Potential Problems Research Articles

Different perceptual worlds: Parent and youth perspectives on parenting outcome trajectories from a Latino family-based program.

Discrepancies between parent and youth perceptions of their relationship are a common aspect of generational acculturation gaps influencing immigrant families. Programs designed to strengthen parenting practices among immigrant Latino families commonly address immigration stresses, including differences between parent and youth perceptions, but little is known about discrepancies in their appraisals of program effects on parenting behavior. A randomized trial was conducted examining effects on parent behavior of a program for immigrant families with youth aged 10-14, developed through community-based participatory research principles. Families (346 parents and youth) were recruited by organizations serving Latino families in a Midwestern metropolitan area and randomly assigned to the eight-session psychoeducation and skill-building program or a waitlist control. Parents and youth completed self-report measures at pre-intervention, post-intervention (4 months), and a 6-month follow-up regarding parents' expression of acceptance, efforts to solicit information about the child's experiences, and consistency of discipline, key foci of the program. Based on social cognition theory, the study focused on possible differences in parents' and youths' perceptions of change in parenting behavior. Parents in the treatment group reported pre-post improved acceptance, consistent discipline, and solicitation, whereas youth reported improvement only in parental solicitation, a pattern maintained at follow-up. In the control group, the only change was youth-reported reduction in parental acceptance. Parents' perceptions of improvement are encouraging, but overall lack of improvements from the youth perspective poses a potential problem for impact on parent-child relations. Interventions may need to target both parent and youth cognitions about behavior changes directly.

Transgenerational inheritance of methylmercury and vitamin A-induced toxicological effects in a Wistar rats environmental-based model

Mercury (Hg) and vitamin A (VitA) are two environmental factors with potential health impacts, especially during pregnancy and early childhood. Fish and seafood may present elevated levels of methylmercury (MeHg), the major Hg derivative, and VitA. This study aimed to evaluate the transgenerational effects of exposure to MeHg and/or VitA on epigenetic and toxicological parameters in a Wistar rat model. Our findings revealed persistent toxicological effects in generations F1 and F2 following low/mild doses of MeHg and/or VitA exposure during dams’ (F0) gestation and breastfeeding. Toxicological effects observed in F2 included chronic DNA damage, bone marrow toxicity, altered microglial content, reduced neuronal signal, and diminished male longevity. Sex-specific patterns were also observed. Co-exposure to MeHg and VitA showed both synergistic and antagonistic effects. Additionally, the study demonstrated that MeHg and VitA affected histone methylation and caused consistent effects in F2. While MeHg exposure has been associated with transgenerational inheritance effects in other organisms, this study provides the first evidence of transgenerational inheritance of MeHg and VitA-induced toxicological effects in rodents. Although the exact mechanism is not yet fully understood, these findings suggest that MeHg and VitA may perpetuate their impacts across generations. The study highlights the need for remedial policies and interventions to mitigate the potential health problems faced by future generations exposed to MeHg or VitA. Further research is warranted to investigate the transgenerational effects beyond F2 and determine the matrilineal or patrilineal inheritance patterns.

Developing, Purchasing, Implementing and Monitoring AI Tools in Radiology: Practical Considerations. A Multi-Society Statement From the ACR, CAR, ESR, RANZCR & RSNA

Artificial intelligence (AI) carries the potential for unprecedented disruption in radiology, with possible positive and negative consequences. The integration of AI in radiology holds the potential to revolutionize healthcare practices by advancing diagnosis, quantification, and management of multiple medical conditions. Nevertheless, the ever-growing availability of AI tools in radiology highlights an increasing need to critically evaluate claims for its utility and to differentiate safe product offerings from potentially harmful, or fundamentally unhelpful ones.This multi-society paper, presenting the views of Radiology Societies in the USA, Canada, Europe, Australia, and New Zealand, defines the potential practical problems and ethical issues surrounding the incorporation of AI into radiological practice. In addition to delineating the main points of concern that developers, regulators, and purchasers of AI tools should consider prior to their introduction into clinical practice, this statement also suggests methods to monitor their stability and safety in clinical use, and their suitability for possible autonomous function. This statement is intended to serve as a useful summary of the practical issues which should be considered by all parties involved in the development of radiology AI resources, and their implementation as clinical tools. Key Points•The incorporation of artificial intelligence (AI) in radiological practice demands increased monitoring of its utility and safety.•Cooperation between developers, clinicians, and regulators will allow all involved to address ethical issues and monitor AI performance.•AI can fulfil its promise to advance patient well-being if all steps from development to integration in healthcare are rigorously evaluated.

Developing, Purchasing, Implementing and Monitoring AI Tools in Radiology: Practical Considerations. A Multi-Society Statement From the ACR, CAR, ESR, RANZCR & RSNA.

Artificial Intelligence (AI) carries the potential for unprecedented disruption in radiology, with possible positive and negative consequences. The integration of AI in radiology holds the potential to revolutionize healthcare practices by advancing diagnosis, quantification, and management of multiple medical conditions. Nevertheless, the ever‑growing availability of AI tools in radiology highlights an increasing need to critically evaluate claims for its utility and to differentiate safe product offerings from potentially harmful, or fundamentally unhelpful ones. This multi‑society paper, presenting the views of Radiology Societies in the USA, Canada, Europe, Australia, and New Zealand, defines the potential practical problems and ethical issues surrounding the incorporation of AI into radiological practice. In addition to delineating the main points of concern that developers, regulators, and purchasers of AI tools should consider prior to their introduction into clinical practice, this statement also suggests methods to monitor their stability and safety in clinical use, and their suitability for possible autonomous function. This statement is intended to serve as a useful summary of the practical issues which should be considered by all parties involved in the development of radiology AI resources, and their implementation as clinical tools.

Analyzing the Development Status of Contemporary Chinese Cosmetics Market via Practices of Merge and Acquisition in the Luxury Industry

China’s cosmetics industry has long been in a situation of potential problems. Especially during the COVID-19 pandemic, the cosmetics industry suffered certain setbacks, resulting in limited development. The cosmetics market in China has always been dominated by foreign products. Through research, it has been found that there are many domestic cosmetics brands, but there is a lack of experience in management and operation. This article analyzes the mergers and acquisitions and development history of international luxury goods groups, and analyzes whether there are any parts that can be used for reference to promote the development of the domestic cosmetics industry. The article found that due to the unified production and non-reliance on manual characteristics of the cosmetics industry, only a portion of experience in management and operation can be learnt. It does not support Chinese brands to develop solely according to the merger and acquisition methods of luxury goods groups.

Analysis of microplastic particles by using single particle inductively coupled plasma mass spectrometry

A method based on single particle inductively coupled plasma mass spectrometry (SP-ICP-MS) with the use of regular sample introduction system was developed for the study of microplastics released from consumer products. With the standard type nebulizer used in SP-ICP-MS, the effect of sample introduction rate was evaluated and the flow rate of 0.18 mL min−1 was selected for further use. Under this condition, the transport efficiency was determined by using a commercially available uniform size of 50 nm AuNPs, and the calibration graph was constructed by using sucrose as dissolved forms of carbon. With this calibration approach, size analysis of polystyrene particles in the range of 1 – 6 µm was performed with the size detection limit of approx. 400 nm. The SP-ICP-MS was then applied to determine the particle size of laboratory synthesized polystyrene latex. The sizes obtained were found to positively deviate from the reference sizes reported by scanning electron microscopy (SEM), suggesting the potential problem from matrix interferences. Therefore, particle washing method by using deionized water was proposed to purify the polystyrene particles from their suspending medium. After particle washing, the sizes obtained from SP-ICP-MS with correction factor agreed well with the reference sizes. Therefore, the SP-ICP-MS method was applied to investigate the microplastics released from teabags and disposable face masks with the results compared with those from dynamic light scattering (DLS) and SEM.

The Effect of Information Quality, System Quality and Organizational Capability on the Implementation of HMIS at Regional public hospital Pambalah Batung, Hulu Sungai Utara Regency

The Hospital Management Information System (HMIS) is an integral part of overall hospital services and has even become one of the main joints in daily activities. Evaluation of HMIS implementation is carried out because it will assess the benefits derived from HMIS implementation and find potential problems faced by users and organizations. The results of this evaluation can be used as a reference for improving or perfecting the HMIS and minimizing the potential for existing problems, so that HMIS becomes better, perfect and can support the vision, mission and goals of the organization. The find out the quality of information, system quality and organizational capabilities in implementing HMIS at Pambalah Batung Hospital. This research is an associative research with a quantitative paradigm. The sample in this research is 150 respondents. The data analysis technique used a simple and multiple linear regression analysis test. There is an influence between information quality (p=0.000), system quality (p=0.000) and organizational capability (p=0.000) on HMIS implementation. Information quality, system quality and organizational capability simultaneously influence HMIS implementation (p=0.000). Information quality is the most dominant in HMIS implementation with a constant value (b = 0.387) (4.680). There is influence between information quality, system quality and organizational capability partially and simultaneously on HMIS implementation. Information quality has a dominant significant effect on HMIS implementation at Pambalah Batung Hospital. Pambalah Batung Amuntai Hospital, Hulu Sungai Utara Regency, further improves the information system for HMIS employees and must pay more attention to information systems by always improving good information systems and also providing information to Pambalah Batung Hospital.

Dermatology Self-Medication in Nursing Students and Professionals: A Multicentre Study.

Current evidence shows that the prevalence of self-medication in healthcare professionals and their students is troublingly high despite them knowing the risks involved. There is limited research on self-medication in dermatology, and there are even fewer studies on this practice among nurses and nursing students, despite the potential mucocutaneous health problems that may affect them. The aims of our study were to examine the prevalence of self-medication mainly in the field of dermatology among nurses and nursing students as well as to explore if age or years of professional/academic practice influenced such behaviour. This multicentre cross-sectional study was conducted in 2021. In total, 120 nurses from the University Hospital of Pontevedra and 303 nursing students from the Universities of Vigo and Santiago de Compostela (N-W Spain) participated in this study (n = 423). An ad hoc questionnaire was used to evaluate self-medication decision-making. Self-medication for dermatological diseases was reported by 58.39% (n = 247) of participants. Among our respondents, 44.44% of nurses and 42.68% of students would recommend treatment for skin diseases to a third party. We found a higher prevalence of medication without prescription in nurses than in students (p < 0.001). More experience (p = 0.01) and older age (p < 0.001) were associated with more self-medication in the case of nurses and students, respectively. The prevalence of self-medication and treatment recommendation to a third party are cause for concern. Identifying these situations and associated factors may help to implement evidence-based strategies and education.

Substance use and labour market nexus in South Africa

Substance abuse is a major public concern for the entire world. Using data from the National Income Dynamic Study wave four, this study examines the impact of substance (alcohol and tobacco) consumption on labour market outcomes in South Africa using the multinomial endogenous switching regression technique. This method controls for any potential selection bias and endogeneity problems. The results from the study reveal that individuals’ decisions to consume alcohol only, tobacco only, and a combination of both are driven by socioeconomic, health, and demographic factors. The estimated causal effect shows that substance use reduces individuals’ earnings in almost all cases and increases working hours. The findings suggest that efforts to control the use of alcohol and tobacco in South Africa should focus more on sensitization programmes that address the health, psychological, and economic implications of using these substances.

A Redactable Blockchain Scheme Supporting Quantum-Resistance and Trapdoor Updates

Applying chameleon hash functions to redactable blockchains is still challenging work. Most redactable blockchain solutions using this technique have potential problems, such as too weak decentralization performance and trapdoors with exposure risks. In addition, quantum computing also threatens the security of blockchain systems. The above two issues imply that the development of redactable blockchains is still constrained, and that quantum-resistance will be requirements for blockchain applications. Therefore, we constructed a chameleon hash function over lattices while utilizing a hierarchical identity mechanism to manage trapdoors and assign edit permissions. This variant of the chameleon hash function can support trapdoor updates and quantum-resistant performance, namely a hierarchical identity-based chameleon hash with revocable subkey (HIBCH-RS). We demonstrated the safety performance of HIBCH-RS by defining its safety concepts of collision resistance. Our HIBCH-RS scheme provides a solution for implementing a redactable blockchain with identity encryption and post-quantum cryptography. Finally, this quantum-resistant redactable blockchain was implemented on the Hyperledger Fabric blockchain platform.

Development of Syntax Acquisition in 3-Year-Old Children: A Longitudinal Study

A longitudinal study of syntax acquisition in three-year-old children provides a deeper understanding of how children develop their language abilities. By summarizing the findings from this research, we hope to take concrete steps to support optimal language development in the early stages of a child's life. This research uses the literature review research method, the literature review research method is an approach that involves examining and analyzing existing literature or research to gain a thorough understanding of a topic or research question. This process begins by determining the research topic and searching for relevant literature through various sources such as academic databases and digital libraries. The findings of this research provide a strong basis for designing early childhood education programs that pay attention to syntax acquisition patterns. Learning materials can be arranged according to children's developmental stages to support their optimal development. In addition, this research confirms that understanding language development at an early age can act as an indicator of children's psychological health. Monitoring syntax acquisition can help detect potential developmental problems or disorders early, opening up opportunities for more effective intervention.

Cultural shock of high‐speed rail: Evidence from social trust

AbstractThe opening of high‐speed rail (HSR), as an exogenous shock, has had a profound and complex effect on social life. This study analyzes the effect of the opening of HSR on social trust. Results show that the opening of HSR promotes social trust. Mechanism analysis showed that although the opening of HSR accelerated population mobility and decreased trust in strangers, economic growth and improvement of local social issues mitigated the negative effects of its opening. In addition, our results also show that individuals turn to trust in their parents, neighbors, and doctors. Considering the potential endogeneity problem, instrumental variable and difference‐in‐differences estimators consistently indicated the promoting effect of the HSR opening on trust. Heterogeneity analysis showed that the opening of HSR had a greater effect on female, urban residents, younger groups, and married people. Last, cities with larger populations and tourist cities were more vulnerable to shocks.

Inquiry in uncertainty-nursing students' learning experience in challenge-based learning: A qualitative study

BackgroundCurrently, nursing students face a significant lack of preparedness in efficiently addressing complex issues. The use of challenge-based learning, a student-centred situational learning method that utilizes practice scenarios to solve complex problems, can help alleviate the challenges in nurse education. However, there remains to be more extensive exploration on the application of challenge-based learning in nurse practice education. ObjectivesThis study aims to explore the learning experiences of nursing students in challenge-based learning to gain a deeper understanding of the ways and mechanisms through which challenge-based learning enhances specific learning abilities. Design/methodsThis study utilized a hermeneutic phenomenological design, employing semi-structured interviews and thematic analysis. SettingsA university in Hunan, China, hosted the nursing skills competition based on the principles of challenge-based learning, targeting senior students from nursing schools in Hunan province. ParticipantsA total of 24 fourth-year students from six colleges, including one male and twenty-three female students. ResultsTwo themes and seven sub-themes emerged from the study. Theme 1 Constructing a knowledge system in complex scenarios with sub-themes: Case-based education centred on comprehensive knowledge promotes knowledge linkage; Reverse reasoning promotes knowledge differentiation; Making mistakes helps finding the correct path of knowledge; Traps inspire identification of potential problems. Theme 2 Inquiry in uncertainty with sub-themes: Unexpected changes promote exploration of general principles; Combining knowledge with diverse case scenarios promotes flexible thinking; The uncertainty of knowledge fosters independent thinking. ConclusionsThe complexity and variability inherent in challenging learning situations promote the construction of students' knowledge systems and the cultivation of an inquisitive spirit. The identification of these mechanisms contributes to the optimization of instructional environment design, the development of a culture of continuous learning and innovation, and effectively tackling complex issues within an ever-evolving global context.

Eigenstate calculation in the state-averaged (multi-layer) multi-configurational time-dependent Hartree approach.

A new approach for the calculation of eigenstates with the state-averaged (multi-layer) multi-configurational time-dependent Hartree (MCTDH) approach is presented. The approach is inspired by the recent work of Larsson [J. Chem. Phys. 151, 204102 (2019)]. It employs local optimization of the basis sets at each node of the multi-layer MCTDH tree and successive downward and upward sweeps to obtain a globally converged result. At the top node, the Hamiltonian represented in the basis of the single-particle functions (SPFs) of the first layer is diagonalized. Here p wavefunctions corresponding to the p lowest eigenvalues are computed by a block Lanczos approach. At all other nodes, a non-linear operator consisting of the respective mean-field Hamiltonian matrix and a projector onto the space spanned by the respective SPFs is considered. Here, the eigenstate corresponding to the lowest eigenvalue is computed using a short iterative Lanczos scheme. Two different examples are studied to illustrate the new approach: the calculation of the vibrational states of methyl and acetonitrile. The calculations for methyl employ the single-layer MCTDH approach, a general potential energy surface, and the correlation discrete variable representation. A five-layer MCTDH representation and a sum of product-type Hamiltonian are used in the acetonitrile calculations. Very fast convergence and order of magnitude reductions in the numerical effort compared to the previously used block relaxation scheme are found. Furthermore, a detailed comparison with the results of Avila and Carrington [J. Chem. Phys. 134, 054126 (2011)] for acetonitrile highlights the potential problems of convergence tests for high-dimensional systems.

URGENSI PENGAWASAN DALAM PENYUSUNAN DPTb DAN DPK MENGAHADAPI PEMILU 2024 DI BAWASLU PADANG PARIAMAN

DPT (Permanent Voter List) comes from data from the last general election and elections. Through this DPT, the public can actively participate in the 2024 elections. One indicator of the success of the election is high voter participation, because it will provide strong legitimacy to whoever wins and becomes the government. If people are not registered in the DPT, they can propose an Additional Voter List (DPTb) so they can exercise their voting rights. Apart from that, the community also maintains a Special Voter List (DPK), which is a list of voters who have a residency identity but are not yet registered in the DPT and DPTb. For this reason, it is important for the Pariman Regency Bawaslu to supervise the DPTb and DPK proposal stages. Election monitoring strategies that can be carried out in involving the community are (1) Mapping and strengthening participants, (2) Determining appropriate information content, (3) Effective delivery of information, (4) Panwaslu as a facilitator. The methods used in this service are lectures, questions and answers, and discussions. The lecture was carried out in presenting material on forms of supervision that participants can carry out, reading potential problems in determining the DPTb and DPK and providing solutions so that the 2024 resumption runs smoothly. This activity was held on Tuesday 26 August 2023 at the Sambalado Hall, Jalan Zaini, Simpang Kurai Taji Village, Pariaman City.

HPLC-MS/MS Phenolic Characterization of Olive Pomace Extracts Obtained Using an Innovative Mechanical Approach.

Olive pomace results from the production of olive oil. Even if olive pomace represents a potential environmental problem, it contains phenolic compounds, which are widely recognized for their beneficial properties for human health. In this study, an innovative and sustainable technological approach to extract phenolic compounds from fresh olive pomace, based on food-grade solvent instead of those usually adopted, is investigated. Characterization and shelf-life evaluation of the hydroalcoholic extracts obtained from the procedure developed for different industrial purposes were also carried out. The phenolic fractions of the different samples were studied with the Folin-Ciocâlteu method to quantify that the total reducing molecules and HPLC-MS/MS analysis was used to define the profile through the identification and quantification of 42 compounds, belonging to five chemical families. Regarding shelf-life, the hydroalcoholic extract showed no significant reduction in phenolic content, for both instrumental evaluations, retaining most of the phenolic compounds present in the raw material; negative attributes were not perceived by sensory evaluation. Thus, these lab-scale results can be the starting point to develop a procedure that is suitable for a real olive mill, representing a valorization strategy in a circular economy and the perspective of new business models.

One-Pot Assembly of Mannose-Capped Lipoarabinomannan Motifs up to 101-Mer from the Mycobacterium tuberculosis Cell Wall.

Lipoarabinomannan (LAM) from the Mycobacterium tuberculosis cell envelope represents important targets for the development of new therapeutic agents against tuberculosis, which is a deadly disease that has plagued mankind for a long time. However, the accessibility of long, branched, and complex lipoarabinomannan over 100-mer remains a long-standing challenge. Herein, we report the modular synthesis of mannose-capped lipoarabinomannan 101-mer from the M. tuberculosis cell wall using a one-pot assembly strategy on the basis of glycosyl ortho-(1-phenylvinyl)benzoates (PVB), which not only accelerates the modular synthesis but also precludes the potential problems associated with one-pot glycosylation with thioglycosides. Shorter sequences including 18-mer, 19-mer, and 27-mer are also synthesized for in-depth structure-activity relationship biological studies. Current synthetic routes also highlight the following features: (1) streamlined synthesis of various linear and branched glycans using one-pot orthogonal glycosylation on the combination of glycosyl N-phenyltrifluoroacetimidates, glycosyl ortho-alkynylbenzoates, and glycosyl PVB; (2) highly stereoselective construction of 10 1,2-cis-arabinofuranosyl linkages using 5-O-(2-quinolinecarbonyl)-directing 1,2-cis-arabinofuranosylation via a hydrogen-bond-mediated aglycone delivery strategy; and (3) convergent [(18 + 19) × 2 + 27] one-pot synthesis of the 101-mer LAM polysaccharide. The present work demonstrates that this orthogonal one-pot glycosylation strategy can highly streamline the chemical synthesis of long, branched, and complex polysaccharides.

Fictitious Point Technique Based on Finite-Difference Method for 2.5D Direct-Current Resistivity Forward Problem

With the widespread application of the direct-current resistivity method, searching for accurate and fast-forward algorithms has become the focus of research for geophysicists and engineers. Three-dimensional forward modeling can be the best way to identify geo-electrical anomalies but are hampered by computational limitations because of the large amount of data. A practical compromise, or even alternative, is represented by 2.5D modeling characterized using a 3D source in a 2D medium. Thus, we develop a 2.5D direct-current resistivity forward modeling algorithm. The algorithm incorporates the finite-difference approximation and fictitious point technique that can improve the efficiency and accuracy of numerical simulation. Firstly, from the boundary value problem of the electric potential generated by the point source, the discrete expressions of the governing equation are derived from the finite-difference approach. The numerical solutions of the discrete electric potential are calculated after the approximate treatment of the boundary conditions with a finite-difference method based on a fictitious point scheme. Secondly, through the simulation of a homogeneous half-space model and a one-dimensional model, and compared with the analytical results, the correctness and stability of the finite-difference forward algorithm are verified. Lastly, through the numerical simulation for a two-dimensional model, 2.5D direct-current sounding responses are summarized, which can provide a qualitative interpretation of field data.

Biological and productive aspects of the black soldier fly Hermetia illucens (Diptera: Stratiomyidae) in meal moth rearing residues Ephestia kuehniella (Lepidoptera: Pyralidae)

AbstractThe inadequate disposal of organic waste generated in insect biofactories breeding biological agents may become a potential environmental problem. The use of Hermetia illucens (Diptera: Stratiomyidae) may play an important role in the circular economy of this process, transforming waste into high‐quality biomass. Therefore, this work aims to analyse the degradation of organic residues of Ephestia kuehniella (Lepidoptera: Pyralidae) production using the black soldier fly. Four types of waste from the moth breeding process were evaluated: residues of the meal diet when moth larvae were in the last instar; residues of the meal diet when completing the cycle; residues formed by webs in the pupation process mixed with residual exoskeleton, and residues of dead adults. These residues were tested in isolation and in mixtures of 50%, using as control a standard diet composed of chicken feed. Survival rate, development time, emerged adults, weight, size, residue reduction, and bioconversion were evaluated. The residue used in diets affected the total development time of H. illucens. The mean number of survivors differed from 87% to 74% for larvae that reached the pre‐pupal stage. The viability of pre‐pupae to adult stage ranged from 54% to 6% for residue treatments and 97% for the control. Differences in the growth and weight gain of larvae were significantly different. The rate of residue reduction from 54% to 80% and bioconversion into larval biomass were satisfactory. However, regarding adult emergence, the numbers show variations, indicating that certain residues are not suitable for the maintenance of fly breeding.

Electronic health record and primary care physician self-reported quality of care: a multilevel study in China

ABSTRACT Background Health information technology is one of the building blocks of a high-performing health system. However, the evidence regarding the influence of an electronic health record (EHR) on the quality of care remains mixed, especially in low- and middle-income countries. Objective This study examines the association between greater EHR functionality and primary care physician self-reported quality of care. Methods A total of 224 primary care physicians from 38 community health centres (CHCs) in four large Chinese cities participated in a cross-sectional survey to assess CHC care quality. Each CHC director scored their CHC’s EHR functionality on the availability of ten typical features covering health information, data, results management, patient access, and clinical decision support. Data analysis utilised hierarchical linear modelling. Results The availability of five EHR features was positively associated with physician self-reported clinical quality: share records online with providers outside the practice (β = 0.276, p = 0.04), access records online by the patient (β = 0.325, p = 0.04), alert provider of potential prescription problems (β = 0.353, p = 0.04), send the patient reminders for care (β = 0.419, p = 0.003), and list patients by diagnosis or health risk (β = 0.282, p = 0.04). However, no association was found between specific features availability or total features score and physician self-reported preventive quality. Conclusions This study provides evidence that the availability of EHR systems, and specific features of these systems, was positively associated with physician self-reported quality of care in these 38 CHCs. Future longitudinal studies focused on standardised quality metrics, and designed to control known confounding variables, will further inform quality improvement efforts in primary care.