BALTIMORE -- Personal health records may be the next step in the evolution of health information technology, but these electronic documents raise several legal and security issues for long-term care facilities.

"PHRs might in fact have the opportunity to leapfrog over things that are happening in electronic health records," Dr. Steven Labkoff, director of business technology for Pfizer Inc., said at a meeting on long-term care health information technology.


The main difference between personal health records (PHRs) and electronic health records is who owns them. Ideally, patients should own their PHRs. But it is still unclear who should control what information is entered in the document and, perhaps more important, who should be able to delete information from the record, experts said at the meeting, sponsored by the American Health Information Management Association (AHIMA).

An online public survey conducted in 2003 found that 71% of respondents believed that personal health records would improve the quality of health care, said Jill Burrington-Brown, the practice manager for health information management products and services at AHIMA.

"The time is now to accelerate the development of personal health records," she said, citing a report from Connecting for Health, a project of the Markle Foundation to promote the adoption and use of personal health records.

"A second finding was that PHRs are a means to necessary ends, such as increased consumer health awareness, activation, safety, and self-efficacy," she said.


During roundtable discussions, meeting attendees said that they thought personal health records are a potentially important component of health information technology efforts, but many also had misgivings about the security risk represented by giving seniors, some with cognitive deficits, electronic access to their health records.

"Every day is a day that we work on security to make sure it is tight and concise," said Daniel Wilt, director of information technology for Erickson Retirement Communities.

Erickson has launched a pilot program that allows residents to remotely access laboratory results, physician notes, and medical histories. The system also allows them to set appointments and keep health journals.

"They want their labs. That's the one thing they really want. They go to the medical center, they run back upstairs, they go to their computers, and they ask 'It's been 20 minutes; where are my labs?' We have to explain it takes 24 hours," he said.

While most users really like the system, administrators have had to struggle with how much access the public should have. For example, Mr. Wilt said, should administrators allow adult children to look at records or let residents change information that they deem incorrect?

By definition, personal health records need to be individually owned, said Ms. Burrington-Brown.

"The individuals own the PHR in a similar way as we own money in the bank. There is some conversation in the industry about who really owns that, because of who produces it. That is a conversation that is going to be going on" for quite some time, she said.

Industry groups are working on a standard format for personal health records, while groups such as the American Health Information Community and the National Committee on Vital and Health Statistics are developing standards to ensure interoperability and security of those documents.

"We have a lot of PHR activities occurring at many levels," she said.

The study examines change in relation to the personal development and creditability of students as they progress through a high school in Tennessee. It is suggested as a model for all high schools to insure that personal development and creditability of students occurs. Clearly, female students tend to do better than male ones, but for this group of 550 students both male and female student show excellent progress in such development. The PDT test promises to be an excellent means for use by high schools and colleges to insure progress is being made in the personal development of students.

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The American Psychiatric Association used 26 advisory committees in the development of DSM-III-R and DSM-IV (1994) where the Global Assessment Functioning Scale was determined to be critical in the health and success of individuals. It consists of a five point scale where a rating of 5 suggests excellent Global Functioning, a rating of 3 as average, and a rating of 1 as the absence of effective Global Functioning. The problem with the DSM-IV scale is that it fails to identify any of the critical elements involved in Global Functioning or Personal Development; so that specific change can be planned for. From Third Force Psychology and Person-Centered Theory by Rogers (1945) and Maslow 1954) we learn that Global Functioning is based on the Personal Development of the individual, and introduces some of the basic critical elements involved in Personal Development.

Assessing Personal Development


The Personal Development Test (PDT) (Cassel & Chow, 2002) is designed to measure the Personal Development of youth and adults. It is comprised of 200 true/false type items with 25 in each of the 8 part scores. It is based on Dewey's definition of a democracy--the interdependence of independent individuals. The first 4 part scores measure Personal Maturity for the Independence element in the Dewey definition, and the second 4 part scores measure Social Integration for the interdependnce one. Each one of the 8 part scores provides a meaningful understanding of the functioning basis of Personal Development.

I Personal Maturity--able to compete and succeed in an economic based society:

Self-efficacy--Exercise of personal control with high expectations and long staying power, and the development of long-term goals..

Coping Skills--possession of personal manipulative skills with a willingness and ability to develop others as needed.

Positive Assertiveness--begins with character education involving use and abuse of tobacco, alcohol, and drugs; and including action towards goal-attainment.

Locus of Control--belief that success is not luck, but scientific decision making.

II Social Integration--ability to get along with all kinds of people--different races and religions:

Conformity--accept and become an integral part of community and nation with a "team' like spirit.

Sympathy--ability to empathize and put self in place of the other person, and feel their pain and pleasures.

Self-esteem--sensing that peers have a lofty and important image of you as a team member.

Caring--Whatever happens to one person or animal anywhere in the world is important to all persons everywhere.

Confluence Score

The Confluence Score is comprised of 42 items; which includes 21 pairs of the 200 PDT items, and deals squarely with agreement and harmony of one's responses--creditability. About half of those 21 pairs are direct opposites, and the other half lack agreement with the other item in the pair in varying degrees. If the individual, for example, scores one of those items in the pair "true," and fails to score the second item in the pair "false," there is a lack of congruence--agreement or harmony. In this sense, then, the "Confluence Score" is a measure of "creditability" of the person taking the test; as well as the test results. It may mean, of course, that the Test Taker did not read or understand the items involved. What ever the reason for such failure, the notion of creditability still holds. People are inclined to want to make self look favorable and tend to answer test questions in agreement with own positive image; often not in agreement with facts. The Confluence Score seeks to verify creditability of the test taker as well as the test results.

Validity of Confluence Score

Validity means the statistical degree of agreement between the item or score and other data of relevance. It is clear beyond any doubt that the Confluent Score could be used very effectively to predict the student's PDT scores (Personal Development of students), or even the student's GPA (Grade Point Average) (r = 0.399). The Confluence Score is an integral part of the PDT test--same items used to measure Personal Development; not an addition as in the Minnesota Multiphaisc Inventory (1970).

The basketball hoop bends forward in front of the two-story house in Ashtabula, Ohio, where newly named Lutheran bishop Elizabeth Eaton raised two children, sent them to public schools and lived while she pastored a small church.

Leaving will be hard, but Eaton wants a house closer to her office as the Northeastern Ohio bishop in the Evangelical Lutheran Church in America. And she wants to be closer to the church where her husband, Conrad Selnick, serves as pastor.

In addition, they want a home that makes the right impression because a bishop is, in theological terms, a servant of servants. Her lifestyle as the spiritual leader of a region that includes America's poorest city is part of the church's witness, she said.


So Eaton doesn't expect to buy anything too lavish. She said her new house may not even be as big as her current four-bedroom, two-and-a-half-bath home, valued at $140,000. "I hope we don't get into conspicuous consumption," she said.

For many clergy, choosing a residence can be a balancing act between biblical and theological emphases on a simple lifestyle on the one hand and personal and practical considerations on the other. "'It doesn't do anyone any good to live in a shack," Eaton noted.

The issue is complex for religious leaders, especially in America's heartland.

Cleveland's Catholic bishop, Richard Lennon, lives with four priests in a downtown rectory. Meanwhile, Episcopal bishop Mark Hollingsworth Jr. owns a suburban home on 2.4 acres that he bought for $1.66 million in 2004.


Lennon said he tries to follow church teachings that encourage clerics "to set aside every appearance of vanity in their possessions"; Hollingsworth said he wants a place where he can entertain and host events for the diocese.

The visible fortunes of religious leaders have ebbed and flowed throughout church history. The earliest Christian leaders were poor carpenters, fishermen and tentmakers. In a well-known biblical passage, Jesus advises a rich young man: "Sell your possessions and give the money to the poor, and you will have treasure in heaven; then, come, follow me."

As Christianity gained social cachet in later centuries, displays of opulence were considered by some to be a sign of the respect due the church and its leaders. Financial excess and corruption produced a backlash move toward simpler lifestyles, said Craig Blomberg of Denver Seminary, author of Neither Poverty nor Riches: A Biblical Theology of Material Possessions.

Today spiritual leaders are challenged by different theological imperatives. At one end is the "prosperity theology" movement that sees individual wealth as a sign of God's favor. At the other end are theologians who say spiritual leaders called to serve the poor should live with their flocks.

"If people are looking for nice, simple, neat formulas, they don't exist," Blomberg said. "It's probably best discerned community by community."

Cleveland's Catholic bishops had lived in a lakefront mansion on 18 acres until it was sold in 1977. Lennon now has a bedroom and a sitting room totaling about 200 square feet in the rectory at St. John Cathedral.

The modest living quarters suit the bishop, who said in written responses to questions that he strives to live by the Vatican II directive urging priests and bishops to embrace voluntary poverty, "by which they are more manifestly conformed to Christ." His evening walks take him among the poor and the homeless.

Lennon said clerics are encouraged in their lifestyle not to jeopardize their ability to "evangelize the poor." For the bishop, that means having a home that will not "appear unapproachable to anyone, lest anyone, even the most humble, fear to visit," he said.

More than 50 miles away in Plain Township, United Methodist bishop John Hopkins lives in church-assigned housing, on a corner lot in a development that borders a golf course.

Hopkins said the four-bedroom colonial, with a market value of $327,000, lets him provide guest housing to missionaries and their families and other visitors such as college presidents. But he also said, "As you live in nicer neighborhoods, you've got to work doubly hard to be in touch with your constituencies."

When Hollingsworth was elected bishop in 2003, he, his wife and his four children were offered housing by the diocese. Hollingsworth chose instead to buy a $1.66 million home with seven bedrooms, seven full and two partial bathrooms and five fireplaces across from a park in Shaker Heights.

The bishop bought the house with what he would only describe as his "personal resources." No church money was used, according to the diocese.

"The elements that went into deciding where to live were primarily personal and had to do with finding a home for our young family that had access to schools and proximity to my office and also a place where we could offer hospitality to the diocese," Hollingsworth said.--David Briggs, RNS

Editor's Note: Boyd Rayward was the recipient of the ASIS&T Research Award for 2004. The award honors outstanding research contributions in the field of information science.

My research over the years has focused on historical questions related to library and information science as providing the intellectual underpinning of a variety of professional practices related to the dissemination and use of information. I have published a number of historical studies examining Utopian schemes for managing knowledge, the evolution of institutionalized or organizational aspects of information infrastructure (as represented especially by libraries, museums and systems for the international organization and dissemination of information), and the emergence of what I think of as an interdiscipline - nowadays often designated library and information science - concerned with the study of these phenomena.


Studies of the Life and Work of Paul Otlet

The Universe of Information: The Work of Paul Otlet for Documentation and International Organization was an initial study of a hitherto neglected figure. A Russian translation of this book was published in 1977 and a Spanish edition in 1996. With the advent of the Internet and the Web, it has become clear how pioneering and important historically the work of Paul Otlet and his colleagues was. It seems yet even more relevant today with the recently announced agreement between Google and a number of research libraries to digitize and make their collections available through the Web. I have argued that in Otlet's world of paper, card and cabinet technology he provided a theoretical basis for, and described many of the functionalities characteristic of, today's information technology and the uses to which it has been put. Two articles that might be mentioned in this context are "Visions of Xanadu: Paul Otlet (1868-1944) and Hypertext," and "The origins of information science and the International Institute of Bibliography/International Federation of Documentation (FID)." Both articles were reprinted in ASIS&T's Historical Studies in Information Science.


Otlet's innovative thinking encourages us to question and to broaden our understanding of what constitutes a document. His technological experiments and speculations suggest how clearly he understood that technology limits not only what we can do but also what we realize is possible in the management of information and that, reciprocally, technology can open up what we can think as well as what we can do. Many of the failures he experienced and his conceptual struggles with them also made him acutely aware that managing and deploying information are profoundly social processes that are embedded in political and ideological structures of various kinds. Otlet's Traité de Documentation is, for me, the first systematic information science treatise. I believe that his ideas have a historical role in our understanding of the emergence of the Internet and World Wide Web and the functionalities they represent that is as important as any of the roles attributed to such pioneering and iconic figures as H.G. Wells, Vannevar Bush, Ted Nelson and others. The World Wide Web: how readily he would have embraced this simple evocative locution for what he called the International Network for Universal Documentation!

International Organization and Dissemination of Knowledge: Selected Essays of Paul Otlet was designed to make some of his thinking available in the English-speaking world. A collection of my own papers on Otlet-related matters has been translated by Pilar Arnau Rived into Spanish as Hasta Ia Documentacion Electronica. A recent article, "Knowledge Organization and a New World Polity: The Rise and Fall and Rise of the Ideas of Paul Otlet," is an attempt to assess the historiography that has developed around Otlet and his work in the last 25 years or so and introduces the Otlet-themed issue of the bi-lingual Transnational Associations/Associations Transnationales, the journal of the Union of International Associations.

Historiographical Questions Related to Library and Information Science

My studies of Otlet's work made me aware that asking, "What is a library or bibliography or information or librarianship or library and information science?" is to ask interesting historically contingent questions. My first exploration of some of these questions took a kind of "evolutionist" view in "The Development of Library and Information Science: Disciplinary Differentiation, Competition and Convergence," in Machlup and Mansfield's The Study of Information: Interdisciplinary Messages. Later in "The History and Historiography of Information Science: Some Reflections," which introduced an issue that I edited of Information Processing and Management on the history of information science, I tried to give a broader view of what I saw as the nature of information and the roles and functions of the systems that we have devised as a society to manage information, of which the library is an historically important example. I think of all of these elements as society's information infrastructure - before the term was taken over and limited in its designation by the telecommunications industry ("History and Historiography of Information Science"). The first of two more recent studies explores the idea of emergent communities that are both national and international in their interest in historical study of information systems and science, while the second explores the idea of how we might think about pioneers in a field like library and information science ("Scientific and Technological Information Systems" and "When and Why Is a Pioneer?").

THE Bureau of Economic Analysis has been working on a research and development (R&D) satellite account since 2004 to help economists gain a better understanding of R&D activity and its effect on economic growth. This article introduces the 2006 satellite account, which provides preliminary estimates of R&D investment and the impact of R&D investment on such measures as gross domestic product (GDP), investment, and saving.


The full 2006 satellite account, released in September and accessible via , modifies the accounting conventions used in the national income and product accounts (NIPAs) in order to explore the impact of "capitalizing" R&D--that is, treating R&D spending as an investment rather than as an expense. The new account does not affect the official measure of GDP. Rather, the satellite account provides a framework to explore new methodologies and provide regularly updated estimates of R&D in preparation for future incorporation into the input-output (I-O) accounts and the NIPAs.

The R&D satellite account was developed in partnership with the National Science Foundation (NSF), the Federal agency that is responsible for producing R&D-related statistics for the United States. NSF provided funding for the R&D satellite account project, and its staff reviewed account methodologies and results. Using R&D expenditure data from the NSF, BEA developed estimates of R&D investment, the R&D, and the resulting macroeconomic effects for 1959-2002. (1) Revised estimates are scheduled to be released in September 2007.


The 2006 account measures the direct effect of R&D investment on final demand only; it does not include spillover effects. Spillovers--the economic benefits of R&D available to entities that did not pay to create the R&D--are not included in the national accounts framework because the national accounts value assets at their market value. This treatment is consistent with the treatment of other types of spillovers in the national accounts.

The new account makes clear that treating R&D as an investment would have a substantial impact on GDP and other measures. Highlights from the new satellite account include the following:

* Current-dollar investment in R&D totaled $276.5 billion in 2002.

* Recognizing R&D as investment would increase the level of current-dollar GDP by an average 21/2 percent per year in 1959-2002 (chart 1). (2) * Businesses' investment in commercial and all other types of buildings would account for just over 2 percent

of real GDP growth in 1995-2002. * R&D investment and the income flows arising from accumulated R&D capital would account for about 4 1/2 percent of real GDP growth in 1959-2002. In 1995-2002, R&D investment would account for about 6 1/2 percent of growth.

* R&D investment would increase current-dollar gross private domestic investment in 2002 more than 11 percent, or $178 billion. The national saving rate in 2002 would be 16 percent, instead of 14 percent.

* Business investment in R&D as a percentage of GDP surpassed government investment as a percentage of GDP in 1981.

* Business investment accounted for just under 2 percent of current-dollar GDP in 2000, compared with just over 1 percent in 1960.

[GRAPHIC 1 OMITTED]

The release of the satellite account in September marks another step in BEA's efforts to adapt its measures of economic activity to structural changes in the economy (see the box "Previous NIPA Improvements Related to R&D"), particularly in the field of intangible assets. BEA plans several additional enhancements to the R&D satellite account in the near future: An improved treatment of the international aspects of R&D, improved measures of prices for R&D, and new industry-based estimates of R&D. Current plans, subject to available funding, call for the incorporation of R&D into the I-O accounts in 2012 and into the NIPAs in 2013.

The 2006 satellite account builds on the earlier work at BEA. (3) In 1994, BEA introduced the elements needed to translate R&D expenditures into investment, deflate investment, and develop R&D stock measures. In 2005, BEA went a step further and presented the general structure of the account along with rough estimates of the impact on GDP, gross domestic income (GDI), and national saving. The 2006 satellite account extends these previous efforts by exploring alternative scenarios that take into account the notable characteristics of R&D activity and by developing a more complete national accounts framework to estimate R&D activity.

In addition, BEA now recognizes the funder of R&D as the owner of R&D, that is, the entity that benefits from the activity; earlier versions focused on the performer of R&D. The change stems from the need to assign income flows to the economic sectors included in the national economic accounts. Assigning ownership from performer data is difficult because the performer is not necessarily the owner. Often, the original recipient of R&D funds may subcontract to others.

Leading Beyond Excellence: Discover How to Achieve Leadership Significance and Your Personal Dreams With 7 Practical Steps by Lisa Williams, Ph.D., Executive Publishers International, February 2005 $24.95, ISBN: 0-9726075-9-5

American society has developed a short attention span in an evergrowing, fast-paced world. Taking advantage of this attention span, Williams offers a cutting-edge leadership program and a self-discovery process.

Unfortunately, the attempt doesn't work. Her intentions are very clear, but the reader is lost after taking the "Spiral of Influence Survey" It is part of Williams's theory that the process of leading beyond excellence is best represented by a spiral because a person's inner development is a continuing process.


Trying to determine how you rate from the survey is confusing. The book relies too heavily on the survey to help the reader determine which stage they need developed, but it does not provide enough explanation of why the stages exist or what recourse can be taken. Not confusing are the weekly words of wisdom and the action steps in the book.

Developing Future Animal Science Industry Leaders through the Development of Personal Qualities, Leadership Skills, Communication Skills and Animal Science Technical Components

Hilary K. Maricle, Susan M, Fritz and Linda D. Moody

Department of Agricultural Leadership, Education and Communication

University of Nebraska-Lincoln

PO Box 830709

Lincoln, NE 68583-0709

Email: hmaricle2@unl.edu


Developing leaders in the animal science industry encompasses many areas (e.g. animal science technical skills, personal qualities, communication skills, and leadership skills). This study identified key competencies in four areas needed in the next five years by animal science graduates. Researchers used a modified Delphi technique to ascertain: 1) importance and priority; 2) proficiency level; and 3) agreement of respondents with the proficiency level. Forty-four of the 24 faculty and 20 industry experts rated the importance and priority of 193 competencies. Seventy-one competencies were identified as highly important and of critical priority. In the next round, experts rated the proficiency levels of the competencies, and finally, reported their agreement with the group ratings. Comparisons were made between post-secondary and industry responses in each of the rounds, as well as comparisons of responses by participant age and educational level. In total, personal qualities, communication skills and leadership skills were determined by the experts to be of higher importance and priority than animal science technical skills. Results of the study will be used as the basis of future animal science curriculum changes.