondas melanippe Grose-Smith (Satyrinae).

Species of the amathusiine genus Taenaris Hubner known to occur in Australia, predominantly from Torres Strait, are reviewed and illustrated. T. myops kirschi Staudinger is recorded for the first time in Australia from four male specimens collected on Dauan Island, Torres Strait. A female specimen of the satyrine Elymnias agondas melanippe Grose-Smith also collected from Dauan Island represents the first record of this taxon from Australia. The high degree of variation observed in the external facies of Taenaris from Torres Strait and reliable taxonomic separation of female specimens are discussed. Taenaris-like forms of the papilionid, Papilio aegeus ormenus Guerin-Meneville and E. a. melanippe from Torres Strait and Dauan Island respectively are illustrated and reviewed. The form of P. a. ormenus from Torres Strait that is most similar to Taenaris spp. is identified as form ormenus Guerin-Meneville variety onesimus Hewitson.