 clinically relevant morphologic terms was calculated among all reviewers, and separately among radiologists and clinicians. The percentage agreement was defined as poor (<0.50), moderate (0.51-0.70), good (0.71-0.90), and excellent (0.91-1.00). Results: Overall agreement was good to excellent for the terms collection (percentage agreement = 1; IQR 0.68-1), relation with pancreas (1; 0.68-1), content (0.88; 0.87-1), shape (1; 0.78-1), mass effect (0.78; 0.62-1), loculated gas bubbles (1; 1-1), and air-fluid levels (1; 1-1). Overall agreement was moderate for extent of pancreatic nonenhancement (0.60; 0.46-0.88) and encapsulation (0.56; 0.48-0.69). The percentage agreement was greater among radiologists than clinicians for extent of pancreatic nonenhancement (0.75 vs. 0.57, p = 0.008), encapsulation (0.67 vs. 0.46, p = 0.001), and content (1 vs. 0.78, p = 0.008). Conclusion: Interobserver agreement for the new set of morphologic terms to describe peripancreatic collections in AP is good to excellent. Therefore, we recommend that current clinically based definitions for CT findings in AP (e.g. pancreatic abscess) should no longer be used.
A review of lessons from past EMMER/COPE successes and failures demonstrates two factors commonly observed in implementations that achieve positive (versus negative) outcomes: 1) designing a system that is usable by clinicians n the clinical work context, and 2) adequately preparing users to adopt changes associated with the implementation. Based on this, a framework for User-centered Implementation (GUCCI) is presented.
This framework combines methods from user- centered design and change management to provide an implementation methodology that addresses these factors during implementation and improves the likelihood that positive outcomes are achieved. Next, this study examines clinician acceptance of an EMMER/COPE system implemented in a pediatric hospital system, Children’s Healthcare of Atlanta (Children’s).
Children’s was selected for this research because they have employed an implementation approach founded in user-centered implementation principles and methods. The study examined physician, nurse, and other staff perceptions about the system’s usefulness (performance expectancy (PEE)) implementation. The pre- and post-implementation models demonstrate that the factors that influence PEE change over time. Compatibility with work practices was important both prior to and following implementation.
Prior to implementation, users who perceived a greater need for the system and felt that their needs were represented in the sign process also had xi higher expectations of the impact the system would have on their Job performance. After implementation, PEE ratings were influenced primarily by characteristics of the system. These characteristics included how well the system supported clinical decision making, facilitated sharing information, and how easy it was to use (E).
One aspect of the roll process, the support provided by super users, also had a positive impact on PEE and E after implementation. This finding highlights the importance of having front-line support resources available on the units. Because Children’s employed a GUCCI-based implementation approach, it was expected that good levels of user acceptance of the EMMER/COPE would be achieved. Study results indicate Children’s implementation achieved positive perceptions of system ease of use (E).
However, this ease of use did not consistently translate to favorable ratings of the systems’ impact on individual Job performance. Post-implementation PEE ratings remained neutral or positive for most user subgroups, a finding likely related to the fact that during this intermediate stage of the implementation both the paper hart and EMMER must be used. Managing these dual locations for patient information may be contributing to predominantly neutral, rather than positive, PEE ratings since this limits the ability of the system to contribute to gains in personal efficiency and effectiveness.
The findings on factors that influence PEE and E, two aspects of technology acceptance, and the PEE and E levels achieved with Children’s EMMER were applied to provide further guidance for using GUCCI to achieve clinician acceptance of EMMER systems. Designing EMMER/COPE systems that are usable within the clinical work intent is important because it enables clinicians to focus time and energy on the patient, rather than on using the system. Accomplishing this in practice is difficult given the complexity of these systems and the dynamic clinical care processes they must support.
However, the GUCCI framework presented here can be effectively applied to EMMER/COPE implementations to ensure the usability, utility, and, consequently, acceptance of these systems. INTRODUCTION safety. As a result, many healthcare, government, and business groups are encouraging healthcare providers to adopt EMMER and COPE. For example, in the US the federal government, some state governments, and the Leap Frog Group, a consortium adopting these systems (2003).
Knowledge and the application of knowledge regarding drug therapy (30%) Knowledge and use of knowledge regarding patient factors that affect drug therapy (29. 2%) Use of calculations, decimal points, or unit and rate expression factors (17. 5%) COPE, especially COPE including dose guideline support, can significantly reduce the potential for all of these factors contributing to errors. Note that while the literature provides evidence of the benefits of EMMER/COPE, these benefits are not reported consistently across all EMMER/COPE implementations.While breaking in a gun is more of an old wives tail...

It does have merits in certain areas and different meanings. With a self defense gun, I'm going to put a lot of ammo through it to make sure it functions reliably. I also test fair bit of SD ammo to make sure it feeds properly. 

On long range/PRS shooters tend to get better accuracy after first 60 to 100 rounds, depending on barrel manufacture. The first rounds can act like a very fine grit sandpaper and any microscopic burrs left from turning are removed. While it's not critical accuracy changes between bullet 1 and 500, it can be noticeable for serious shooters.Previous Entry | Next Entry
First blush memory usage is not that different from Mozilla. Moz peaked at 62M and Opera peaked at 70M after restarting and opening the same set of bookmarks. But I want to see what Opera is like over time, the way I use it regularly. I have caching set to '0' in Moz and I turned off caching in Opera.
I quite like Opera. It might take a little while to settle in, but I think I can give it a fair run now that the buttons are small enough. There are functionality things that are annoying though:
- The most infuriating one is the toLocaleDateString() method for the Date Object. This method, as specified in ECMA-262 3rd Edition (§15.9.5.6, page 124), is supposed to return "the date portion of the current date-time in the current time zone in a convenient, human-readable form that corresponds to the conventions of the host environment's current locale". It's up to the individual browser to implement something reasonable. So, document.writeln(new Date().toLocaleDateString()); right now should give me something like: "Friday, March 25, 2005".
But Opera's implementation gives me "3/25/2005". >K{ And I find that Opera has some very unexpected interpretations of HTML and CSS sometimes...
I can't make custom keywords like Mozilla. They have search bars for Google, Google News, Google Groups, (but no Google Images which is the second most frequent one I use), Amazon, Ebay, a dictionary (but I want Merriam-Webster Online), several translation ones (but no Chinese!!) and I end up removing them all.
Edit C:\Documents and Settings\[LOCALUSER]\Application Data\Opera\Opera\profile\search.ini to change them. w00t!! =)
- Hitting ESC doesn't stop animated GIFs. => Adding "Enable GIF animation" box to a toolbar works, but takes up a lot of toolbar space. I might be able to map something to it in Preferences->Mouse and Keyboard.
- No bookmark groups... they're just folders, like Firefox. At least, the option to Open All is in the same place at the top each time.
- I can't bookmark all the pages I currently have open. I have to add them one by one. This annoys me because it's CTRL-T to set a bookmark instead of CTRL-D. I have small hands and CTRL-T is a bigger stretch. And unlike CTRL-D which just dumps the link to a default location, CTRL-T will bring up a dialogue that lets you add the link to a specific location. So, instead of add-add-add-add-add-add, open bookmarks, drag them all into my folder, I have to go through the complete adding procedure n times.
No custom ordering of bookmarks. It's alphabetical and it won't let me change it. It seems to remember the order if I add them manually from scratch. But if I import my Mozilla bookmarks, the order can be slightly off and there's no way for me to change it.
View->Sort by my order. And rearrange.
- I can't block images from a certain server with just the vanilla install. Mozilla lets me right-click->Block images from this server. Firefox was even nicer. It says "Block images from ________" and it gave