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Articles 1531 - 1560 of 4859
Full-Text Articles in Public Health
Life In Hampton Roads Survey: Hurricanes And Covid-19, News @ Odu
Life In Hampton Roads Survey: Hurricanes And Covid-19, News @ Odu
News Items
No abstract provided.
2020-08-07_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services
2020-08-07_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services
Cumulative Michigan COVID-19 Data
The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html.
This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) and rapid virus antigen detection point of care (POC) tests, look for current infection. Serology (antibody) tests are used to look for the possibility of previous infection.
Source: Michigan Disease Surveillance System (MDSS) and Vital Records
The website contained the tables …
2020-08-07_Michigandaily_Covidmap, Michigan Department Of Health & Human Services
2020-08-07_Michigandaily_Covidmap, Michigan Department Of Health & Human Services
Daily Michigan COVID-19 Update
The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.
The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.
The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …
Harm Reduction In Prison Settings: A Relevant Approach To Reduce Hiv Transmission?, Amine Ghrabi
Harm Reduction In Prison Settings: A Relevant Approach To Reduce Hiv Transmission?, Amine Ghrabi
International Programs
Harm reduction defines a set of policies and interventions aiming to address the adverse health consequences associated with drug use. Compared to the general population, prisoners are disproportionally affected by HIV. Thanks to its strong emphasis on public health and human rights principles, harm reduction can effectively reduce transmission of HIV inside prison settings.
Particulate Matter Pollution And Its Effect On Covid-19, Aída Fica Conejeros
Particulate Matter Pollution And Its Effect On Covid-19, Aída Fica Conejeros
International Programs
Growing research supports the significant effects of particulate matter on COVID-19. This air pollutant has been identified before as responsible for serious respiratory diseases. Studies on the differences in high and low polluted cities confirmed that COVID-19 not only correlates to the number of infections but also, increases of 1 ��g/m3 can cause a mortality rate to rise by 8% and the hospital admissions by 4.4%. However, laboratory studies are still needed to support these findings.
Promoting Community Engagement Through Basic User Tutorial Of Epa Geospatial Screening Tools, Jonas Nguyen
Promoting Community Engagement Through Basic User Tutorial Of Epa Geospatial Screening Tools, Jonas Nguyen
Master's Projects and Capstones
Social inequalities are riddled with health disparities and outcomes leading toward lower life expectancy. Communities of color, low income, and rural neighborhoods lack the voice and resources to effectively oppose industrial settlement which would likely lead to the release of toxic wastes into the water, air and ground ultimately affecting residential health. Empowering members through community engagement is a relatively new strategic process where researchers are finding mutual benefits in design, implementation, and results. This study aims to identify and promote tools for community engagement within the scope of environmental justice by working with EPA geospatial screening tools and designing …
Con Confianza: Using Community-Based Participatory Research Principles To Inform Community-Academic Partnership Practices And Build Trust In Hispanic Communities, Sharon Tafolla
Master's Projects and Capstones
Hispanic communities are at disproportionate risk for chronic diseases and researchers have cited the need for further community and culturally informed studies to improve research outcomes to either make treatments and interventions more generalizable or modify them to the needs of Hispanic communities. However, many of the same linguistic and cultural barriers to health care access and utilization also impact the ability for Hispanic groups to participate in research studies. Community Academic Partnerships (CAPs) are positioned to conduct culturally and linguistically competent research in Hispanic communities. For research in Hispanic communities to be effective, CAPs must prioritize practices that build …
Program Evaluation: Bring Change To Mind High School Club, Rachel Goldberg
Program Evaluation: Bring Change To Mind High School Club, Rachel Goldberg
Master's Projects and Capstones
Introduction. Mental illness (MI) stigma is common and causes adverse consequences such as reduced self-esteem and discrimination in housing and employment. Bring Change to Mind (BC2M), a national non-profit organization, strives to reduce this stigma through their high school club program. The evaluation goals were to assess the program’s operations and measure club members’ and advisors’ attitudes and perceptions around mental health (MH) and MI.
Methods. Qualtrics surveys were used to gather information from general club members (GCMs) (N=645), club advisors (N=97), and graduating seniors (N=57). BC2M staff held 52 small group discussions with club leaders. Data analysis was conducted …
2020-08-06_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services
2020-08-06_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services
Michigan COVID-19 Hospital Data
The webpage was obtained from Michigan's Coronavirus Cumulative Data page, under the link Data About Places. Data is self-reported by hospitals daily to the EM Resource System per MDHHS Director Robert Gordon's Emergency Order.
Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.
2020-08-06_Michigandaily_Covidmap, Michigan Department Of Health & Human Services
2020-08-06_Michigandaily_Covidmap, Michigan Department Of Health & Human Services
Daily Michigan COVID-19 Update
The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.
The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.
The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …
2020-08-06_Michiganoverview_Covidlongtermcare, Michigan Department Of Health & Human Services
2020-08-06_Michiganoverview_Covidlongtermcare, Michigan Department Of Health & Human Services
Michigan COVID-19 Long Term Care Data
The COVID Long Term Care Facilities page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173-526911--,00.html.
This report is created by the Michigan Department of Health & Human Services from data self-reported by long-term care facilities into EMResource. Data is updated on an ongoing basis.
The data below represents a cumulative total of confirmed COVID-19 resident cases, cumulative total of suspected and confirmed resident deaths, cumulative total of confirmed COVID-19 staff cases, and cumulative total of suspected and confirmed staff deaths reported by SNFs in Michigan since January 1, 2020. Case numbers are provisional and may change as facilities correct …
2020-08-06_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services
2020-08-06_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services
Cumulative Michigan COVID-19 Data
The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html.
This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) and rapid virus antigen detection point of care (POC) tests, look for current infection. Serology (antibody) tests are used to look for the possibility of previous infection.
Source: Michigan Disease Surveillance System (MDSS) and Vital Records
The website contained the tables …
Ptsd And Depressive Symptoms As Potential Mediators Of The Association Between World Trade Center Exposure And Subjective Cognitive Concerns In Rescue/Recovery Workers, Ankura Singh, Rachel Zeig-Owens, Laura Rabin, Theresa Schwartz, Mayris P. Webber, David Appel, David J. Prezant, Charles B. Hall
Ptsd And Depressive Symptoms As Potential Mediators Of The Association Between World Trade Center Exposure And Subjective Cognitive Concerns In Rescue/Recovery Workers, Ankura Singh, Rachel Zeig-Owens, Laura Rabin, Theresa Schwartz, Mayris P. Webber, David Appel, David J. Prezant, Charles B. Hall
Publications and Research
We observed that World Trade Center (WTC) exposure, post-traumatic stress disorder (PTSD) symptoms and depressive symptoms were associated with subjective cognitive concerns in Fire Department of the City of New York (FDNY) rescue/recovery workers. This follow-up study examined whether PTSD symptoms and/or depressive symptoms mediate the observed association between WTC exposure and subjective cognitive concerns. We included WTC-exposed FDNY workers who completed the Cognitive Function Instrument (CFI), measuring self-perceived cognitive decline (N = 9516). PTSD symptoms and depressive symptoms were assessed using the PCL-S and CES-D, respectively. Multivariable linear regression estimated the association between WTC exposure and CFI score, adjusting …
How Does The Effect Of Hurricane Katrina Influence Healthcare Infrastructure And Resilience?, Sean Y. Wei
How Does The Effect Of Hurricane Katrina Influence Healthcare Infrastructure And Resilience?, Sean Y. Wei
University Honors Theses
In August 2005, Hurricane Katrina brought upon the city of New Orleans, LA one of the costliest natural disasters in U.S. history. This paper looks at how hospitals were prepared before Katrina, responded to, and grappled with the aftermath of this natural disaster. In the aftermath of Katrina, careful investigation of the healthcare system along with its hospitals, physicians, patients, and residents allow us to take innovative measures and provide guidance to create recommendations to better monitor and care for individuals in the future. Frameworks of resilience theories, studies, and recommendations display how and why disaster planning is essential. The …
Effect Of Cannabidiol And ∆9-Tetrahydrocannabinol Concentration On Breast Cancer Cell Viability, Dorothy Achiaa Agyemang
Effect Of Cannabidiol And ∆9-Tetrahydrocannabinol Concentration On Breast Cancer Cell Viability, Dorothy Achiaa Agyemang
Ursidae: The Undergraduate Research Journal at the University of Northern Colorado
-Tetrahydrocannabinol (THC) and cannabidiol (CBD) are phytocannabinoids that have a potential impact in cancer treatments. Studies have shown that certain cannabinoids cause cancer cells to die, but only with selective concentrations, which have not been well documented. The first study of this thesis was to determine the exact concentration of CBD and THC needed to kill human MCF-7 breast cancer cells rather than create mass multiplication leading to more growth of the cancer. To conduct this experiment, cell culture was performed with a MCF-7 breast cancer cell line. The treatment groups were treated with CBD or THC at varying concentrations …
2020-08-05_Michiganoverview_Covidlongtermcare, Michigan Department Of Health & Human Services
2020-08-05_Michiganoverview_Covidlongtermcare, Michigan Department Of Health & Human Services
Michigan COVID-19 Long Term Care Data
The COVID Long Term Care Facilities page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173-526911--,00.html.
This report is created by the Michigan Department of Health & Human Services from data self-reported by long-term care facilities into EMResource. Data is updated on an ongoing basis.
The data below represents a cumulative total of confirmed COVID-19 resident cases, cumulative total of suspected and confirmed resident deaths, cumulative total of confirmed COVID-19 staff cases, and cumulative total of suspected and confirmed staff deaths reported by SNFs in Michigan since January 1, 2020. Case numbers are provisional and may change as facilities correct …
2020-08-05_Michigandaily_Covidmap, Michigan Department Of Health & Human Services
2020-08-05_Michigandaily_Covidmap, Michigan Department Of Health & Human Services
Daily Michigan COVID-19 Update
The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.
The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.
The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …
2020-08-05_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services
2020-08-05_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services
Cumulative Michigan COVID-19 Data
The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html.
This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) and rapid virus antigen detection point of care (POC) tests, look for current infection. Serology (antibody) tests are used to look for the possibility of previous infection.
Source: Michigan Disease Surveillance System (MDSS) and Vital Records
The website contained the tables …
2020-08-05_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services
2020-08-05_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services
Michigan COVID-19 Hospital Data
The webpage was obtained from Michigan's Coronavirus Cumulative Data page, under the link Data About Places. Data is self-reported by hospitals daily to the EM Resource System per MDHHS Director Robert Gordon's Emergency Order.
Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Available PPE Tracking for COVID-19 (Statewide Available PPE and Bed Tracking), as well as the tables PPE Days On Hand and Patient Census.
Collaborative Strategies To Reduce Incomplete Operating Room Instruments Trays, Richard Neusch, Nicole Wagner, Colby Fike, Suneela Nayak
Collaborative Strategies To Reduce Incomplete Operating Room Instruments Trays, Richard Neusch, Nicole Wagner, Colby Fike, Suneela Nayak
Operations Transformation
In an academic tertiary medical care center, the OR was receiving incomplete instrument trays. This issue became increasingly problematic in wasted staff time and cost to the institution.
Using a tracking system to generate a missing instrument report, baseline metrics were established. Reviewing each report, an interdepartmental team comprised of members of the OR and sterile processing departments, initiated a number of countermeasures.
Since the start of these countermeasures, there has been a reduction in the receipt of incomplete OR trays. Next steps include creating a tag process by which the OR instrument trays from one case would be kept …
The Spectrum Of Primary Immunodeficiencies At A Tertiary Care Hospital In Pakistan, Sonia Qureshi, Fatima Mir, Samina Junejo, Khalid Saleem, Samreen Zaidi, Abdullah B. Naveed, Khalil Ahmad, Farah Naz Qamar
The Spectrum Of Primary Immunodeficiencies At A Tertiary Care Hospital In Pakistan, Sonia Qureshi, Fatima Mir, Samina Junejo, Khalid Saleem, Samreen Zaidi, Abdullah B. Naveed, Khalil Ahmad, Farah Naz Qamar
Department of Paediatrics and Child Health
Background: Primary Immunodeficiency Disorders (PIDs) are well-known disorders in the West. but the recognition and diagnosis of these disorders is challenging in developing countries. We present the spectrum of PIDs seen at a tertiary care center in Pakistan, identified using clinical case definitions and molecular methods.
Methods: A retrospective chart review of children suspected to have PID was conducted at the Aga Khan University Hospital (AKUH) Karachi, Pakistan from 2010 to 2016. Data on demographics, clinical features, family history of consanguinity, sibling death, details of laboratory workup done for PID and molecular tests targeted panel next generation sequencing (NGS) or …
Special Issue – July 2021 The Impact Of Inequity & Health Disparities On The Human Experience, Patient Experience Journal
Special Issue – July 2021 The Impact Of Inequity & Health Disparities On The Human Experience, Patient Experience Journal
Patient Experience Journal
Patient Experience Journal (PXJ) is excited to announce the call for submissions for its July 2021 special issue on the impact of racial inequality, health disparities, and discrimination on the human experience. The world now finds itself in the grips of a global pandemic that is taking its toll on communities socially and economically, placing strain on healthcare workers and revealing the very systemic weaknesses and inherent biases that have been resting just beneath the surface of our society for years. The challenge of disparity and inequity is not unique to healthcare, but in the era of COVID-19, what many …
Micro-Volunteering At Scale Can Help Health Systems Respond To Emergencies, Such As The Covid-19 Pandemic, Neil Churchill Obe
Micro-Volunteering At Scale Can Help Health Systems Respond To Emergencies, Such As The Covid-19 Pandemic, Neil Churchill Obe
Patient Experience Journal
One of the unprecedented challenges of the Covid-19 pandemic has been to support millions of clinically high-risk individuals who were advised to self-isolate for long periods to reduce the likelihood of infection. The NHS in England issued a mass call for volunteers in March 2020 to help support people who were shielding or vulnerable for other reasons during the lockdown. Three quarters of a million people came forward to aid the health at home experience for these vulnerable individuals by providing friendly telephone calls, help with shopping or collection of medicines or transport to essential hospital appointments. Hospitals also used …
Cards From The Community: Engagement Of The Local Community To Enhance Patient And Staff Experience During The Covid-19 Pandemic, Brittany Branson
Cards From The Community: Engagement Of The Local Community To Enhance Patient And Staff Experience During The Covid-19 Pandemic, Brittany Branson
Patient Experience Journal
During the COVID-19 pandemic, in accordance with recommendations from the Centers for Disease Control and Prevention (CDC.gov), strict visitation restrictions were implemented across the six hospital Yale New Haven Health System (YNHHS) in an effort to protect patients, visitors and staff. In addition, to the extent that it is possible, YNHHS staff have been encouraged to work remotely. While these measures achieve the goal of reducing the number of people within the hospitals and enable successful social distancing, they also may contribute to social isolation for both patients and staff. A program called “Cards from the Community” was developed to …
My Six-Word Story: Power To Reconnect And Connect, Alexie Puran
My Six-Word Story: Power To Reconnect And Connect, Alexie Puran
Patient Experience Journal
The COVID-19 global pandemic is a threat to the well-being of our healthcare professionals. Recent studies on the mental health effects of healthcare professionals from China and Italy have revealed higher levels of depression, anxiety and psychological distress. As a Pediatric Emergency Medicine physician working on the frontline and a H3 (Helping Healers Heal) Peer Champion, I sought to support my staff’s well-being and emotional resilience. My Six-Word Story, a simple and meaningful activity was designed to support the psycho-social well-being of those on the frontline providing care. This new project was implemented in the Pediatric Emergency Department at NYC …
Nursing Leadership During Covid-19: Enhancing Patient, Family And Workforce Experience, Anne Aquilia, Karen Grimley, Barbara Jacobs, Maryellen Kosturko, Jerry Mansfield, Charlotte Mathers, Peggie Parniawski, Laura Wood, Victoria Niederhauser
Nursing Leadership During Covid-19: Enhancing Patient, Family And Workforce Experience, Anne Aquilia, Karen Grimley, Barbara Jacobs, Maryellen Kosturko, Jerry Mansfield, Charlotte Mathers, Peggie Parniawski, Laura Wood, Victoria Niederhauser
Patient Experience Journal
The global COVID-19 pandemic has challenged nurse leaders in ways that one could not imagine six months ago. Along with ongoing priorities of providing high quality, cost-effective and safe care, nurse leaders are also committed to creating environments that support excellence in patient and family experience. This article will provide exemplars of how nurse leaders used decisive decision-making, adapted to novel situations and issues, ensured reliable and safe delivery of care and engaged patients, families and their workforce to create excellent experiences of care during the pandemic. Throughout this crisis, nurse leaders have learned how to grapple with quick and …
Caring For Our Caregivers In Body, Mind And Spirit During The Covid-19 Pandemic, Rick Evans, Philip J. Wilner, Kristen Spillane
Caring For Our Caregivers In Body, Mind And Spirit During The Covid-19 Pandemic, Rick Evans, Philip J. Wilner, Kristen Spillane
Patient Experience Journal
New York City became the epicenter of the coronavirus pandemic in March 2020. The surge of critically ill patients combined with widespread social distancing measures created extraordinary challenges for healthcare workers. Many frontline workers experienced significant physical, psychological, and emotional distress. They faced demanding patient care responsibilities while managing personal obligations and health concerns.
During the COVID-19 pandemic, it was imperative that NewYork-Presbyterian care for its workforce’s physical, psychological and emotional needs, not only because of our commitment to our colleagues as people, but also because of our obligation to continue to deliver high quality care and experience to the …
Leveraging The Agility Of The Care Experience Dyad Partnership Model During Covid-19, Vanessa Mona, Rana Awdish Md Fccp
Leveraging The Agility Of The Care Experience Dyad Partnership Model During Covid-19, Vanessa Mona, Rana Awdish Md Fccp
Patient Experience Journal
The extraordinary nature of COVID-19 has presented, and will likely continue to present, unique challenges for care delivery systems; not only in respect to delivery of care to patients, but also in respect to the ways in which health systems care for, and facilitate safe working environments for their employees. It was identified early on that COVID-19 would challenge our Health System, Henry Ford, in its ability to provide an optimal experience of care for our patients. We realized that the feelings of isolation experienced by patients, anxieties experienced by their families and impacts to the well-being of our employees …
Johns Hopkins Medicine Responds To Covid-19: Adjusting Patient- Family- And Staff-Centered Care, Stacy L. C. Colimore, Lisa Allen, Zach Lawrence, Nicole Iarrobino, Sylvia Kavouriou, Adey Betre, Chevaunne Edwards, Amel Elshinawi, Lisa Filbert, Tameka Glenn, Jade Hewitt, Lisa Jibril, Brittney Lawrence, Ariel Mabry, Deborah Miller, Nicole Pritchett, Heather Webb
Johns Hopkins Medicine Responds To Covid-19: Adjusting Patient- Family- And Staff-Centered Care, Stacy L. C. Colimore, Lisa Allen, Zach Lawrence, Nicole Iarrobino, Sylvia Kavouriou, Adey Betre, Chevaunne Edwards, Amel Elshinawi, Lisa Filbert, Tameka Glenn, Jade Hewitt, Lisa Jibril, Brittney Lawrence, Ariel Mabry, Deborah Miller, Nicole Pritchett, Heather Webb
Patient Experience Journal
The extraordinary impact of the novel coronavirus disease 2019 (COVID-19) on the health care industry included a major, nearly immediate paradigm shift in the visitation policy for Johns Hopkins Medicine. This large health system, comprising six hospitals, a home care group, community physician practices and satellite outpatient sites moved from essentially open visitation to no visitation, creating an entirely new set of needs for our staff, patients and their loved ones. We developed new ways of communicating and connecting staff members, staff and patients, staff and the patient’s loved ones, and patients and their loved ones. Our intent was to …
Family Connect: Keeping Families Informed During The Covid-19 Pandemic, Brittany Branson, Anne K. Wilkinson, Jaya Sondhi, Irma Dadic, Devin M. Giguere, Rachel Ramsey, Regina Grinblat, Katherine A. Hochman
Family Connect: Keeping Families Informed During The Covid-19 Pandemic, Brittany Branson, Anne K. Wilkinson, Jaya Sondhi, Irma Dadic, Devin M. Giguere, Rachel Ramsey, Regina Grinblat, Katherine A. Hochman
Patient Experience Journal
Family Connect programs to enhance communication with families and care partners who were unable to visit their inpatient loved ones during the COVID-19 crisis. While they differed in composition, the Family Connect programs at both institutions leveraged providers who had decreased clinical activity during the pandemic. The Family Connect team became integrated with the team. At both institutions, Family Connect teams perform virtual chart review, discuss patient status and care plan with the primary provider and communicate with the patient’s designated family member or care partner daily. Conversations are documented in the electronic medical record (EMR), which allows for metric …