Understanding how physician perceptions of job demand and process benefits evolve during CPOE implementation.

We examine how physicians' perceptions of two computerized provider order entry (CPOE) capabilities, standardisation of care protocols and documentation quality, are associated with their perceptions of turnaround time, medical error, and job demand at three phases of CPOE implementation: pre-go-live, initial use, and continued use. Through a longitudinal study at a large urban hospital, we find standardisation of care protocols is positively associated with turnaround time reduction in all phases but positively associated with job demand increase only in the initial use phase. Standardisation also has a positive association with medical error reduction in the initial use phase, but later this effect becomes fully mediated through turnaround time reduction in the continued use phase. Documentation quality has a positive association with medical error reduction in the initial use phase and this association strengthens in the continued use phase. Our findings provide insights to effectively manage physicians' response to CPOE implementation.

Gender Effects on the Impact of Colorectal Cancer Risk Calculators on Screening Intentions: Experimental Study.

BACKGROUND: According to a 2020 study by the American Cancer Society, colorectal cancer (CRC) represents the third leading cause of cancer both in incidence and death in the United States. Nonetheless, CRC screening remains lower than that for other high-risk cancers such as breast and cervical cancer. Risk calculators are increasingly being used to promote cancer awareness and improve compliance with CRC screening tests. However, research concerning the effects of CRC risk calculators on the intention to undergo CRC screening has been limited. Moreover, some studies have found the impacts of CRC risk calculators to be inconsistent, reporting that receiving personalized assessments from such calculators lowers people's risk perception. OBJECTIVE: The objective of this study is to examine the effect of using CRC risk calculators on individuals' intentions to undergo CRC screening. In addition, this study aims to examine the mechanisms through which using CRC risk calculators might influence individuals' intentions to undergo CRC screening. Specifically, this study focuses on the role of perceived susceptibility to CRC as a potential mechanism mediating the effect of using CRC risk calculators. Finally, this study examines how the effect of using CRC risk calculators on individuals' intentions to undergo CRC screening may vary by gender. METHODS: We recruited a total of 128 participants through Amazon Mechanical Turk who live in the United States, have health insurance, and are in the age group of 45 to 85 years. All participants answered questions needed as input for the CRC risk calculator but were randomly assigned to treatment (CRC risk calculator results immediately received) and control (CRC risk calculator results made available after the experiment ended) groups. The participants in both groups answered a series of questions regarding demographics, perceived susceptibility to CRC, and their intention to get screened. RESULTS: We found that using CRC risk calculators (ie, answering questions needed as input and receiving calculator results) has a positive effect on intentions to undergo CRC screening, but only for men. For women, using CRC risk calculators has a negative effect on their perceived susceptibility to CRC, which in turn reduces the intention to sign up for CRC screening. Additional simple slope and subgroup analyses confirm that the effect of perceived susceptibility on CRC screening intention is moderated by gender. CONCLUSIONS: This study shows that using CRC risk calculators can increase individuals' intentions to undergo CRC screening, but only for men. For women, using CRC risk calculators can reduce their intentions to undergo CRC screening, as it reduces their perceived susceptibility to CRC. Given these mixed results, although CRC risk calculators can be a useful source of information on one's CRC risk, patients should be discouraged from relying solely on them to inform decisions regarding CRC screening.

Does extended CPOE use reduce patient length of stay?

OBJECTIVE: This study compares use of Computerized Provider Order Entry (CPOE) and related clinical systems (i.e., extended CPOE) across 796 clinical teams caring for five distinct patient conditions. Our focus is the relationship between clinical teams' extended CPOE use and extent of prolonged stay (EPS), defined as the deviation in patients' observed length of stay from expected risk-adjusted length of stay. MATERIALS AND METHODS: Using archival data from two affiliated hospitals in the Southeastern United States, we focused on five different patient conditions of varying mortality risk (vaginal birth, knee/hip replacement, cardiovascular surgery, organ transplant and pneumonia). For each patient, we (1) differentiated between the following three types of care team members-Responsible physician, Core team (excluding the responsible physician), and Support team, (2) created a composite of CPOE orders, documentation entries, patient record lookups, order set adherence, alert acknowledgement, and progress note entries to assess the deep structure use (DSU) of CPOE by the three types of members in the patients' care team, and (3) aggregated DSU of CPOE across all three types of care team members to calculate Total team DSU. RESULTS: Teams with higher Total team DSU of CPOE had lower EPS for all five patient conditions. Patients of Core teams with higher DSU of CPOE had lower EPS in all conditions except organ transplant, comprising 93% of the patients studied. Higher DSU of CPOE by all three clinician types significantly reduced EPS for vaginal birth and knee/hip replacement, whereas higher DSU by two of the three types of care team members significantly reduced EPS for cardiovascular surgery and pneumonia. CONCLUSIONS: Our results suggest that a clinician team that uses CPOE in a comprehensive manner is better informed enabling the team to coordinate care more effectively, resulting in reduced EPS.

Fifteen years of cold matter on the atom chip: promise, realizations, and prospects.

Here we review the field of atom chips in the context of Bose-Einstein Condensates (BEC) as well as cold matter in general. Twenty years after the first realization of the BEC and 15 years after the realization of the atom chip, the latter has been found to enable extraordinary feats: from producing BECs at a rate of several per second, through the realization of matter-wave interferometry, and all the way to novel probing of surfaces and new forces. In addition, technological applications are also being intensively pursued. This review will describe these developments and more, including new ideas which have not yet been realized.

Laser-induced atomic fragment fluorescence spectroscopy: a facile technique for molecular spectroscopy of spin-forbidden states.

Spectra of spin-forbidden and spin-allowed transitions in the mixed b (3)Pi(u) approximately A (1)Sigma(u)(+) state of Na(2) are measured separately by two-photon excitation using a single tunable dye laser. The two-photon excitation produces Na(*)(3p) by photodissociation, which is easily and sensitively detected by atomic fluorescence. At low laser power, only the A (1)Sigma(u)(+) state is excited, completely free of triplet excitation. At high laser power, photodissociation via the intermediate b (3)Pi(u) triplet state becomes much more likely, effectively "switching" the observations from singlet spectroscopy to triplet spectroscopy with only minor apparatus changes. This technique of perturbation-assisted laser-induced atomic fragment fluorescence may therefore be especially useful as a general vehicle for investigating perturbation-related physics pertinent to the spin-forbidden states, as well as for studying allowed and forbidden states of other molecules.