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Using openEHR Archetypes for Automated Extraction of Numerical Information from Clinical Narratives
(2019)
Up to 80% of medical information is documented by unstructured data such as clinical reports written in natural language. Such data is called unstructured because the information it contains cannot be retrieved automatically as straightforward as from structured data. However, we assume that the use of this flexible kind of documentation will remain a substantial part of a patient’s medical record, so that clinical information systems have to deal appropriately with this type of information description. On the other hand, there are efforts to achieve semantic interoperability between clinical application systems through information modelling concepts like HL7 FHIR or openEHR. Considering this, we propose an approach to transform unstructured documented information into openEHR archetypes. Furthermore, we aim to support the field of clinical text mining by recognizing and publishing the connections between openEHR archetypes and heterogeneous phrasings. We have evaluated our method by extracting the values to three openEHR archetypes from unstructured documents in English and German language.
We present a simple method to find topics in user reviews that accompany ratings for products or services. Standard topic analysis will perform sub-optimal on such data since the word distributions in the documents are not only determined by the topics but by the sentiment as well. We reduce the influence of the sentiment on the topic selection by adding two explicit topics, representing positive and negative sentiment. We evaluate the proposed method on a set of over 15,000 hospital reviews. We show that the proposed method, Latent Semantic Analysis with explicit word features, finds topics with a much smaller bias for sentiments than other similar methods.
Lemmatization is a central task in many NLP applications. Despite this importance, the number of (freely) available and easy to use tools for German is very limited. To fill this gap, we developed a simple lemmatizer that can be trained on any lemmatized corpus. For a full form word the tagger tries to find the sequence of morphemes that is most likely to generate that word. From this sequence of tags we can easily derive the stem, the lemma and the part of speech (PoS) of the word. We show (i) that the quality of this approach is comparable to state of the art methods and (ii) that we can improve the results of Part-of-Speech (PoS) tagging when we include the morphological analysis of each word.
Background:
Promoting patient and occupational safety are two key challenges for hospitals. When aiming to improve these two outcomes synergistically, psychosocial working conditions, leadership by hospital management and supervisors, and perceptions of patient and occupational safety climate have to be considered. Recent studies have shown that these key topics are interrelated and form a critical foundation for promoting patient and occupational safety in hospitals. So far, these topics have mainly been studied independently from each other. The present study investigated hospital staffs’ perceptions of four different topics: (1) psychosocial working conditions, (2) leadership, (3) patient safety climate, and (4) occupational safety climate. We present results from a survey in two German university hospitals aiming to detect differences between nurses and physicians.
Methods:
We performed a cross-sectional study using a standardized paper-based questionnaire. The survey was conducted with nurses and physicians to assess the four topics. The instruments mainly consisted of scales of the German version of the COPSOQ (Copenhagen Psychosocial Questionnaire), one scale of the Copenhagen Burnout Inventory (CBI), scales to assess leadership and transformational leadership, scales to assess patient safety climate using the Hospital Survey on Patient Safety Culture (HSPSC), and analogous items to assess occupational safety climate.
Results:
A total of 995 completed questionnaires out of 2512 distributed questionnaires were returned anonymously. The overall response rate was 39.6%. The sample consisted of 381 physicians and 567 nurses. We found various differences with regard to the four topics. In most of the COPSOQ and the HSPSC-scales, physicians rated psychosocial working conditions and patient safety climate more positively than nurses. With regard to occupational safety, nurses
indicated higher occupational risks than physicians.
Conclusions:
The WorkSafeMed study combined the assessment of the four topics psychosocial working conditions, leadership, patient safety climate, and occupational safety climate in hospitals. Looking at the four topics provides an overview of where improvements in hospitals may be needed for nurses and physicians. Based on these results,
improvements in working conditions, patient safety climate, and occupational safety climate are required for health care professionals in German university hospitals – especially for nurses.
Die Krux öffentlicher Verwaltungskommunikation – Public Relations der öffentlichen Verwaltung
(2019)
„Öffentliche Verwaltung – Verwaltung in der Öffentlichkeit?“ – bereits der Titel des Bandes, in dem dieser Beitrag erscheint, verweist auf ein zentrales Problem der Kommunikation öffentlicher Verwaltung. Er führt nämlich zu der Frage, ob das abschließende Fragezeichen angebracht ist: Kann sich Verwaltung Öffentlichkeit entziehen? Schon einfache Realitätsbeobachtung reicht aus, um diese Frage zu verneinen, weil es auf der Hand liegt, dass sich Organisationen öffentlicher Beobachtung nicht willentlich entziehen können: Sie können übersehen oder ignoriert werden, im nächsten Augenblick aber wieder Gegenstand von Beobachtung sein.
Das wissenschaftliche Publikationswesen befindet sich in einem Transformationsprozess, weg von der Bezahlung des lesenden Zugriffs durch den Kauf von Lizenzen durch Bibliotheken, hin zu der Vergütung der Verlagsleistungen durch Publikationsgebühren. Ziel ist der freie Zugang zu Forschungsergebnissen in wissenschaftlichen Publikationen und den dazugehörigen Forschungsdaten. Dieser freie Zugang zu wissenschaftlicher Literatur wird weltweit, unter dem Begriff Open Access gefördert und vorangebracht. Veränderungen in der Wissenschaft bedeuten auch immer Änderungen in den Arbeitsabläufen und im Aufgabenbereich wissenschaftlicher Bibliotheken. Diese Arbeit beschäftigt sich mit der Fragestellung, welche Angebote medizinische Fachbibliotheken in Deutschland, Österreich und der Schweiz den Wissenschaftlern ihrer Institution im Bereich des Open Access Publizierens bieten. Aufbauend auf den Ergebnissen einer Webseitenanalyse, werden Handlungsempfehlungen für die Ärztliche Zentralbibliothek im Universitätsklinikum Hamburg-Eppendorf für den Aufbau von Publikationsdiensten, insbesondere für Open Access, erstellt.
The NOA project collects and stores images from open access publications and makes them findable and reusable. During the project a focus group workshop was held to determine whether the development is addressing researchers’ needs. This took place before the second half of the project so that the results could be considered for further development since addressing users’ needs is a big part of the project. The focus was to find out what content and functionality they expect from image repositories.
In a first step, participants were asked to fill out a survey about their images use. Secondly, they tested different use cases on the live system. The first finding is that users have a need for finding scholarly images but it is not a routine task and they often do not know any image repositories. This is another reason for repositories to become more open and reach users by integrating with other content providers. The second finding is that users paid attention to image licenses but struggled to find and interpret them while also being unsure how to cite images. In general, there is a high demand for reusing scholarly images but the existing infrastructure has room to improve.
Die allgemeine Digitalisierung und besonders die IT Branche in Hannover, stellen Arbeitgeber_innen und Arbeitnehmer_innen vor große Herausforderungen. Berufsbezeichnungen im IT Sektor zeichnen sich im Gegensatz zu klassischen Berufsfeldern nicht dadurch aus, dass sie vereinheitlicht sind. Unterschiedlichste Berufsbezeichnungen verlangen oftmals identische Kompetenzen. Die Kompetenzen und Fähigkeiten der Arbeitnehmer_innen stehen ebenso immer mehr im Fokus der Arbeitgeber_innen, wie die Bereitschaft der permanenten Weiterbildung.
Zielgebend der vorliegenden Abschlussarbeit ist eine Datenbasis für ein kompetenzbasiertes IT Tool zu liefern, welches den Anspruch hat, die bereits beschriebenen Herausforderungen zu analysieren und zu klassifizieren. Zunächst ist daher eine Klassifikation, der auf dem hannoverschen Jobmarkt gesuchten IT Kompetenzen, zu erstellen. Vorbereitend wird eine Marktanalyse angefertigt, die sowohl Jobsuchmaschinen auf ihre Kompetenzorientierung als auch IT Kompetenzklassifikationen untersucht. Die erstellte Klassifikation bildet anschließend die Grundlage für das Kompetenzmatching zwischen Klassifikation und den Kompetenzen, die hannoversche IT Studierende erlernen, um zu verdeutlichen, in welchen Kompetenzen Weiterbildungsbedarf besteht. Die entstandene Datenbasis wird in einer MySQL Datenbank präsentiert, um eine möglichst flexible Verwendung und Weiterentwicklung des Datenbestands zu ermöglichen.
Background:
Huntington’s disease (HD) is a rare, genetic, neurodegenerative and ultimately fatal disease with no cure or progression-delaying treatment currently available. HD is characterized by a triad of cognitive, behavioural and motor symptoms. Evidence on epidemiology and management of HD is limited, especially for Germany. This study aims to estimate the incidence and prevalence of HD and analyze the current routine care based on German claims data.
Methods:
The source of data was a sample of the Institute for Applied Health Research Berlin (InGef) Research Database, comprising data of approximately four million insured persons from approximately 70 German statutory health insurances. The study was conducted in a retrospective cross-sectional design using 2015 and 2016 as a two-year observation period. At least two outpatient or inpatient ICD-10 codes for HD (ICD-10: G10) during the study period were required for case identification. Patients were considered incident if no HD diagnoses in the 4 years prior to the year of case identification were documented. Information on outpatient drug dispensations, medical aids and remedies were considered to describe the current treatment situation of HD patients.
Results:
A 2-year incidence of 1.8 per 100,000 persons (95%-Confidence interval (CI): 1.4–2.4) and a 2-year period prevalence of 9.3 per 100,000 persons (95%-CI: 8.3–10.4) was observed. The prevalence of HD increased with advancing age, peaking at 60–69 years (16.8 per 100,000 persons; 95%-CI: 13.4–21.0) and decreasing afterwards.
The most frequently observed comorbidities and disease-associated symptoms in HD patients were depression (42.9%), dementia (37.7%), urinary incontinence (32.5%), extrapyramidal and movement disorders (30.5%), dysphagia (28.6%) and disorders of the lipoprotein metabolism (28.2%).
The most common medications in HD patients were antipsychotics (66.9%), followed by antidepressants (45.1%). Anticonvulsants (16.6%), opioids (14.6%) and hypnotics (9.7%) were observed less frequently.
Physical therapy was the most often used medical aid in HD patients (46.4%). Nursing services and speech therapy were used by 27.9 and 22.7% of HD patients, respectively, whereas use of psychotherapy was rare (3.2%).
Conclusions:
Based on a representative sample, this study provides new insights into the epidemiology and routine care of HD patients in Germany, and thus, may serve as a starting point for further research.
Background: Antimicrobial resistance has become a serious global problem. A potential post-antibiotic era is threatening present and future medical advances. In Pakistan, the usage of antibiotic is unnecessarily high and due to over exposure to these drugs, bacteria are developing resistance against these drugs. It is necessary to improve public awareness about the rational use of antibiotics in order to bring a change in consumer’s behaviour. Therefore, present study was undertaken to assess the existing knowledge, attitude and practices related to antibiotic usage among university students.
Methods: A cross-sectional study was carried out among university students from Karachi, Pakistan during May-June 2018. 200 students were approached to participate in the study of which 159 agreed to participate (males: 70, females: 89). Pretested questionnaire was distributed to the study subjects and the collected data was analyzed using IBM SPSS version 23.
Results: Substantial number of (33% and 50%) participants were unaware about the differences in antibiotic: anti-inflammatory drugs and antibiotic: antipyretics respectively. 29% of the participants thought it is right to stop antibiotics only based on symptomatic improvement. Thirty nine percent and eighty three percent participants believed that antibiotics should always be prescribed to treat flu like symptoms and pneumonia respectively.
Conclusions: Participants demonstrated average knowledge about antibiotics. Similarly, their attitude and practice toward antibiotic use was associated with misconceptions. An educational intervention is necessary to make them aware about rational use of antibiotics.