Evidence for handheld electronic medical records in improving care: a systematic review

BACKGROUND: Handheld electronic medical records are expected to improve physician performance and patient care. To confirm this, we performed a systematic review of the evidence assessing the effects of handheld electronic medical records on clinical care. METHODS: To conduct the systematic review, we searched MEDLINE, EMBASE, CINAHL, and the Cochrane library from 1966 through September 2005. We included randomized controlled trials that evaluated effects on practitioner performance or patient outcomes of handheld electronic medical records compared to either paper medical records or desktop electronic medical records. Two reviewers independently reviewed citations, assessed full text articles and abstracted data from the studies. RESULTS: Two studies met our inclusion criteria. No other randomized controlled studies or non-randomized controlled trials were found that met our inclusion criteria. Both studies were methodologically strong. The studies examined changes in documentation in orthopedic patients with handheld electronic medical records compared to paper charts, and both found an increase in documentation. Other effects noted with handheld electronic medical records were an increase in time to document and an increase in wrong or redundant diagnoses. CONCLUSION: Handheld electronic medical records may improve documentation, but as yet, the number of studies is small and the data is restricted to one group of patients and a small group of practitioners. Further study is required to determine the benefits with handheld electronic medical records especially in assessing clinical outcomes

Safe and fit genetically modified insects for pest control: from lab to field applications

Insect transgenesis is continuously being improved to increase the efficacy of population suppression and replacement strategies directed to the control of insect species of economic and sanitary interest. An essential prerequisite for the success of both pest control applications is that the fitness of the transformant individuals is not impaired, so that, once released in the field, they can efficiently compete with or even out-compete their wild-type counterparts for matings in order to reduce the population size, or to spread desirable genes into the target population. Recent research has shown that the production of fit and competitive transformants can now be achieved and that transgenes may not necessarily confer a fitness cost. In this article we review the most recent published results of the fitness assessment of different transgenic insect lines and underline the necessity to fulfill key requirements of ecological safety. Fitness evaluation studies performed in field cages and medium/large-scale rearing will validate the present encouraging laboratory results, giving an indication of the performance of the transgenic insect genotype after release in pest control programmes

Amplitude and frequency variability of the pulsating DB white dwarf stars KUV 05134+2605 and PG 1654+160 observed with the Whole Earth Telescope

WOS: 000182039700036We have acquired new time series photometry of the two pulsating DB white dwarf stars KUV 05134+2605 and PG 1654+160 with the Whole Earth Telescope. Additional single-site photometry is also presented. We use all these data plus all available archival measurements to study the temporal behaviour of the pulsational amplitudes and frequencies of these stars for the first time. We demonstrate that both KUV 05134+2605 and PG 1654+160 pulsate in many modes, the amplitudes of which are variable in time; some frequency variability of PG 1654+160 is also indicated. Beating of multiple pulsation modes cannot explain our observations; the amplitude variability must therefore be intrinsic. We cannot find stable modes to be used for determinations of the evolutionary period changes of the stars. Some of the modes of PG 1654+160 appear at the same periods whenever detected. The mean spacing of these periods (approximate to40 s) suggests that they are probably caused by non-radial gravity-mode pulsations of spherical degree l = 1. If so, PG 1654+160 has a mass around 0.6 M.. The time-scales of the amplitude variability of both stars (down to two weeks) are consistent with theoretical predictions of resonant mode coupling, a conclusion which might however be affected by the temporal distribution of our data