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The article discusses the mechanical methods of enlargement production and related processes in use at the U.S. Library of Congress. The production speed, which has been initiated by the continuous enlargers just described with their continuous rolls of sensitized paper in place of the cut sheets used in the past, is maintained in the next step, the automatic processing of the exposed paper. An important feature of these film processors consists of a continuous replenishment apparatus which maintains all the processing solutions at constant strength regardless of the footage of paper that passes through the solutions.

This article attempts to measure the scientific productivity in terms of number of papers published in journals by authors in the field of information science, compared to the publication pattern for science in general. Information science has been defined by the American Society for Information Science as the science that investigates the properties and behavior of information, the forces governing the flow of information, and the means of processing information, for optimum accessibility and usability. According to this definition, information science emerges as an umbrella-like discipline. If the basic professional society in this discipline is considered to be the American Society for Information Science, then its prime indexing journal may be considered to be "Information Science Abstracts," and its prime review vehicle may be the "Annual Review of Information Science and Technology."

To a great extent, the effectiveness of a government may be traced to its constituting documents which serve as a guide or map for how it is supposed to function. From a systems perspective, we may expect a more systemic Constitution to inform the operation of a government that is more systemic and so more effective. This paper uses Integrative Propositional Analysis (IPA) to conduct a preliminary evaluation of the systemic structure of the US Constitution. The analysis finds that the US Constitution has a vanishingly low level of structure. This previously unrecognized lack of structure provides a new explanation for why the nation is increasingly misgoverned (and/or more difficult to govern) and why divisions are deepening between partisan groups, leading to argument and conflict. A path forward is suggested to develop a more systemic Constitution and more effective governance; one supporting a more just, prosperous, and sustainable society. [ABSTRACT FROM AUTHOR]

Background: Anaphylaxis is a life‐threatening allergic reaction with significant risk for children with allergies. Access to potentially life‐saving medication is critical for these children. This review aims to describe state laws and policies guiding stock epinephrine in schools for allergic or anaphylactic events and detail recommendations for best practices. Methods: This paper is a comprehensive review of the 50 states and the District of Columbia's (DC) laws and policies for stock epinephrine at schools for children in pre‐kindergarten through 12th grade. Results: All 50 states and DC allow undesignated epinephrine in schools to use for allergic or anaphylactic reactions. A key difference arises in whether states allow (N = 37) or mandate (N = 14) that schools stock epinephrine. States exhibit differences in the body responsible for developing stock epinephrine policy (N = 48), along with stakeholders responsible for developing procedures (N = 30) and implementing them (N = 19). Differences also exist in state epinephrine procurement, administration, training, and liability. Conclusions: This review of stock epinephrine laws and policies highlights the significant variation in state legislation despite widespread adoption. Only one‐quarter of states mandate that schools have stock epinephrine available for emergency use, underscoring need for a more unified approach with consistent guidelines, comprehensive training, and possible funding for implementation. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess the extent to which academic promotion and tenure (APT) criteria and guidelines in schools of nursing recognize predatory publishing. This assessment included an analysis of APT documents looking specifically for guidance about predatory publications by faculty in schools of nursing. Design: This study used a cross‐sectional, descriptive design and was conducted in 2020. Methods: A mixed methods approach was used to collect data from two sources. Data were extracted from APT documents for 92 research‐intensive universities found online and specifically focused on documents for universities and for schools of nursing in the United States. Interviews were conducted with a subsample of academic administrators (n = 10) from selected schools. Findings: The majority (57%; n = 50) of APT documents reviewed addressed quality of the journals in which faculty publish. However, very nonspecific terms, such as "high quality" or "peer reviewed" were used. None of the documents reviewed (n = 88) included any reference to predatory journals. Deans who were interviewed validated the analysis of the APT documents. While most deans reported faculty were aware of predatory journals and the risks of publishing in them, formal guidelines for consequences for publishing in predatory journals were not developed or available. Conclusion: This study examined how schools of nursing in research‐intensive universities address the issue of predatory journals. APT criteria do not provide guidance to faculty and promotion and tenure committees about issues related to predatory publications as low‐quality publication outlets. Recommendations for APT committees, mentors, and faculty are provided. Clinical relevance: Clinicians rely on researchers, many of whom are faculty, to publish rigorous studies that produce evidence they can translate into practice. One measure of the quality of a study's findings is where the paper is published and reflects the level of peer review it has been through. Faculty who publish in predatory journals may not have had their work reviewed by experts; evidence produced may or may not be adequate for translation to guide nursing practice. [ABSTRACT FROM AUTHOR]

A person's right to access his or her protected health information is a core feature of the U.S. Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. If the information is stored electronically, covered entities must be able to provide patients with some type of machine-readable, electronic copy of their data. The aim of this study was to understand how academic dental institutions execute the Privacy Rule's right of access in the context of electronic health records (EHRs). A validated electronic survey was distributed to the clinical deans of 62 U.S. dental schools during a two-month period in 2014. The response rate to the survey was 53.2% (N=33). However, three surveys were partially completed, and of the 30 completed surveys, the 24 respondents who reported using axiUm as the EHR at their dental school clinic were the ones on which the results were based (38.7% of total schools at the time). Of the responses analyzed, 86% agreed that clinical modules should be considered part of a patient's dental record, and all agreed that student teaching-related modules should not. Great variability existed among these clinical deans as to whether administrative and financial modules should be considered part of a patient record. When patients request their records, close to 50% of responding schools provide the information exclusively on paper. This study found variation among dental schools in their implementation of the Privacy Rule right of access, and although all the respondents had adopted EHRs, a large number return records in paper format. [ABSTRACT FROM AUTHOR]

‘Scraps’: hidden nursing information and its influence on the delivery of care What nurses commonly describe as ‘scraps’ are defined as the personalized recordings of information that is routinely made on any available piece of paper (hence scraps) or in small notebooks. The use of scraps is common in practice and has been noted in research from across the globe. Drawing on an empirical study it is argued that scraps are a unique combination of personal and professional knowledge that informs the delivery of care. The overall aim of the study was to discover how nurses define and communicate information about patients and the delivery of care to each other on an elderly care unit. The processes by which information was constructed and the organizational structure and interactions that influenced this were also identified. The research design was an ethnographic one that involved: observations of formal nursing end of shift reports (23 handovers) and informal interactions between nurses (146 hours); interviews (n + 34) with registered nurses, student nurses and nursing auxiliaries; and analysis of written records. Data were collected from five acute elderly care wards at a district general hospital in the south of England. A grounded theory analysis was undertaken which revealed that scraps may have a significant role in the communication of information and the delivery of care. Therefore a categorization of scraps within three main themes was undertaken. First, the analysis revealed the processes involved in the construction of scraps. Second, the content and role of scraps in influencing the delivery of care was exposed. Finally, the potentially confidential nature of scraps and consequent problems of storage and disposal was recognized. The findings are discussed in relation to a suggested model of the interrelationship between paperwork, scraps, handovers and the delivery of nursing care. It is concluded that scraps are significant... [ABSTRACT FROM AUTHOR]

The article presents information on the Royal Society Catalogue as an index to Nineteenth Century American Science. The Royal Society Catalogue of Scientific Papers is investigated in terms of its coverage of American science journals and American scientists. The Royal Society Catalogue serves today as an indispensable aid for the historian of nineteenth century science. The Royal Society Catalogue lists in the front of volume 1 all the journals indexed; additions and corrections appear in subsequent volumes. Included in that list are the places of publication; it was an easy task, therefore, to determine which were American journals. The number of journals in each decade approximates the general publication pattern demonstrated by the tabulation of American entries in Bolton's Catalogue (referred to earlier), which showed an acceleration in the number of new scientific periodicals.

The article provides information on the bibliographies of documentation. The publications of the American Council of Learned Societies during the last two years have been prepared on an IBM typewriter and lithoprinted with a minimum of expense. The principal purpose of the operation has been to secure dependable figures on costs. "Article Bibliography," is a 3-volume, 4500 page bibliography, listing or summarizing more than 20,000 scientific papers and reports pertaining to the Arctic, and also official documents, books of exploration, and general magazine articles. "Machine Translation," discusses the present state of research on machine translation in the U.S. The present outlook is that fully automatic translation seems out of the question in the near future; it would require storage capacities of trillions of bits of information or the invention of programming techniques that could greatly increase the machine's efficiency by learning, or some combination of these two factors

The article presents some shorter communications, news and technical notes related to the field of documentation in the U.S. The American Documentation Institute, one of the pioneers in the application of microfilm to the needs of research, has deposited negatives of the following journals in the Photoduplication Service of the Library of Congress, Washington D.C. University Microfilms Inc. has announced that Congressional hearings and reports will be photographed during 1952, as the first in a series of the U.S. public documents projected by this producer. Some 200 English literary periodicals of the 17th, I8th, and 19th centuries are being produced by University Microfilms at a subscription cost of $500. for approximately 100,000 pages annually until the series is completed.

The article reports that since many fine manuscripts are constantly being crowded out of the various professional library Journals on account of space limitations, the U.S. Publications Committee of the Association of College and Reference Libraries is about to inaugurate a series of occasional papers. These papers will be known as ACRL Monographs and will appear at three to four month intervals. Among other manuscripts now being considered by the Committee are contributions on the history of reference service, librarians as bookmen, the structure of the Soviet academies, and the like.

This article focuses on the report of the American Documentation Institute's Standing Committee on Organization of Information. The Committee submitted a "working paper." This deals with the possibility of arranging documentation and related fields into a more or less permanent structure or framework. The framework might be useful as a guide in arranging meetings and conference programs. To achieve it requires analysis of the main functions of documentation. The paper is still in committee because different views have been submitted by some members of the committee, and some members have submitted no views.

Presents an abstract of the article "The Use of Material," by Ralph E. Cleland, published in the April 15, 1955 issue of the journal "Science." Comment on the large number of biological papers pouring into American libraries; Question whether a biological society should circulate 2,000 to 3,000 copies of an article that will be critically examined by only 20 or even 100 persons; Suggestion to consider a more economical and practical system of publishing digests of articles in journal form.

This article summarizes the results of a comparison of the coverage of "Literature Notes" with that of other services. The results reported here are indicative of the variations in coverage among the services and give some idea of the total extent of the literature. These variations result in part from differences in the scope of the services: Chemical Literature includes some items of interest solely to chemists that the other services would consider too specialized to include, such as detailed discussions of chemical nomenclature, and Library Science Abstracts.

This article presents an annotated collection of bibliographical notes on and abstracts of books and articles pertaining to the various aspects of the organization of information, which is the eighth installment of the bibliography compiled cooperatively by the Committee on Organization of Information of the American Documentation Institute. The "American Printer," published in December 1951, reportedly, covers printer's buying guide and directory issue. Documentalists are advised to scrutinize this issue of American Printer. The "Inquiry Concerning the Professional Education of Librarians and Documentalists" is a final report to the Joint Committee on Professional Training of the International Federation of Library Associations and of the International Federation for Documentation on an inquiry conducted with UNESCO's support. It, reportedly, discusses the state of professional training for librarians and information officers and their status in many different countries and also the varying qualifications and means of selection for the profession and current curricula and textbooks.

The article presents a collection of bibliographical notes on and abstracts of books and articles pertaining to various aspects of the organization of information is the sixth installment of the bibliography compiled cooperatively by the Committee on Organization of Information of the American Documentation Institute. "Abstracts of Corrosion Literature" published in the April 1951 issue of "Science," will be printed by the National Association of Corrosion Engineers on punch cards to reduce time needed to search literature for information. "The Association of Research Libraries Committee on National Needs," an article from the Library of Congress Information Bulletin, provides information on the committee, which was established recently to consider the adequacy of national resources of research materials in terms of the content, growth, organization and bibliographical control of library collections as those collections may be called upon to serve critical national needs in the present and in the future.

Highlights of the history of the American Documentation Institute (ADI) (1937-1967) are sketched, giving background on the concepts and aspirations of Watson Davis (1896-1967), founder of ADI and one of the first Americans to become interested in documentation as a separate field of endeavor. Davis organized ADI as a service organization, concentrating primarily on offering microfilming services. Since 1952 ADI has grown in importance as a professional organization, gradually developing to a state of financial self-sufficiency, intellectual influence, and benefaction to its members. These developments are traced for the most part in chronologial order, sometimes with the use of footnotes to bring up to date matters introduced in the text at the time of their earliest importance. [ABSTRACT FROM AUTHOR]

This article presents information related to literature notes. As a result of a number of exchange agreements, and in order to increase its coverage, "Literature Notes" will include some abstracts copied or adapted from other publications. The American Documentation Institute is not able to supply copies of the publications abstracted. Copies can be obtained from the publisher or issuing organization, or may be consulted in libraries. After discussing new means of reproduction which make bibliographical access easier and help to solve the problem of out of print books, the author turns to mechanical storage and retrieval of information, films, and tape recordings.

The problems of keeping abreast of currently published knowledge, and of locating previously published material of current interest harass industrialists, lawyers, military planners, scientists, and engineers. In recognition of the mounting quantity and increasing complexity of the literature of metallurgy, the American Society for Metals initiated, in January 1960, a mechanized searching service which is based on the positive results obtained in an experimental and pilot program conducted during the years 1955-1959. This new service offered by the American Society for Metals employs machine searching, in response to inquiries, of the core metallurgical literature published thoughout the world. The analysis, encoding, and machine searching of the metallurgical literature is conducted by the Center for Documentation and Communication Research at Western Reserve University under contract with the American Society for Metals. In order to ensure a more complete mechanized literature searching service, application was made to the National Science Foundation for a grant, for a two and one-half year period, which would augment substantially the subject areas included in the new service, and would permit the analysis and encoding of unpublished reports, in addition to literature published in the established periodicals. The National Science Foundation has provided funds for the first year of this expanded program, renewable through the two and one-half year period believed to be necessary to establish the service on a financially self-supporting basis. Two principal types of services are being offered by the American Society for Metals at the present stage of the program: (1) Current awareness searches, the results of which are transmitted to the subscribers every two weeks, providing prompt, current information on specific problems, in the form of pertinent abstracts. (2) Copies of encoded tapes of the year's literature, which may be purchased by those who wish to conduct searches with their own equipment. As a considerable quantity of encoded material is accumulated, a third service will be offered: Retrospective (bibliographic) searches conducted on demand for the total, or any portion, of the "machine library." An ad hoc committee is being appointed by the National Academy of Sciences -- National Research Council to participate in further planning of the test program, and in evaluating the results during the planned period of financial assistance to be given by the National Science Foundation. A committee of the American Society for Metals has been active for a number of years in discharging similar responsibilities on behalf of the Society. This first paper in the series describes the background, plans, initial stages, and problems of the operational mechanized searching service in metallurgy and allied subject fields. [ABSTRACT FROM AUTHOR]

This article presents news notes. Announcement was made at the 1959 convention of the American Documentation Institute at Lehigh University, Bethlehem, Pennsylvania of the election of the new officers of the Institute for the year 1960. The Council of the American Documentation Institute has discussed at length the matter of U.S. representation to the Federation Internationale de Documentation and especially its own future role. In view of the clearly developing need to broaden and strengthen U.S. representation in FID, a resolution was passed by the ADI Council.

Policy PointsChild lead poisoning is associated with socioeconomic inequity and perpetuates health inequality.Methods for testing and detection of child lead poisoning are ill suited to the current demographics and characteristics of the problem.A three‐pronged revision of current testing approaches is suggested.Employing the suggested revisions can immediately increase our national capacity for equitable, inclusive testing and detection. Child lead poisoning, the longest‐standing child public health epidemic in US history, is associated with socioeconomic inequity and perpetuates health inequality. Removing lead from children's environments ("primary prevention") is and must remain the definitive solution for ending child lead poisoning. Until that goal can be realized, protecting children's health necessarily depends on the adequacy of our methods for testing and detection. Current methods for testing and detection, however, are no longer suited to the demographics and magnitude of the problem. We discuss the potential deployment and feasibility of a three‐pronged revision of current practices including: 1) acceptance of capillary samples for final determination of lead poisoning, with electronic documentation of "clean" collection methods submitted by workers who complete simple Centers for Disease Control and Prevention–endorsed online training and certification for capillary sample collection; 2) new guidance specifying the analysis of capillary samples by inductively coupled plasma mass spectrometry or graphite furnace atomic absorption spectrometry with documented limit of detection ≤0.2 μg/dL; and 3) adaptive "census tract–specific" universal testing and monitoring guidance for children from birth to 10 years of age. These testing modifications can bring child blood lead level (BLL) testing into homes and communities, immediately increasing our national capacity for inclusive and equitable detection and monitoring of dangerous lower‐range BLLs in US children. [ABSTRACT FROM AUTHOR]

Background: The quality of care of the 6.5 million Americans living with dementia has been suboptimal, leading to worse outcomes and higher costs. Few health systems have formal systems in place to guide the care of these patients. To help improve the care of persons living with dementia, we developed and preliminarily evaluated the effectiveness of electronic health record (EHR)-generated recommendations for patients with dementia. Methods: This quality improvement study was conducted from October 2020 through June 2022 at a single academic healthcare system and included patients identified as having dementia on their problem list and their physicians. Ten (seven outpatient and three inpatient) algorithms based on clinical logic and evidence were embedded in an EHR system to generate specific recommendations based on combinations of utilization, diagnosis, and medications. The number of each type of recommendation generated, and orders for each type of recommendation were recorded, as well as physician's perceptions of this approach. Results: Three thousand six hundred and nine recommendations on 763 patients were triggered by the algorithms in the outpatient setting, and 185 referrals were placed. The most common recommendations were for ongoing care through the UCLA Alzheimer's and Dementia Care program, Palliative Care, the Extensivist Clinic, Urogynecology, and Clinical Pharmacy. The most commonly acted upon by providers were recommendations for referral to Pharmacists and the UCLA Alzheimer's and Dementia Care program. The most common reason for not responding to specific recommendations was that these were not perceived as relevant to the patient. Compared to general medicine physicians, geriatricians felt more comfortable managing dementia care without a referral to a service (23% (95% CI 15%–34%) versus 3% (95% CI 0%–17%), p = 0.012) and less commonly felt the recommendation was appropriate (1% (95% CI 0%–7%) versus 13% (95% CI 4%–30%), p = 0.02). Conclusions: EHR-generated algorithms can help guide patients with dementia to appropriate clinical services. [ABSTRACT FROM AUTHOR]

Policy PointsPatients and families can identify clinically relevant errors, including "blindspots"—safety hazards that are difficult for clinicians or organizations to see.Health information transparency, including patient access to electronic visit notes, now federally mandated in the US and the subject of policy debate worldwide, creates a new opportunity to engage patients in diagnostic safety. However, not all patients access notes.Patient identification of blindspots in their notes underscores the need to systematically and equitably engage willing patients in safety, promote patient "good catches," and establish routine systems for patient feedback to help avoid preventable diagnostic errors and delays. Context: Policy shifts toward health information transparency provide a new opportunity for patients to contribute to diagnostic safety. We investigated whether sharing clinical notes with patients can support identification of "diagnostic safety blindspots"—potentially consequential breakdowns in the diagnostic process that may be difficult for clinical staff to observe. Method: We used mixed methods to analyze patient‐reported ambulatory documentation errors among 22,889 patients at three US health care centers who read ≥ 1 visit note(s). We identified blindspots by tailoring a previously established taxonomy. We used multiple regression analysis to identify factors associated with blindspot identification. Findings: 774 patients reported a total of 962 blindspots in 4 categories: (1) diagnostic misalignments (n = 421, 43.8%), including inaccurate symptoms or histories and failures or delay in diagnosis; (2) errors of omission (38.1%) including missed main concerns or next steps, and failure to listen to patients; (3) problems occurring outside visits (14.3%) such as tests, referrals, or appointment access; and (4) multiple low‐level problems (3.7%) cascading into diagnostic breakdowns. Many patients acted on the blindspots they identified, resulting in "good catches" that may prevent potential negative consequences. Older, female, sicker, unemployed or disabled patients, or those who work in health care were more likely to identify a blindspot. Individuals reporting less formal education; those self‐identifying as Black, Asian, other, or multiple races; and participants who deferred decision‐making to providers were less likely to report a blindspot. Conclusion: Patients who read notes have unique insight about potential errors in their medical records that could impact diagnostic reasoning but may not be known to clinicians—underscoring a critical role for patients in diagnostic safety and organizational learning. From a policy standpoint, organizations should encourage patient review of visit notes, build systems to track patient‐reported blindspots, and promote equity in note access and blindspot reporting. [ABSTRACT FROM AUTHOR]

The article provides information on Auxiliary Publication, which is now an accepted and useful adjunct to scientific and scholarly publishing. Auxiliary Publication was inaugurated under the auspices of Science Service as a part of the American Documentation Institute's Documentation Division. The plan was set forth in communications to journals on January 20, 1936, and shortly thereafter documents were received for deposit, the first document being 1001. Since its inauguration there have been 2, 148 documents deposited through April 30, 1951. The fact that a document is not ordered or is ordered only a small number of times is a compliment to the judgment of the cooperating editor and an assurance to the editor that by utilizing Auxiliary Publication and saving the cost of complete publication of the document in his journal, he is conserving the resources of scientific and scholarly publishing without dangering the free flow of scientific or scholarly information.

Purpose: Nurses are on the forefront of delivering care to patients hospitalized with COVID‐19. Nurses' impact on patient care can be discerned through assessment and documentation strategies, including structured and unstructured narratives, clinical pathways, flowsheets, and problem‐based approaches. To date, there are no published reports regarding nursing assessment and documentation during the COVID‐19 pandemic using an assessment framework to capture clinical decision making, nursing diagnoses, and key social determinant of health (SDoH) data. Hence, the purpose of this investigation was to conduct an exploratory nursing documentation audit of patients hospitalized with COVID‐19 during the first surge to identify types and frequency of nurse‐sensitive indicators, including SDoH. Method: This pilot study utilized a retrospective chart review design at a single academic medical center, utilizing Gordon's Eleven Functional Health Patterns (FHP) framework to extract clinical, social, and nursing assessment data for patients hospitalized with COVID‐19. Descriptive statistics were computed for continuous variables and counts/percentages for categorical variables. Findings: Data from 94 patient records were analyzed. Most patients were male (59.6%), with a mean age of 58 years. Nearly 15% of patients were Black and 12.8% were Hispanic, most residing in four geographic areas. Nine of the 11 FHPs were reflected in nurse‐sensitive indicators documented in the electronic health record. SDoH data were inconsistently documented, including race, education, history of neglect/abuse, and occupation. Conclusion: The FHP framework captured many nurse‐sensitive indicators during the first COVID‐19 surge, although screening for and documenting SDoH data were limited. Implications for nursing practice: Findings can influence the development of nursing assessment and documentation during crisis care delivery that are inclusive of distinct sociodemographic factors, in addition to clinical factors, to provide comprehensive, culturally sensitive care. Such documentation will enhance the use of nursing knowledge guided by a nursing framework to make visible the essential contributions of nurses to healthcare delivery. [ABSTRACT FROM AUTHOR]

Loan processors and underwriters at mortgage firms seek to gather substantial supporting documentation to properly understand and model loan risks. In doing so, loan originations become prone to closing delays, risking client dissatisfaction and consequent revenue losses. We collaborate with a large national mortgage firm to examine the extent to which these delays are predictable, using internal discussion threads to prioritize interventions for loans most at risk. Substantial work experience is required to predict delays, and we find that even highly trained employees have difficulty predicting delays by reviewing discussion threads. We develop an array of methods to predict loan delays. We apply four modern out‐of‐the‐box sentiment analysis techniques, two dictionary‐based and two rule‐based, to predict delays. We contrast these approaches with domain‐specific approaches, including firm‐provided keyword searches and "smoke terms" derived using machine learning. Performance varies widely across sentiment approaches; while some sentiment approaches prioritize the top‐ranking records well, performance quickly declines thereafter. The firm‐provided keyword searches perform at the rate of random chance. We observe that the domain‐specific smoke term approaches consistently outperform other approaches and offer better prediction than loan and borrower characteristics. We conclude that text mining solutions would greatly assist mortgage firms in delay prevention. [ABSTRACT FROM AUTHOR]

Background: Evaluating older adults with cognitive dysfunction in emergency departments (EDs) requires obtaining collateral information from sources other than the patient. Understanding the challenges emergency clinicians face in obtaining collateral information can inform development of interventions to improve geriatric emergency care and, more specifically, detection of ED delirium. The objective was to understand emergency clinicians' experiences obtaining collateral information on older adults with cognitive dysfunction, both before and during the COVID‐19 pandemic. Methods: From February to May 2021, we conducted semi‐structured interviews with a purposive sample of 22 emergency physicians and advanced practice providers from two urban academic hospitals and one community hospital in the Northeast United States. Interviews lasted 10–20 min and were digitally recorded and transcribed. Interview transcripts were analyzed for dominant themes using a combined deductive–inductive approach. Responses regarding experiences before and during the pandemic were compared. Results: Five major challenges emerged regarding (1) availability of caregivers, (2) reliability of sources, (3) language barriers, (4) time constraints, and (5) incomplete transfer documentation. Participants perceived all challenges, but those relating to transfer documentation were amplified by the COVID‐19 pandemic. Conclusion: Emergency clinicians' perspectives can inform efforts to support caregiver presence at bedside and develop standardized communication tools to improve recognition of delirium and, more broadly, geriatric emergency care. [ABSTRACT FROM AUTHOR]

Purpose: An emerging need to improve health care transition planning has developed worldwide as more youth with special health care needs are surviving to adulthood. Nurses have been instrumental in facilitating transition planning and supporting youth throughout this process. While various transition tools have been developed, health professionals' utilization and perception of these tools have yet to be explored. Furthermore, there are no universally‐accepted documentation tools for transition planning. The purpose of this study was to develop and implement a transition process planning and communication tool to facilitate transition planning among multiple, pediatric subspecialties within a system‐wide transition program. Design and Methods: This project was a cross‐sectional quality improvement initiative. Eligible encounters in the electronic medical record (N = 20,645) were obtained from 38 subspecialty clinics at a large, freestanding pediatric health system. Transition planning documentation was monitored for 8 months pre‐implementation and 14 months post‐implementation of the tool. Health professionals (N = 89) completed a survey to assess the tool's feasibility. Results: Implementation of the tool was feasible and corresponded with increased transition planning documentation post‐implementation. Nurses represented 33% of the sample that utilized the tool. Survey results revealed barriers to documentation and utilization of the tool, along with strategies for improvement. Practice Implications: This study demonstrates that health professionals, especially pediatric nurses and nurse practitioners, are willing to adopt new, electronic documentation tools to enhance multidisciplinary transition planning consistent with best practices. Future studies should address identified barriers, assess the effectiveness of the tool on improving transition outcomes, and consider implications for integration into global health care models. System‐wide implementation of such tools may improve multidisciplinary communication and coordination of care for youth with special health care needs. [ABSTRACT FROM AUTHOR]

Background: We examine the experiences with and perceptions of the effect of reading clinical outpatient visit notes on patients with multiple chronic conditions at three healthcare organizations with significant experience sharing clinical notes with patients. Methods: A cross‐sectional survey was conducted via patient portals at three diverse healthcare organizations in the United States: Beth Israel Deaconess Medical Center (Boston, MA), UW Medical Center (Seattle, WA), and Geisinger Health System (Danville, PA). Participants were aged 65 and older patient portal users who read at least one clinical note over the 12 months before the survey. We examined the effect of note reading on patient engagement and managing medications. Results: The majority of respondents had read two or more clinical notes in the 12 months before the survey. Patients with more than two chronic conditions were more likely than those with fewer or none to report that reading their notes helped them remember their care plan, take their medications as prescribed, and understand and feel more in control of their medications. Very few patients reported feeling worried or confused about their health or medications due to reading their notes. Conclusions: Older patients with chronic conditions are particularly vulnerable to misremembering and mismanaging their care and medication plans. Findings from this study suggest that these patients and their care partners could receive important benefits from accessing their notes. Healthcare organizations should work to maximize patient's engagement with their health information both through the patient portal and through other methods to ensure that patients and the healthcare systems reap the full benefit of the increased transparency of medical records. [ABSTRACT FROM AUTHOR]

Discriminatory legislation targeting Latinx immigrants in the United States has shifted how parents communicate with their children about the hostile political climate. One way that Latinx parents talk about and prepare their children to face prejudice is through ethnic‐racial socialization, which can promote children's positive development. Few scholars, however, have focused on how Latinx immigrant families with precarious documentation status socialize their children around issues of immigration, documentation status, and the potential for family separation. The current study seeks to broaden our understanding and conceptualization of ethnic‐racial socialization practices among Latinx immigrant families living in the United States to include documentation status socialization to better capture the messages parents transmit to their children about the causes and potential impacts of their documentation status. Thirty‐nine Latinx immigrant mothers aged 35–53 (M = 41.66), (22 undocumented, 17 documented) were interviewed regarding the ways in which their documentation status informs their ethnic‐racial socialization practices. Five subthemes of Documentation Status Socialization were identified among both undocumented and documented parents. Example of subthemes included Limitations and Restrictions of Undocumented Status, and Documentation Privilege, in which parents discussed the limitation of being undocumented as well as the privilege that comes with the legal documentation status with their youth. Our findings yield important implications for practice and research alike. [ABSTRACT FROM AUTHOR]

The article reports that over 80 per cent of all the technical reports issued by the various U.S. bureaus, offices, and laboratories engaged in government-supported research related to national defense come under the bibliographic control of four information agencies. These are the technical information services of the Atomic Energy Commission and the National Advisory Committee for Aeronautics and the two Department of Defense information centers, the Central Air Documents Office and the Navy Research Section of the Library of Congress.

Presents several letters to the editor. Information on a guide to the increasing number of short films relevant to documentation; View on mathematical analysis of various superimposed coding methods with a great deal of interest; response on a paper by Gerald Oster from the Department of Chemistry, Polytechnic Institute of Brooklyn, New York entitled "Photoreproduotion."

A description is given of a mechanised and automated coordinate index system which by the substitution of punched tape for term cards and the use of film offers a wide range of new applications. As in the Uniterm System, each document receives a number. Each position in the punched tape or film is numbered successively from a selected starting point and these numbers represent the numbers given to the documents. Each punched tape represents one term and a perforation in this tape reveals that the document, the number of which corresponds to that of the perforation, has this term as one of its characteristics. A film contains at each perforation a greatly reduced image of a reference to the document the number of which corresponds to that of the perforation. Thus, if a punched tape and the film are read synchronously, each reference image with a number corresponding to a perforation in the tape will be automatically reproduced. In this way, then, references to all documents for which a particular term is a characteristic can be obtained. On the other hand, by reading several tapes synchronously it is possible to record fully automatically the numbers belonging to those documents which possess all the terms represented by the tapes. [ABSTRACT FROM AUTHOR]

A detailed description of the mechanized techniques now being used by the Technical Information Service of the Atomic Energy Commission in the preparation of the several indexes for Nuclear Science Abstracts. These innovations which make use of standard equipment have resulted in substantial reductions in the time and cost required to prepare author (both personal and corporate) subject, and report number indexes for NSA. The new techniques have also proved of value in preparing cumulative indexes, as well as those for individual issues. [ABSTRACT FROM AUTHOR]

This article reports that the increased speeds, distances and areas encompassed in modern naval operations require a large collection of documentary, graphical and map material. The necessity for mass duplication of this bulk of material, retention of quality, and time and cost factors complicate the problem of distribution of material to the operating units. Information originating both inside and outside of the U.S. Department of the Navy must be constantly disseminated to the operating units. The central office, which receives this information, must not only index and file it as quickly and easily as possible, but also send it to the cognizant unit. Many methods have been devised to solve the problem of collecting, cataloging, reproducing and distributing graphic information in quantity.

Objective: To assess the impact of provider incentive policy on smoking status documentation.Data Sources: Primary data were extracted from structured electronic medical records (EMRs) from 15 community health centers (CHCs).Study Design: This was an observational study of data from 2006 to 2013, assessing changes in documentation of smoking status over time.Data Extraction Methods: We extracted structured EMR data for patients age 18 and older with at least one primary care visit.Principal Findings: Rates of documented smoking status rose from 30 percent in 2006 to 90 percent in 2013; the largest increase occurred from 2011 to 2012 following policy changes (21.3% [95% CI, 8.2%, 34.4%] from the overall trend). Rates varied by clinic and across patient subgroups.Conclusions: Documentation of smoking status improved markedly after introduction of new federal standards. Further improvement in documentation is still needed, especially for males, nonwhite patients, those using opioids, and HIV + patients. More research is needed to study whether changes in documentation lead to improvements in counseling, cessation, and patient outcomes. [ABSTRACT FROM AUTHOR]

This article focuses on report of the American Documentation Institute's (ADI) Auxiliary Publications Program. One of the least known yet potentially most useful services in Documentation is that provided during the past 25 years by the American Documentation Institute through its Auxiliary Publications Depository. This program was started in 1937 by Watson Davis of Science Service in an attempt to demonstrate the usefulness of microfilm in storage and dissemination of scientific and technological literature or data. The ADI service provides an opportunity for the editor of any reputable or disreputable scientific, technical or other periodical, journal or serial to achieve the rare data, charts, diagrams, maps, bibliographies, etc.

This article presents a reply to writer Calvin N. Mooers on matters related to coding for the Rapid Selector. In a previous communication an improved method of coding for the Rapid Selector was suggested. Since then, a rather severe criticism of this has been made by Mooers. However, this was not caused by the inadequate statistical analysis, as Mooers seems to feel, but instead resulted from a too brief treatment of the word coding method. Although these matters have already been treated elsewhere, it now seems desirable to give a more detailed summary in the pages of American Documentation.

This article reports that the special committee named by the Board of Trustees of the American Documentation Institute (ADI) has reviewed critically the assignment made to it as the Committee on Auxiliary Publication. Consideration of that subject, reportedly, has seemed to require a review of some of the very basic principles underlying the field of documentation and the purposes of ADI. Furthermore, it has seemed wise to consider auxiliary publication of article manuscripts, which was the assignment to this committee, in its relationship to the broader problem of all types of supplemental publication. Supplemental publication is considered to be extremely important to many persons who need specialized material for scientific, engineering, or scholarly investigations. It is suggested that both the receiving of orders and the stimulating of new business be retained in the office of the treasurer at Science Service. By noting the type of orders received, and during processing of these, a substantial opportunity for promotion would develop at negligible new cost.

The Sixteenth Annual Meeting of the Society for Psychophysiological Research will be held at the Vacation Village Hotel in San Diego, California, in October 1976. Registration information may be obtained from Dr. Laverne C. Johnson or Richard Townsend. Information regarding submission of papers and deadline for abstracts may be obtained from Dr. Gary E. Schwartz. Department of Psychology of Yale University in New Haven, Connecticut.

Abstract: Background: Data are lacking on how emergency medicine (EM) malpractice cases with resident involvement differs from cases that do not name a resident. Objectives: The objective was to compare malpractice case characteristics in cases where a resident is involved (resident case) to cases that do not involve a resident (nonresident case) and to determine factors that contribute to malpractice cases utilizing EM as a model for malpractice claims across other medical specialties. Methods: We used data from the Controlled Risk Insurance Company (CRICO) Strategies’ division Comparative Benchmarking System (CBS) to analyze open and closed EM cases asserted from 2009 to 2013. The CBS database is a national repository that contains professional liability data on > 400 hospitals and > 165,000 physicians, representing over 30% of all malpractice cases in the United States (>350,000 claims). We compared cases naming residents (either alone or in combination with an attending) to those that did not involve a resident (nonresident cohort). We reported the case statistics, allegation categories, severity scores, procedural data, final diagnoses, and contributing factors. Fisher's exact test or t‐test was used for comparisons (alpha set at 0.05). Results: A total of 845 EM cases were identified of which 732 (87%) did not name a resident (nonresident cases), while 113 (13%) included a resident (resident cases). There were higher total incurred losses for nonresident cases. The most frequent allegation categories in both cohorts were “failure or delay in diagnosis/misdiagnosis” and “medical treatment” (nonsurgical procedures or treatment regimens, i.e., central line placement). Allegation categories of safety and security, patient monitoring, hospital policy and procedure, and breach of confidentiality were found in the nonresident cases. Resident cases incurred lower payments on average ($51,163 vs. $156,212 per case). Sixty‐six percent (75) of resident versus 57% (415) of nonresident cases were high‐severity claims (permanent, grave disability or death; p = 0.05). Procedures involved were identified in 32% (36) of resident and 26% (188) of nonresident cases (p = 0.17). The final diagnoses in resident cases were more often cardiac related (19% [21] vs. 10% [71], p < 0.005) whereas nonresident cases had more orthopedic‐related final diagnoses (10% [72] vs. 3% [3], p < 0.01). The most common contributing factors in resident and nonresident cases were clinical judgment (71% vs. 76% [p = 0.24]), communication (27% vs. 30% [p = 0.46]), and documentation (20% vs. 21% [p = 0.95]). Technical skills contributed to 20% (22) of resident cases versus 13% (96) of nonresident cases (p = 0.07) but those procedures involving vascular access (2.7% [3] vs 0.1% [1]) and spinal procedures (3.5% [4] vs. 1.1% [8]) were more prevalent in resident cases (p < 0.05 for each). Conclusions: There are higher total incurred losses in nonresident cases. There are higher severity scores in resident cases. The overall case profiles, including allegation categories, final diagnoses, and contributing factors between resident and nonresident cases are similar. Cases involving residents are more likely to involve certain technical skills, specifically vascular access and spinal procedures, which may have important implications regarding supervision. Clinical judgment, communication, and documentation are the most prevalent contributing factors in all cases and should be targets for risk reduction strategies. [ABSTRACT FROM AUTHOR]

Objective: To investigate magnitude and sources of discrepancy in quality metrics using claims versus electronic health record (EHR) data.Study Design: Assessment of proportions of HbA1c and LDL testing for people ascertained as diabetic from the respective sources. Qualitative interviews and review of EHRs of discrepant cases.Data Collection/extraction: Claims submitted to Rhode Island Medicaid by three practice sites in 2013; program-coded EHR extraction; manual review of selected EHRs.Principal Findings: Of 21,030 adult Medicaid beneficiaries attributed to a primary care patient at a site by claims or EHR data, concordance on assignment ranged from 0.30 to 0.41. Of patients with concordant assignment, the ratio of patients ascertained as diabetic by EHR versus claims ranged from 1.06 to 1.14. For patients with concordant assignment and diagnosis, the ratio based on EHR versus claims ranged from 1.08 to 18.34 for HbA1c testing, and from 1.29 to 14.18 for lipid testing. Manual record review of 264 patients discrepant on diagnosis or testing identified problems such as misuse of ICD-9 codes, failure to submit claims, and others.Conclusions: Claims data underestimate performance on these metrics compared to EHR documentation, by varying amounts. Use of claims data for these metrics is problematic. [ABSTRACT FROM AUTHOR]

Older homeless‐experienced adults have low engagement in advance care planning (ACP) despite high morbidity and mortality. We conducted a cross‐sectional analysis of a cohort of 350 homeless‐experienced adults aged 50 and older in Oakland, California. We assessed the prevalence of potential surrogate decision‐makers, ACP contemplation, discussions, and ACP documentation (surrogate designation, advance directives). We used multivariable logistic regression to examine factors associated with ACP discussions and documentation. The median age of the cohort was 59 (range 52–82), 75.2% were male, and 82.1% were black. Sixty‐one percent reported a potential surrogate, 21.5% had discussed ACP, and 19.0% reported ACP documentation. In multivariable models, having 1 to 5 confidants versus none (adjusted odds ratio (aOR)=5.8, 95% confidence interval (CI)=1.7–20.0), 3 or more chronic conditions versus none (aOR=2.3, 95% CI=0.9–5.6), and a recent primary care visit (aOR=2.1, 95% CI=1.0–4.4) were associated with higher odds of ACP discussions and each additional 5 years of homelessness (aOR=0.7, 95% CI=0.5—0.9) with lower odds. Having 1 to 5 confidants (aOR=5.0, 95% CI=1.4–17.5), being black (aOR=5.5, 95% CI=1.5–19.5), and having adequate versus limited literacy (aOR=7.0, 95% CI=1.5–32.4) were associated with higher odds of ACP documentation and illicit drug use (aOR=0.3, 95% CI=0.1–0.9) with lower odds. Although the majority of older homeless‐experienced adults have a potential surrogate, few have discussed or documented their ACP wishes; the odds of both were greater with larger social networks. Future interventions must be customized for individuals with limited social networks and address the instability of homelessness, health literacy, and the constraints of safety‐net healthcare settings. [ABSTRACT FROM AUTHOR]

Objectives To examine the effect of the Tool to Reduce Inappropriate Medications ( TRIM), a web tool linking an electronic health record ( EHR) to a clinical decision support system, on medication communication and prescribing. Design Randomized clinical trial. Setting Primary care clinics at a Veterans Affairs Medical Center. Participants Veterans aged 65 and older prescribed seven or more medications randomized to receipt of TRIM or usual care (N = 128). Intervention TRIM extracts information on medications and chronic conditions from the EHR and contains data entry screens for information obtained from brief chart review and telephonic patient assessment. These data serve as input for automated algorithms identifying medication reconciliation discrepancies, potentially inappropriate medications ( PIMs), and potentially inappropriate regimens. Clinician feedback reports summarize discrepancies and provide recommendations for deprescribing. Patient feedback reports summarize discrepancies and self-reported medication problems. Measurements Primary: subscales of the Patient Assessment of Care for Chronic Conditions ( PACIC) related to shared decision-making; clinician and patient communication. Secondary: changes in medications. Results 29.7% of TRIM participants and 15.6% of control participants provided the highest PACIC ratings; this difference was not significant. Adjusting for covariates and clustering of patients within clinicians, TRIM was associated with significantly more-active patient communication and facilitative clinician communication and with more medication-related communication among patients and clinicians. TRIM was significantly associated with correction of medication discrepancies but had no effect on number of medications or reduction in PIMs. Conclusion TRIM improved communication about medications and accuracy of documentation. Although there was no association with prescribing, the small sample size provided limited power to examine medication-related outcomes. [ABSTRACT FROM AUTHOR]

Objective: The median time required to perform a surgical procedure is important in determining payment under Medicare's physician fee schedule. Prior studies have demonstrated that the current methodology of using physician surveys to determine surgical times results in overstated times. To measure surgical times more accurately, we developed and validated a methodology using available data from anesthesia billing data and operating room (OR) records.Data Sources: We estimated surgical times using Medicare 2011 anesthesia claims and New York Statewide Planning and Research Cooperative System 2011 OR times. Estimated times were validated using data from the National Surgical Quality Improvement Program. We compared our time estimates to those used by Medicare in the fee schedule.Study Design: We estimate surgical times via piecewise linear median regression models.Principal Findings: Using 3.0 million observations of anesthesia and OR times, we estimated surgical time for 921 procedures. Correlation between these time estimates and directly measured surgical time from the validation database was 0.98. Our estimates of surgical time were shorter than the Medicare fee schedule estimates for 78 percent of procedures.Conclusions: Anesthesia and OR times can be used to measure surgical time and thereby improve the payment for surgical procedures in the Medicare fee schedule. [ABSTRACT FROM AUTHOR]

Aims To identify barriers and facilitators associated with initial implementation of a US alcohol and other substance use Screening, Brief Intervention, and Referral to Treatment (SBIRT) grant program, and to identify modifications in program design that addressed implementation challenges. Design A mixed-method approach used quantitative and qualitative data, including SBIRT provider ratings of implementation barriers and facilitators, staff interview responses and program documentation. Setting Multiple sites within the first seven programs funded in a national demonstration program in the United States. Participants One hundred and two SBIRT providers were surveyed; 221 SBIRT stakeholders and staff were interviewed. Measurements Mean ratings of barriers and facilitators were calculated using provider survey responses. An inductive content analysis of interview responses identified factors perceived to support and challenge implementation; program modifications that occurred over time were recorded. Findings Providers rated pre-selected implementation facilitators higher than barriers. Content analysis of interview responses revealed six themes: committed leaders; intra- and inter-organizational communication/collaboration; provider buy-in and model acceptance; contextual factors; quality assurance; and grant requirements. Over time, programs tended to: adopt more efficient 'pre-screen' item sets; screen for risk factors in addition to alcohol/substance use; use contracted specialists to deliver SBIRT services; conduct services in high-volume emergency department and trauma center settings; and implement on-site and telephonic treatment delivery. Conclusions Screening, Brief Intervention and Referral to Treatment program implementation in the United States is facilitated by committed leadership and the use of substance use specialists, rather than medical generalists, to deliver services. Many implementation challenges can be addressed by an adequate start-up phase focused on comprehensive education and training, and on the development of intra- and inter-organizational communication and collaboration; opinion leader support; and practitioner and host site buy-in. [ABSTRACT FROM AUTHOR]

Objectives To understand the perceived preparedness of frontline nurses (registered nurses ( RNs), licensed practical nurses ( LPNs)), unit nurse managers, and skilled nursing facility ( SNF) administrators in providing care for residents with peripherally inserted central catheters ( PICCs) in SNFs. Design Exploratory, qualitative pilot study. Setting Two community based SNFs. Participants Residents with PICCs, frontline nurses ( RNs, LPNs), unit nurse managers, and SNF administrators. Methods Over 36 weeks, 56 residents with PICCs and their nurses were observed and informally interviewed, focusing on PICC care practices and documentation. In addition, baseline PICC data were collected on placement indication (e.g., antimicrobial administration), placement setting (hospital vs SNF), and dwell time. Focus groups were then conducted with frontline nurses and unit nurse managers, and semistructured interviews were conducted with SNF administrators to evaluate perceived preparedness for PICC care. Data were analyzed using a descriptive analysis approach. Results Variations in documentation were observed during weekly informal interviews and observations. Differences were noted between resident self-reported PICC concerns (quality of life) and those described by frontline nurses. Deficiencies in communication between hospitals and SNFs with respect to device care, date of last dressing change, and PICC removal time were also noted. During focus group sessions, perceived inadequacy of information at the time of care transitions, limited availability of resources to care for PICCs, and gaps in training and education were highlighted as barriers to improving practice and safety. Conclusion Practices for PICC care in SNFs can be improved. Multimodal strategies that enhance staff education, improve information exchange during care transitions, and increase resource availability in SNFs appear necessary to enhance PICC care and safety. [ABSTRACT FROM AUTHOR]

An introduction is presented concerning an article by Blaum et al and Naik et al concerning the implementing of patient-centered care in the U.S. healthcare system. [ABSTRACT FROM AUTHOR]

A total of 295 veterans who died by suicide in 2009 across 11 states and received Veterans Affairs (VA) health care in the 6 months prior to death were identified. The suicide risk factors documented and the care received at these veterans' last VA contacts are described, and the study explores whether veterans present differently to VA care (i.e., different risk factors documented or different care settings accessed) based on the proximity of their last contact to suicide. Many veterans were seen in primary care (n = 136; 46%) for routine follow-up (n = 168; 57%). Fifty-three (18%) were assessed for suicidal thoughts; 20 (38%) of whom endorsed such thoughts. Although higher frequencies of some risk factors at last contacts more proximal to suicide compared to those more distal were observed, findings overall highlight the challenges clinicians face detecting enhanced risk prior to suicide. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the degree to which dental schools in the United States have policies and procedures in place that facilitate the implementation of evidence-based clinical guidelines. The authors sent surveys to all 65 U.S. dental schools in 2014; responses were obtained from 38 (58%). The results showed that, of the nine policies and procedures examined, only two were fully implemented by 50% or more of the responding schools: guidelines supported through clinical faculty education or available chairside (50%), and students informed of guidelines in both the classroom and clinic (65.8%). Although 92% of the respondents reported having an electronic health record, 80% of those were not using it to track compliance with guidelines. Five schools reported implementing more policies than the rest of the schools. The study found that the approach to implementing guidelines at most of the responding schools did not follow best practices although five schools had an exemplary set of policies and procedures to support guideline implementation. These results suggest that most dental schools are currently not implementing guidelines effectively and efficiently, but that the goal of schools' having a comprehensive implementation program for clinical guidelines is achievable since some are doing so. Future studies should determine whether interventions to improve implementation in dental schools are needed. [ABSTRACT FROM AUTHOR]