WorldWideScience

Sample records for identify credible health

  1. The Effect of Top-Level Domains and Advertisements on Health Web Site Credibility

    Science.gov (United States)

    Wang, Zuoming; Loh, Tracy

    2004-01-01

    Background Concerns over health information on the Internet have generated efforts to enhance credibility markers; yet how users actually assess the credibility of online health information is largely unknown. Objective This study set out to (1) establish a parsimonious and valid questionnaire instrument to measure credibility of Internet health information by drawing on various previous measures of source, news, and other credibility scales; and (2) to identify the effects of Web-site domains and advertising on credibility perceptions. Methods Respondents (N = 156) examined one of 12 Web-site mock-ups and completed credibility scales in a 3 x 2 x 2 between-subjects experimental design. Factor analysis and validity checks were used for item reduction, and analysis of variance was employed for hypothesis testing of Web-site features' effects. Results In an attempt to construct a credibility instrument, three dimensions of credibility (safety, trustworthiness, and dynamism) were retained, reflecting traditional credibility sub-themes, but composed of items from disparate sources. When testing the effect of the presence or absence of advertising on a Web site on credibility, we found that this depends on the site's domain, with a trend for advertisements having deleterious effects on the credibility of sites with .org domain, but positive effects on sites with .com or .edu domains. Conclusions Health-information Web-site providers should select domains purposefully when they can, especially if they must accept on-site advertising. Credibility perceptions may not be invariant or stable, but rather are sensitive to topic and context. Future research may employ these findings in order to compare other forms of health-information delivery to optimal Web-site features. PMID:15471750

  2. Trust and Credibility in Web-Based Health Information: A Review and Agenda for Future Research.

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    Sbaffi, Laura; Rowley, Jennifer

    2017-06-19

    Internet sources are becoming increasingly important in seeking health information, such that they may have a significant effect on health care decisions and outcomes. Hence, given the wide range of different sources of Web-based health information (WHI) from different organizations and individuals, it is important to understand how information seekers evaluate and select the sources that they use, and more specifically, how they assess their credibility and trustworthiness. The aim of this study was to review empirical studies on trust and credibility in the use of WHI. The article seeks to present a profile of the research conducted on trust and credibility in WHI seeking, to identify the factors that impact judgments of trustworthiness and credibility, and to explore the role of demographic factors affecting trust formation. On this basis, it aimed to identify the gaps in current knowledge and to propose an agenda for future research. A systematic literature review was conducted. Searches were conducted using a variety of combinations of the terms WHI, trust, credibility, and their variants in four multi-disciplinary and four health-oriented databases. Articles selected were published in English from 2000 onwards; this process generated 3827 unique records. After the application of the exclusion criteria, 73 were analyzed fully. Interest in this topic has persisted over the last 15 years, with articles being published in medicine, social science, and computer science and originating mostly from the United States and the United Kingdom. Documents in the final dataset fell into 3 categories: (1) those using trust or credibility as a dependent variable, (2) those using trust or credibility as an independent variable, and (3) studies of the demographic factors that influence the role of trust or credibility in WHI seeking. There is a consensus that website design, clear layout, interactive features, and the authority of the owner have a positive effect on trust or

  3. Adolescent Health Literacy: The Importance of Credible Sources for Online Health Information

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    Ghaddar, Suad F.; Valerio, Melissa A.; Garcia, Carolyn M.; Hansen, Lucy

    2012-01-01

    Background: Little research has examined adolescent health literacy and its relationship with online health information sources. The purpose of this study is to explore health literacy among a predominantly Hispanic adolescent population and to investigate whether exposure to a credible source of online health information, MedlinePlus[R], is…

  4. Students’ Trust Formation and Credibility Judgements in Online Health Information – A Review Article

    Directory of Open Access Journals (Sweden)

    Mahmood Khosrowjerdi

    2017-06-01

    Full Text Available Health information is a frequent subject for online information seeking. Research on the phenomenon has to a certain extent included students. This review, based on an analysis of 61 articles, shows the current state of the art of research on students’ trust in online health information. The review covers methodological approaches and findings of previous previous empirical studies: research design; trustworthy health information sources; credibility assessment; and factors impacting on trust formation. The analysis of research designs reveals that the survey method was most frequent, but small qualitative studies were also occurring. More than half of the studies were administered in the USA, while only a smaller part concerned ‘non-Western’ countries. Female subjects were more frequent than male.The concept of trust was not always explicitly defined in the studies. The students' actual propensity to use internet was generally taken as an expression of trust. The antecedents of trust identified in the studies can be summarized as the perceived quality of the information, the perceived credibility of the source or source provider, the users’ general inclination to trust, the actual use of information, and the perceived intelligibility of the information. The findings show that Internet was among the main sources for health information, but parents or other family members, friends, schools, health professionals were also frequent sources of health information, and students were not immediately accepting online information as trustworthy. The students’ trust and credibility judgments were influenced by social and demographic, cultural, psychological, knowledge and skills-related, and source, system and content-related factors. Governmental and organizational websites were reported as the most trustful sources, although some issues regarding website features and presentation of content were reported as barriers. Easy access were of

  5. Evidence for the credibility of health economic models for health policy decision-making

    DEFF Research Database (Denmark)

    Søgaard, Rikke; Lindholt, Jes S.

    2012-01-01

    OBJECTIVE: To investigate whether the credibility of health economic models of screening for abdominal aortic aneurysms for health policy decision-making has improved since 2005 when a systematic review by Campbell et al. concluded that reporting standards were poor and there was divergence between...... benefited from general advances in health economic modelling and some improvements in reporting were noted. However, the low level of agreement between studies in model structures and assumptions, and difficulty in justifying these (convergent validity), remain a threat to the credibility of health economic...... models. Decision-makers should not accept the results of a modelling study if the methods are not fully transparent and justified. Modellers should, whenever relevant, supplement a primary report of results with a technical report detailing and discussing the methodological choices made....

  6. Methodology for identifying credible disruptions to isolation of nuclear waste within Columbia River basalts

    International Nuclear Information System (INIS)

    Davis, J.D.

    1982-01-01

    Analysis of potential preclosure and postclosure disruptive events and processes is comprised of evaluation of (1) potential uncertainties and omissions associated with characterization of the site; (2) credible events and processes resulting from the dynamics of natural systems; (3) potential, credible changes in isolation conditions induced by the presence of the repository, and (4) potential, credible future changes impacting isolation capability resulting from man's activities, independent of repository construction/operation. This report presents the overall methodology for identification, classification and analysis of disruptive events based on Nuclear Regulatory Commission and Environmental Protection Agency guidelines proposed in drafts of 10 CFR 60 and 40 CFR 191. Potential credible disruptive events, processes, and conditions are considered with respect to whether they are anticipated or unanticipated, and determined to have reasonably foreseeable, very unlikely, or extremely unlikely probability of occurrence. 85 refs., 2 figs., 7 tabs

  7. Information Literacy on the Web: How College Students Use Visual and Textual Cues to Assess Credibility on Health Websites

    Directory of Open Access Journals (Sweden)

    Katrina L. Pariera

    2012-12-01

    Full Text Available One of the most important literacy skills in today’s information society is the ability to determine the credibility of online information. Users sort through a staggering number of websites while discerning which will provide satisfactory information. In this study, 70 college students assessed the credibility of health websites with a low and high design quality, in either low or high credibility groups. The study’s purpose was to understand if students relied more on textual or visual cues in determining credibility, and to understand if this affected their recall of those cues later. The results indicate that when viewing a high credibility website, high design quality will bolster the credibility perception, but design quality will not compensate for a low credibility website. The recall test also indicated that credibility does impact the participants’ recall of visual and textual cues. Implications are discussed in light of the Elaboration Likelihood Model.

  8. Instructor Credibility across Disciplines: Identifying Students' Differentiated Expectations of Instructor Behaviors

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    Obermiller, Carl; Ruppert, Bryan; Atwood, April

    2012-01-01

    Business communication instructors can face a unique set of challenges to maintain their credibility with students. Communication plays an important role in the instructor-student relationship, and students judge instructors' ability to teach communication based on their ability to practice what they teach. The authors' empirical study shows that…

  9. Source attribution and credibility of health and appearance exercise advertisements: relationship with implicit and explicit attitudes and intentions.

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    Berry, Tanya R; Shields, Chris

    2014-02-01

    The relationship of attributed source (commercial or nonprofit) and credibility of exercise advertisements to explicit and implicit exercise-related attitudes and intentions was examined. Male and female participants (N = 227) were randomly assigned to watch health or appearance-related advertisements and then completed an implicit attitudes task and questionnaires. Health advertisements and those attributed to a nonprofit source were rated more credible. Appearance condition participants who attributed the advertisement to a nonprofit source also rated the advertisement as more credible. Participants who rated a commercial advertisement as credible reported higher implicit instrumental attitudes. Implications for exercise promotion are discussed.

  10. The use of tags and tag clouds to discern credible content in online health message forums.

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    O'Grady, Laura; Wathen, C Nadine; Charnaw-Burger, Jill; Betel, Lisa; Shachak, Aviv; Luke, Robert; Hockema, Stephen; Jadad, Alejandro R

    2012-01-01

    Web sites with health-oriented content are potentially harmful if inaccurate or inappropriate medical information is used to make health-related decisions. Checklists, rating systems and guidelines have been developed to help people determine what is credible, but recent Internet technologies emphasize applications that are collaborative in nature, including tags and tag clouds, where site users 'tag' or label online content, each using their own labelling system. Concepts such as the date, reference, author, testimonial and quotations are considered predictors of credible content. An understanding of these descriptive tools, how they relate to the depiction of credibility and how this relates to overall efforts to label data in relation to the semantic web has yet to emerge. This study investigates how structured (pre-determined) and unstructured (user-generated) tags and tag clouds with a multiple word search feature are used by participants to assess credibility of messages posted in online message forums. The targeted respondents were those using web sites message forums for disease self-management. We also explored the relevancy of our findings to the labelling or indexing of data in the context of the semantic web. Diabetes was chosen as the content area in this study, since (a) this is a condition with increasing prevalence and (b) diabetics have been shown to actively use the Internet to manage their condition. From January to March 2010 participants were recruited using purposive sampling techniques. A screening instrument was used to determine eligibility. The study consisted of a demographic and computer usage survey, a series of usability tests and an interview. We tested participants (N=22) on two scenarios, each involving tasks that assessed their ability to tag content and search using a tag cloud that included six structured credibility terms (statistics, date, reference, author, testimonial and quotations). MORAE Usability software (version 3

  11. The dual impact of "appeal" and "researcher credibility" on mail survey response rate in the context of preventive health care.

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    Angur, M G; Nataraajan, R; Chawla, S K

    1994-01-01

    Health and fitness centers are becoming increasingly aware of their importance in the realm of preventive health care. Many hospitals have begun to open and run fitness centers, a trend that seems very likely to continue. In a competitive environment, every center would desire to obtain maximum valid customer information at minimum cost, and this paper addresses this issue. The authors investigate the confluence of both appeal and researcher credibility on mail questionnaire response rates from a metropolitan membership of a large fitness center. Personal appeal with high researcher credibility was found to generate significantly higher response rate followed by the hybrid appeal with low researcher credibility.

  12. The effect of source credibility on consumers' perceptions of the quality of health information on the Internet.

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    Bates, Benjamin R; Romina, Sharon; Ahmed, Rukhsana; Hopson, Danielle

    2006-03-01

    Recent use of the Internet as a source of health information has raised concerns about consumers' ability to tell 'good' information from 'bad' information. Although consumers report that they use source credibility to judge information quality, several observational studies suggest that consumers make little use of source credibility. This study examines consumer evaluations of web pages attributed to a credible source as compared to generic web pages on measures of message quality. In spring 2005, a community-wide convenience survey was distributed in a regional hub city in Ohio, USA. 519 participants were randomly assigned one of six messages discussing lung cancer prevention: three messages each attributed to a highly credible national organization and three identical messages each attributed to a generic web page. Independent sample t-tests were conducted to compare each attributed message to its counterpart attributed to a generic web page on measures of trustworthiness, truthfulness, readability, and completeness. The results demonstrated that differences in attribution to a source did not have a significant effect on consumers' evaluations of the quality of the information.Conclusions. The authors offer suggestions for national organizations to promote credibility to consumers as a heuristic for choosing better online health information through the use of media co-channels to emphasize credibility.

  13. Credibility and Usefulness of Health Information on Facebook: A Survey Study with U.S. College Students

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    Kim, Sung Un; Syn, Sue Yeon

    2016-01-01

    Introduction: This study examines ways in which college students perceive the credibility and usefulness of health information on Facebook, depending on topic sensitivity, information source and demographic factors. Method: With self-selection sampling, data were collected from two universities through an online survey; 351 responses were used for…

  14. Credibility and music´s effect as therapeutic kind in health

    Directory of Open Access Journals (Sweden)

    Karyne Cristine da Fonseca

    2006-12-01

    Full Text Available This article has as purpose to analise the professional´s music therapist´s perception about the credibility and approval of music therapy by their clients. It´s a qualitative research, developed in Goiânia-GO, between 2003, august and 2004, june. We verified that the professional´s majority noted their client´s credibility related to music capacity in transmitting pleasant sensations and its capacity to act in a efficient way on the healing process of some diseases. They too evidence that the music therapy needs to be published with more effectiveness for the population.

  15. Credibility elements of eWOM messages in the context of health care services. A Romanian perspective.

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    Purcarea, V L; Gheorghe, I R; Petrescu, C M

    2013-09-15

    The purpose of this paper is to investigate the Romanian consumers' determinants of eWOM messages' perceived credibility in the context of health care services. We selected a sample of 127 women and we administered a questionnaire. We used the partial least squares to uncover the established relationships between the variables of the model, namely the argument strength and the source credibility of a eWOM message and the intention to purchase a health care service based on the information embedded in the eWOM messages. The results revealed that all variables had positive direct correlations with each other but the argument strength of a message has the highest impact on the intention.

  16. From intermediation to disintermediation and apomediation: new models for consumers to access and assess the credibility of health information in the age of Web2.0.

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    Eysenbach, Gunther

    2007-01-01

    This theoretical paper discusses the model that, as a result of the social process of disintermediation enabled by digital media, traditional intermediaries are replaced by what this author calls apomediaries, which are tools and peers standing by to guide consumers to trustworthy information, or adding credibility to information. For apomediation to be an attractive and successful model for consumers, the recipient has to reach a certain degree of maturity and autonomy. Different degrees of autonomy may explain differences in information seeking and credibility appraisal behaviours. It is hypothesized that in an apomediated environment, tools, influential peers and opinion leaders are the primary conveyors of trust and credibility. In this environment, apomediary credibility may become equally or more important than source credibility or even message credibility. It is suggested to use tools of network analysis to study the dynamics of apomediary credibility in a networked digital world. There are practical implications of the apomediation model for developers of consumer health websites which aspire to come across as "credible: Consumers need and want to be able to be co-creators of content, not merely be an audience who is broadcasted to. Web2.0 technology enables such sites. Engaging and credible Web sites are about building community and communities are built upon personal and social needs.

  17. Preferred providers and the credible commitment problem in health insurance: first experiences with the implementation of managed competition in the Dutch health care system.

    Science.gov (United States)

    Boonen, Lieke H H M; Schut, Frederik T

    2011-04-01

    We investigate the impact of the transition towards managed competition in the Dutch health care system on health insurers' contracting behaviour. Specifically, we examine whether insurers have been able to take up their role as prudent buyers of care and examine consumers' attitudes towards insurers' new role. Health insurers' contracting behaviour is investigated by an extensive analysis of available information on purchasing practices by health insurers and by interviews with directors of health care purchasing of the four major health insurers, accounting for 90% of the market. Consumer attitudes towards insurers' new role are investigated by surveys among a representative sample of enrollees over the period 2005-2009. During the first four years of the reform, health insurers were very reluctant to engage in selective contracting and preferred to use 'soft' positive incentives to encourage preferred provider choice rather than engaging in restrictive managed care activities. Consumer attitudes towards channelling vary considerably by type of provider but generally became more negative in the first two years after the reform. Insurers' reluctance to use selective contracting can be at least partly explained by the presence of a credible-commitment problem. Consumers do not trust that insurers with restrictive networks are committed to provide good quality care. The credible-commitment problem seems to be particularly relevant to the Netherlands, since Dutch enrollees are not used to restrictions on provider choice. Since consumers are quite sensitive to differences in provider quality, more reliable information about provider quality is required to reduce the credible-commitment problem.

  18. How Environmental Uncertainty Moderates the Effect of Relative Advantage and Perceived Credibility on the Adoption of Mobile Health Services by Chinese Organizations in the Big Data Era.

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    Chen, Xing; Zhang, Xing

    2016-01-01

    Despite the importance of adoption of mobile health services by an organization on the diffusion of mobile technology in the big data era, it has received minimal attention in literature. This study investigates how relative advantage and perceived credibility affect an organization's adoption of mobile health services, as well as how environmental uncertainty changes the relationship of relative advantage and perceived credibility with adoption. A research model that integrates relative advantage, perceived credibility, environmental uncertainty, and an organization's intention to use mobile health service is developed. Quantitative data are collected from senior managers and information systems managers in 320 Chinese healthcare organizations. The empirical findings show that while relative advantage and perceived credibility both have positive effects on an organization's intention to use mobile health services, relative advantage plays a more important role than perceived credibility. Moreover, environmental uncertainty positively moderates the effect of relative advantage on an organization's adoption of mobile health services. Thus, mobile health services in environments characterized with high levels of uncertainty are more likely to be adopted because of relative advantage than in environments with low levels of uncertainty.

  19. How Environmental Uncertainty Moderates the Effect of Relative Advantage and Perceived Credibility on the Adoption of Mobile Health Services by Chinese Organizations in the Big Data Era

    Directory of Open Access Journals (Sweden)

    Xing Chen

    2016-01-01

    Full Text Available Despite the importance of adoption of mobile health services by an organization on the diffusion of mobile technology in the big data era, it has received minimal attention in literature. This study investigates how relative advantage and perceived credibility affect an organization’s adoption of mobile health services, as well as how environmental uncertainty changes the relationship of relative advantage and perceived credibility with adoption. A research model that integrates relative advantage, perceived credibility, environmental uncertainty, and an organization’s intention to use mobile health service is developed. Quantitative data are collected from senior managers and information systems managers in 320 Chinese healthcare organizations. The empirical findings show that while relative advantage and perceived credibility both have positive effects on an organization’s intention to use mobile health services, relative advantage plays a more important role than perceived credibility. Moreover, environmental uncertainty positively moderates the effect of relative advantage on an organization’s adoption of mobile health services. Thus, mobile health services in environments characterized with high levels of uncertainty are more likely to be adopted because of relative advantage than in environments with low levels of uncertainty.

  20. The Importance of 'Likes': The Interplay of Message Framing, Source, and Social Endorsement on Credibility Perceptions of Health Information on Facebook.

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    Borah, Porismita; Xiao, Xizhu

    2018-01-01

    Online sources not only permeate the information-seeking environment of the younger generation, but also have profound influence in shaping their beliefs and behaviors. In this landscape, examining the factors responsible for credibility perceptions of online information is fundamental, particularly for health-related information. Using a 2 (frames: gain vs. loss) × 2 (source: expert vs. non-expert) × 2 (social endorsement: high vs. low) randomized between-subjects experimental design, this study examines the effect of health message framing and the moderating effects of social endorsement and source type on credibility perceptions of Facebook posts. Testing across two issues--physical activity and alcohol consumption--findings indicate that the gain-framed message was perceived as most credible. Additionally, significant three-way interactions suggest that social endorsement and source type affect the relationship between message framing and credibility perceptions. Specifically, the findings demonstrate that a gain-framed message from an expert source with high number of 'likes' is considered the most credible message. These findings have significant implications for information gathering from social media sources, such as the influence of 'likes' on health information.

  1. The role of negative affect and message credibility in perceived effectiveness of smokeless tobacco health warning labels in Navi Mumbai, India and Dhaka, Bangladesh: A moderated-mediation analysis.

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    Mutti-Packer, Seema; Reid, Jessica L; Thrasher, James F; Romer, Daniel; Fong, Geoffrey T; Gupta, Prakash C; Pednekar, Mangesh S; Nargis, Nigar; Hammond, David

    2017-10-01

    There is strong evidence showing that pictorial health warnings are more effective than text-only warnings. However, much of this evidence comes from high-income countries and is limited to cigarette packaging. Moreover, few studies have identified mechanisms that might explain the impact of warnings. The current study examined the potential mediating role of negative affect and the moderating influence of message credibility in perceived effectiveness of smokeless tobacco warnings in two low- and middle-income countries (LMICs). Field interviews were conducted in India and Bangladesh, with adult (19+ years) smokeless tobacco users (n=1053), and youth (16-18years) users (n=304) and non-users (n=687). Respondents were randomly assigned to view warnings in one of four conditions: (1) Text-only, (2) pictorial with symbolic imagery, (3) pictorial with graphic images of health effects, or (4) pictorial with personalized graphic images plus a personal testimonial. The findings provide support for the mediating influence of negative affect in perceived effectiveness, for adult and youth smokeless tobacco users who viewed pictorial warnings (vs. text-only), and graphic health warnings (vs. personal testimonials). Among adults, message credibility moderated the indirect effect; the association was stronger when credibility was high and weaker when it was low. Among youth users and non-users, message credibility did not moderate the indirect effect. Consistent with research from high-income countries, these findings highlight the importance of selecting imagery that will elicit negative emotional reactions and be perceived as credible. Differential effects among adults and youth highlight the importance of pre-testing images. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Consumer Health Information Websites with High Visual Design Ratings Likely to Be also Highly Rated for Perceived Credibility. A Review of: Robins, D., Holmes, J., & Stansbury, M. (2010. Consumer health information on the web: The relationship of visual design and perceptions of credibility. Journal of the American Society for Information Science and Technology, 61(1, 13-19.

    Directory of Open Access Journals (Sweden)

    Kate Kelly

    2010-09-01

    Full Text Available Objective – To answer two research questions: 1 What is the relationship between the visual design of a consumer health information web site and perceptions of the credibility of information found on it? 2 Is there a relationship between brand recognition, visual design preference, and credibility judgments?Design – Qualitative (correlation of rating of response to stimulus and quantitative (credibility coding of participant commentsSetting – Not stated; assumed to be academic institutions in the United States.Subjects – Thirty-four participants over the age of 35 (34 for statistical power and age over 35 on the hypothesis that this age group is most likely to seek health information on the Internet.Methods – Screen shots of 31 consumer health information sites chosen from the results of a Google search using the term “consumer health information” were converted to slide format and shown to participants. The 31 sites included 12 of the top ranked consumer health information sites derived from three sources: the Consumer and Patient Health Information Section (CAPHIS of the Medical Library Association (MLA, the MLA itself, and Consumer Reports. Participants were read and shown a script explaining the process prior to being asked to view and rate the 31 sites. Participants were first shown a blank slide with a crosshair to focus attention. Then a stimulus slide was shown for 2.8 seconds. A blank black screen was shown while they determined their rating. Participants were first asked to rate the visual design and aesthetics of the 31 web sites using a rating scale of -4 to -1 for negative judgments and +1 to +4 for positive judgments. Then they were asked to remember why they had made positive or negative ratings and why some web sites were preferred to others. The process was repeated with the slides re-ordered, and participants were asked to rate the credibility of the sites using the same rating scales. Upon completion

  3. Treatment credibility, expectancy, and preference: Prediction of treatment engagement and outcome in a randomized clinical trial of hatha yoga vs. health education as adjunct treatments for depression.

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    Uebelacker, Lisa A; Weinstock, Lauren M; Battle, Cynthia L; Abrantes, Ana M; Miller, Ivan W

    2018-06-02

    Hatha yoga may be helpful for alleviating depression symptoms. The purpose of this analysis is to determine whether treatment program preference, credibility, or expectancy predict engagement in depression interventions (yoga or a control class) or depression symptom severity over time. This is a secondary analysis of a randomized controlled trial (RCT) of hatha yoga vs. a health education control group for treatment of depression. Depressed participants (n = 122) attended up to 20 classes over a period of 10 weeks, and then completed additional assessments after 3 and 6 months. We assessed treatment preference prior to randomization, and treatment credibility and expectancy after participants attended their first class. Treatment "concordance" indicated that treatment preference matched assigned treatment. Treatment credibility, expectancy, and concordance were not associated with treatment engagement. Treatment expectancy moderated the association between treatment group and depression. Depression severity over time differed by expectancy level for the yoga group but not for the health education group. Controlling for baseline depression, participants in the yoga group with an average or high expectancy for improvement showed lower depression symptoms across the acute intervention and follow-up period than those with a low expectancy for improvement. There was a trend for a similar pattern for credibility. Concordance was not associated with treatment outcome. This is a secondary, post-hoc analysis and should be considered hypothesis-generating. Results suggest that expectancy improves the likelihood of success only for a intervention thought to actively target depression (yoga) and not a control intervention. Copyright © 2018. Published by Elsevier B.V.

  4. How credible are the study results? Evaluating and applying internal validity tools to literature-based assessments of environmental health hazards

    Science.gov (United States)

    Rooney, Andrew A.; Cooper, Glinda S.; Jahnke, Gloria D.; Lam, Juleen; Morgan, Rebecca L.; Boyles, Abee L.; Ratcliffe, Jennifer M.; Kraft, Andrew D.; Schünemann, Holger J.; Schwingl, Pamela; Walker, Teneille D.; Thayer, Kristina A.; Lunn, Ruth M.

    2016-01-01

    Environmental health hazard assessments are routinely relied upon for public health decision-making. The evidence base used in these assessments is typically developed from a collection of diverse sources of information of varying quality. It is critical that literature-based evaluations consider the credibility of individual studies used to reach conclusions through consistent, transparent and accepted methods. Systematic review procedures address study credibility by assessing internal validity or “risk of bias” — the assessment of whether the design and conduct of a study compromised the credibility of the link between exposure/intervention and outcome. This paper describes the commonalities and differences in risk-of-bias methods developed or used by five groups that conduct or provide methodological input for performing environmental health hazard assessments: the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group, the Navigation Guide, the National Toxicology Program’s (NTP) Office of Health Assessment and Translation (OHAT) and Office of the Report on Carcinogens (ORoC), and the Integrated Risk Information System of the U.S. Environmental Protection Agency (EPA-IRIS). Each of these groups have been developing and applying rigorous assessment methods for integrating across a heterogeneous collection of human and animal studies to inform conclusions on potential environmental health hazards. There is substantial consistency across the groups in the consideration of risk-of-bias issues or “domains” for assessing observational human studies. There is a similar overlap in terms of domains addressed for animal studies; however, the groups differ in the relative emphasis placed on different aspects of risk of bias. Future directions for the continued harmonization and improvement of these methods are also discussed. PMID:26857180

  5. Credibility and advocacy in conservation science

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    Horton, Cristi C.; Peterson, Tarla Rai; Banerjee, Paulami

    2015-01-01

    Abstract Conservation policy sits at the nexus of natural science and politics. On the one hand, conservation scientists strive to maintain scientific credibility by emphasizing that their research findings are the result of disinterested observations of reality. On the other hand, conservation scientists are committed to conservation even if they do not advocate a particular policy. The professional conservation literature offers guidance on negotiating the relationship between scientific objectivity and political advocacy without damaging conservation science's credibility. The value of this guidance, however, may be restricted by limited recognition of credibility's multidimensionality and emergent nature: it emerges through perceptions of expertise, goodwill, and trustworthiness. We used content analysis of the literature to determine how credibility is framed in conservation science as it relates to apparent contradictions between science and advocacy. Credibility typically was framed as a static entity lacking dimensionality. Authors identified expertise or trustworthiness as important, but rarely mentioned goodwill. They usually did not identify expertise, goodwill, or trustworthiness as dimensions of credibility or recognize interactions among these 3 dimensions of credibility. This oversimplification may limit the ability of conservation scientists to contribute to biodiversity conservation. Accounting for the emergent quality and multidimensionality of credibility should enable conservation scientists to advance biodiversity conservation more effectively. PMID:26041036

  6. Identifiable Data Files - Health Outcomes Survey (HOS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare Health Outcomes Survey (HOS) identifiable data files are comprised of the entire national sample for a given 2-year cohort (including both respondents...

  7. Applying Semantic Web technologies to improve the retrieval, credibility and use of health-related web resources.

    Science.gov (United States)

    Mayer, Miguel A; Karampiperis, Pythagoras; Kukurikos, Antonis; Karkaletsis, Vangelis; Stamatakis, Kostas; Villarroel, Dagmar; Leis, Angela

    2011-06-01

    The number of health-related websites is increasing day-by-day; however, their quality is variable and difficult to assess. Various "trust marks" and filtering portals have been created in order to assist consumers in retrieving quality medical information. Consumers are using search engines as the main tool to get health information; however, the major problem is that the meaning of the web content is not machine-readable in the sense that computers cannot understand words and sentences as humans can. In addition, trust marks are invisible to search engines, thus limiting their usefulness in practice. During the last five years there have been different attempts to use Semantic Web tools to label health-related web resources to help internet users identify trustworthy resources. This paper discusses how Semantic Web technologies can be applied in practice to generate machine-readable labels and display their content, as well as to empower end-users by providing them with the infrastructure for expressing and sharing their opinions on the quality of health-related web resources.

  8. Credibility and Crisis Stress Testing

    Directory of Open Access Journals (Sweden)

    Li Lian Ong

    2014-02-01

    Full Text Available Credibility is the bedrock of any crisis stress test. The use of stress tests to manage systemic risk was introduced by the U.S. authorities in 2009 in the form of the Supervisory Capital Assessment Program. Since then, supervisory authorities in other jurisdictions have also conducted similar exercises. In some of those cases, the design and implementation of certain elements of the framework have been criticized for their lack of credibility. This paper proposes a set of guidelines for constructing an effective crisis stress test. It combines financial markets impact studies of previous exercises with relevant case study information gleaned from those experiences to identify the key elements and to formulate their appropriate design. Pertinent concepts, issues and nuances particular to crisis stress testing are also discussed. The findings may be useful for country authorities seeking to include stress tests in their crisis management arsenal, as well as for the design of crisis programs.

  9. Comparison of credible patients of very low intelligence and non-credible patients on neurocognitive performance validity indicators.

    Science.gov (United States)

    Smith, Klayton; Boone, Kyle; Victor, Tara; Miora, Deborah; Cottingham, Maria; Ziegler, Elizabeth; Zeller, Michelle; Wright, Matthew

    2014-01-01

    The purpose of this archival study was to identify performance validity tests (PVTs) and standard IQ and neurocognitive test scores, which singly or in combination, differentiate credible patients of low IQ (FSIQ ≤ 75; n = 55) from non-credible patients. We compared the credible participants against a sample of 74 non-credible patients who appeared to have been attempting to feign low intelligence specifically (FSIQ ≤ 75), as well as a larger non-credible sample (n = 383) unselected for IQ. The entire non-credible group scored significantly higher than the credible participants on measures of verbal crystallized intelligence/semantic memory and manipulation of overlearned information, while the credible group performed significantly better on many processing speed and memory tests. Additionally, credible women showed faster finger-tapping speeds than non-credible women. The credible group also scored significantly higher than the non-credible subgroup with low IQ scores on measures of attention, visual perceptual/spatial tasks, processing speed, verbal learning/list learning, and visual memory, and credible women continued to outperform non-credible women on finger tapping. When cut-offs were selected to maintain approximately 90% specificity in the credible group, sensitivity rates were highest for verbal and visual memory measures (i.e., TOMM trials 1 and 2; Warrington Words correct and time; Rey Word Recognition Test total; RAVLT Effort Equation, Trial 5, total across learning trials, short delay, recognition, and RAVLT/RO discriminant function; and Digit Symbol recognition), followed by select attentional PVT scores (i.e., b Test omissions and time to recite four digits forward). When failure rates were tabulated across seven most sensitive scores, a cut-off of ≥ 2 failures was associated with 85.4% specificity and 85.7% sensitivity, while a cut-off of ≥ 3 failures resulted in 95.1% specificity and 66.0% sensitivity. Results are discussed in light of

  10. How Experts' Use of Medical Technical Jargon in Different Types of Online Health Forums Affects Perceived Information Credibility: Randomized Experiment With Laypersons.

    Science.gov (United States)

    Zimmermann, Maria; Jucks, Regina

    2018-01-23

    Online health forums are widely used, but the quality of advice differs as much as the knowledge backgrounds of the audience members who receive the advice. It is important to understand how people judge the information given online. In line with the communication accommodation theory (CAT), online forums represent specific social contexts of communication which can present either accommodative or nonaccommodative language to an audience. Accordingly, use of accommodative or nonaccommodative language might affect people's perceived trust in the communicator. The objective of this study was to investigate how experts who use accommodative (vs nonaccommodative) language are evaluated by passive users of an online forum. Participants (n=98) took part in an online experiment and read experts' posts about 10 nutrition myths. Following a 2 x 2 mixed design, experts' posts were written using either low or high amounts of medical technical jargon (MTJ) (within factor) and were directed at different audiences (mainly other medical experts [in a professional forum] vs a user group mainly comprising laypersons [in an advisory forum]) (between factor). Accommodation occurred where experts used high amounts of MTJ to address other medical experts in the professional forum; it also occurred when experts used low amounts of MTJ to address laypersons in the advisory forum. Conversely, nonaccommodation occurred when experts used high amounts of MTJ in the advisory forum and low amounts of MTJ in the professional forum. In each condition, participants evaluated the credibility of the information, the trustworthiness of the experts, and the accommodation by the experts. Overall, participants judged the credibility of information to be higher when experts used MTJ that was accommodative to the designated audience, F 1,95 =3.10, P=.04, η p 2 =.031. In addition, participants judged the experts in professional forums to be more trustworthy than experts in advisory forums (all F 1,96

  11. Identifying health disparities across the tobacco continuum.

    Science.gov (United States)

    Fagan, Pebbles; Moolchan, Eric T; Lawrence, Deirdre; Fernander, Anita; Ponder, Paris K

    2007-10-01

    Few frameworks have addressed work-force diversity, inequities and inequalities as part of a comprehensive approach to eliminating tobacco-related health disparities. This paper summarizes the literature and describes the known disparities that exist along the tobacco disease continuum for minority racial and ethnic groups, those living in poverty, those with low education and blue-collar and service workers. The paper also discusses how work-force diversity, inequities in research practice and knowledge allocation and inequalities in access to and quality of health care are fundamental to addressing disparities in health. We examined the available scientific literature and existing public health reports to identify disparities across the tobacco disease continuum by minority racial/ethnic group, poverty status, education level and occupation. Results indicate that differences in risk indicators along the tobacco disease continuum do not explain fully tobacco-related cancer consequences among some minority racial/ethnic groups, particularly among the aggregate groups, blacks/African Americans and American Indians/Alaska Natives. The lack of within-race/ethnic group data and its interactions with socio-economic factors across the life-span contribute to the inconsistency we observe in the disease causal paradigm. More comprehensive models are needed to understand the relationships among disparities, social context, diversity, inequalities and inequities. A systematic approach will also help researchers, practitioners, advocates and policy makers determine critical points for interventions, the types of studies and programs needed and integrative approaches needed to eliminate tobacco-related disparities.

  12. The Source and Credibility of Colorectal Cancer Information on Twitter.

    Science.gov (United States)

    Park, SoHyun; Oh, Heung-Kwon; Park, Gibeom; Suh, Bongwon; Bae, Woo Kyung; Kim, Jin Won; Yoon, Hyuk; Kim, Duck-Woo; Kang, Sung-Bum

    2016-02-01

    Despite the rapid penetration of social media in modern life, there has been limited research conducted on whether social media serves as a credible source of health information. In this study, we propose to identify colorectal cancer information on Twitter and assess its informational credibility. We collected Twitter messages containing colorectal cancer-related keywords, over a 3-month period. A review of sample tweets yielded content and user categorization schemes. The results of the sample analysis were applied to classify all collected tweets and users, using a machine learning technique. The credibility of the information in the sampled tweets was evaluated. A total of 76,119 tweets were analyzed. Individual users authored the majority of tweets (n = 68,982, 90.6%). They mostly tweeted about news articles/research (n = 16,761, 22.0%) and risk/prevention (n = 14,767, 19.4%). Medical professional users generated only 2.0% of total tweets (n = 1509), and medical institutions rarely tweeted (n = 417, 0.6%). Organizations tended to tweet more about information than did individuals (85.2% vs 63.1%; P users. Coupled with the Internet's potential to increase social support, Twitter may contribute to enhancing public health and empowering users, when used with proper caution.

  13. Chapter 8: The credibility crisis

    International Nuclear Information System (INIS)

    Poumadere, M.

    1991-01-01

    In the credibility crisis, a generalized state of conflicting cognitions is probably prevalent, along with possible individual and social pathologies. These cognitive conflicts and emotional traumas are linked to both the characteristics of Chernobyl as a human-made disaster and the specific nature of Chernobyl as a nuclear disaster. Three major elements as constituents of this nature are identified: The rupture of a social contract, the loss of a socially valued object, and the sudden removal of established distances. Further research and basic information are needed in this area where little specific observation is reported. A better grasp of the impact of nuclear energy on our societies can lead to better adapted policy, increased local and social solidarity, more decentralized initiative and risk management, and better organized primary prevention in nuclear disaster. (orig./DG)

  14. Impact of Celebrity Credibility on Advertising Effectiveness

    Directory of Open Access Journals (Sweden)

    Sadia Aziz

    2013-05-01

    Full Text Available Advertisers often make use of endorsers or representatives as trustworthy sources of persuasion for consumers' attitudes. Promotion of products through celebrities is a trendy advertising practice around the world. The present study judged the impact of celebrity credibility on advertising effectiveness in terms of consumer’s attitude towards the advertisement, attitude towards the brand and their purchase intention. This study also explored the differences of respondent’s responses towards the advertisements of brand through famous celebrities as well as unknown celebrities. Different TV advertisements were used for the experiment. Several statistical tools were applied to test the hypotheses and identify significant differences & the proposed relationships among the variables. Overall findings suggests that the respondents considered the famous celebrities of the brand as the most credible celebrities, having positive impact on consumers attitude towards the advertisement, attitude to the brand and their favorable purchase intentions as compare to the unknown celebrity with less credibility.

  15. Credibility Discourse of PR Agencies

    DEFF Research Database (Denmark)

    Isaksson, Maria; Jørgensen, Poul Erik Flyvholm

    2008-01-01

    to giving assurance of their expertise, trustworthiness and empathy, thus confirming our overall expectation that corporate credibility discourse is relatively uniform from a European perspective. However, contrary to our assumptions, the results of our study show that PR credibility discourse demonstrates...

  16. Marginality, Credibility, and Impression Management: The Asian Sociologist in America.

    Science.gov (United States)

    Unnithan, N. Prabha

    1988-01-01

    Relates personal experiences of a sociologist of Asian origin in an effort to illustrate problems inherent in the process of becoming accepted as an academic sociologist. Identifies important themes of marginality, credibility, and impression management. Points out ways in which the Asian sociologists can go about achieving credibility. (KO)

  17. Selling Health to the Distracted: Consumer Responses to Source Credibility and Ad Appeal Type in a Direct-to-Consumer Advertisement.

    Science.gov (United States)

    Lemanski, Jennifer L; Villegas, Jorge

    2015-01-01

    Since 1997, when the U.S. Food and Drug Administration first allowed prescription drug companies to release ads directly targeting the public, direct-to-consumer (DTC) advertising has become an integral part of the pharmaceutical industry marketing toolkit, reaching over $4 billion in 2005. In an experiment where cognitive load, a task that requires the investment of a subject's memory in an unrelated task; source credibility; and advertising appeal type (affective or cognitive) were manipulated, attitude toward the ad was measured for a print DTC meningitis vaccine ad. Main effect results for source credibility and advertising appeal type on attitude toward the ad were found, and interactions between manipulated variables were apparent when the individual difference variables related to a specific illness (vaccination history, living in a dorm, family members or friends who had suffered the illness) were taken into account.

  18. Assessing the credibility of diverting through containment penetrations

    International Nuclear Information System (INIS)

    Cooley, J.N.; Swindle, D.W. Jr.

    1980-01-01

    A viable approach has been developed for identifying those containment penetrations in a nuclear fuel reprocessing plant which are credible diversion routes. The approach is based upon systematic engineering and design analyses and is applied to each type of penetration to determine which penetrations could be utilized to divert nuclear material from a reprocessing facility. The approach is described and the results of an application are discussed. In addition, the concept of credibility is developed and discussed. For a typical reprocessing plant design, the number of penetrations determined to be credible without process or piping modifications was approx. 16% of the penetrations originally identified

  19. The Credibility of Science Communication

    Directory of Open Access Journals (Sweden)

    Nielsen, L. H.

    2007-10-01

    Full Text Available Current developments in the media marketplace and an increased need for visibility to secure funding are leading inevitably to faster, simpler and more aggressive science communication. This article presents the results of an exploratory study of potential credibility problems in astronomy press releases, their causes, consequences and possible remedies. The study consisted of eleven open-ended interviews with journalists, scientists and public information officers. Results suggest that credibility issues are central to communication, deeply integrated into the workflow and can have severe consequences for the actors (especially the scientist, but are an unavoidable part of thecommunication process.

  20. Evaluation method of nuclear nonproliferation credibility

    International Nuclear Information System (INIS)

    Kwon, Eun-ha; Ko, Won Il

    2009-01-01

    This paper presents an integrated multicriteria analysis method for the quantitative evaluation of a state's nuclear nonproliferation credibility level. Underscoring the implications of policy on the sources of political demand for nuclear weapons rather than focusing on efforts to restrict the supply of specific weapons technology from the 'haves' to the 'have-nots', the proposed methodology considers the political, social, and cultural dimensions of nuclear proliferation. This methodology comprises three steps: (1) identifying the factors that influence credibility formation and employing them to construct a criteria tree that will illustrate the relationships among these factors; (2) defining the weight coefficients of each criterion through pairwise comparisons of the Analytical Hierarchy Process (AHP); and (3) assigning numerical scores to a state under each criterion and combining them with the weight coefficients in order to provide an overall assessment of the state. The functionality of this methodology is examined by assessing the current level of nuclear nonproliferation credibility of four countries: Japan, North Korea, South Korea, and Switzerland.

  1. Risky Business: Communicating with Credibility

    Science.gov (United States)

    Greenberger, Leonard S.

    2011-01-01

    In hostile situations, a communicator's goal is to establish and maintain trust and credibility with the audience. School business officials need the special skills and techniques of what's known as "risk communication." Few people are natural risk communicators. Those who do it well honed their skills over many years spent in hostile…

  2. Improving credibility evaluations on Wikipedia

    NARCIS (Netherlands)

    Lucassen, T.; Schmettow, Martin; Wiering, Caro H.; Pieters, Jules M.; Boer, Henk

    2011-01-01

    In this chapter, ongoing research on trust in Wikipedia is used as a case study to illustrate the design process of a support tool for Wikipedia, following the ASCE-model. This research is performed from a cognitive perspective and aims at users actively evaluating the credibility of information on

  3. Using the National Provider Identifier for Health Care...

    Data.gov (United States)

    U.S. Department of Health & Human Services — The establishment in recent years of a National Provider Identifier (NPI) offers a new method for counting and categorizing physicians and other health care...

  4. LCLS Maximum Credible Beam Power

    International Nuclear Information System (INIS)

    Clendenin, J.

    2005-01-01

    The maximum credible beam power is defined as the highest credible average beam power that the accelerator can deliver to the point in question, given the laws of physics, the beam line design, and assuming all protection devices have failed. For a new accelerator project, the official maximum credible beam power is determined by project staff in consultation with the Radiation Physics Department, after examining the arguments and evidence presented by the appropriate accelerator physicist(s) and beam line engineers. The definitive parameter becomes part of the project's safety envelope. This technical note will first review the studies that were done for the Gun Test Facility (GTF) at SSRL, where a photoinjector similar to the one proposed for the LCLS is being tested. In Section 3 the maximum charge out of the gun for a single rf pulse is calculated. In Section 4, PARMELA simulations are used to track the beam from the gun to the end of the photoinjector. Finally in Section 5 the beam through the matching section and injected into Linac-1 is discussed

  5. Credibility is the first principle

    International Nuclear Information System (INIS)

    Beecher, William

    2002-01-01

    The first principle of an effective public affairs program on nuclear energy is credibility. If credibility is lacking, no matter how artful the message, it will not be persuasive. There has long been a problem in the United States. For years much of the industry followed the practice, when there was an event at a nuclear power plant that resulted in an unplanned release of radioactivity, to tell the public there was 'no release' if in fact the release was below the technical specifications of what the NRC mandates as being safe. The NRC is a safety regulator. It can tell nuclear power plant operators what to do, or not do, when it comes to safety, but doesn't have the right to tell them what to say to the public. The example of an emergency exercise and the NRC press release on that occasion showed the direction how companies could be influenced to behave in order to prevent such avoidably negative news coverage, i.e. attaining credibility when public anxiety is concerned

  6. Surveillance of Washington OSHA exposure data to identify uncharacterized or emerging occupational health hazards.

    Science.gov (United States)

    Lofgren, Don J; Reeb-Whitaker, Carolyn K; Adams, Darrin

    2010-07-01

    Chemical substance exposure data from the Washington State Occupational Safety and Health Administration (OSHA) program were reviewed to determine if inspections conducted as a result of a report of a hazard from a complainant or referent may alert the agency to uncharacterized or emerging health hazards. Exposure and other electronically stored data from 6890 health inspection reports conducted between April 2003 and August 2008 were extracted from agency records. A total of 515 (7%) inspections with one or more personal airborne chemical substance samples were identified for further study. Inspections by report of a hazard and by targeting were compared for the following: number of inspections, number and percentage of inspections with workers exposed to substances above an agency's permissible exposure limit, types of industries inspected, and number and type of chemical substances assessed. Report of a hazard inspections documented work sites with worker overexposure at the same rate as agency targeted inspections (approximately 35% of the time), suggesting that complainants and referents are a credible pool of observers capable of directing the agency to airborne chemical substance hazards. Report of a hazard inspections were associated with significantly broader distribution of industries as well as a greater variety of chemical substance exposures than were targeted inspections. Narrative text that described business type and processes inspected was more useful than NAICS codes alone and critical in identifying processes and industries that may be associated with new hazards. Finally, previously identified emerging hazards were found among the report of a hazard data. These findings indicate that surveillance of OSHA inspection data can be a valid tool to identify uncharacterized and emerging health hazards. Additional research is needed to develop criteria for objective review and prioritization of the data for intervention. Federal OSHA and other state

  7. Identifying the core competencies of mental health telephone triage.

    Science.gov (United States)

    Sands, Natisha; Elsom, Stephen; Gerdtz, Marie; Henderson, Kathryn; Keppich-Arnold, Sandra; Droste, Nicolas; Prematunga, Roshani K; Wereta, Zewdu W

    2013-11-01

    The primary aim of this study was to identify the core competencies of mental health telephone triage, including key role tasks, skills, knowledge and responsibilities, in which clinicians are required to be competent to perform safe and effective triage. Recent global trends indicate an increased reliance on telephone-based health services to facilitate access to health care across large populations. The trend towards telephone-based health services has also extended to mental health settings, evidenced by the growing number of mental health telephone triage services providing 24-hour access to specialist mental health assessment and treatment. Mental health telephone triage services are critical to the early identification of mental health problems and the provision of timely, appropriate interventions. In spite of the rapid growth in mental health telephone triage and the important role these services play in the assessment and management of mental illness and related risks, there has been very little research investigating this area of practice. An observational design was employed to address the research aims. Structured observations (using dual wireless headphones) were undertaken on 197 occasions of mental health telephone triage over a three-month period from January to March 2011. The research identified seven core areas of mental health telephone triage practice in which clinicians are required to be competent in to perform effective mental health telephone triage, including opening the call; performing mental status examination; risk assessment; planning and action; termination of call; referral and reporting; and documentation. The findings of this research contribute to the evidence base for mental health telephone triage by articulating the core competencies for practice. The mental health telephone triage competencies identified in this research may be used to define an evidence-based framework for mental health telephone triage practice that aims to

  8. Identifying Factors for Worker Motivation in Zambia's Rural Health Facilities.

    Science.gov (United States)

    Cross, Samuel S; Baernholdt, Dr Marianne

    2017-01-01

    Within Zambia there is a shortage of health workers in rural areas. This study aims to identify motivating factors for retaining rural health workers. Sixty rural health workers completed surveys and 46 were interviewed. They rated the importance of six motivating factors and discussed these and other factors in interviews. An interview was conducted with a Government Human Resources Manager (HR Manager) to elicit contextual information. All six factors were identified as being very important motivators, as were two additional factors. Additional career training was identified by many as the most important factor. Comparison of results and the HR Manager interview revealed that workers lacked knowledge about opportunities and that the HR manager was aware of barriers to career development. The Zambian government might better motivate and retain rural health workers by offering them any combination of identified factors, and by addressing the barriers to career development.

  9. Text mining electronic health records to identify hospital adverse events

    DEFF Research Database (Denmark)

    Gerdes, Lars Ulrik; Hardahl, Christian

    2013-01-01

    Manual reviews of health records to identify possible adverse events are time consuming. We are developing a method based on natural language processing to quickly search electronic health records for common triggers and adverse events. Our results agree fairly well with those obtained using manu...

  10. Identifying public health competencies relevant to family medicine.

    Science.gov (United States)

    Harvey, Bart J; Moloughney, Brent W; Iglar, Karl T

    2011-10-01

    Public health situations faced by family physicians and other primary care practitioners, such as severe acute respiratory syndrome (SARS) and more recently H1N1, have resulted in an increased interest to identify the public health competencies relevant to family medicine. At present there is no agreed-on set of public health competencies delineating the knowledge and skills that family physicians should possess to effectively face diverse public health challenges. Using a multi-staged, iterative process that included a detailed literature review, the authors developed a set of public health competencies relevant to primary care, identifying competencies relevant across four levels, from "post-MD" to "enhanced." Feedback from family medicine and public health educator-practitioners regarding the set of proposed "essential" competencies indicated the need for a more limited, feasible set of "priority" areas to be highlighted during residency training. This focused set of public health competencies has begun to guide relevant components of the University of Toronto's Family Medicine Residency Program curriculum, including academic half-days; clinical experiences, especially identifying "teachable moments" during patient encounters; resident academic projects; and elective public health agency placements. These competencies will also be used to guide the development of a family medicine-public health primer and faculty development sessions to support family medicine faculty facilitating residents to achieve these competencies. Once more fully implemented, an evaluation will be initiated to determine the degree to which these public health competencies are being achieved by family medicine graduates, especially whether they attained the knowledge, skills, and confidence necessary to effectively face diverse public health situations-from common to emergent. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  11. CREDIBILITY OF WEBSITES THROUGH FACETS AND DIMENSIONS

    Directory of Open Access Journals (Sweden)

    Oana ȚUGULEA

    2017-05-01

    Full Text Available This study aims to investigate important aspects to concern on when building a commercial presentation website, in order to increase the credibility of the certain categories of a presentation website. Factor analysis was used in order to identify the dimensions of each category. The categories and resulted dimensions discussed were: “image” – with the following dimensions: Projected image, Specialist, Advert and Coherence, “relationship” – with the following dimensions: Bi-directional communication and Contact information, “product presentation” – with the following dimensions: In-depth description and Variety and “site functionality” – with the following dimensions: Usefulness, Official relationship, Complete communication, Exterior communication, Information format and References.

  12. Credible Phenomenological Research: A Mixed-Methods Study

    Science.gov (United States)

    Flynn, Stephen V.; Korcuska, James S.

    2018-01-01

    The authors conducted a 3-phase investigation into the credible standards for phenomenological research practices identified in the literature and endorsed by a sample of counselor education qualitative research experts. Utilizing a mixed-methods approach, the findings offer evidence that professional counseling has a distinctive format in which…

  13. Cross-validation of the Dot Counting Test in a large sample of credible and non-credible patients referred for neuropsychological testing.

    Science.gov (United States)

    McCaul, Courtney; Boone, Kyle B; Ermshar, Annette; Cottingham, Maria; Victor, Tara L; Ziegler, Elizabeth; Zeller, Michelle A; Wright, Matthew

    2018-01-18

    To cross-validate the Dot Counting Test in a large neuropsychological sample. Dot Counting Test scores were compared in credible (n = 142) and non-credible (n = 335) neuropsychology referrals. Non-credible patients scored significantly higher than credible patients on all Dot Counting Test scores. While the original E-score cut-off of ≥17 achieved excellent specificity (96.5%), it was associated with mediocre sensitivity (52.8%). However, the cut-off could be substantially lowered to ≥13.80, while still maintaining adequate specificity (≥90%), and raising sensitivity to 70.0%. Examination of non-credible subgroups revealed that Dot Counting Test sensitivity in feigned mild traumatic brain injury (mTBI) was 55.8%, whereas sensitivity was 90.6% in patients with non-credible cognitive dysfunction in the context of claimed psychosis, and 81.0% in patients with non-credible cognitive performance in depression or severe TBI. Thus, the Dot Counting Test may have a particular role in detection of non-credible cognitive symptoms in claimed psychiatric disorders. Alternative to use of the E-score, failure on ≥1 cut-offs applied to individual Dot Counting Test scores (≥6.0″ for mean grouped dot counting time, ≥10.0″ for mean ungrouped dot counting time, and ≥4 errors), occurred in 11.3% of the credible sample, while nearly two-thirds (63.6%) of the non-credible sample failed one of more of these cut-offs. An E-score cut-off of 13.80, or failure on ≥1 individual score cut-offs, resulted in few false positive identifications in credible patients, and achieved high sensitivity (64.0-70.0%), and therefore appear appropriate for use in identifying neurocognitive performance invalidity.

  14. Benchmarking in health care: using the Internet to identify resources.

    Science.gov (United States)

    Lingle, V A

    1996-01-01

    Benchmarking is a quality improvement tool that is increasingly being applied to the health care field and to the libraries within that field. Using mostly resources assessible at no charge through the Internet, a collection of information was compiled on benchmarking and its applications. Sources could be identified in several formats including books, journals and articles, multi-media materials, and organizations.

  15. Identifying Twitter influencer profiles for health promotion in Saudi Arabia.

    Science.gov (United States)

    Albalawi, Yousef; Sixsmith, Jane

    2017-06-01

    New media platforms, such as Twitter, provide the ideal opportunity to positively influence the health of large audiences. Saudi Arabia has one of the highest number of Twitter users of any country, some of whom are very influential in setting agendas and contributing to the dissemination of ideas. Those opinion leaders, both individuals and organizations, influential in the new media environment have the potential to raise awareness of health issues, advocate for health and potentially instigate change at a social level. To realize the potential of the new media platforms for public health, the function of opinion leaders is key. This study aims to identify and profile the most influential Twitter accounts in Saudi Arabia. Multiple measures, including: number of followers and four influence scores, were used to evaluate Twitter accounts. The data were then filtered and analysed using ratio and percentage calculations to identify the most influential users. In total, 99 Saudi Twitter accounts were classified, resulting in the identification of 25 religious men/women, 16 traditional media, 14 sports related, 10 new media, 6 political, 6 company and 4 health accounts. The methods used to identify the key influential Saudi accounts can be applied to inform profile development of Twitter users in other countries. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Credibility of Policy Announcements Under Asymmetric Information

    DEFF Research Database (Denmark)

    Christensen, Michael

    1999-01-01

    In a simple macro-economic model, where the monetary authorities process superior information about a real shocks, the scope for an active stabilization policy is shown to depend on the credibility of the policy maker. Lack of credibility increases the need for an active stabilization policy...

  17. Brand emotional credibility: effects of mixed emotions about branded products with varying credibility.

    Science.gov (United States)

    Mileti, Antonio; Prete, M Irene; Guido, Gianluigi

    2013-10-01

    This research investigates the effects of mixed emotions on the positioning and on the intention to purchase different categories of branded products (i.e., Attractiveness-products, Expertise-products, and Trustworthiness-products), in relation to their main component of credibility (Ohanian, 1990). On the basis of a focus group (n = 12) aimed to identify the three branded products used as stimuli and a pre-test (n = 240) directed to discover emotions elicited by them, two studies (n = 630; n = 240) were carried out. Positioning and multiple regression analyses showed that positive and negative emotions are positively related with the positioning and the purchase intention of Attractiveness-products, and, respectively, positively and negatively related with those of Trustworthiness-products; whereas negative emotions are negatively associated with those of Expertise-products. Brand Emotional Credibility--i.e., the emotional believability of the brand positioning signals--may help to identify unconscious elements and the simultaneous importance of mixed emotions associated with different products to match consumers' desires and expectations.

  18. Credible nuclear waste management: a legislative perspective

    International Nuclear Information System (INIS)

    Jeffords, J.M.

    1978-01-01

    The past credibility of the AEC, ERDA, and NRC, along with the present credibility of DOE and NRC, are questioned. The results of voter responses to a moratorium on expansion of nuclear power are linked to the question of past credibility of these Federal agencies. It is proposed that the future of nuclear power be linked directly to the Executive Branch of the government via a new bureaucracy, a Waste Management Authority. This new bureaucracy would be completely separated from the construction or licensing phase of nuclear power, except it would have final say over any nuclear power expansion pending an acceptable solution to the waste reprocessing question

  19. Standards for collection of identifying information for health record keeping

    International Nuclear Information System (INIS)

    Carpenter, M.; Fair, M.E.; Lalonde, P.; Scott, T.

    1988-09-01

    A new recommended guideline for the standard data collection of individual identifying information has been developed and tested by Statistics Canada. The purpose of developing a standard method is to improve health record keeping in Canada: in particular for long term medical follow-up studies of individuals exposed to potentially hazardous agents for detection of possible health risks or delayed harm, e.g. individuals exposed to radiation through occupations, the environment, emergencies, or therapeutic practice. A data collection standard is also useful for epidemiological follow-up studies for other occupation groups such as chemical workers and miners, or for lifestyle, genetic and other studies. Statistics Canada, Health Division, Occupational and Environmental Health Research Unit (OEHRU), from their experience with long term health studies using the Canadian Mortality Data Base, has prepared a 'Data Collection Package' to include the developed and tested data collection guideline. It is anticipated this will help produce more thorough and comparable on-going record keeping while saving costs and time for many organizations e.g. Atomic Energy Control Board licensees who report radiation doses to the National Dose Registry, as well as for other companies and organizations across the country where long term medical follow-up studies are anticipated now or in the future. It may also allow for broader industrial, national and international comparisons. The guideline consists of a two page Individual Identity Summary (IIS): the first page for completion by the individual/employee to give unique identifying information; the second page for the study organizer/employer to include essential additional information (work history etc.). A third optional page can be used by organizations wishing to collect data on children. The Data Collection Package also includes brief explanatory notes, a suggested file record layout and detailed computer coding advice for entering

  20. Strategy to Increase U.S. Credibility

    National Research Council Canada - National Science Library

    Shanks, Wayne M

    2006-01-01

    ...) National Security Strategy (NSS). The public's mistrust of the United States is born out of a widespread misunderstanding and mistrust of its policies and a lack of USG credibility especially in the Greater Middle East...

  1. How Organizational Design Can Make Delegation Credible

    OpenAIRE

    Foss, Kirsten; Foss, Nicolai J.

    2005-01-01

    Credible delegation of discretion obtains when it is a rational strategy for managers not to overrule employee decisions that are based on delegated decision rights or renege on the level of delegated discretion (and this is common knowledge). Making delegation of discretion credible becomes a crucial issue when organizations want to sustain the advantages that may flow from delegation: Such advantages are dependent on motivated employees, and managerial overruling or reneging is harmful to m...

  2. Credibility and trust in risk communication

    International Nuclear Information System (INIS)

    Renn, O.; Levine, D.

    1989-01-01

    The paper attempts to summarize the major findings of the psychological and sociological literature on trust and credibility, and to apply these findings to the specific arena of risk communication. A few guidelines for risk communication that appear appropriate for the social and institutional context in which the risk debate takes place are presented. The case studies of credibility of nuclear energy, biotechnology, medicine, and aviation are discussed. (DG)

  3. Exchange rate stabilization under imperfect credibility

    OpenAIRE

    Calvo, Guillermo; Vegh, Carlos

    1991-01-01

    This paper analyzes stabilization policy under predetermined exchange rates in a cash-in-advance, staggered-prices model. Under full credibility, a reduction in the rate of devaluation results in an immediate and permanent reduction in the inflation rate, with no effect on output or consumption. In contrast, a non-credible stabilization results in an initial expansion of output, followed by a later recession. The inflation rate of home goods remains above the rate of devaluation throughout...

  4. Identifying key hospital service quality factors in online health communities.

    Science.gov (United States)

    Jung, Yuchul; Hur, Cinyoung; Jung, Dain; Kim, Minki

    2015-04-07

    The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. We defined social media-based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea's two biggest online portals were used to test the effectiveness of detection of social media-based key quality factors for hospitals. To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91% and 78%, respectively. In terms of recommendation classification, performance (ie, precision) is 78% on average. Extraction and

  5. Credibility engineering in the food industry: linking science, regulation, and marketing in a corporate context.

    Science.gov (United States)

    Penders, Bart; Nelis, Annemiek P

    2011-12-01

    We expand upon the notion of the "credibility cycle" through a study of credibility engineering by the food industry. Research and development (R&D) as well as marketing contribute to the credibility of the food company Unilever and its claims. Innovation encompasses the development, marketing, and sales of products. These are directed towards three distinct audiences: scientific peers, regulators, and consumers. R&D uses scientific articles to create credit for itself amongst peers and regulators. These articles are used to support health claims on products. However, R&D, regulation, and marketing are not separate realms. A single strategy of credibility engineering connects health claims to a specific public through linking that public to a health issue and a food product.

  6. Identifying health facilities outside the enterprise: challenges and strategies for supporting health reform and meaningful use.

    Science.gov (United States)

    Dixon, Brian E; Colvard, Cyril; Tierney, William M

    2014-06-24

    Objective: To support collation of data for disability determination, we sought to accurately identify facilities where care was delivered across multiple, independent hospitals and clinics. Methods: Data from various institutions' electronic health records were merged and delivered as continuity of care documents to the United States Social Security Administration (SSA). Results: Electronic records for nearly 8000 disability claimants were exchanged with SSA. Due to the lack of standard nomenclature for identifying the facilities in which patients received the care documented in the electronic records, SSA could not match the information received with information provided by disability claimants. Facility identifiers were generated arbitrarily by health care systems and therefore could not be mapped to the existing international standards. Discussion: We propose strategies for improving facility identification in electronic health records to support improved tracking of a patient's care between providers to better serve clinical care delivery, disability determination, health reform and meaningful use. Conclusion: Accurately identifying the facilities where health care is delivered to patients is important to a number of major health reform and improvement efforts underway in many nations. A standardized nomenclature for identifying health care facilities is needed to improve tracking of care and linking of electronic health records.

  7. Credible baseline analysis for multi-model public policy studies

    Energy Technology Data Exchange (ETDEWEB)

    Parikh, S.C.; Gass, S.I.

    1981-01-01

    The nature of public decision-making and resource allocation is such that many complex interactions can best be examined and understood by quantitative analysis. Most organizations do not possess the totality of models and needed analytical skills to perform detailed and systematic quantitative analysis. Hence, the need for coordinated, multi-organization studies that support public decision-making has grown in recent years. This trend is expected not only to continue, but to increase. This paper describes the authors' views on the process of multi-model analysis based on their participation in an analytical exercise, the ORNL/MITRE Study. One of the authors was the exercise coordinator. During the study, the authors were concerned with the issue of measuring and conveying credibility of the analysis. This work led them to identify several key determinants, described in this paper, that could be used to develop a rating of credibility.

  8. Credibility Perceptions of User Generated Content

    OpenAIRE

    Murugan, S.; Nagarajan, Dr. P.S.

    2017-01-01

    Social media users generate a large volume of user generated content in various social media platforms to share their experiences in using a brand or a service. In the travel industry, the user generated content reviews are used by the prospective travellers to decide their travel plans. In the 1950’s credibility research of the media was started when television was introduced as a new media in the world dominated by newspapers. In the Social Media platforms, the credibility assessment is muc...

  9. Identifying and assessing strategies for evaluating the impact of mobile eye health units on health outcomes.

    Science.gov (United States)

    Fu, Shiwan; Turner, Angus; Tan, Irene; Muir, Josephine

    2017-12-01

    To identify and assess strategies for evaluating the impact of mobile eye health units on health outcomes. Systematic literature review. Worldwide. Peer-reviewed journal articles that included the use of a mobile eye health unit. Journal articles were included if outcome measures reflected an assessment of the impact of a mobile eye health unit on health outcomes. Six studies were identified with mobile services offering diabetic retinopathy screening (three studies), optometric services (two studies) and orthoptic services (one study). This review identified and assessed strategies in existing literature used to evaluate the impact of mobile eye health units on health outcomes. Studies included in this review used patient outcomes (i.e. disease detection, vision impairment, treatment compliance) and/or service delivery outcomes (i.e. cost per attendance, hospital transport use, inappropriate referrals, time from diabetic retinopathy photography to treatment) to evaluate the impact of mobile eye health units. Limitations include difficulty proving causation of specific outcome measures and the overall shortage of impact evaluation studies. Variation in geographical location, service population and nature of eye care providers limits broad application. © 2017 National Rural Health Alliance Inc.

  10. Identifying Health Consumers' eHealth Literacy to Decrease Disparities in Accessing eHealth Information.

    Science.gov (United States)

    Park, Hyejin; Cormier, Eileen; Gordon, Glenna; Baeg, Jung Hoon

    2016-02-01

    The increasing amount of health information available on the Internet highlights the importance of eHealth literacy skills for health consumers. Low eHealth literacy results in disparities in health consumers' ability to access and use eHealth information. The purpose of this study was to assess the perceived eHealth literacy of a general health consumer population so that healthcare professionals can effectively address skills gaps in health consumers' ability to access and use high-quality online health information. Participants were recruited from three public library branches in a Northeast Florida community. The eHealth Literacy Scale was used. The majority of participants (n = 108) reported they knew how and where to find health information and how to use it to make health decisions; knowledge of what health resources were available and confidence in the ability to distinguish high- from low-quality information were considerably less. The findings suggest the need for eHealth education and support to health consumers from healthcare professionals, in particular, how to access and evaluate the quality of health information.

  11. A framework to establish credibility of computational models in biology.

    Science.gov (United States)

    Patterson, Eann A; Whelan, Maurice P

    2017-10-01

    Computational models in biology and biomedical science are often constructed to aid people's understanding of phenomena or to inform decisions with socioeconomic consequences. Model credibility is the willingness of people to trust a model's predictions and is often difficult to establish for computational biology models. A 3 × 3 matrix has been proposed to allow such models to be categorised with respect to their testability and epistemic foundation in order to guide the selection of an appropriate process of validation to supply evidence to establish credibility. Three approaches to validation are identified that can be deployed depending on whether a model is deemed untestable, testable or lies somewhere in between. In the latter two cases, the validation process involves the quantification of uncertainty which is a key output. The issues arising due to the complexity and inherent variability of biological systems are discussed and the creation of 'digital twins' proposed as a means to alleviate the issues and provide a more robust, transparent and traceable route to model credibility and acceptance. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Credibility improves topical blog post retrieval

    NARCIS (Netherlands)

    Weerkamp, W.; de Rijke, M.

    2008-01-01

    Topical blog post retrieval is the task of ranking blog posts with respect to their relevance for a given topic. To improve topical blog post retrieval we incorporate textual credibility indicators in the retrieval process. We consider two groups of indicators: post level (determined using

  13. Distribution system reliability evaluation using credibility theory

    African Journals Online (AJOL)

    Xufeng Xu, Joydeep Mitra

    have found that credibility theory, which broadens the scope of fuzzy set theory, is an effective tool for representing fuzzy events, and have developed a theoretical .... Based on the status of switches, the distribution system can be divided into multiple SPSS, which are connected with tie switches. For example, SPSS.

  14. Identifying Value Indicators and Social Capital in Community Health Partnerships

    Science.gov (United States)

    Hausman, Alice J.; Becker, Julie; Brawer, Rickie

    2005-01-01

    Increasingly, public health practice is turning to the application of community collaborative models to improve population health status. Despite the growth of these activities, however, evaluations of the national demonstrations have indicated that community health partnerships fail to achieve measurable results and struggle to maintain integrity…

  15. Participatory approach to identify interventions to improve the health, safety, and work productivity of smallholder women vegetable farmers in the Gambia.

    Science.gov (United States)

    Vanderwal, Londa; Rautiainen, Risto; Ramirez, Marizen; Kuye, Rex; Peek-Asa, Corinne; Cook, Thomas; Culp, Kennith; Donham, Kelley

    2011-03-01

    This paper describes the qualitative, community-based participatory approach used to identify culturally-acceptable and sustainable interventions to improve the occupational health, safety, and productivity of smallholder women vegetable farmers in The Gambia (West Africa). This approach was used to conduct: 1) analysis of the tasks and methods traditionally used in vegetable production, and 2) selection of interventions. The most arduous garden tasks that were amenable to interventions were identified, and the interventions were selected through a participatory process for further evaluation. Factors contributing to the successful implementation of the participatory approach used in this study included the following: 1) ensuring that cultural norms were respected and observed; 2) working closely with the existing garden leadership structure; and 3) research team members working with the subjects for an extended period of time to gain first-hand understanding of the selected tasks and to build credibility with the subjects.

  16. Identifying interprofessional global health competencies for 21st-century health professionals.

    Science.gov (United States)

    Jogerst, Kristen; Callender, Brian; Adams, Virginia; Evert, Jessica; Fields, Elise; Hall, Thomas; Olsen, Jody; Rowthorn, Virginia; Rudy, Sharon; Shen, Jiabin; Simon, Lisa; Torres, Herica; Velji, Anvar; Wilson, Lynda L

    2015-01-01

    At the 2008 inaugural meeting of the Consortium of Universities for Global Health (CUGH), participants discussed the rapid expansion of global health programs and the lack of standardized competencies and curricula to guide these programs. In 2013, CUGH appointed a Global Health Competency Subcommittee and charged this subcommittee with identifying broad global health core competencies applicable across disciplines. The purpose of this paper is to describe the Subcommittee's work and proposed list of interprofessional global health competencies. After agreeing on a definition of global health to guide the Subcommittee's work, members conducted an extensive literature review to identify existing competencies in all fields relevant to global health. Subcommittee members initially identified 82 competencies in 12 separate domains, and proposed four different competency levels. The proposed competencies and domains were discussed during multiple conference calls, and subcommittee members voted to determine the final competencies to be included in two of the four proposed competency levels (global citizen and basic operational level - program oriented). The final proposed list included a total of 13 competencies across 8 domains for the Global Citizen Level and 39 competencies across 11 domains for the Basic Operational Program-Oriented Level. There is a need for continued debate and dialog to validate the proposed set of competencies, and a need for further research to identify best strategies for incorporating these competencies into global health educational programs. Future research should focus on implementation and evaluation of these competencies across a range of educational programs, and further delineating the competencies needed across all four proposed competency levels. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  17. Identifying risks for mental health problems in HIV positive ...

    African Journals Online (AJOL)

    Background: Mental health problems of adolescents are underserved in low and middle-income countries where they account for a significant proportion of disease burden. Perinatally infected HIV-positive adolescents have a high prevalence of mental health disorders; however, little is known about those retained in care in ...

  18. Preparing for the data revolution: identifying minimum health information competencies among the health workforce.

    Science.gov (United States)

    Whittaker, Maxine; Hodge, Nicola; Mares, Renata E; Rodney, Anna

    2015-04-01

    Health information is required for a variety of purposes at all levels of a health system, and a workforce skilled in collecting, analysing, presenting, and disseminating such information is essential to fulfil these demands. While it is established that low- and middle-income countries (LMICs) are facing shortages in human resources for health (HRH), there has been little systematic attention focussed on non-clinical competencies. In response, we developed a framework that defines the minimum health information competencies required by health workers at various levels of a health system. Using the Delphi method, we consulted with leading global health information system (HIS) experts. An initial list of competencies and draft framework were developed based on results of a systematic literature review. During the second half of 2012, we sampled 38 experts with broad-based HIS knowledge and extensive development experience. Two rounds of consultation were carried out with the same group to establish validity of the framework and gain feedback on the draft competencies. Responses from consultations were analysed using Qualtrics® software and content analysis. In round one, 17 experts agreed to participate in the consultation and 11 (65%) completed the survey. In the second round, 11 experts agreed to participate and eight (73%) completed the survey. Overall, respondents agreed that there is a need for all health workers to have basic HIS competencies and that the concept of a minimum HIS competency framework is valid. Consensus was reached around the inclusion of 68 competencies across four levels of a health system. This consultation is one of the first to identify the HIS competencies required among general health workers, as opposed to specialist HIS roles. It is also one of the first attempts to develop a framework on minimum HIS competencies needed in LMICs, highlighting the skills needed at each level of the system, and identifying potential gaps in current

  19. Integrating national community-based health worker programmes into health systems: a systematic review identifying lessons learned from low-and middle-income countries.

    Science.gov (United States)

    Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

    2014-09-22

    Despite the development of national community-based health worker (CBHW) programmes in several low- and middle-income countries, their integration into health systems has not been optimal. Studies have been conducted to investigate the factors influencing the integration processes, but systematic reviews to provide a more comprehensive understanding are lacking. We conducted a systematic review of published research to understand factors that may influence the integration of national CBHW programmes into health systems in low- and middle-income countries. To be included in the study, CBHW programmes should have been developed by the government and have standardised training, supervision and incentive structures. A conceptual framework on the integration of health innovations into health systems guided the review. We identified 3410 records, of which 36 were finally selected, and on which an analysis was conducted concerning the themes and pathways associated with different factors that may influence the integration process. Four programmes from Brazil, Ethiopia, India and Pakistan met the inclusion criteria. Different aspects of each of these programmes were integrated in different ways into their respective health systems. Factors that facilitated the integration process included the magnitude of countries' human resources for health problems and the associated discourses about how to address these problems; the perceived relative advantage of national CBHWs with regard to delivering health services over training and retaining highly skilled health workers; and the participation of some politicians and community members in programme processes, with the result that they viewed the programmes as legitimate, credible and relevant. Finally, integration of programmes within the existing health systems enhanced programme compatibility with the health systems' governance, financing and training functions. Factors that inhibited the integration process included a rapid

  20. The SADI Personal Health Lens: A Web Browser-Based System for Identifying Personally Relevant Drug Interactions.

    Science.gov (United States)

    Vandervalk, Ben; McCarthy, E Luke; Cruz-Toledo, José; Klein, Artjom; Baker, Christopher J O; Dumontier, Michel; Wilkinson, Mark D

    2013-04-05

    The Web provides widespread access to vast quantities of health-related information that can improve quality-of-life through better understanding of personal symptoms, medical conditions, and available treatments. Unfortunately, identifying a credible and personally relevant subset of information can be a time-consuming and challenging task for users without a medical background. The objective of the Personal Health Lens system is to aid users when reading health-related webpages by providing warnings about personally relevant drug interactions. More broadly, we wish to present a prototype for a novel, generalizable approach to facilitating interactions between a patient, their practitioner(s), and the Web. We utilized a distributed, Semantic Web-based architecture for recognizing personally dangerous drugs consisting of: (1) a private, local triple store of personal health information, (2) Semantic Web services, following the Semantic Automated Discovery and Integration (SADI) design pattern, for text mining and identifying substance interactions, (3) a bookmarklet to trigger analysis of a webpage and annotate it with personalized warnings, and (4) a semantic query that acts as an abstract template of the analytical workflow to be enacted by the system. A prototype implementation of the system is provided in the form of a Java standalone executable JAR file. The JAR file bundles all components of the system: the personal health database, locally-running versions of the SADI services, and a javascript bookmarklet that triggers analysis of a webpage. In addition, the demonstration includes a hypothetical personal health profile, allowing the system to be used immediately without configuration. Usage instructions are provided. The main strength of the Personal Health Lens system is its ability to organize medical information and to present it to the user in a personalized and contextually relevant manner. While this prototype was limited to a single knowledge domain

  1. The SADI Personal Health Lens: A Web Browser-Based System for Identifying Personally Relevant Drug Interactions

    Science.gov (United States)

    Vandervalk, Ben; McCarthy, E Luke; Cruz-Toledo, José; Klein, Artjom; Baker, Christopher J O; Dumontier, Michel

    2013-01-01

    Background The Web provides widespread access to vast quantities of health-related information that can improve quality-of-life through better understanding of personal symptoms, medical conditions, and available treatments. Unfortunately, identifying a credible and personally relevant subset of information can be a time-consuming and challenging task for users without a medical background. Objective The objective of the Personal Health Lens system is to aid users when reading health-related webpages by providing warnings about personally relevant drug interactions. More broadly, we wish to present a prototype for a novel, generalizable approach to facilitating interactions between a patient, their practitioner(s), and the Web. Methods We utilized a distributed, Semantic Web-based architecture for recognizing personally dangerous drugs consisting of: (1) a private, local triple store of personal health information, (2) Semantic Web services, following the Semantic Automated Discovery and Integration (SADI) design pattern, for text mining and identifying substance interactions, (3) a bookmarklet to trigger analysis of a webpage and annotate it with personalized warnings, and (4) a semantic query that acts as an abstract template of the analytical workflow to be enacted by the system. Results A prototype implementation of the system is provided in the form of a Java standalone executable JAR file. The JAR file bundles all components of the system: the personal health database, locally-running versions of the SADI services, and a javascript bookmarklet that triggers analysis of a webpage. In addition, the demonstration includes a hypothetical personal health profile, allowing the system to be used immediately without configuration. Usage instructions are provided. Conclusions The main strength of the Personal Health Lens system is its ability to organize medical information and to present it to the user in a personalized and contextually relevant manner. While this

  2. Trust and credibility: measured by multidimensional scaling

    International Nuclear Information System (INIS)

    Warg, L.E.; Bodin, L.

    1998-01-01

    Full text of publication follows: in focus of much of today's research interest in risk communication, is the fact that the communities do not trust policy and decision makers such as politicians, government or industry people. This is especially serious in the years to come when we are expecting risk issues concerning for example the nuclear industry, global warming and hazardous waste, to be even higher on the political and social agenda all over the world. Despite the research efforts devoted to trust, society needs an in depth understanding of trust for conducting successful communication regarding environmental hazards. The present abstract is about an experimental study in psychology where focus has been on the possibility to use the multidimensional scaling technique to explore the characteristics people consider to be of importance when they say that certain persons are credible. In the study, a total of 61 students of the University of Oerebro, Sweden, were required to make comparisons of the similarity between 12 well-known swedish persons from politics science, media, industry, 'TV-world' and literature (two persons at a time), regarding their credibility when making statements about risks in society. In addition, the subjects were rating the importance of 19 factors for the credibility of a source. These 61 persons comprised three groups of students: pedagogists, business economists, and chemists. There were 61 % women and 39% men and the mean age was 23 years. The results will be analyzed using multidimensional scaling technique. Differences between the three groups will be analyzed and presented as well as those between men and women. In addition, the 19 factors will be discussed and considered when trying to label the dimensions accounted for by the multidimensional scaling technique. The result from this study will contribute to our understanding of important factors behind human judgments concerning trust and credibility. It will also point to a

  3. Impact of Celebrity Credibility on Advertising Effectiveness

    OpenAIRE

    Sadia Aziz; Usman Ghani; Abdullah Niazi

    2013-01-01

    Advertisers often make use of endorsers or representatives as trustworthy sources of persuasion for consumers' attitudes. Promotion of products through celebrities is a trendy advertising practice around the world. The present study judged the impact of celebrity credibility on advertising effectiveness in terms of consumer’s attitude towards the advertisement, attitude towards the brand and their purchase intention. This study also explored the differences of respondent’s responses towards t...

  4. Establishing model credibility involves more than validation

    International Nuclear Information System (INIS)

    Kirchner, T.

    1991-01-01

    One widely used definition of validation is that the quantitative test of the performance of a model through the comparison of model predictions to independent sets of observations from the system being simulated. The ability to show that the model predictions compare well with observations is often thought to be the most rigorous test that can be used to establish credibility for a model in the scientific community. However, such tests are only part of the process used to establish credibility, and in some cases may be either unnecessary or misleading. Naylor and Finger extended the concept of validation to include the establishment of validity for the postulates embodied in the model and the test of assumptions used to select postulates for the model. Validity of postulates is established through concurrence by experts in the field of study that the mathematical or conceptual model contains the structural components and mathematical relationships necessary to adequately represent the system with respect to the goals for the model. This extended definition of validation provides for consideration of the structure of the model, not just its performance, in establishing credibility. Evaluation of a simulation model should establish the correctness of the code and the efficacy of the model within its domain of applicability. (24 refs., 6 figs.)

  5. Aggregated trustworthiness: Redefining online credibility through social validation

    DEFF Research Database (Denmark)

    Jessen, Johan; Jørgensen, Anker Helms

    2012-01-01

    This article investigates the impact of social dynamics on online credibility. Empirical studies by Pettingill (2006) and Hargittai, et al. (2010) suggest that social validation and online trustees play increasingly important roles when evaluating credibility online. This dynamic puts pressure...

  6. CPSFS: A Credible Personalized Spam Filtering Scheme by Crowdsourcing

    Directory of Open Access Journals (Sweden)

    Xin Liu

    2017-01-01

    Full Text Available Email spam consumes a lot of network resources and threatens many systems because of its unwanted or malicious content. Most existing spam filters only target complete-spam but ignore semispam. This paper proposes a novel and comprehensive CPSFS scheme: Credible Personalized Spam Filtering Scheme, which classifies spam into two categories: complete-spam and semispam, and targets filtering both kinds of spam. Complete-spam is always spam for all users; semispam is an email identified as spam by some users and as regular email by other users. Most existing spam filters target complete-spam but ignore semispam. In CPSFS, Bayesian filtering is deployed at email servers to identify complete-spam, while semispam is identified at client side by crowdsourcing. An email user client can distinguish junk from legitimate emails according to spam reports from credible contacts with the similar interests. Social trust and interest similarity between users and their contacts are calculated so that spam reports are more accurately targeted to similar users. The experimental results show that the proposed CPSFS can improve the accuracy rate of distinguishing spam from legitimate emails compared with that of Bayesian filter alone.

  7. The prostate health index selectively identifies clinically significant prostate cancer

    NARCIS (Netherlands)

    S. Loeb (Stacy); M.G. Sanda (Martin G.); D.L. Broyles (Dennis L.); S.S. Shin (Sanghyuk S.); C.H. Bangma (Chris); J.T. Wei (John T.); A.W. Partin (Alan W.); G.G. Klee (George); K.M. Slawin (Kevin M.); L.S. Marks (Leonard S.); R.H.N. van Schaik (Ron); D.W. Chan (Daniel); L. Sokoll (Lori); A.B. Cruz (Amabelle B.); I.A. Mizrahi (Isaac A.); W.J. Catalona (William)

    2015-01-01

    textabstractPurpose The Prostate Health Index (phi) is a new test combining total, free and [-2]proPSA into a single score. It was recently approved by the FDA and is now commercially available in the U.S., Europe and Australia. We investigate whether phi improves specificity for detecting

  8. Neural network to identify individuals at health risk

    OpenAIRE

    Magoc, Tanja; Magoc, Dejan

    2011-01-01

    The risk of diseases such as heart attack and high blood pressure could be reduced by adequate physical activity. However, even though majority of general population claims to perform some physical exercise, only a minority exercises enough to keep a healthy living style. Thus, physical inactivity has become one of the major concerns of public health in the past decade. Research shows that the highest decrease in physical activity is noticed from high school to college. Thus, it i...

  9. Source Credibility and the Biasing Effect of Narrative Information on the Perception of Vaccination Risks.

    Science.gov (United States)

    Haase, Niels; Betsch, Cornelia; Renkewitz, Frank

    2015-08-01

    Immunization rates are below the Global Immunization Vision and Strategy established by the World Health Organization. One reason for this are anti-vaccination activists, who use the Internet to disseminate their agenda, frequently by publishing narrative reports about alleged vaccine adverse events. In health communication, the use of narrative information has been shown to be effectively persuasive. Furthermore, persuasion research indicates that the credibility of an information source may serve as a cue to discount or augment the communicated message. Thus, the present study investigated the effect of source credibility on the biasing effect of narrative information regarding the perception of vaccination risks. 265 participants were provided with statistical information (20%) regarding the occurrence of vaccine adverse events after vaccination against a fictitious disease. This was followed by 20 personalized narratives from an online forum on vaccination experiences. The authors varied the relative frequency of narratives reporting vaccine adverse events (35% vs. 85%), narrative source credibility (anti-vaccination website vs. neutral health forum), and the credibility of the statistical information (reliable data vs. unreliable data vs. control) in a between-subjects design. Results showed a stable narrative bias on risk perception that was not affected by credibility cues. However, narratives from an anti-vaccination website generally led to lower perceptions of vaccination risks.

  10. Credibility enacted : Understanding the meaning of credible political leadership in the Dutch parliamentary election campaign of 2010

    NARCIS (Netherlands)

    van Zuydam, Sabine; Hendriks, Frank

    2018-01-01

    In times of perception politics, the credibility of electoral candidates is a crucial asset in political marketing. This raises the question to which political leaders citizens attribute credibility and how political credibility is gained and lost through media performance. We analyze and compare

  11. Credibility enacted : Understanding the meaning of credible political leadership in the Dutch parliamentary election campaign of 2010

    NARCIS (Netherlands)

    van Zuydam, Sabine; Hendriks, Frank

    2015-01-01

    In times of perception politics, the credibility of electoral candidates is a crucial asset in political marketing. This raises the question to which political leaders citizens attribute credibility and how political credibility is gained and lost through media performance. We analyze and compare

  12. Identifying mental health services in clinical genetic settings.

    Science.gov (United States)

    Cappelli, M; Esplen, M J; Wilson, B J; Dorval, M; Bottorff, J L; Ly, M; Carroll, J C; Allanson, J; Humphreys, E; Rayson, D

    2009-10-01

    The purpose of this study was to examine the mental health needs of individuals at risk for adult onset hereditary disorder (AOHD) from the perspective of their genetic service providers, as it is unknown to what extent psychosocial services are required and being met. A mail-out survey was sent to 281 providers on the membership lists of the Canadian Association of Genetic Counsellors and the Canadian College of Medical Geneticists. The survey assessed psychosocial issues that were most commonly observed by geneticists, genetic counsellors (GCs), and nurses as well as availability and types of psychosocial services offered. Of the 129 respondents, half of genetic service providers reported observing signs of depression and anxiety, while 44% noted patients' concerns regarding relationships with family and friends. In terms of providing counselling to patients, as the level of psychological risk increased, confidence in dealing with these issues decreased. In addition, significantly more GCs reported that further training in psychosocial issues would be most beneficial to them if resources were available. As a feature of patient care, it is recommended that gene-based predictive testing include an integrative model of psychosocial services as well as training for genetic service providers in specific areas of AOHD mental health.

  13. On the credibility of scientific findings

    International Nuclear Information System (INIS)

    Maier-Leibnitz, H.

    1987-01-01

    Since the beginning of the so-called nuclear controversy, problems of risk and of safety increasingly have come to be discussed also by persons not really qualified for the job; often, results and findings were presented which, although technically unfounded or based on wrong assumptions or conclusions, have greatly helped to create fear and concern about the peaceful uses of nuclear energy. In a study of the credibility gap faced by science, criteria are given for the competency of experts vis-a-vis specific problems. The most important aspect in arriving at the truth is felt to be the weighing of alternative decisions. (orig./HP) [de

  14. Preserving medical correctness, readability and consistency in de-identified health records

    DEFF Research Database (Denmark)

    Pantazos, Kostas; Lauesen, Søren; Lippert, Søren

    2016-01-01

    A health record database contains structured data fields that identify the patient, such as patient ID, patient name, e-mail and phone number. These data are fairly easy to de-identify, that is, replace with other identifiers. However, these data also occur in fields with doctors’ free-text notes...... database, ending up with 323,122 patient health records. We had to invent many methods for de-identifying potential identifiers in the free-text notes. The de-identified health records should be used with caution for statistical purposes because we removed health records that were so special...

  15. Measuring Credibility Perceptions in CSR Communication: A Scale Development to Test Readers’ Perceived Credibility of CSR Reports

    Science.gov (United States)

    Lock, Irina; Seele, Peter

    2017-01-01

    Credibility is central to communication but often jeopardized by “credibility gaps.” This is especially true for communication about corporate social responsibility (CSR). To date, no tool has been available to analyze stakeholders’ credibility perceptions of CSR communication. This article presents a series of studies conducted to develop a scale to assess the perceived credibility of CSR reports, one of CSR communication’s most important tools. The scale provides a novel operationalization of credibility using validity claims of Habermas’s ideal speech situation as subdimensions. The scale development process, carried out in five studies including a literature review, a Delphi study, and three validation studies applying confirmatory factor analysis, resulted in the 16-item Perceived Credibility (PERCRED) scale. The scale shows convergent, discriminant, concurrent, and nomological validity and is the first validated measure for analyzing credibility perceptions of CSR reports. PMID:29278260

  16. Measuring Credibility Perceptions in CSR Communication: A Scale Development to Test Readers' Perceived Credibility of CSR Reports.

    Science.gov (United States)

    Lock, Irina; Seele, Peter

    2017-11-01

    Credibility is central to communication but often jeopardized by "credibility gaps." This is especially true for communication about corporate social responsibility (CSR). To date, no tool has been available to analyze stakeholders' credibility perceptions of CSR communication. This article presents a series of studies conducted to develop a scale to assess the perceived credibility of CSR reports, one of CSR communication's most important tools. The scale provides a novel operationalization of credibility using validity claims of Habermas's ideal speech situation as subdimensions. The scale development process, carried out in five studies including a literature review, a Delphi study, and three validation studies applying confirmatory factor analysis, resulted in the 16-item Perceived Credibility (PERCRED) scale. The scale shows convergent, discriminant, concurrent, and nomological validity and is the first validated measure for analyzing credibility perceptions of CSR reports.

  17. Development of a Severe Accident Mitigation Support with Speediness and Credibility

    International Nuclear Information System (INIS)

    Hur, Sup; Park, Jae Chang; Choi, Jong Gyun; Kim, Jung Taek; Kim, Chang Hwoi

    2014-01-01

    This study suggests a methodology of severe accident mitigation support with speediness and credibility. Using this methodology, the severe accident is automatically identified based on the information credibility check. And then, proper mitigation function, available mitigation routes, and an optimal mitigation path are automatically suggested. The basic logic of the information credibility is based on environmental evaluation, historical evaluation and some conventional methods such as redundancy and diversity comparison of instruments. To identify the available mitigation routes, availability of paths and components, source status, process limitation, expected adverse effect, and mitigation capability of the path are automatically were evaluated. Among the available routes, the optimal mitigation path was finally suggested based on the path priority criteria and physical relationship

  18. Correction: An Indicator of Media Credibility

    Directory of Open Access Journals (Sweden)

    Gordana Vilović

    2010-12-01

    Full Text Available The regularity of publishing corrections, clarifi cations, and letters to the editor, entail a high level of respect among the media for their audiences as they signify accountability and media credibility.This study began on the general assumption that the Croatian media is reluctant to publish corrections regularly, projecting an image that errors simply do not occur. Certainly errorless reporting is impossible due to fact that journalism is a profession prone to human error. Therefore, this study has enacted a content analysis methodology to follow the four primary Croatian daily newspapers, Jutarnji list, Večernji list, 24 sata and Vjesnik, for the period between May 6 and 30, 2010. The primary conclusion is that Croatian newspaper editors are hesitant to publish corrections if they are not under pressure from the Media Law.

  19. Credibility of the Printed Media: The Swine Flu as a Case Study

    Directory of Open Access Journals (Sweden)

    Ksenija Žlof

    2011-12-01

    Full Text Available The issue of credibility becomes especially pronounced in times of crises, which characteristically abound in the unknown, uncertainty, and doubt. Such crises are mostly sudden, often complex, andsometimes mired in controversial events. The public subsequently craves more information in times of crises, such that they may obtain more precise guidance, and ease their ability to cope. Given the relatively low frequency of crisis situations, most people lack actual experience relevant to a given predicament. The appearance of Virus A (H1N1 at the onset of 2009 is one such case. Despite H1N1’s classification as a broad-scale, serious health hazard, preventive vaccinations failed to reach a large segment of the population. We contend that the lack of credibility in informing the public through the media contributed considerably to this failure. Therefore, the aim of this paper is to determine the level of credible information provided by the print media from which the general public could have taken an informed position on the crisis in question. Quantitative research and content analysis ascertained from a body of print media sources with national coverage reveals that the Croatian print media, contrary to our expectations, largely rely on official sources and transparently cite authors, which contributes to a higher degree of credibility. Yet further analysis of the number of sources suggests that most journalists used on average only one or no named sources, which significantly reduces the credibility of the published articles.

  20. Establishing the credibility of archaeoastronomical sites

    Science.gov (United States)

    Ruggles, Clive L. N.

    2015-08-01

    This is not a talk about archaeoastronomy per se, but rather about how the Astronomy and World Heritage Initiative helps us deal with archaeoastronomical sites as potential World Heritage.In 2011, an attempt to nominate a prehistoric “observatory” site onto the World Heritage List proved unsuccessful because UNESCO rejected the interpretation as statistically and archaeologically unproven. The case highlights an issue at the heart of archaeoastronomical methodology and interpretation: the mere existence of astronomical alignments in ancient sites does not prove that they were important to those who constructed and used the sites, let alone giving us insights into their likely significance and meaning. Advances in archaeoastronomy over several decades have resulted in the development of a substantial body of theory and practice (Ruggles 2014) where the most favoured interpretations depend upon integrating methods from astronomy, anthropology and other disciplines, but individual cases can still engender considerable controversy.The fact that more archaeoastronomical sites are now appearing on national tentative lists prior to their WHL nomination means that this is no longer just an academic issue; establishing the credibility of the archaeoastronomical interpretations is crucial to any assessment of their value in heritage terms.In this talk I shall describe progress that has been made within the Astronomy and World Heritage Initiative towards establishing broadly acceptable measures of archaeoastronomical credibility that make sense in the context of the heritage evaluation process. I will focus particularly, but not exclusively, on sites that are included in the Thematic Studies and/or are already included on national Tentative Lists, such as the Portuguese/Spanish seven-stone antas (Neolithic dolmens) and Chankillo in Peru (solar observation device dating to c. 300BC). I will also mention how the recognition of astronomical attributes of potential

  1. Extent, accuracy, and credibility of breastfeeding information on the Internet.

    Science.gov (United States)

    Shaikh, Ulfat; Scott, Barbara J

    2005-05-01

    Our objective was to test and describe a model for evaluating Websites related to breastfeeding. Forty Websites most likely to be accessed by the public were evaluated for extent, accuracy, credibility, presentation, ease of use, and adherence to ethical and medical Internet publishing standards. Extent and accuracy of Website content were determined by a checklist of critical information. The majority of Websites reviewed provided accurate information and complied with the International Code of Marketing of Breast-milk Substitutes. Approximately half the Websites complied with standards of medical Internet publishing. While much information on breastfeeding on the Internet is accurate, there is wide variability in the extent of information, usability of Websites, and compliance with standards of medical Internet publishing. Results of this study may be helpful to health care professionals as a model for evaluating breastfeeding-related Websites and to highlight considerations when recommending or designing Websites.

  2. Enhancing the quality and credibility of qualitative analysis.

    OpenAIRE

    Patton, M Q

    1999-01-01

    Varying philosophical and theoretical orientations to qualitative inquiry remind us that issues of quality and credibility intersect with audience and intended research purposes. This overview examines ways of enhancing the quality and credibility of qualitative analysis by dealing with three distinct but related inquiry concerns: rigorous techniques and methods for gathering and analyzing qualitative data, including attention to validity, reliability, and triangulation; the credibility, comp...

  3. Strategies Employed by Citizen Science Programs to Increase the Credibility of Their Data

    Directory of Open Access Journals (Sweden)

    Amy Freitag

    2016-05-01

    Full Text Available The success of citizen science in producing important and unique data is attracting interest from scientists and resource managers. Nonetheless, questions remain about the credibility of citizen science data. Citizen science programs desire to meet the same standards of credibility as academic science, but they usually work within a different context, for example, training and managing significant numbers of volunteers with limited resources. We surveyed the credibility-building strategies of 30 citizen science programs that monitor environmental aspects of the California coast. We identified a total of twelve strategies: Three that are applied during training and planning; four that are applied during data collection; and five that are applied during data analysis and program evaluation. Variation in the application of these strategies by program is related to factors such as the number of participants, the focus on group or individual work, and the time commitment required of volunteers. The structure of each program and available resources require program designers to navigate tradeoffs in the choices of their credibility strategies. Our results illustrate those tradeoffs and provide a framework for the necessary discussions between citizen science programs and potential users of their data—including scientists and decision makers—about shared expectations for credibility and practical approaches for meeting those expectations. This article has been corrected here: http://dx.doi.org/10.5334/cstp.91

  4. Extracting Credible Dependencies for Averaged One-Dependence Estimator Analysis

    Directory of Open Access Journals (Sweden)

    LiMin Wang

    2014-01-01

    Full Text Available Of the numerous proposals to improve the accuracy of naive Bayes (NB by weakening the conditional independence assumption, averaged one-dependence estimator (AODE demonstrates remarkable zero-one loss performance. However, indiscriminate superparent attributes will bring both considerable computational cost and negative effect on classification accuracy. In this paper, to extract the most credible dependencies we present a new type of seminaive Bayesian operation, which selects superparent attributes by building maximum weighted spanning tree and removes highly correlated children attributes by functional dependency and canonical cover analysis. Our extensive experimental comparison on UCI data sets shows that this operation efficiently identifies possible superparent attributes at training time and eliminates redundant children attributes at classification time.

  5. Persuading Girls to Take Elective Physical Science Courses in High School: Who Are the Credible Communicators?

    Science.gov (United States)

    Koballa, Thomas R., Jr.

    1988-01-01

    Identifies communicators whom eighth-grade girls perceive as credible regarding reasons for taking elective physical science courses in high school. Finds that father, woman science teacher, mother, and boy high school student are ranked highly. Attributes associated with the communicators were classified as prestige, trustworthiness, similarity,…

  6. Persuading girls to take elective physical science courses in high school: Who are the credible communicators?

    Science.gov (United States)

    Koballa, Thomas R., Jr.

    Eighth-grade girls (N=257) randomly selected from nine different public junior high schools in central Texas were questioned in order to identify the communicators whom they perceive as highly credible regarding reasons for taking elective physical science courses in high school and the attributes associated with these communicators. Four persons were each identified by better than 10 percent of the sample as the best person to try to convince junior high school girls to take elective physical science courses in high school. In order of perceived credibility, these persons are father, woman science teacher, mother, and boy high school student. Slight variations in the order of perceived credibility were found when the responses from girls of the different ethnic groups represented in the sample (Caucasian, Hispanic, Black, and Asian) were examined separately. Attributes listed by the respondents for father, woman science teacher, mother, and boy high school student were examined and classified into the categories of prestige, trustworthiness, similarity, attractiveness, and power. Prestige and trustworthiness are the attributes associates most frequently with communicators identified as highly credible. Implications of the present study and suggestions for further research are discussed.

  7. Nuclear strategy: India's march towards credible deterrence

    International Nuclear Information System (INIS)

    Sethi, Manpreet

    2009-01-01

    May 1998 was a momentous event in India's life. At one level, the five nuclear tests marked the culmination of the long debate on India's nuclear status. At another level, they initiated the country's journey towards credible nuclear deterrence. In the eleventh year of its existence as a state with nuclear weapons, India is engaged in a range of activities to meaningfully integrate the nuclear weapon into its national security strategy. The US and the USSR, at the same stage of their lives were engaged in pretty much a similar exercise. However, unlike the superpowers, for whom the immense destructive potential of the atomic weapon and its implications for inter-state relations suddenly burst on the scene and sent them scrambling to craft strategies that could fit the new reality, India's acquisition of nuclear weapons capability, though dictated by circumstances, came with a basic understanding of the ground rules of the game of nuclear deterrence. In fact, it may be recalled that soon after the tests, there was a spate of books and studies on India's nuclear strategy. A draft nuclear doctrine was made public just fifteen months after the tests and operational issues were beginning to be grappled with

  8. Topic familiarity and information skills in online credibility evaluation

    NARCIS (Netherlands)

    Lucassen, T.; Schraagen, J.M.C.

    2013-01-01

    With the rise of user generated content, evaluating the credibility of information has become increasingly important. It is already known that various user characteristics influence the way credibility evaluation is performed. Domain experts on the topic at hand primarily focus on semantic features

  9. Data Credibility: A Perspective from Systematic Reviews in Environmental Management

    Science.gov (United States)

    Pullin, Andrew S.; Knight, Teri M.

    2009-01-01

    To use environmental program evaluation to increase effectiveness, predictive power, and resource allocation efficiency, evaluators need good data. Data require sufficient credibility in terms of fitness for purpose and quality to develop the necessary evidence base. The authors examine elements of data credibility using experience from critical…

  10. Institutional credibility and the future of Danish journalism

    DEFF Research Database (Denmark)

    Ørsten, Mark; Burkal, Rasmus

    Credibility is frequently represented as both an ideal goal for journalism as a profession (Vultree, 2010) and as an integral part of the survival strategy of the news industry (Meyer, 2004). Yet there exists no widely accepted operationalization of the concept of credibility. In this paper we...... ethics among Danish journalists....

  11. Health assessments for Indigenous Australians at Orange Aboriginal Medical Service: health problems identified and subsequent follow up.

    Science.gov (United States)

    Dutton, Tegan; Stevens, Wendy; Newman, Jamie

    2016-01-01

    This study aimed to document the types, management and follow up of health issues identified by all Aboriginal Health Assessments (AHA) performed at Orange Aboriginal Medical Service from 1 January 2011 to 31 December 2012. This was done with a retrospective audit of clinical records. In total, 1169 AHAs were performed: 41% child, 53% adult and 6% older person AHAs. Newly identified health issues were documented in 85% (984). Being overweight (41%; 476) and smoking (26%; 301) were the common risk factors identified. As a result of the AHA, most children who were not up-to-date with their vaccinations received catch-up immunisations; 11% (36) of adult women (n=314) received a Pap smear, although Pap smear status was unknown or not up-to-date for 61% (192); 27% (311) of cases were prescribed new medication; and 1239 referrals were made but only 40% were attended. At 6 months following the AHA, 26% (240) of cases with newly identified health issues were completely managed and followed up, whereas 25% (226) received no follow up. The AHAs are useful for identifying new health issues; however, follow up of the identified health issues should be improved. If AHAs are to improve health outcomes, appropriate management and follow up of the identified health issues are essential.

  12. Building credibility in international banking and financial markets

    DEFF Research Database (Denmark)

    Jørgensen, Poul Erik Flyvholm; Isaksson, Maria

    2008-01-01

    . There is also clear evidence that corporate advertising is in fact strongly focussed on communicating credibility with less than 10% of discourse and visuals devoted to credibility-free themes and issues. Research implications/limitations - The study takes a production perspective, using discourse......Purpose - The research draws a detailed picture of how international corporate banks and financial institutions approach image advertising to enhance impressions of their credibility. The purpose of the work is twofold, namely to demonstrate (1) how corporate credibility can be conceptualised...... appeal forms. A corpus of 74 print adverts was then analysed in order to establish how financial marketers use the appeal forms to strengthen their corporate reputations. The patterns of credibility appeals obtained were then linked to the supporting visuals to provide a fuller picture of the industry...

  13. Health Research and Millennium Development Goals: Identifying the Gap From Public Health Perspective.

    Science.gov (United States)

    El Lawindi, Mona I; Galal, Yasmine S; Khairy, Walaa A

    2015-08-23

    Assessing the research output within the universities could provide an effective means for tracking the Millennium Development Goals (MDGs) progress. This analytical database study was designed to assess the trend of research theses conducted by the Public Health Department (PHD), Faculty of Medicine, Cairo University during the period 1990 to 2014 as related to the: MDGS, Faculty and department research priority plans and to identify the discrepancies between researchers' priorities versus national and international research priorities. A manual search of the theses was done at the Postgraduate Library using a specially designed checklist to chart adherence of each thesis to: MDGs, Faculty and department research plans (RPs). The theses' profile showed that the highest research output was for addressing the MDGS followed by the PHD and Faculty RPs. Compliance to MDGs 5 and 6 was obvious, whereas; MDGs 2, 3, and 7 were not represented at all after year 2000. No significant difference was found between PH theses addressing the Faculty RPs and those which were not before and after 2010. A significantly lower percent of PH theses was fulfilling the PHD research priorities compared to those which were not after 2010. This study showed a definite decline in research output tackling the MDGS and PHD research priorities, with a non-significant increase in the production of theses addressing the Faculty RPs. The present study is a practical model for policy makers within the universities to develop and implement a reliable monitoring and evaluation system for assessment of research output.

  14. Would a madman have been so wise as this?" The effects of source credibility and message credibility on validation.

    Science.gov (United States)

    Foy, Jeffrey E; LoCasto, Paul C; Briner, Stephen W; Dyar, Samantha

    2017-02-01

    Readers rapidly check new information against prior knowledge during validation, but research is inconsistent as to whether source credibility affects validation. We argue that readers are likely to accept highly plausible assertions regardless of source, but that high source credibility may boost acceptance of claims that are less plausible based on general world knowledge. In Experiment 1, participants read narratives with assertions for which the plausibility varied depending on the source. For high credibility sources, we found that readers were faster to read information confirming these assertions relative to contradictory information. We found the opposite patterns for low credibility characters. In Experiment 2, readers read claims from the same high or low credibility sources, but the claims were always plausible based on general world knowledge. Readers consistently took longer to read contradictory information, regardless of source. In Experiment 3, participants read modified versions of "The Tell-Tale Heart," which was narrated entirely by an unreliable source. We manipulated the plausibility of a target event, as well as whether high credibility characters within the story provided confirmatory or contradictory information about the narrator's description of the target event. Though readers rated the narrator as being insane, they were more likely to believe the narrator's assertions about the target event when it was plausible and corroborated by other characters. We argue that sourcing research would benefit from focusing on the relationship between source credibility, message credibility, and multiple sources within a text.

  15. Practical differences among probabilities, possibilities, and credibilities

    Science.gov (United States)

    Grandin, Jean-Francois; Moulin, Caroline

    2002-03-01

    This paper presents some important differences that exist between theories, which allow the uncertainty management in data fusion. The main comparative results illustrated in this paper are the followings: Incompatibility between decisions got from probabilities and credibilities is highlighted. In the dynamic frame, as remarked in [19] or [17], belief and plausibility of Dempster-Shafer model do not frame the Bayesian probability. This framing can however be obtained by the Modified Dempster-Shafer approach. It also can be obtained in the Bayesian framework either by simulation techniques, or with a studentization. The uncommitted in the Dempster-Shafer way, e.g. the mass accorded to the ignorance, gives a mechanism similar to the reliability in the Bayesian model. Uncommitted mass in Dempster-Shafer theory or reliability in Bayes theory act like a filter that weakens extracted information, and improves robustness to outliners. So, it is logical to observe on examples like the one presented particularly by D.M. Buede, a faster convergence of a Bayesian method that doesn't take into account the reliability, in front of Dempster-Shafer method which uses uncommitted mass. But, on Bayesian masses, if reliability is taken into account, at the same level that the uncommited, e.g. F=1-m, we observe an equivalent rate for convergence. When Dempster-Shafer and Bayes operator are informed by uncertainty, faster or lower convergence can be exhibited on non Bayesian masses. This is due to positive or negative synergy between information delivered by sensors. This effect is a direct consequence of non additivity when considering non Bayesian masses. Unknowledge of the prior in bayesian techniques can be quickly compensated by information accumulated as time goes on by a set of sensors. All these results are presented on simple examples, and developed when necessary.

  16. Credibility assessment in child sexual abuse investigations: A descriptive analysis.

    Science.gov (United States)

    Melkman, Eran P; Hershkowitz, Irit; Zur, Ronit

    2017-05-01

    A major challenge in cases of child sexual abuse (CSA) is determining the credibility of children's reports. Consequently cases may be misclassified as false or deemed 'no judgment possible'. Based on a large national sample of reports of CSA made in Israel in 2014, the study examines child and event characteristics contributing to the probability that reports of abuse would be judged credible. National data files of all children aged 3-14, who were referred for investigation following suspected victimization of sexual abuse, and had disclosed sexual abuse, were analyzed. Cases were classified as either 'credible' or 'no judgment possible'. The probability of reaching a 'credible' judgment was examined in relation to characteristics of the child (age, gender, cognitive delay, marital status of the parents,) and of the abusive event (abuse severity, frequency, perpetrator-victim relationship, perpetrator's use of grooming, and perpetrator's use of coercion), controlling for investigator's identity at the cluster level of the analysis. Of 1563 cases analyzed, 57.9% were assessed as credible. The most powerful predictors of a credible judgment were older age and absence of a cognitive delay. Reports of children to married parents, who experienced a single abusive event that involved perpetrator's use of grooming, were also more likely to be judged as credible. Rates of credible judgments found are lower than expected suggesting under-identification of truthful reports of CSA. In particular, those cases of severe and multiple abuse involving younger and cognitively delayed children are the ones with the lowest chances of being assessed as credible. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Preparing for the data revolution: identifying minimum health information competencies among the health workforce

    OpenAIRE

    Whittaker, Maxine; Hodge, Nicola; Mares, Renata E; Rodney, Anna

    2015-01-01

    Background Health information is required for a variety of purposes at all levels of a health system, and a workforce skilled in collecting, analysing, presenting, and disseminating such information is essential to fulfil these demands. While it is established that low- and middle-income countries (LMICs) are facing shortages in human resources for health (HRH), there has been little systematic attention focussed on non-clinical competencies. In response, we developed a framework that defines...

  18. Identifying Lesbian, Gay, Bisexual, and Transgender Search Terminology: A Systematic Review of Health Systematic Reviews.

    Directory of Open Access Journals (Sweden)

    Joseph G L Lee

    Full Text Available Research on the health of lesbian, gay, bisexual, and transgender (LGBT populations can provide important information to address existing health inequalities. Finding existing research in LGBT health can prove challenging due to the plethora of terminology used. We sought to describe existing search strategies and to identify more comprehensive LGBT search terminology. We iteratively created a search string to identify systematic reviews and meta-analyses about LGBT health and implemented it in Embase, PubMed/MEDLINE, and PsycINFO databases on May 28-29, 2015. We hand-searched the journal LGBT Health. Inclusion criteria were: systematic reviews and meta-analyses that addressed LGBT health, used systematic searching, and used independent coders for inclusion. The published search terminology in each record and search strings provided by authors on request were cross-referenced with our original search to identify additional terminology. Our search process identified 19 systematic reviews meeting inclusion criteria. The number of search terms used to identify LGBT-related records ranged from 1 to 31. From the included studies, we identified 46 new search terms related to LGBT health. We removed five search terms as inappropriate and added five search terms used in the field. The resulting search string included 82 terms. There is room to improve the quality of searching and reporting in LGBT health systematic reviews. Future work should attempt to enhance the positive predictive value of LGBT health searches. Our findings can assist LGBT health reviewers in capturing the diversity of LGBT terminology when searching.

  19. eWOM credibility on social networking sites: A framework

    OpenAIRE

    Moran, Gillian; Muzellec, Laurent

    2017-01-01

    Social networking sites (SNS) offer brands the ability to spread positive electronic Word of Mouth (eWOM) for the purposes of building awareness and acquiring new customers. However, the credibility of eWOM is threatened of late as marketers increasingly try to manipulate eWOM practices on SNS. A greater understanding of eWOM credibility is necessary to better enable marketers to leverage true consumer engagement by generating credible peer-to-peer communications. Yet, to date, there is no on...

  20. EVALUATION OF NATIONAL BANK OF ROMANIA MONETARY POLICY CREDIBILITY

    Directory of Open Access Journals (Sweden)

    Toader Valentin

    2008-05-01

    Full Text Available In this paper, using the models from the economic literature, the authors study the credibility level of National Bank of Romania (NRB during the time span Mars 2007 – Mars 2008. We will use three types of credibility indexes - two from the economic literature and one proposed by the authors. Also, we will emphasize the impact of unpredictable shocks - the natural calamities (drought which affected the aggregate supply in the summer of 2007 and the depreciation of RON against the euro - on the NBR credibility.

  1. Learning to Promote Health at an Emergency Care Department: Identifying Expansive and Restrictive Conditions

    Science.gov (United States)

    Gustavsson, Maria; Ekberg, Kerstin

    2015-01-01

    This article reports on the findings of a planned workplace health promotion intervention, and the aim is to identify conditions that facilitated or restricted the learning to promote health at an emergency care department in a Swedish hospital. The study had a longitudinal design, with interviews before and after the intervention and follow-up…

  2. Reported credibility techniques in higher education evaluation studies that use qualitative methods: A research synthesis.

    Science.gov (United States)

    Liao, Hongjing; Hitchcock, John

    2018-06-01

    This synthesis study examined the reported use of credibility techniques in higher education evaluation articles that use qualitative methods. The sample included 118 articles published in six leading higher education evaluation journals from 2003 to 2012. Mixed methods approaches were used to identify key credibility techniques reported across the articles, document the frequency of these techniques, and describe their use and properties. Two broad sets of techniques were of interest: primary design techniques (i.e., basic), such as sampling/participant recruitment strategies, data collection methods, analytic details, and additional qualitative credibility techniques (e.g., member checking, negative case analyses, peer debriefing). The majority of evaluation articles reported use of primary techniques although there was wide variation in the amount of supporting detail; most of the articles did not describe the use of additional credibility techniques. This suggests that editors of evaluation journals should encourage the reporting of qualitative design details and authors should develop strategies yielding fuller methodological description. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Labont? Identifies Key Issues for Health Promoters in the New World Order

    OpenAIRE

    Raphael, Dennis

    2016-01-01

    For over 35 years Ronald Labonté has been critically analyzing the state of health promotion in Canada and the world. In 1981, he identified the shortcomings of the groundbreaking Lalonde Report by warning of the seductive appeal of so-called lifestyle approaches to health. Since then, he has left a trail of critical work identifying the barriers to — and opportunities for —health promotion work. More recently, he has shown how the rise of economic globalization and acceptance of neo-liberal ...

  4. Identifying research priorities for public health research to address health inequalities: use of Delphi-like survey methods.

    Science.gov (United States)

    Turner, S; Ollerhead, E; Cook, A

    2017-10-09

    In the funding of health research and public health research it is vital that research questions posed are important and that funded research meets a research need or a gap in evidence. Many methods are used in the identification of research priorities, however, these can be resource intensive, costly and logistically challenging. Identifying such research priorities can be particularly challenging for complex public health problems as there is a need to consult a number of experts across disciplines and with a range of expertise. This study investigated the use of Delphi-like survey methods in identifying important research priorities relating to health inequalities and framing tractable research questions for topic areas identified. The study was conducted in two phases, both using Delphi-like survey methods. Firstly, public health professionals with an interest in health inequalities were asked to identify research priorities. Secondly academic researchers were asked to frame tractable research questions relating to the priorities identified. These research priorities identified using Delphi-like survey methods were subsequently compared to those identified using different methods. A total of 52 public health professionals and 21 academics across the United Kingdom agreed to take part. The response rates were high, from public health professionals across three survey rounds (69%, 50% and 40%) and from academics across one round (52%), indicating that participants were receptive to the method and motivated to respond. The themes identified as encompassing the most important research priorities were mental health, healthy environment and health behaviours. Within these themes, the topic areas that emerged most strongly included community interventions for prevention of mental health problems and the food and alcohol environment. Some responses received from academic researchers were (as requested) in the form of tractable research questions, whereas others

  5. Tacit knowledge of public health nurses in identifying community health problems and need for new services: a case study.

    Science.gov (United States)

    Yoshioka-Maeda, Kyoko; Murashima, Sachiyo; Asahara, Kiyomi

    2006-09-01

    The purpose of this study was to explore the tacit knowledge of public health nurses in identifying community health problems and developing relevant new projects. Previous research only roughly showed those skills for creating new community health services, such as lobbying. Nine Japanese public health nurses who had created new projects in their municipalities were selected by theoretical sampling and interviewed in 2002-2003. Yin's Case Study Method, especially the multiple-case study design, was used. All 9 public health nurses used similar approaches in identifying community health problems and the need for creating new services, even though their experiences differed and the kinds of projects varied. They identified the difficulties of clients, recognized clients who had the same problems, elucidated the limitations of existing services, and forecasted outcomes from the neglect of the clients' problems. Then they succeeded in creating a new project by examining individual health problems in the context of their community's characteristics, societal factors, and using existing policies to support their clients. This is the first study to explore the skills of public health nurses and their intention to use such skills in creating new projects as well as the exact process. They could identify community health problems that will be the basis for developing new services to provide care for individual clients. This is different from the traditional community assessment approach that requires the collection of a huge amount of information to clarify community health problems. The tacit knowledge of public health nurses will help to create needs-oriented new services more smoothly.

  6. Does the Credible Fiscal Policy Support the Prices Stabilization?

    Directory of Open Access Journals (Sweden)

    Kuncoro Haryo

    2015-06-01

    Full Text Available This paper aims at analyzing the co-movement between fiscal policy and monetary policy rules in the context of price stabilization. More specifically, we observe the potential impact of fiscal policy credibility on the price stabilization in the inflation targeting framework. Motivated by the fact that empirical studies concerning this aspect are still limited, we take the case of Indonesia over the period 2001-2013. Based on the quarterly data analysis, we found that the impact of credibility typically depends on characteristics of fiscal rules commitment. On one hand, the credibility of debt rule reduces the inflation rate. In contrast, the incredible deficit rule policy does not have any impact on the inflation rate and therefore does not support to inflation targeting. Given those results, we conclude that credibility matters in stabilizing price levels. Accordingly, those findings suggest tightening coordination between monetary and fiscal policy to maintain fiscal sustainability in accordance with price stabilization policy

  7. Mathematical Validation and Credibility of Diagnostic Blocks for Spinal Pain.

    Science.gov (United States)

    Engel, Andrew J; Bogduk, Nikolai

    2016-10-01

    Diagnostic blocks are used in different ways for the diagnosis of spinal pain, but their validity has not been fully evaluated. Four clinical protocols were analyzed mathematically to determine the probability of correct responses arising by chance. The complement of this probability was adopted as a measure of the credibility of correct responses. The credibility of responses varied from 50% to 95%, and was determined less by the agents used but more by what information was given to patients and if the agents were fully randomized for each block. Randomized, comparative local anesthetic blocks offer a credibility of 75%, but randomized, placebo-controlled blocks provide a credibility of 95%, and are thereby suitable as a criterion standard for diagnostic blocks. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Credibility judgments in web page design - a brief review.

    Science.gov (United States)

    Selejan, O; Muresanu, D F; Popa, L; Muresanu-Oloeriu, I; Iudean, D; Buzoianu, A; Suciu, S

    2016-01-01

    Today, more than ever, knowledge that interfaces appearance analysis is a crucial point in human-computer interaction field has been accepted. As nowadays virtually anyone can publish information on the web, the credibility role has grown increasingly important in relation to the web-based content. Areas like trust, credibility, and behavior, doubled by overall impression and user expectation are today in the spotlight of research compared to the last period, when other pragmatic areas such as usability and utility were considered. Credibility has been discussed as a theoretical construct in the field of communication in the past decades and revealed that people tend to evaluate the credibility of communication primarily by the communicator's expertise. Other factors involved in the content communication process are trustworthiness and dynamism as well as various other criteria but to a lower extent. In this brief review, factors like web page aesthetics, browsing experiences and user experience are considered.

  9. The 'Thin film of gold': monetary rules and policy credibility

    OpenAIRE

    Niall Ferguson; Moritz Schularick

    2012-01-01

    This paper asks whether developing countries can reap credibility gains from submitting policy to a strict monetary rule. Following earlier work, we look at the gold standard era (1880-1914) as a "natural experiment" to test whether adoption of a rule-based monetary framework such as the gold standard increased policy credibility. On the basis of the largest possible dataset covering almost sixty independent and colonial borrowers in the London market, we challenge the traditional view that g...

  10. Exchange-Rate-Based Stabilization under Imperfect Credibility

    OpenAIRE

    Guillermo Calvo; Carlos A. Végh Gramont

    1991-01-01

    This paper analyzes stabilization policy under predetermined exchange rates in a cash-in-advance, staggered-prices model. Under full credibility, a reduction in the rate of devaluation results in an immediate and permanent reduction in the inflation rate, with no effect on output or consumption. In contrast, a non-credible stabilization results in an initial expansion of output, followed by a later recession. The inflation rate of home goods remains above the rate of devaluation throughout th...

  11. GROWTH, LIQUIDITY CONSTRAINTS, CREDIBILITY AND THE EFFECTS OF SHOCKS UNDER A NON-CREDIBLE GOVERNMENT

    Directory of Open Access Journals (Sweden)

    DURMUŞ ÖZDEMİR

    2013-06-01

    Full Text Available This paper presents an overlapping generations model for a small open economy. The model is calibrated to fit data for Turkey. Simulations suggest that for a fairly open economy such as Turkey, credibility and liquidity constraints matter and the choice of income taxation rate, the mix of government spending and the long-run government debt/GDP ratio can all significantly affect the economic growth. The paper also examines the effectiveness of fiscal policy under different levels of liquidity constraint in an open economy within a dynamic framework. It shows that liquidity constraints can affect the outcome of any fiscal policy. Hence fiscal policy is even more important for the less developed economies of the world.

  12. Extension and Application of Credibility Models in Predicting Claim Frequency

    Directory of Open Access Journals (Sweden)

    Yuan-tao Xie

    2018-01-01

    Full Text Available In nonlife actuarial science, credibility models are one of the main methods of experience ratemaking. Bühlmann-Straub credibility model can be expressed as a special case of linear mixed models (LMMs with the underlying assumption of normality. In this paper, we extend the assumption of Bühlmann-Straub model to include Poisson and negative binomial distributions as they are more appropriate for describing the distribution of a number of claims. By using the framework of generalized linear mixed models (GLMMs, we obtain the generalized credibility premiums that contain as particular cases another credibility premium in the literature. Compared to generalized linear mixed models, our extended credibility models also have an advantage in that the credibility factor falls into the range from 0 to 1. The performance of our models in comparison with an existing model in the literature is also evaluated through numerical studies, which shows that our approach produces premium estimates close to the optima. In addition, our proposed model can also be applied to the most commonly used ratemaking approach, namely, the net, the optimal Bonus-Malus system.

  13. Mental Health of Prisoners: Identifying Barriers to Mental Health Treatment and Medication Continuity

    Science.gov (United States)

    Connell, Nadine M.

    2014-01-01

    Objectives. We assessed mental health screening and medication continuity in a nationally representative sample of US prisoners. Methods. We obtained data from 18 185 prisoners interviewed in the 2004 Survey of Inmates in State and Federal Correctional Facilities. We conducted survey logistic regressions with Stata version 13. Results. About 26% of the inmates were diagnosed with a mental health condition at some point during their lifetime, and a very small proportion (18%) were taking medication for their condition(s) on admission to prison. In prison, more than 50% of those who were medicated for mental health conditions at admission did not receive pharmacotherapy in prison. Inmates with schizophrenia were most likely to receive pharmacotherapy compared with those presenting with less overt conditions (e.g., depression). This lack of treatment continuity is partially attributable to screening procedures that do not result in treatment by a medical professional in prison. Conclusions. A substantial portion of the prison population is not receiving treatment for mental health conditions. This treatment discontinuity has the potential to affect both recidivism and health care costs on release from prison. PMID:25322306

  14. Identifying and Prioritizing Information Needs and Research Priorities of Public Health Emergency Preparedness and Response Practitioners.

    Science.gov (United States)

    Siegfried, Alexa L; Carbone, Eric G; Meit, Michael B; Kennedy, Mallory J; Yusuf, Hussain; Kahn, Emily B

    2017-10-01

    This study describes findings from an assessment conducted to identify perceived knowledge gaps, information needs, and research priorities among state, territorial, and local public health preparedness directors and coordinators related to public health emergency preparedness and response (PHPR). The goal of the study was to gather information that would be useful for ensuring that future funding for research and evaluation targets areas most critical for advancing public health practice. We implemented a mixed-methods approach to identify and prioritize PHPR research questions. A web survey was sent to all state, city, and territorial health agencies funded through the Public Health Emergency Preparedness (PHEP) Cooperative Agreement program and a sample of local health departments (LHDs). Three focus groups of state and local practitioners and subject matter experts from the Centers for Disease Control and Prevention (CDC) were subsequently conducted, followed by 3 meetings of an expert panel of PHPR practitioners and CDC experts to prioritize and refine the research questions. We identified a final list of 44 research questions that were deemed by study participants as priority topics where future research can inform PHPR programs and practice. We identified differences in perceived research priorities between PHEP awardees and LHD survey respondents; the number of research questions rated as important was greater among LHDs than among PHEP awardees (75%, n=33, compared to 24%, n=15). The research questions identified provide insight into public health practitioners' perceived knowledge gaps and the types of information that would be most useful for informing and advancing PHPR practice. The study also points to a higher level of information need among LHDs than among PHEP awardees. These findings are important for CDC and the PHPR research community to ensure that future research studies are responsive to practitioners' needs and provide the information

  15. Establishing Credibility in the Multicultural Classroom: When the Instructor Speaks with an Accent

    Science.gov (United States)

    McLean, Chikako Akamatsu

    2007-01-01

    Applying theories of cultural dimensions, teacher credibility, and nonverbal immediacy, this chapter explores classroom management techniques used by Asian female teachers to establish credibility. (Contains 1 note.)

  16. Do adult mental health services identify child abuse and neglect? A systematic review.

    Science.gov (United States)

    Read, John; Harper, David; Tucker, Ian; Kennedy, Angela

    2018-02-01

    Child abuse and neglect play a causal role in many mental health problems. Knowing whether users of mental health services were abused or neglected as children could be considered essential for developing comprehensive formulations and effective treatment plans. In the present study we report the findings of a systematic review, using independent searches of three databases designed to discover how often mental health staff find out whether their clients were abused or neglected as children. Twenty-one relevant studies were identified. Most people who use mental health services are never asked about child abuse or neglect. The majority of cases of child abuse or neglect are not identified by mental health services. Only 28% of abuse or neglect cases identified by researchers are found in the clients' files: emotional abuse, 44%; physical abuse, 33%; sexual abuse, 30%; emotional neglect, 17%; and physical neglect, 10%. Between 0% and 22% of mental health service users report being asked about child abuse. Men and people diagnosed with psychotic disorders are asked less than other people. Male staff ask less often than female staff. Some improvement over time was found. Policies compelling routine enquiry, training, and trauma-informed services are required. © 2017 Australian College of Mental Health Nurses Inc.

  17. Identifying and describing feelings and psychological flexibility predict mental health in men with HIV.

    Science.gov (United States)

    Landstra, Jodie M B; Ciarrochi, Joseph; Deane, Frank P; Hillman, Richard J

    2013-11-01

    Difficulty identifying and describing feelings (DIDF) and psychological flexibility (PF) predict poor emotional adjustment. To examine the relationship between DIDF and PF and whether DIDF and low PF would put men undergoing cancer screening at risk for poor adjustment. Longitudinal self-report survey. Two hundred and one HIV-infected men who have sex with men participated in anal cancer screening at two time points over 14 weeks. Psychological flexibility was assessed by the Acceptance and Action Questionnaire II and DIDF by the Toronto Alexithymia Scale-20. We also measured depression, anxiety, stress (DASS) and health-related quality of life (QOL; SF-12). Both DIDF and PF were reliable predictors of mental health. When levels of baseline mental health were controlled, greater DIDF predicted increases in Time 2 depression, anxiety and stress and decreases in mental and physical QOL. The link between PF and mental health was entirely mediated by DIDF. Being chronically low in PF could lead to greater DIDF and thereby worse mental health. Having more PF promotes the ability to identify and differentiate the nuances of pleasant and unpleasant emotions, which enhances an individual's mental health. Intentionally enhancing men's ability to identify and describe feelings or PF may assist them to better manage a range of difficult life experiences such as health screenings and other potentially threatening information. © 2013 The British Psychological Society.

  18. The corporation and the community: Credibility, legitimacy, and imposed risk

    International Nuclear Information System (INIS)

    Wade, C.; Rosenthal, I.

    1991-10-01

    In this age of rapid changes, large segments of society no longer trust any institution or authority in regard to pronouncements on what is safe. Because of this distrust, the public has demanded and obtained increased rights for individuals to intervene directly in decisions affecting them. Rosenthal warns that an organization that just fulfills its legal requirements for safety is no longer doing enough. Industry leaders must work toward re-establishing credibility by identifying persons who are potentially at risk as a result of industry activities, involving them in the communication process, and justifying the firm's social benefits. Seeking social legitimacy, chemical manufacturers have formed self-assessment groups and community councils, which have reaped unexpected benefits but have forced them to deal with issues they would have preferred to avoid. To industry leaders who contend that these types of activities are not worth the effort, Rosenthal presents a timely warning. Government and business must reduce public concerns significantly and make stakeholders more willing to tolerate imposed risk because of perceived benefits. It the public's concern is not reduced, we will all be required to make greater and greater investments in an inefficient and largely fruitless pursuit of absolute safety. 16 refs

  19. Reactor safety research - visible demonstrations and credible computations

    Energy Technology Data Exchange (ETDEWEB)

    Loewenstein, W B; Divakaruni, S M

    1985-11-01

    EPRI has been conducting nuclear safety research for a number of years with the primary goal of assuring the safety and reliability of the nuclear plants. The visibility is emphasized by sponsoring or participating in large scale test demonstrations to credibly support the complex computations that are the basis for quantification of safety margins. Recognizing the success of the airline industry in receiving favorable public perception, the authors compare the design and operation practices of the airline industry with those of the nuclear industry practices to identify the elements contributing to public concerns and unfavorable perceptions. In this paper, authors emphasize the importance of proper communications of research results to the public in a manner that non-specialists understand. Further, EPRI supported research and results in the areas of source term, seismic and structural engineering research, analysis using probabilistic risk assessment (PRA), quantification of safety margins, digital technology development and implementation, and plant transient and performance evaluations are discussed in the paper. (orig./HP).

  20. The corporation and the community: Credibility, legitimacy, and imposed risk

    Energy Technology Data Exchange (ETDEWEB)

    Wade, C. (ed.) (Los Alamos National Lab., NM (United States)); Rosenthal, I. (Pennsylvania Univ., Philadelphia, PA (United States). Center for Risk and Decision Processes)

    1991-10-01

    In this age of rapid changes, large segments of society no longer trust any institution or authority in regard to pronouncements on what is safe. Because of this distrust, the public has demanded and obtained increased rights for individuals to intervene directly in decisions affecting them. Rosenthal warns that an organization that just fulfills its legal requirements for safety is no longer doing enough. Industry leaders must work toward re-establishing credibility by identifying persons who are potentially at risk as a result of industry activities, involving them in the communication process, and justifying the firm's social benefits. Seeking social legitimacy, chemical manufacturers have formed self-assessment groups and community councils, which have reaped unexpected benefits but have forced them to deal with issues they would have preferred to avoid. To industry leaders who contend that these types of activities are not worth the effort, Rosenthal presents a timely warning. Government and business must reduce public concerns significantly and make stakeholders more willing to tolerate imposed risk because of perceived benefits. It the public's concern is not reduced, we will all be required to make greater and greater investments in an inefficient and largely fruitless pursuit of absolute safety. 16 refs.

  1. Reactor safety research - visible demonstrations and credible computations

    International Nuclear Information System (INIS)

    Loewenstein, W.B.; Divakaruni, S.M.

    1985-01-01

    EPRI has been conducting nuclear safety research for a number of years with the primary goal of assuring the safety and reliability of the nuclear plants. The visibility is emphasized by sponsoring or participating in large scale test demonstrations to credibly support the complex computations that are the basis for quantification of safety margins. Recognizing the success of the airline industry in receiving favorable public perception, the authors compare the design and operation practices of the airline industry with those of the nuclear industry practices to identify the elements contributing to public concerns and unfavorable perceptions. In this paper, authors emphasize the importance of proper communications of research results to the public in a manner that non-specialists understand. Further, EPRI supported research and results in the areas of source term, seismic and structural engineering research, analysis using probabilistic risk assessment (PRA), quantification of safety margins, digital technology development and implementation, and plant transient and performance evaluations are discussed in the paper. (orig./HP)

  2. Identifying management competencies for health care executives: review of a series of Delphi studies.

    Science.gov (United States)

    Hudak, R P; Brooke, P P; Finstuen, K

    2000-01-01

    This analysis reviews a selected body of research that identifies the essential areas of management expertise required of future health care executives. To ensure consistency, six studies are analyzed, utilizing the Delphi technique, to query a broad spectrum of experts in different fields and sites of health care management. The analysis identifies a number of management competencies, i.e., managerial capabilities, which current and aspiring health care executives, in various settings and with differing educational backgrounds, should possess to enhance the probability of their success in current and future positions of responsibility. In addition, this review identifies the skills (technical expertise), knowledge (facts and principles) and abilities (physical, mental or legal power) required to support achievement of these competencies. Leadership and resource management, including cost and finance dimensions, are the highest-rated requisite management competencies. The dominant skills, knowledge and abilities (SKAs) are related to interpersonal skills. The lowest-rated SKAs are related to job-specific, technical skills. Recommendations include the review of this research by formal and continuing education programs to determine the content of their courses and areas for future research. Similarly, current health care executives should assess this research to assist in identifying competency gaps. Lastly, this analysis recommends that the Delphi technique, as a valid and replicable methodology, be applied toward the study of non-executive health care managers, e.g., students, clinicians, mid-level managers and integrated systems administrators, to determine their requisite management competencies and SKAs.

  3. Medical Student Perceptions of Global Surgery at an Academic Institution: Identifying Gaps in Global Health Education.

    Science.gov (United States)

    Mehta, Ambar; Xu, Tim; Murray, Matthew; Casey, Kathleen M

    2017-12-01

    Robust global health demands access to safe, affordable, timely surgical care for all. The long-term success of global surgery requires medical students to understand and engage with this emerging field. The authors characterized medical students' perceptions of surgical care relative to other fields within global health. An optional, anonymous survey was given to all Johns Hopkins medical students from February to March 2016 to assess perceptions of surgical care and its role in global health. Of 480 students, 365 (76%) completed the survey, with 150 (41%) reporting global health interests. One-third (34%) of responding students felt that surgical care is one of two fields with the greatest potential global health impact in the future, second to infectious disease (49%). A minority (28%) correctly identified that trauma results in more deaths worldwide than obstetric complications or HIV/AIDS, tuberculosis, and malaria combined. Relative to other examined fields, students perceived surgical care as the least preventive and cost-effective, and few students (3%) considered adequate surgical care the best indicator of a robust health care system. Students believed that practicing in a surgical field was least amenable to pursuing a global health career, citing several barriers. Medical students have several perceptions of global surgery that contradict current evidence and literature, which may have implications for their career choices. Opportunities to improve students' global health knowledge and awareness of global surgery career paths include updating curricula, fostering meaningful international academic opportunities, and creating centers of global surgery and global health consortia.

  4. Unmet health needs identified by Haitian women as priorities for attention: a qualitative study.

    Science.gov (United States)

    Peragallo Urrutia, Rachel; Merisier, Delson; Small, Maria; Urrutia, Eugene; Tinfo, Nicole; Walmer, David K

    2012-06-01

    This 2009 qualitative study investigated Haitian women's most pressing health needs, barriers to meeting those needs and proposed solutions, and how they thought the community and outside organizations should be involved in addressing their needs. The impetus for the study was to get community input into the development of a Family Health Centre in Leogane, Haiti. Individual interviews and focus group discussions were conducted with 52 adult women in six communities surrounding Leogane. The most pressing health needs named by the women were accessible, available and affordable health care, potable water, enough food to eat, improved economy, employment, sanitation and education, including health education. Institutional corruption, lack of infrastructure and social organization, the cost of health care, distance from services and lack of transport as barriers to care were also important themes. The involvement of foreign organizations and local community groups, including grassroots women's groups who would work in the best interests of other women, were identified as the most effective solutions. Organizations seeking to improve women's health care in Haiti should develop services and interventions that prioritize community partnership and leadership, foster partnerships with government, and focus on public health needs. Copyright © 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  5. Credibility judgments of narratives: language, plausibility, and absorption.

    Science.gov (United States)

    Nahari, Galit; Glicksohn, Joseph; Nachson, Israel

    2010-01-01

    Two experiments were conducted in order to find out whether textual features of narratives differentially affect credibility judgments made by judges having different levels of absorption (a disposition associated with rich visual imagination). Participants in both experiments were exposed to a textual narrative and requested to judge whether the narrator actually experienced the event he described in his story. In Experiment 1, the narrative varied in terms of language (literal, figurative) and plausibility (ordinary, anomalous). In Experiment 2, the narrative varied in terms of language only. The participants' perceptions of the plausibility of the story described and the extent to which they were absorbed in reading were measured. The data from both experiments together suggest that the groups applied entirely different criteria in credibility judgments. For high-absorption individuals, their credibility judgment depends on the degree to which the text can be assimilated into their own vivid imagination, whereas for low-absorption individuals it depends mainly on plausibility. That is, high-absorption individuals applied an experiential mental set while judging the credibility of the narrator, whereas low-absorption individuals applied an instrumental mental set. Possible cognitive mechanisms and implications for credibility judgments are discussed.

  6. Enhancing the quality and credibility of qualitative analysis.

    Science.gov (United States)

    Patton, M Q

    1999-12-01

    Varying philosophical and theoretical orientations to qualitative inquiry remind us that issues of quality and credibility intersect with audience and intended research purposes. This overview examines ways of enhancing the quality and credibility of qualitative analysis by dealing with three distinct but related inquiry concerns: rigorous techniques and methods for gathering and analyzing qualitative data, including attention to validity, reliability, and triangulation; the credibility, competence, and perceived trustworthiness of the qualitative researcher; and the philosophical beliefs of evaluation users about such paradigm-based preferences as objectivity versus subjectivity, truth versus perspective, and generalizations versus extrapolations. Although this overview examines some general approaches to issues of credibility and data quality in qualitative analysis, it is important to acknowledge that particular philosophical underpinnings, specific paradigms, and special purposes for qualitative inquiry will typically include additional or substitute criteria for assuring and judging quality, validity, and credibility. Moreover, the context for these considerations has evolved. In early literature on evaluation methods the debate between qualitative and quantitative methodologists was often strident. In recent years the debate has softened. A consensus has gradually emerged that the important challenge is to match appropriately the methods to empirical questions and issues, and not to universally advocate any single methodological approach for all problems.

  7. #SupportTheCause: Identifying Motivations to Participate in Online Health Campaigns

    NARCIS (Netherlands)

    Nguyen, Dong-Phuong; van den Broek, Tijs Adriaan; Hauff, C.; Hiemstra, Djoerd; Ehrenhard, Michel Léon

    We consider the task of automatically identifying participants’ motivations in the public health campaign Movember and investigate the impact of the different motivations on the amount of campaign donations raised. Our classification scheme is based on the Social Identity Model of Collective Action

  8. Identifying Health Beliefs Influencing Hispanic College Men's Willingness to Vaccinate against HPV

    Science.gov (United States)

    Stephens, Dionne P.; Thomas, Tami L.; Eaton, Asia

    2016-01-01

    This study identifies health beliefs influencing Hispanic college men's human papillomavirus (HPV) vaccine uptake decision making processes. Hispanic college men were interviewed about their HPV vaccine knowledge, and information seeking behaviors. Overall, participants did not view HPV infection or vaccination as an immediate concern or priority;…

  9. Identifying Knowledge Gaps in Clinicians Who Evaluate and Treat Vocal Performing Artists in College Health Settings.

    Science.gov (United States)

    McKinnon-Howe, Leah; Dowdall, Jayme

    2018-05-01

    The goal of this study was to identify knowledge gaps in clinicians who evaluate and treat performing artists for illnesses and injuries that affect vocal function in college health settings. This pilot study utilized a web-based cross-sectional survey design incorporating common clinical scenarios to test knowledge of evaluation and management strategies in the vocal performing artist. A web-based survey was administered to a purposive sample of 28 clinicians to identify the approach utilized to evaluate and treat vocal performing artists in college health settings, and factors that might affect knowledge gaps and influence referral patterns to voice specialists. Twenty-eight clinicians were surveyed, with 36% of respondents incorrectly identifying appropriate vocal hygiene measures, 56% of respondents failing to identify symptoms of vocal fold hemorrhage, 84% failing to identify other indications for referral to a voice specialist, 96% of respondents acknowledging unfamiliarity with the Voice Handicap Index and the Singers Voice Handicap Index, and 68% acknowledging unfamiliarity with the Reflux Symptom Index. The data elucidated specific knowledge gaps in college health providers who are responsible for evaluating and treating common illnesses that affect vocal function, and triaging and referring students experiencing symptoms of potential vocal emergencies. Future work is needed to improve the standard of care for this population. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  10. Baccalaureate Nursing Students' Abilities in Critically Identifying and Evaluating the Quality of Online Health Information.

    Science.gov (United States)

    Theron, Maggie; Redmond, Anne; Borycki, Elizabeth M

    2017-01-01

    Both the Internet and social media have become important tools that patients and health professionals, including health professional students, use to obtain information and support their decision-making surrounding health care. Students in the health sciences require increased competence to select, appraise, and use online sources to adequately educate and support patients and advocate for patient needs and best practices. The purpose of this study was to ascertain if second year nursing students have the ability to critically identify and evaluate the quality of online health information through comparisons between student and expert assessments of selected online health information postings using an adapted Trust in Online Health Information scale. Interviews with experts provided understanding of how experts applied the selected criteria and what experts recommend for implementing nursing informatics literacy in curriculums. The difference between student and expert assessments of the quality of the online information is on average close to 40%. Themes from the interviews highlighted several possible factors that may influence informatics competency levels in students, specifically regarding the critical appraisal of the quality of online health information.

  11. The potential for research-based information in public health: Identifying unrecognised information needs

    Directory of Open Access Journals (Sweden)

    Forsetlund Louise

    2001-01-01

    Full Text Available Abstract Objective To explore whether there is a potential for greater use of research-based information in public health practice in a local setting. Secondly, if research-based information is relevant, to explore the extent to which this generates questioning behaviour. Design Qualitative study using focus group discussions, observation and interviews. Setting Public health practices in Norway. Participants 52 public health practitioners. Results In general, the public health practitioners had a positive attitude towards research-based information, but believed that they had few cases requiring this type of information. They did say, however, that there might be a potential for greater use. During five focus groups and six observation days we identified 28 questions/cases where it would have been appropriate to seek out research evidence according to our definition. Three of the public health practitioners identified three of these 28 cases as questions for which research-based information could have been relevant. This gap is interpreted as representing unrecognised information needs. Conclusions There is an unrealised potential in public health practice for more frequent and extensive use of research-based information. The practitioners did not appear to reflect on the need for scientific information when faced with new cases and few questions of this type were generated.

  12. Workshop on establishing institutional credibility for SEAB Task Force on Radioactive Waste Management

    International Nuclear Information System (INIS)

    1994-01-01

    At the request of the Secretary of Energy Advisory Board's Task Force on Civilian Radioactive Waste Management, the National Research Council sponsored a workshop on Establishing Institutional Credibility. The purpose of the workshop was to (1) identify the range of available knowledge regarding the theoretical and conceptual issues of how institutions establish their credibility and legitimacy with key constituents, and (2) to help explore and clarify fundamental concepts in management theory related to these issues. The examination was to include what is known about how organizations establish, maintain, lose, and regain public trust and confidence. There was to be no attempt to develop consensus on these issues or to suggest particular courses of action. The workshop was held on October 24-25, 1991, in Denver, Colorado

  13. Format as a False Judge of Credibility: Messages from Librarians and Faculty and Student Responses

    Directory of Open Access Journals (Sweden)

    Amy E. Mark

    2011-11-01

    Full Text Available The purpose of this case study is to explore how students make sense of and respond to messages about information in higher education. This study identifies the messages students in higher education receive about information gathering, conducting research, and the credibility and authority of information sources. This research revealed that students are receiving the message from faculty that format is a stand-in for credibility. Research to date focuses on how to steer students to information privileged by the academy: academic, peer reviewed articles, and books. The voice of students is often absent. This study employs the critical framework of Paulo Freire in order to give voice to student perceptions of information.

  14. Identifying research priorities for patient safety in mental health: an international expert Delphi study

    Science.gov (United States)

    Murray, Kevin; Thibaut, Bethan; Ramtale, Sonny Christian; Adam, Sheila; Darzi, Ara; Archer, Stephanie

    2018-01-01

    Objective Physical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health. Design Semistructured interviews were conducted with the experts to ascertain their views on research priorities in patient safety in mental health. A three-round online Delphi study was used to ascertain consensus on 117 research priority statements. Setting and participants Academic and service user experts from the USA, UK, Switzerland, Netherlands, Ireland, Denmark, Finland, Germany, Sweden, Australia, New Zealand and Singapore were included. Main outcome measures Agreement in research priorities on a five-point scale. Results Seventy-nine statements achieved consensus (>70%). Three out of the top six research priorities were patient driven; experts agreed that understanding the patient perspective on safety planning, on self-harm and on medication was important. Conclusions This is the first international Delphi study to identify research priorities in safety in the mental field as determined by expert academic and service user perspectives. A reasonable consensus was obtained from international perspectives on future research priorities in patient safety in mental health; however, the patient perspective on their mental healthcare is a priority. The research agenda for patient safety in mental health identified here should be informed by patient safety science more broadly and used to further establish this area as a priority in its own right. The safety of mental health patients must have parity with that of physical health patients to achieve this. PMID:29502096

  15. Vigilance and reason - The keys to continued credibility

    International Nuclear Information System (INIS)

    Arlotto, G.A.

    1994-01-01

    I have entitle my speech open-quotes Vigilance and Reason-The Keys to Continued Credibilityclose quotes. A partitioning of the words gives insight into my view of where we are, where we may be going, and that we have control of our fate. open-quotes Continuedclose quotes indicates that I believe, at present, the American Society of Mechanical Engineers (ASME) Codes and Standards process has credibility. open-quotes Keysclose quotes connotes that we are at a crossroads and something must be done to stay on track. And open-quotes Vigilance and Reasonclose quotes suggest that we can achieve our goal of continued credibility through exercising vigilance and reason. We cannot rest on our laurels. We must take conscious, positive actions to strengthen the credibility of our products; otherwise we will backslide. It is up to us

  16. Credibility of experts and institutions in emergency situations

    International Nuclear Information System (INIS)

    Renn, O.; Kastenholz, H.G.

    1997-01-01

    This article deals with the most important results of communication and psychological studies on credibility and trust in emergency situations. The central insight in this paper has been that communication about the different elements of credibility needs to start before any emergency in order to build trust among the various constituents. In addition, emergency handling institutions need to reflect the experiences they have made during an emergency and involve the public in a social learning process to improve the existing emergency plans. Credibility of institutions relies on the congruence between the expectations of the public with respect to the demanded performance and the preception of the actual performance. Any institution needs to adjust its communication about public expectations as well as institute sufficient control and monitoring to improve actual performance. (orig.) [de

  17. Establishing the credibility of qualitative research findings: the plot thickens.

    Science.gov (United States)

    Cutcliffe, J R; McKenna, H P

    1999-08-01

    Qualitative research is increasingly recognized and valued and its unique place in nursing research is highlighted by many. Despite this, some nurse researchers continue to raise epistemological issues about the problems of objectivity and the validity of qualitative research findings. This paper explores the issues relating to the representativeness or credibility of qualitative research findings. It therefore critiques the existing distinct philosophical and methodological positions concerning the trustworthiness of qualitative research findings, which are described as follows: quantitative studies should be judged using the same criteria and terminology as quantitative studies; it is impossible, in a meaningful way, for any criteria to be used to judge qualitative studies; qualitative studies should be judged using criteria that are developed for and fit the qualitative paradigm; and the credibility of qualitative research findings could be established by testing out the emerging theory by means of conducting a deductive quantitative study. The authors conclude by providing some guidelines for establishing the credibility of qualitative research findings.

  18. Community health center provider ability to identify, treat and account for the social determinants of health: a card study.

    Science.gov (United States)

    Lewis, Joy H; Whelihan, Kate; Navarro, Isaac; Boyle, Kimberly R

    2016-08-27

    The social determinants of health (SDH) are conditions that shape the overall health of an individual on a continuous basis. As momentum for addressing social factors in primary care settings grows, provider ability to identify, treat and assess these factors remains unknown. Community health centers care for over 20-million of America's highest risk populations. This study at three centers evaluates provider ability to identify, treat and code for the SDH. Investigators utilized a pre-study survey and a card study design to obtain evidence from the point of care. The survey assessed providers' perceptions of the SDH and their ability to address them. Then providers filled out one anonymous card per patient on four assigned days over a 4-week period, documenting social factors observed during encounters. The cards allowed providers to indicate if they were able to: provide counseling or other interventions, enter a diagnosis code and enter a billing code for identified factors. The results of the survey indicate providers were familiar with the SDH and were comfortable identifying social factors at the point of care. A total of 747 cards were completed. 1584 factors were identified and 31 % were reported as having a service provided. However, only 1.2 % of factors were associated with a billing code and 6.8 % received a diagnosis code. An obvious discrepancy exists between the number of identifiable social factors, provider ability to address them and documentation with billing and diagnosis codes. This disparity could be related to provider inability to code for social factors and bill for related time and services. Health care organizations should seek to implement procedures to document and monitor social factors and actions taken to address them. Results of this study suggest simple methods of identification may be sufficient. The addition of searchable codes and reimbursements may improve the way social factors are addressed for individuals and populations.

  19. eHealth Literacy and Health Behaviors Affecting Modern College Students: A Pilot Study of Issues Identified by the American College Health Association.

    Science.gov (United States)

    Britt, Rebecca Katherine; Collins, William Bart; Wilson, Kari; Linnemeier, Georgiann; Englebert, Andrew Mark

    2017-12-19

    The eHealth Literacy Scale (eHEALS) has been widely adopted by researchers to understand how eHealth literacy can be put into context. eHealth researchers need to know how to promote positive health behavior changes across college students, given the importance of the Internet to acquire and use health information. The American College Health Association identified a set of key health issues that affect college students today. By understanding how eHEALS might be related to college students' maintenance of their health and their use of online health resources, researchers will be provided with a better understanding of eHealth literacy and its pragmatic implications for health campaigns and future interventions. The goal of the study was to examine what eHEALS reveals about college student health behaviors identified by the American College Health Association. To understand college student current health maintenance and their intentions to maintain their health and use online resources, the theory of planned behavior was used as the theoretical framework for the study. Data were collected via a survey of 422 college students that included the eHEALS measure and questions about health issues based on the recommendations of the American College Health Association. These questions asked about college student current health, subsequent use of online health resources, and their intention to maintain their health and make use of such resources in the future. eHEALS was positively and significantly associated with all 8 areas of health issues identified by the American College Health Association for college student current maintenance of health and use of online health resources and for future intention of health maintenance and use of online resources. Key issues that emerged with eHealth literacy were maintaining safe sex practices and seeking out related information, seeking out information on an exercise regime, information on vaccinations, and maintaining a balanced

  20. eHealth Literacy and Health Behaviors Affecting Modern College Students: A Pilot Study of Issues Identified by the American College Health Association

    Science.gov (United States)

    Collins, William Bart; Wilson, Kari; Linnemeier, Georgiann; Englebert, Andrew Mark

    2017-01-01

    Background The eHealth Literacy Scale (eHEALS) has been widely adopted by researchers to understand how eHealth literacy can be put into context. eHealth researchers need to know how to promote positive health behavior changes across college students, given the importance of the Internet to acquire and use health information. The American College Health Association identified a set of key health issues that affect college students today. By understanding how eHEALS might be related to college students’ maintenance of their health and their use of online health resources, researchers will be provided with a better understanding of eHealth literacy and its pragmatic implications for health campaigns and future interventions. Objective The goal of the study was to examine what eHEALS reveals about college student health behaviors identified by the American College Health Association. To understand college student current health maintenance and their intentions to maintain their health and use online resources, the theory of planned behavior was used as the theoretical framework for the study. Methods Data were collected via a survey of 422 college students that included the eHEALS measure and questions about health issues based on the recommendations of the American College Health Association. These questions asked about college student current health, subsequent use of online health resources, and their intention to maintain their health and make use of such resources in the future. Results eHEALS was positively and significantly associated with all 8 areas of health issues identified by the American College Health Association for college student current maintenance of health and use of online health resources and for future intention of health maintenance and use of online resources. Key issues that emerged with eHealth literacy were maintaining safe sex practices and seeking out related information, seeking out information on an exercise regime, information on

  1. Standards of practice for forensic mental health nurses--identifying contemporary practice.

    Science.gov (United States)

    Martin, Trish; Maguire, Tessa; Quinn, Chris; Ryan, Jo; Bawden, Louise; Summers, Monica

    2013-01-01

    Forensic mental health nursing is a recognized field of nursing in most countries. Despite a growing body of literature describing aspects of practice, no publication has been found that captures the core knowledge, skills, and attitudes of forensic mental health nurses. One group of nurses in Australia have pooled their knowledge of relevant literature and their own clinical experience and have written standards of practice for forensic mental health nursing. This paper identifies the need for standards, provides a summary of the standards of practice for forensic mental health nurses, and concludes with how these standards can be used and can articulate to others the desired and achievable level of performance in the specialty area.

  2. Identifying indigenous peoples for health research in a global context: a review of perspectives and challenges.

    Science.gov (United States)

    Bartlett, Judith G; Madariaga-Vignudo, Lucia; O'Neil, John D; Kuhnlein, Harriet V

    2007-09-01

    Identifying Indigenous Peoples globally is complex and contested despite there being an estimated 370 million living in 70 countries. The specific context and use of locally relevant and clear definitions or characterizations of Indigenous Peoples is important for recognizing unique health risks Indigenous Peoples face, for understanding local Indigenous health aspirations and for reflecting on the need for culturally disaggregated data to plan meaningful research and health improvement programs. This paper explores perspectives on defining Indigenous Peoples and reflects on challenges in identifying Indigenous Peoples. Literature reviews and Internet searches were conducted, and some key experts were consulted. Pragmatic and political definitions by international institutions, including the United Nations, are presented as well as characterizations of Indigenous Peoples by governments and academic researchers. Assertions that Indigenous Peoples have about definitions of indigeneity are often related to maintenance of cultural integrity and sustainability of lifestyles. Described here are existing definitions and interests served by defining (or leaving undefined) such definitions, why there is no unified definition and implications of "too restrictive" a definition. Selected indigenous identities and dynamics are presented for North America, the Arctic, Australia and New Zealand, Latin America and the Caribbean, Asia and Africa. While health researchers need to understand the Indigenous Peoples with whom they work, ultimately, indigenous groups themselves best define how they wish to be viewed and identified for research purposes.

  3. Credibility and the media as a political institution

    DEFF Research Database (Denmark)

    Ørsten, Mark; Burkal, Rasmus

    2014-01-01

    of credibility in Danish news media. Credibility is defined at an institutional level by two dimensions: A) the accuracy and reliability of the news stories featured in leading Danish news media, and B) journalists’ knowledge and understanding of the Danish code of press ethics. The results show that sources...... only find objective errors in 14.1% of the news stories, which is a lower figure than most other studies report. The results also show that Danish journalists find bad press ethics to be an increasing problem and attribute this problem to increased pressure in the newsroom....

  4. Credible accident analyses for TRIGA and TRIGA-fueled reactors

    International Nuclear Information System (INIS)

    Hawley, S.C.; Kathren, R.L.

    1982-04-01

    Credible accidents were developed and analyzed for TRIGA and TRIGA-fueled reactors. The only potential for offsite exposure appears to be from a fuel-handling accident that, based on highly conservative assumptions, would result in dose equivalents of less than or equal to 1 mrem to the total body from noble gases and less than or equal to 1.2 rem to the thyroid from radioiodines. Credible accidents from excess reactivity insertions, metal-water reactions, lost, misplaced, or inadvertent experiments, core rearrangements, and changes in fuel morphology and ZrH/sub x/ composition are also evaluated, and suggestions for further study provided

  5. How Public Health Nurses Identify and Intervene in Child Maltreatment Based on the National Clinical Guideline

    Directory of Open Access Journals (Sweden)

    Paavilainen Eija

    2014-01-01

    Full Text Available Objectives. To describe how Finnish public health nurses identify and intervene in child maltreatment and how they implement the National Clinical Guideline in their work. Design and Sample. Cross-sectional survey of 367 public health nurses in Finland. Measures. A web-based questionnaire developed based on the content areas of the guideline: identifying, intervening, and implementing. Results. The respondents reported they identify child maltreatment moderately (mean 3.38, intervene in it better (4.15, and implement the guideline moderately (3.43, scale between 1 and 6. Those with experience of working with maltreated children reported they identify them better P<0.001, intervene better P<0.001, and implement the guideline better P<0.001 than those with no experience. This difference was also found for those who were aware of the guideline, had read it, and participated in training on child maltreatment, as compared to those who were not aware of the guideline, had not read it, or had not participated in such training. Conclusions. The public health nurses worked quite well with children who had experienced maltreatment and families. However, the results point out several developmental targets for increasing training on child maltreatment, for devising recommendations for child maltreatment, and for applying these recommendations systematically in practice.

  6. Profile of an excellent nurse manager: identifying and developing health care team leaders.

    Science.gov (United States)

    Kallas, Kathryn D

    2014-01-01

    The purpose of this research was to identify the profile of an excellent nurse manager who can lead effective health care teams. Leadership attributes and competencies that characterize an excellent nurse manager and tools to identify them are lacking in the literature but are required to efficiently and effectively address the growing shortage of registered nurses (RNs) in health care team leadership roles and the critical linkage of these roles to patient outcomes. A profile of an excellent nurse manager was developed on the basis of the responses of nurse managers across the United States who had been identified as excellent or competent by chief nurse executive assessment or/and the Nurse Manager Ability, Leadership, and Support of Nurses staff survey to the Kouzes and Posner Leadership Practices Inventory: Self Instrument. Statistically significant distinctions exist between nurse managers who are excellent and those who are competent as assessed by the Five Practices of Exemplary Leadership, which together comprise the profile of an excellent nurse manager. The Kouzes and Posner Leadership Practices Inventory: Self Instrument can be used to identify, recruit, and develop RNs in the nurse manager role as excellent leaders of effective health care teams.

  7. Developing a workbook to support the contextualisation of global health systems guidance: a case study identifying steps and critical factors for success in this process at WHO.

    Science.gov (United States)

    Alvarez, Elizabeth; Lavis, John N; Brouwers, Melissa; Schwartz, Lisa

    2018-03-02

    Global guidance can help countries strengthen their health systems to deliver effective interventions to their populations. However, to have an impact, guidance needs to be contextualised or adapted to local settings; this process includes consideration of health system arrangements and political system factors. To date, methods to support contextualisation do not exist. In response, a workbook was designed to provide specific methods and strategies to enable the contextualisation of WHO's 'Optimizing health worker roles to improve maternal and newborn health' (OptimizeMNH) guidance at the national or subnational level. The objective of this study was to describe the process of developing the workbook and identify key steps of the development process, barriers that arose and facilitators that helped overcome some of these barriers. A qualitative single case study design was carried out. Interviews, documents and a reflexive journal were used. Constant comparison and an edit-style of organisation were used during data analysis to develop concepts, themes, subthemes and relationships among them. Thirteen interviews were conducted and 52 documents were reviewed. Three main steps were identified in the process of developing the workbook for health systems guidance contextualisation, namely (1) determining the need for and gaining approval to develop the workbook, (2) developing the workbook (taking on the task, creating the structure of the workbook, operationalising its components, undergoing approval processes and editing it), and (3) implementing the workbook both at the WHO level and at the national/subnational level. Five barriers and/or facilitators emerged relevant to each step, namely (1) having well-placed and credible champions, (2) creating and capitalising on opportunities, (3) finding the right language to engage various actors and obtain buy-in, (4) obtaining and maintaining meaningful buy-in, and (5) ensuring access to resources. Understanding the key

  8. Implementing interventions in adult mental health services to identify and support children of mentally ill parents.

    OpenAIRE

    Lauritzen, Camilla

    2014-01-01

    Paper 3 of this thesis is not available in Munin: 3. Lauritzen, C., & Reedtz, C.: 'Support for children of mental health service users in Norway', Mental Health Practice (2013), vol. 16:12-18. Available at http://dx.doi.org/10.7748/mhp2013.07.16.10.12.e875 This dissertation is a result of a large-scale longitudinal project (the BAP-study) where the overall aim was to monitor and evaluate the implementation of clinical change to identify and support children of mentally ill parents within t...

  9. An exploratory study identifying where local government public health decision makers source their evidence for policy.

    Science.gov (United States)

    Stoneham, Melissa; Dodds, James

    2014-08-01

    The Western Australian (WA) Public Health Bill will replace the antiquated Health Act 1911. One of the proposed clauses of the Bill requires all WA local governments to develop a Public Health Plan. The Bill states that Public Health Plans should be based on evidence from all levels, including national and statewide priorities, community needs, local statistical evidence, and stakeholder data. This exploratory study, which targeted 533 WA local government officers, aimed to identify the sources of evidence used to generate the list of public health risks to be included in local government Public Health Plans. The top four sources identified for informing local policy were: observation of the consequences of the risks in the local community (24.5%), statewide evidence (17.6%), local evidence (17.6%) and coverage in local media (16.2%). This study confirms that both hard and soft data are used to inform policy decisions at the local level. Therefore, the challenge that this study has highlighted is in the definition or constitution of evidence. SO WHAT? Evidence is critical to the process of sound policy development. This study highlights issues associated with what actually constitutes evidence in the policy development process at the local government level. With the exception of those who work in an extremely narrow field, it is difficult for local government officers, whose role includes policymaking, to read the vast amount of information that has been published in their area of expertise. For those who are committed to the notion of evidence-based policymaking, as advocated within the WA Public Health Bill, this presents a considerable challenge.

  10. Luka Brajnović – From Fidelity to Oneself towards Credibility of Profession

    Directory of Open Access Journals (Sweden)

    Danijel Labaš

    2010-12-01

    Full Text Available In certain periods, at certain places and in certain media, the reputation and credibility of the journalistic profession has suff ered for a number of reasons, including ignorance, mediocrity, dishonorable or morally questionable methods of journalists, or scandalous, fabricated or partial news stories. This is the opinion of Luka Brajnović, whose reflections in a comparative analysis with other authors comprise the ”contemplative axis” of this article. The fundamental task and goal of this article is to present and analyze Mr Brajnović’s refl ections on the possibility of saving or restoring the reputation and credibility of the journalistic profession. Journalists and the media will not be able to restore credibility as long as extravagant ideas exist about journalism as a profession that deals with ”public whispering, accusations and dissatisfaction with everything that has been established, or as a neutral profession that is ethically hybrid and indifferent towards good and evil”. Such an understanding of the journalistic profession runs against a positive image and reputation of journalism, a fi eld which is in itself worthy of respect of the entire public. In journalism, just as in other professions, unethical behavior on the part of a small number of journalists and media outlets casts a shadow on the journalistic profession as a whole, causing the reputation of the profession to become dependent upon a positive image and the reputation of those individuals working in it. As results of this article show – which for the fi rst time analytically approaches the scientific arguments and refl ections of Mr Brajnović in the Croatian public sphere – ethical and intellectual health, which can restore credibility to the journalistic profession, are the very elements rooted deep inside of it.

  11. Identifying Mental Health Elements among Technical University Students Using Fuzzy Delphi Method

    Science.gov (United States)

    Pua, P. K.; Lai, C. S.; Lee, M. F.

    2017-08-01

    Mental health is a part of our daily life that is often experienced. As a student, mental health issue often encounters a variety of difficult challenges at the higher education institution. A student with good mental health can handle and cope the normal stress of life, capable work productivity, enhance academic performance and able to make contribute to the community. However, rapidly transformation and changing of society have been impacted on students’ mental health, and it will be deteriorated and negatively impact on students if it absence of preventive controlled. This study aimed to identify the element of mental health among the technical university students. A total of 11 experts were selected to analyze the fuzziness consensus of experts. All collected data was analyzed by using the fuzzy Delphi method and the result shows that there are 4 elements of 8 elements that fulfill the requirement consensus of experts, which threshold value is equal and less than 0.2, the percentage of the expert group is more than 75%. The four elements were depression, anxiety, stress, and fear are often experienced by technical university students. In conclusion, precocious actions have to be taken by university and counseling center, parents and non-government organization in order to mitigate the mental health problem faced by students to improve the quality lifestyle students at the university.

  12. Systematic reviews addressing identified health policy priorities in Eastern Mediterranean countries: a situational analysis.

    Science.gov (United States)

    El-Jardali, Fadi; Akl, Elie A; Karroum, Lama Bou; Kdouh, Ola; Akik, Chaza; Fadlallah, Racha; Hammoud, Rawan

    2014-08-20

    Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors' affiliations, and countries where included primary studies were conducted. Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews (8.5%) included primary

  13. Systematic reviews addressing identified health policy priorities in Eastern Mediterranean countries: a situational analysis

    Science.gov (United States)

    2014-01-01

    Background Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. Methods We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors’ affiliations, and countries where included primary studies were conducted. Results Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews

  14. INVESTIGATINGTHE SOURCEATTRIBUTES INFLUENCINGCONSUMERS’ CREDIBILITY EVALUATIONS OF AN ATHLETE-CELEBRITY ENDORSED PRODUCT

    Directory of Open Access Journals (Sweden)

    Bafokeng Bafokeng Mahao

    2017-01-01

    Full Text Available The use of celebrity endorsement as an advertising strategy has been widelyembraced by numerousorganisations. Nonetheless, scholarly wisdom suggests theneed for cumulative research that seeks to identify the unique set of source factorsthat enhance the credibility of advertising communication messages delivered bycelebrities across countries.Inthis vein, the primary purpose of this research wasto apply the dimensions of thesource attributes theory (Ohanian, 1990 tounderstand the underlying factors that influence South African consumers to havepositive perceptions towards purchasingaproductthat hasbeen endorsed by alocal athlete celebrity-endorser. A quantitative research approach was applied,wherein a self-administered survey questionnaire comprising20scale items wasadapted for this research. Data were collected from a consumer sample of 456consumers based in Gauteng, South Africa. Upon applying exploratory factoranalysisand mean score rankings, source likeability, source trust, source authorityand source credibility were established as the underlying factors influencingconsumers’ credibility evaluations, in descending order of importance. Moreover,the inter-factor correlation matrix revealed positive relationships among theidentified factors. Insights gained from this study could assist practitioners todesign effectiveadvertisementstrategies that fosterpositivecredibility evaluationsthrough known product endorsers.

  15. Identifying features of pocket parks that may be related to health promoting use

    DEFF Research Database (Denmark)

    Peschardt, Karin Kragsig; Stigsdotter, Ulrika K.; Schipperijn, Jasper

    2016-01-01

    . The results show that ‘green features’ do not seem to be of crucial importance for ‘socialising’ whereas, as expected, features promoting gathering should be prioritised. For ‘rest and restitution’, the main results show that ‘green ground cover’ and ‘enclosed green niches’ are important, while ‘disturbing......Urban green spaces have been shown to promote health and well-being and recent research indicates that the two primary potentially health promoting uses of pocket parks are ‘rest and restitution’ and ‘socialising’. The aim of this study is to identify features in pocket parks that may support...... features’ (playground, view outside park) should be avoided. The results add knowledge about the features which support the health promoting use of pocket parks to the existing body of research....

  16. Identifying patients with hypertension: a case for auditing electronic health record data.

    Science.gov (United States)

    Baus, Adam; Hendryx, Michael; Pollard, Cecil

    2012-01-01

    Problems in the structure, consistency, and completeness of electronic health record data are barriers to outcomes research, quality improvement, and practice redesign. This nonexperimental retrospective study examines the utility of importing de-identified electronic health record data into an external system to identify patients with and at risk for essential hypertension. We find a statistically significant increase in cases based on combined use of diagnostic and free-text coding (mean = 1,256.1, 95% CI 1,232.3-1,279.7) compared to diagnostic coding alone (mean = 1,174.5, 95% CI 1,150.5-1,198.3). While it is not surprising that significantly more patients are identified when broadening search criteria, the implications are critical for quality of care, the movement toward the National Committee for Quality Assurance's Patient-Centered Medical Home program, and meaningful use of electronic health records. Further, we find a statistically significant increase in potential cases based on the last two or more blood pressure readings greater than or equal to 140/90 mm Hg (mean = 1,353.9, 95% CI 1,329.9-1,377.9).

  17. Currency option pricing in a credible exchange rate target zone

    NARCIS (Netherlands)

    Veestraeten, D.

    2013-01-01

    This article examines currency option pricing within a credible target zone arrangement where interventions at the boundaries push the exchange rate back into its fluctuation band. Valuation of such options is complicated by the requirement that the reflection mechanism should prevent the arbitrage

  18. Currency option pricing in a credible exchange rate target zone

    NARCIS (Netherlands)

    Veestraeten, D.

    2012-01-01

    This article examines currency option pricing within a credible target zone arrangement where interventions at the boundaries push the exchange rate back into its fluctuation band. Valuation of such options is complicated by the requirement that the reflection mechanism should prevent the arbitrage

  19. The Credibility of Fiscal Rules Policy and Business Cycle Volatility

    Directory of Open Access Journals (Sweden)

    Kuncoro Haryo

    2016-06-01

    Full Text Available The aim of this paper is two-fold; first, it studies the impact of the credibility of fiscal rule policy on the stability of output growth; second, it compares the effectiveness of fiscal rule policy to discretionary and automatic stabilizer fiscal policies to address the fluctuation of output growth. Employing quarterly data over the period 2001-2013 in the case of Indonesia, we obtain that the credible debt rule leads to a decrease in the volatility of output growth while the non-credible deficit rule does not have any effect. Both unsystematic and systematic components of discretionary fiscal policy have a stabilizing function. Interestingly, the automatic stabilization tends to induce the volatility of output growth. Given those results, we infer that government spending is not a good automatic stabilizer. It seems that the lower ratio of government expenditure to GDP along with improving credibility of deficit rule policy has a smoother effect on the economy. Therefore, they implicitly support expenditure cuts when implementing fiscal adjustment with the purpose of reaching fiscal sustainability in the short-run and a stable economic growth in the long-run.

  20. Simulating Terrorism: Credible Commitment, Costly Signaling, and Strategic Behavior

    Science.gov (United States)

    Siegel, David A.; Young, Joseph K.

    2009-01-01

    We present two simulations designed to convey the strategic nature of terrorism and counterterrorism. The first is a simulated hostage crisis, designed primarily to illustrate the concepts of credible commitment and costly signaling. The second explores high-level decision making of both a terrorist group and the state, and is designed to…

  1. Source credibility and the effectiveness of firewise information

    Science.gov (United States)

    Alan D. Bright; Andrew W. Don Carlos; Jerry J. Vaske; James D. Absher

    2007-01-01

    Understanding how residents of the wildlandurban interface (WUI) react to information about firewise behavior can enhance efforts to communicate safety information to the public. This study explored the multiple roles of source credibility on the elaboration and impact of messages about conducting firewise behaviors in the WUI. A mail-back survey to residents of the...

  2. Distribution system reliability evaluation using credibility theory | Xu ...

    African Journals Online (AJOL)

    In this paper, a hybrid algorithm based on fuzzy simulation and Failure Mode and Effect Analysis (FMEA) is applied to determine fuzzy reliability indices of distribution system. This approach can obtain fuzzy expected values and their variances of reliability indices, and the credibilities of reliability indices meeting specified ...

  3. Deflation Risk in the Euro Area and Central Bank Credibility

    NARCIS (Netherlands)

    G. Galati (Gabriele); Z. Gorgi (Zion); R. Moessner (Richhild); C. Zhou (Chen)

    2016-01-01

    textabstractThis paper investigates how the perceived risk that the euro area will experience deflation has evolved over time, and what this risk implies for the credibility of the ECB. We use a novel data set on market participants’ perceptions of short- to long-term deflation risk implied by

  4. Conquering Credibility for Monetary Policy Under Sticky Confidence

    Directory of Open Access Journals (Sweden)

    Jaylson Jair da Silveira

    2015-06-01

    Full Text Available We derive a best-reply monetary policy when the confidence by price setters on the monetary authority’s commitment to price level targeting may be both incomplete and sticky. We find that complete confidence (or full credibility is not a necessary condition for the achievement of a price level target even when heterogeneity in firms’ price level expectations is endogenously time-varying and may emerge as a long-run equilibrium outcome. In fact, in the absence of exogenous perturbations to the dynamic of confidence building, it is the achievement of a price level target for long enough that, due to stickiness in the state of confidence, rather ensures the conquering of full credibility. This result has relevant implications for the conduct of monetary policy in pursuit of price stability. One implication is that setting a price level target matters more as a means to provide monetary policy with a sharper focus on price stability than as a device to conquer credibility. As regards the conquering of credibility for monetary policy, it turns out that actions speak louder than words, as the continuing achievement of price stability is what ultimately performs better as a confidence-building device.

  5. Inflation Targeting and Liquidity Traps under Endogenous Credibility

    NARCIS (Netherlands)

    Hommes, C.; Lustenhouwer, J.

    2015-01-01

    We derive policy implications for an inflation targeting central bank, who's credibility is endogenous and depends on its past ability to achieve its targets. We do this in a New Keynesian framework with heterogeneous agents and boundely rational expectations. Our assumptions about expectation

  6. Investors Assessment of the Credibility of Management Disclosures ...

    African Journals Online (AJOL)

    The objective of this study, is to examine the issue of the assessment of the credibility of management disclosures about a company from the perspective of the investors. It presents the results from a questionnaire survey of a sample of financial Analysts, accountants and other investor. The data were analyzed using the one ...

  7. Perceptions of Credibility of Male and Female Syndicated Political Columnists.

    Science.gov (United States)

    Andsager, Julie L.

    1990-01-01

    Examines perceptions of the credibility of male and female syndicated political columnists. Finds that college students exhibited little prejudice against female versus male bylines in political interpretive columns. Finds a small tendency for male readers to evaluate male bylines higher in stereotypical ways, but female readers do not do this.…

  8. Why Follow the Leader? Collective Action, Credible Commitment and Conflict

    OpenAIRE

    Keefer, Philip

    2012-01-01

    Most analyses of conflict assume that conflicting groups act in a unitary fashion. This assumption is often violated: to reduce their risk of replacement, group leaders prevent both group members and soldiers from acting collectively, making it difficult for leaders to make credible commitments to them. Lifting the assumption that groups are unitary shifts the analysis of a wide range of c...

  9. Evaluation measures for relevance and credibility in ranked lists

    DEFF Research Database (Denmark)

    Lioma, Christina; Simonsen, Jakob Grue; Larsen, Birger

    2017-01-01

    Recent discussions on alternative facts, fake news, and post truth politics have motivated research on creating technologies that allow people not only to access information, but also to assess the credibility of the information presented to them by information retrieval systems. Whereas technology...

  10. Student Perceptions of Peer Credibility Based on Email Addresses

    Science.gov (United States)

    Livermore, Jeffrey A.; Scafe, Marla G.; Wiechowski, Linda S.; Maier, David J.

    2013-01-01

    The purpose of this study was to evaluate students' perceptions of their peer's credibility based on email addresses. The survey was conducted at a community college in Michigan where all students were registered and actively taking at least one course. The survey results show that a student's selection of an email address does influence other…

  11. Faculty Perceptions of Student Credibility Based on Email Addresses

    Science.gov (United States)

    Livermore, Jeffrey A.; Wiechowski, Linda S.; Scafe, Marla G.

    2011-01-01

    The purpose of this study was to evaluate faculty perceptions of student credibility based on email addresses. The survey was conducted at an upper division business school in Michigan where all students have completed at least two years of college courses. The survey results show that a student's selection of an email address does influence the…

  12. Student Perceptions of Faculty Credibility Based on Email Addresses

    Science.gov (United States)

    Livermore, Jeffrey A.; Scafe, Marla G.; Wiechowski, Linda S.

    2010-01-01

    The purpose of this study was to evaluate students' perceptions of faculty credibility based on email addresses. The survey was conducted at an upper division business school in Michigan where all students have completed at least two years of college courses. The survey results show that a faculty member's selection of an email address does…

  13. Using Active Learning to Identify Health Information Technology Related Patient Safety Events.

    Science.gov (United States)

    Fong, Allan; Howe, Jessica L; Adams, Katharine T; Ratwani, Raj M

    2017-01-18

    The widespread adoption of health information technology (HIT) has led to new patient safety hazards that are often difficult to identify. Patient safety event reports, which are self-reported descriptions of safety hazards, provide one view of potential HIT-related safety events. However, identifying HIT-related reports can be challenging as they are often categorized under other more predominate clinical categories. This challenge of identifying HIT-related reports is exacerbated by the increasing number and complexity of reports which pose challenges to human annotators that must manually review reports. In this paper, we apply active learning techniques to support classification of patient safety event reports as HIT-related. We evaluated different strategies and demonstrated a 30% increase in average precision of a confirmatory sampling strategy over a baseline no active learning approach after 10 learning iterations.

  14. Research Priorities for Fertility and Conception Research as Identified by Multidisciplinary Health Care Practitioners and Researchers

    Directory of Open Access Journals (Sweden)

    Lisa J. Moran

    2016-01-01

    Full Text Available The Robinson Research Institute of the University of Adelaide convened a multidisciplinary group of n = 33 clinicians, researchers and representatives of government organisations on the 2 October 2014 for a workshop entitled “Promoting fertility and healthy conception. How do we generate greater reproductive health awareness?” The key aim of the workshop was to assess the body of knowledge that informs clinical practice and government policy, and to identify questions and additional information needed by health practitioners and government representatives working in the field of reproductive health and to frame future research and policy. The workshop identified topics that fell mostly into three categories: lifestyle-related, societal and biological factors. The lifestyle topics included nutrition and diet, exercise, obesity, shift work and other factors deemed to be modifiable at the level of the individual. The societal topics included discussions of matters that are structural, and resistant to change by individuals, including specific ethical issues, social disadvantage, government and educational policies. The biological factors are intrinsic physical states of the individual, and included many factors where there is a dense body of scientific knowledge which may not be readily accessible in less academic language. This workshop thus provided an opportunity to identify further actions that could be undertaken to meet the needs of diverse organisations and groups of professionals with an interest in human fertility. Since so many factors in our social and biological environment can impact fertility and preconception health, it is imperative to involve many disciplines or levels of government or societal organisations that have not traditionally been involved in this area.

  15. Leveraging Diverse Data Sources to Identify and Describe U.S. Health Care Delivery Systems.

    Science.gov (United States)

    Cohen, Genna R; Jones, David J; Heeringa, Jessica; Barrett, Kirsten; Furukawa, Michael F; Miller, Dan; Mutti, Anne; Reschovsky, James D; Machta, Rachel; Shortell, Stephen M; Fraze, Taressa; Rich, Eugene

    2017-12-15

    Health care delivery systems are a growing presence in the U.S., yet research is hindered by the lack of universally agreed-upon criteria to denote formal systems. A clearer understanding of how to leverage real-world data sources to empirically identify systems is a necessary first step to such policy-relevant research. We draw from our experience in the Agency for Healthcare Research and Quality's Comparative Health System Performance (CHSP) initiative to assess available data sources to identify and describe systems, including system members (for example, hospitals and physicians) and relationships among the members (for example, hospital ownership of physician groups). We highlight five national data sources that either explicitly track system membership or detail system relationships: (1) American Hospital Association annual survey of hospitals; (2) Healthcare Relational Services Databases; (3) SK&A Healthcare Databases; (4) Provider Enrollment, Chain, and Ownership System; and (5) Internal Revenue Service 990 forms. Each data source has strengths and limitations for identifying and describing systems due to their varied content, linkages across data sources, and data collection methods. In addition, although no single national data source provides a complete picture of U.S. systems and their members, the CHSP initiative will create an early model of how such data can be combined to compensate for their individual limitations. Identifying systems in a way that can be repeated over time and linked to a host of other data sources will support analysis of how different types of organizations deliver health care and, ultimately, comparison of their performance.

  16. Identifying best-fitting inputs in health-economic model calibration: a Pareto frontier approach.

    Science.gov (United States)

    Enns, Eva A; Cipriano, Lauren E; Simons, Cyrena T; Kong, Chung Yin

    2015-02-01

    To identify best-fitting input sets using model calibration, individual calibration target fits are often combined into a single goodness-of-fit (GOF) measure using a set of weights. Decisions in the calibration process, such as which weights to use, influence which sets of model inputs are identified as best-fitting, potentially leading to different health economic conclusions. We present an alternative approach to identifying best-fitting input sets based on the concept of Pareto-optimality. A set of model inputs is on the Pareto frontier if no other input set simultaneously fits all calibration targets as well or better. We demonstrate the Pareto frontier approach in the calibration of 2 models: a simple, illustrative Markov model and a previously published cost-effectiveness model of transcatheter aortic valve replacement (TAVR). For each model, we compare the input sets on the Pareto frontier to an equal number of best-fitting input sets according to 2 possible weighted-sum GOF scoring systems, and we compare the health economic conclusions arising from these different definitions of best-fitting. For the simple model, outcomes evaluated over the best-fitting input sets according to the 2 weighted-sum GOF schemes were virtually nonoverlapping on the cost-effectiveness plane and resulted in very different incremental cost-effectiveness ratios ($79,300 [95% CI 72,500-87,600] v. $139,700 [95% CI 79,900-182,800] per quality-adjusted life-year [QALY] gained). Input sets on the Pareto frontier spanned both regions ($79,000 [95% CI 64,900-156,200] per QALY gained). The TAVR model yielded similar results. Choices in generating a summary GOF score may result in different health economic conclusions. The Pareto frontier approach eliminates the need to make these choices by using an intuitive and transparent notion of optimality as the basis for identifying best-fitting input sets. © The Author(s) 2014.

  17. Lessons learned from England's Health Checks Programme: using qualitative research to identify and share best practice.

    Science.gov (United States)

    Ismail, Hanif; Kelly, Shona

    2015-10-20

    This study aimed to explore the challenges and barriers faced by staff involved in the delivery of the National Health Service (NHS) Health Check, a systematic cardiovascular disease (CVD) risk assessment and management program in primary care. Data have been derived from three qualitative evaluations that were conducted in 25 General Practices and involved in depth interviews with 58 staff involved all levels of the delivery of the Health Checks. Analysis of the data was undertaken using the framework approach and findings are reported within the context of research and practice considerations. Findings indicated that there is no 'one size fits all' blueprint for maximising uptake although success factors were identified: evolution of the programme over time in response to local needs to suit the particular characteristics of the patient population; individual staff characteristics such as being proactive, enthusiastic and having specific responsibility; a supportive team. Training was clearly identified as an area that needed addressing and practitioners would benefit from CVD specific baseline training and refresher courses to keep them up to date with recent developments in the area. However there were other external factors that impinged on an individual's ability to provide an effective service, some of these were outside the control of individuals and included cutbacks in referral services, insufficient space to run clinics or general awareness of the Health Checks amongst patients. The everyday experiences of practitioners who participated in this study suggest that overall, Health Check is perceived as a worthwhile exercise. But, organisational and structural barriers need to be addressed. We also recommend that clear referral pathways be in place so staff can refer patients to appropriate services (healthy eating sessions, smoking cessation, and exercise referrals). Local authorities need to support initiatives that enable data sharing and linkage so that

  18. The Fukushima radiological emergency and challenges identified for future public health responses.

    Science.gov (United States)

    Miller, Charles W

    2012-05-01

    On 11 March 2011, northern Japan was rocked by first a magnitude 9.0 earthquake off the eastern coast and then an ensuing tsunami. The Fukushima Daiichi Nuclear Power Plant complex was hit by these twin disasters, and a cascade of events was initiated that led to radionuclide releases causing widespread radioactive contamination of residential areas, agricultural land, and coastal waters. Radioactive material from Japan was subsequently transmitted to locations around the globe, including the U.S. The levels of radioactive material that arrived in the U.S. were never large enough to be a concern for health effects, but the presence of this material in the environment was enough to create a public health emergency in the U.S. The radiation safety and public health communities in the U.S. are identifying challenges they faced in responding to this incident. This paper discusses three of those challenges: (1) The growing shortage of trained radiation subject matter experts in the field of environmental transport and dosimetry of radionuclides; (2) the need to begin expressing all radiation-related quantities in terms of the International System of Units; and (3) the need to define when a radiation dose is or is not one of "public health concern." This list represents only a small subset of the list of challenges being identified by public health agencies that responded to the Fukushima incident. However, these three challenges are fundamental to any radiological emergency response. Addressing them will have a significant positive impact on how the U.S. responds to the next radiological emergency.

  19. Using Market Research to Characterize College Students and Identify Potential Targets for Influencing Health Behaviors

    Science.gov (United States)

    Berg, Carla J.; Ling, Pamela M.; Guo, Hongfei; Windle, Michael; Thomas, Janet L.; Ahluwalia, Jasjit S.; An, Lawrence C.

    2013-01-01

    Marketing campaigns, such as those developed by the tobacco industry, are based on market research, which defines segments of a population by assessing psychographic characteristics (i.e., attitudes, interests). This study uses a similar approach to define market segments of college smokers, to examine differences in their health behaviors (smoking, drinking, binge drinking, exercise, diet), and to determine the validity of these segments. A total of 2,265 undergraduate students aged 18–25 years completed a 108-item online survey in fall 2008 assessing demographic, psychographic (i.e., attitudes, interests), and health-related variables. Among the 753 students reporting past 30-day smoking, cluster analysis was conducted using 21 psychographic questions and identified three market segments – Stoic Individualists, Responsible Traditionalists, and Thrill-Seeking Socializers. We found that segment membership was related to frequency of alcohol use, binge drinking, and limiting dietary fat. We then developed three messages targeting each segment and conducted message testing to validate the segments on a subset of 73 smokers representing each segment in spring 2009. As hypothesized, each segment indicated greater relevance and salience for their respective message. These findings indicate that identifying qualitatively different subgroups of young adults through market research may inform the development of engaging interventions and health campaigns targeting college students. PMID:25264429

  20. Feasibility of identifying families for genetic studies of birth defects using the National Health Interview Survey

    Directory of Open Access Journals (Sweden)

    Nolan Vikki G

    2004-05-01

    Full Text Available Abstract Background The purpose of this study was to determine whether the National Health Interview Survey is a useful source to identify informative families for genetic studies of birth defects. Methods The 1994/1995 National Health Interview Survey (NHIS was used to identify households where individuals with two or more birth defects reside. Four groups of households were identified: 1 single non-familial (one individual with one birth defect; 2 single familial (more than one individual with one birth defect; 3 multiple non-familial (one individual with more than one birth defect, and 4 multiple familial (more than one individual with more than one birth defect. The March 2000 U.S. Census on households was used to estimate the total number of households in which there are individuals with birth defects. Results Of a total of 28,094 households and surveyed about birth defects and impairments, 1,083 single non-familial, 55 multiple non-familial, 54 single familial, and 8 multiple familial households were identified. Based on the 2000 U.S. census, it is estimated that there are 4,472,385 households where at least one person has one birth defect in the United States and in 234,846 of them there are at least two affected individuals. Western states had the highest prevalence rates. Conclusions Population-based methods, such as the NHIS, are modestly useful to identify the number and the regions where candidate families for genetic studies of birth defects reside. Clinic based studies and birth defects surveillance systems that collect family history offer better probability of ascertainment.

  1. Structural health monitoring (vibration) as a tool for identifying structural alterations of the lumbar spine

    DEFF Research Database (Denmark)

    Kawchuk, Gregory N; Hartvigsen, Jan; Edgecombe, Tiffany

    2016-01-01

    Structural health monitoring (SHM) is an engineering technique used to identify mechanical abnormalities not readily apparent through other means. Recently, SHM has been adapted for use in biological systems, but its invasive nature limits its clinical application. As such, the purpose of this pr......Structural health monitoring (SHM) is an engineering technique used to identify mechanical abnormalities not readily apparent through other means. Recently, SHM has been adapted for use in biological systems, but its invasive nature limits its clinical application. As such, the purpose...... of this project was to determine if a non-invasive form of SHM could identify structural alterations in the spines of living human subjects. Lumbar spines of 10 twin pairs were visualized by magnetic resonance imaging then assessed by a blinded radiologist to determine whether twin pairs were structurally...... concordant or discordant. Vibration was then applied to each subject's spine and the resulting response recorded from sensors overlying lumbar spinous processes. The peak frequency, area under the curve and the root mean square were computed from the frequency response function of each sensor. Statistical...

  2. Identifying the gaps: Armenian health care legislation and human rights in patient care protections.

    Science.gov (United States)

    Zopunyan, Violeta; Krmoyan, Suren; Quinn, Ryan

    2013-12-12

    Since the collapse of the Soviet Union, the Republic of Armenia has undergone an extensive legislative overhaul. Although a number of developments have aimed to improve the quality and accessibility of Armenia's health care system, a host of factors has prevented the country from fully introducing measures to ensure respect for human rights in patient care. In particular, inadequate health care financing continues to oblige patients to make both formal and informal payments to obtain basic medical care and services. More generally, a lack of oversight and monitoring mechanisms has obstructed the implementation of Armenia's commitments to human rights in several international agreements. Within the framework of a broader project on promoting human rights in patient care, research was carried out to examine Armenia’s health care legislation with the aim of identifying gaps in comparison with international and regional standards. This research was designed using the 14 rights enshrined in the European Charter on Patient Rights as guiding principles, along with domestic legal acts relevant to the rights of health care providers. The gaps analysis revealed numerous problems with Armenian legislation governing the relationships between stakeholders in health care service delivery. It also identified several practical inconsistencies with the international legal instruments ratified by the Armenian government. These legislative shortcomings are illustrated by highlighting key health-related rights violations experienced by patients and their health care providers, and by indicating opportunities for improved rights protections. A full list of human rights relevant to patient care and recommendations for promoting them in the Armenian context is provided in Tables 1 and 2. A number of initiatives must be undertaken in order to promote the full spectrum of human rights in patient care in Armenia. This section highlights certain recommendations flowing from the findings of

  3. Parent-identified barriers to pediatric health care: a process-oriented model.

    Science.gov (United States)

    Sobo, Elisa J; Seid, Michael; Reyes Gelhard, Leticia

    2006-02-01

    To further understand barriers to care as experienced by health care consumers, and to demonstrate the importance of conjoining qualitative and quantitative health services research. Transcripts from focus groups conducted in San Diego with English- and Spanish-speaking parents of children with special health care needs. Participants were asked about the barriers to care they had experienced or perceived, and their strategies for overcoming these barriers. Using elementary anthropological discourse analysis techniques, a process-based conceptual model of the parent experience was devised. The analysis revealed a parent-motivated model of barriers to care that enriched our understanding of quantitative findings regarding the population from which the focus group sample was drawn. Parent-identified barriers were grouped into the following six temporally and spatially sequenced categories: necessary skills and prerequisites for gaining access to the system; realizing access once it is gained; front office experiences; interactions with physicians; system arbitrariness and fragmentation; outcomes that affect future interaction with the system. Key to the successful navigation of the system was parents' functional biomedical acculturation; this construct likens the biomedical health services system to a cultural system within which all parents/patients must learn to function competently. Qualitative analysis of focus group data enabled a deeper understanding of barriers to care--one that went beyond the traditional association of marker variables with poor outcomes ("what") to reveal an understanding of the processes by which parents experience the health care system ("how,"why") and by which disparities may arise. Development of such process-oriented models furthers the provision of patient-centered care and the creation of interventions, programs, and curricula to enhance such care. Qualitative discourse analysis, for example using this project's widely applicable

  4. Identifying Factors Influencing the Establishment of a Health System Reform Plan in Iran's Public Hospitals

    Directory of Open Access Journals (Sweden)

    Rasul Fani khiavi

    2016-09-01

    Full Text Available In today's world, health views have found a wider perspective in which non-medical expectations are particularly catered to. The health system reform plan seeks to improve society's health, decrease treatment costs, and increase patient satisfaction. This study investigated factors affecting the successful establishment of a health system reform plan. A mixed qualitative – quantitative approach was applied to conduct to explore influential factors associated with the establishment of a health system reform plan in Iran's public hospitals. The health systems and approaches to improving them in other countries have been studied. A Likert-based five-point questionnaire was the measurement instrument, and its content validity based on content validity ratio (CVR was 0.87. The construct validity, calculated using the factorial analysis and Kaiser Mayer Olkin (KMO techniques, was 0.964, which is a high level and suggests a correlation between the scale items. To complete the questionnaire, 185 experts, specialists, and executives of Iran’s health reform plan were selected using the Purposive Stratified Non Random Sampling and snowball methods. The data was then analyzed using exploratory factorial analysis and SPSS and LISREL software applications. The results of this research imply the existence of a pattern with a significant and direct relationship between the identified independent variables and the dependent variable of the establishment of a health system reform plan. The most important indices of establishing a health system reform plan, in the order of priority, were political support; suitable proportion and coverage of services presented in the society; management of resources; existence of necessary infrastructures; commitment of senior managers; constant planning, monitoring, and evaluation; and presentation of feedback to the plan's executives, intrasector/extrasector cooperation, and the plan’s guiding committee. Considering the

  5. Stress and mental health among midlife and older gay-identified men.

    Science.gov (United States)

    Wight, Richard G; LeBlanc, Allen J; de Vries, Brian; Detels, Roger

    2012-03-01

    We investigated associations between stress and mental health (positive affect, depressive symptoms) among HIV-negative and HIV-positive midlife and older gay-identified men, along with the mediating and moderating effects of mastery and emotional support. We also studied the mental health effects of same-sex marriage. We obtained data from self-administered questionnaires completed in 2009 or 2010 by a subsample (n = 202; average age = 56.91 years; age range = 44-75 years) of participants in the University of California, Los Angeles component of the Multicenter AIDS Cohort Study, one of the largest and longest-running natural-history studies of HIV/AIDS in the United States. Both sexual minority stress (perceived gay-related stigma, excessive HIV bereavements) and aging-related stress (independence and fiscal concerns) appeared to have been detrimental to mental health. Sense of mastery partially mediated these associations. Being legally married was significantly protective net of all covariates, including having a domestic partner but not being married. Education, HIV status, and race/ethnicity had no significant effects. Sexual minority and aging-related stress significantly affected the emotional lives of these men. Personal sense of mastery may help to sustain them as they age. We observed specific mental health benefits of same-sex legal marriage.

  6. Community Health Workers in the United States: Challenges in Identifying, Surveying, and Supporting the Workforce.

    Science.gov (United States)

    Sabo, Samantha; Allen, Caitlin G; Sutkowi, Katherine; Wennerstrom, Ashley

    2017-12-01

    Community health workers (CHWs) are members of a growing profession in the United States. Studying this dynamic labor force is challenging, in part because its members have more than 100 different job titles. The demand for timely, accurate information about CHWs is increasing as the profession gains recognition for its ability to improve health outcomes and reduce costs. Although numerous surveys of CHWs have been conducted, the field lacks well-delineated methods for gaining access to this hard-to-identify workforce. We outline methods for surveying CHWs and promising approaches to engage the workforce and other stakeholders in conducting local, state, and national studies. We also highlight successful strategies to overcome challenges in CHW surveys and future directions for surveying the field.

  7. One Health approach to identify research needs in bovine and human babesioses: workshop report

    Directory of Open Access Journals (Sweden)

    McElwain Terry F

    2010-04-01

    Full Text Available Abstract Background Babesia are emerging health threats to humans and animals in the United States. A collaborative effort of multiple disciplines to attain optimal health for people, animals and our environment, otherwise known as the One Health concept, was taken during a research workshop held in April 2009 to identify gaps in scientific knowledge regarding babesioses. The impetus for this analysis was the increased risk for outbreaks of bovine babesiosis, also known as Texas cattle fever, associated with the re-infestation of the U.S. by cattle fever ticks. Results The involvement of wildlife in the ecology of cattle fever ticks jeopardizes the ability of state and federal agencies to keep the national herd free of Texas cattle fever. Similarly, there has been a progressive increase in the number of cases of human babesiosis over the past 25 years due to an increase in the white-tailed deer population. Human babesiosis due to cattle-associated Babesia divergens and Babesia divergens-like organisms have begun to appear in residents of the United States. Research needs for human and bovine babesioses were identified and are presented herein. Conclusions The translation of this research is expected to provide veterinary and public health systems with the tools to mitigate the impact of bovine and human babesioses. However, economic, political, and social commitments are urgently required, including increased national funding for animal and human Babesia research, to prevent the re-establishment of cattle fever ticks and the increasing problem of human babesiosis in the United States.

  8. Identifying Health Needs in Peru Through Use of a Community Survey.

    Science.gov (United States)

    Renn, McCartney; Steffen, Lori

    2016-11-01

    Students and faculty from a Midwestern college conducted a neighborhood community needs assessment in an impoverished area of a Peruvian city to identify health needs of residents. Students interviewed residents in their homes, asking about the need for medical, dental, and ophthalmic care and screening for chronic conditions such as diabetes, heart disease, and tuberculosis. The survey provided necessary information to medical mission workers and allowed students to directly observe family living conditions while assessing psychosocial needs of the families interviewed. The challenges of this survey included differing expectations, language barriers, recruiting neighborhood volunteers, safety risks to students, and mistrust by neighborhood residents.

  9. An ethical framework for identifying, preventing, and managing conflicts confronting leaders of academic health centers.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B

    2004-11-01

    Leaders of academic health centers (AHCs) hold positions that by their very nature have a high potential for ethical conflict. The authors offer an ethical framework for identifying, preventing, and managing conflicts in the leadership of AHCs. This framework is based on and implements both the ethical concept of AHCs as fiduciary organizations and also the legitimate interests of various stakeholders. The authors describe practical steps that can be tools for the preventive-ethics leadership of AHCs that enable leaders to avoid strategic ambiguity and strategic procrastination and replace these with transparency. The ethical framework is illustrated by applying it to an organizational case study. The major contribution of the ethical framework is that it transforms decision making from simply negotiating power struggles to explicitly identifying and making ethical decisions based on the legitimate interests and fiduciary responsibilities of all stakeholders.

  10. Identifying and Synchronizing Health Information Technology (HIT) Events from FDA Medical Device Reports.

    Science.gov (United States)

    Kang, Hong; Wang, Frank; Zhou, Sicheng; Miao, Qi; Gong, Yang

    2017-01-01

    Health information technology (HIT) events, a subtype of patient safety events, pose a major threat and barrier toward a safer healthcare system. It is crucial to gain a better understanding of the nature of the errors and adverse events caused by current HIT systems. The scarcity of HIT event-exclusive databases and event reporting systems indicates the challenge of identifying the HIT events from existing resources. FDA Manufacturer and User Facility Device Experience (MAUDE) database is a potential resource for HIT events. However, the low proportion and the rapid evolvement of HIT-related events present challenges for distinguishing them from other equipment failures and hazards. We proposed a strategy to identify and synchronize HIT events from MAUDE by using a filter based on structured features and classifiers based on unstructured features. The strategy will help us develop and grow an HIT event-exclusive database, keeping pace with updates to MAUDE toward shared learning.

  11. The role of surgeons in identifying emerging technologies for health technology assessment.

    Science.gov (United States)

    Stafinski, Tania; Topfer, Leigh-Ann; Zakariasen, Ken; Menon, Devidas

    2010-04-01

    Health technology assessment (HTA) is a tool intended to help policy-makers decide which technologies to fund. However, given the proliferation of new technologies, it is not possible to undertake an HTA of each one before it becomes funded. Consequently, "horizon-scanning" processes have been developed to identify emerging technologies that are likely to have a substantial impact on clinical practice. Although the importance of physicians in the adoption of new technologies is well recognized, their role in horizon scanning in Canada has been limited. The purpose of this project was to pilot an approach to engage physicians, specifically surgeons, in provincial horizon-scanning activities. We invited 18 surgeons from Alberta's 2 medical schools to a horizon-scanning workshop to solicit their views on emerging technologies expected to impact surgical practice within the next 5 years and/or the importance of different attributes or characteristics of new technologies. Surgeons, regardless of specialty, identified developments designed to enhance existing minimally invasive surgical techniques, such as endoscopic, robotic and image-guided surgery. Several nonsurgical areas, including molecular genetics and nano technology, were also identified. Of the 13 technology attributes discussed, safety or risk, effectiveness and feasibility were rated as most important. Lastly, participating surgeons expressed an interest in becoming further involved in local HTA initiatives. Surgeons, as adopters and users of health technologies, represent an important and accessible information source for identifying emerging technologies for HTA. A more formal, ongoing relationship between the government, HTA and surgeons may help to optimize the use of HTA resources.

  12. Ranking the Online Documents Based on Relative Credibility Measures

    Directory of Open Access Journals (Sweden)

    Ahmad Dahlan

    2013-09-01

    Full Text Available Information searching is the most popular activity in Internet. Usually the search engine provides the search results ranked by the relevance. However, for a certain purpose that concerns with information credibility, particularly citing information for scientific works, another approach of ranking the search engine results is required. This paper presents a study on developing a new ranking method based on the credibility of information. The method is built up upon two well-known algorithms, PageRank and Citation Analysis. The result of the experiment that used Spearman Rank Correlation Coefficient to compare the proposed rank (generated by the method with the standard rank (generated manually by a group of experts showed that the average Spearman 0 < rS < critical value. It means that the correlation was proven but it was not significant. Hence the proposed rank does not satisfy the standard but the performance could be improved.

  13. Ranking the Online Documents Based on Relative Credibility Measures

    Directory of Open Access Journals (Sweden)

    Ahmad Dahlan

    2009-05-01

    Full Text Available Information searching is the most popular activity in Internet. Usually the search engine provides the search results ranked by the relevance. However, for a certain purpose that concerns with information credibility, particularly citing information for scientific works, another approach of ranking the search engine results is required. This paper presents a study on developing a new ranking method based on the credibility of information. The method is built up upon two well-known algorithms, PageRank and Citation Analysis. The result of the experiment that used Spearman Rank Correlation Coefficient to compare the proposed rank (generated by the method with the standard rank (generated manually by a group of experts showed that the average Spearman 0 < rS < critical value. It means that the correlation was proven but it was not significant. Hence the proposed rank does not satisfy the standard but the performance could be improved.

  14. Building Credible Human Capital Analytics for Organizational Competitive Advantage

    DEFF Research Database (Denmark)

    Minbaeva, Dana

    2018-01-01

    Despite the enormous interest in human capital analytics (HCA), organizations have struggled to move from operational reporting to HCA. This is mainly the result of the inability of analytics teams to establish credible internal HCA and demonstrate its value. In this article, we stress the import......Despite the enormous interest in human capital analytics (HCA), organizations have struggled to move from operational reporting to HCA. This is mainly the result of the inability of analytics teams to establish credible internal HCA and demonstrate its value. In this article, we stress...... the importance of conceptualizing HCA as an organizational capability and suggest a method for its operationalization. We argue that the development of HCA within an organization requires working with three dimensions of HCA: data quality, analytics capabilities, and strategic ability to act. Moreover, such work...

  15. Eletronuclear's relationship with the Brazilian media: transparency and credibility

    International Nuclear Information System (INIS)

    Alvarez, Gloria

    2013-01-01

    In a capitalist economy the most valued assets are not money, shares or facilities, but credibility. Lack of money can ruin a company, but often it is reputation that delivers the final blow. It has become challenging to safeguard reputation in a world where Communication is increasingly connected and with such an intense and lightning fast flow of information. This is particularly true for the electricity sector - a commodity so prevalent in everyday modern life, but, whose business dealings, are hardly known by the general public. When it comes to nuclear energy, the challenge of establishing an effective Communication with transparency and credibility touches on even more complex elements. The topic of this paper is the scenario through which the Communication process, along with its characteristics and approaches, unfolds between the nuclear sector and the Brazilian media. (author)

  16. The evaluation of trustworthiness to identify health insurance fraud in dentistry.

    Science.gov (United States)

    Wang, Shu-Li; Pai, Hao-Ting; Wu, Mei-Fang; Wu, Fan; Li, Chen-Lin

    2017-01-01

    According to the investigations of the U.S. Government Accountability Office (GAO), health insurance fraud has caused an enormous pecuniary loss in the U.S. In Taiwan, in dentistry the problem is getting worse if dentists (authorized entities) file fraudulent claims. Several methods have been developed to solve health insurance fraud; however, these methods are like a rule-based mechanism. Without exploring the behavior patterns, these methods are time-consuming and ineffective; in addition, they are inadequate for managing the fraudulent dentists. Based on social network theory, we develop an evaluation approach to solve the problem of cross-dentist fraud. The trustworthiness score of a dentist is calculated based upon the amount and type of dental operations performed on the same patient and the same tooth by that dentist and other dentists. The simulation provides the following evidence. (1) This specific type of fraud can be identified effectively using our evaluation approach. (2) A retrospective study for the claims is also performed. (3) The proposed method is effective in identifying the fraudulent dentists. We provide a new direction for investigating the genuineness of claims data. If the insurer can detect fraudulent dentists using the traditional method and the proposed method simultaneously, the detection will be more transparent and ultimately reduce the losses caused by fraudulent claims. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Association of intimate partner violence and health-care provider-identified obesity.

    Science.gov (United States)

    Davies, Rhian; Lehman, Erik; Perry, Amanda; McCall-Hosenfeld, Jennifer S

    2016-07-01

    The association of physical and nonphysical intimate partner violence (IPV) with obesity was examined. Women (N = 1,179) were surveyed regarding demographics, obesity, and IPV exposure using humiliate-afraid-rape-kick (HARK), an IPV screening tool. A three-level lifetime IPV exposure variable measured physical, nonphysical or no IPV. Health-care provider-identified obesity was defined if participants were told by a medical provider within the past 5 years that they were obese. Bivariate analyses examined obesity by IPV and demographics. Multivariable logistic regression assessed odds of obesity by IPV type, adjusting for age, race/ethnicity, education, and marital status. Among participants, 44% reported lifetime IPV (25% physical, 19% nonphysical), and 24% reported health-care provider-identified obesity. In unadjusted analyses, obesity was more prevalent among women exposed to physical IPV (30%) and nonphysical IPV (27%), compared to women without IPV (20%, p = .002). In multivariable models, women reporting physical IPV had 1.67 times greater odds of obesity (95% confidence interval [CI] 1.20, 2.33), and women reporting nonphysical IPV had 1.46 times greater odds of obesity (95% CI 1.01, 2.10), compared to women reporting no exposure. This study extends prior data by showing, not only an association between physical IPV and obesity, but also an association between obesity and nonphysical IPV.

  18. Maximum credible accident analysis for TR-2 reactor conceptual design

    International Nuclear Information System (INIS)

    Manopulo, E.

    1981-01-01

    A new reactor, TR-2, of 5 MW, designed in cooperation with CEN/GRENOBLE is under construction in the open pool of TR-1 reactor of 1 MW set up by AMF atomics at the Cekmece Nuclear Research and Training Center. In this report the fission product inventory and doses released after the maximum credible accident have been studied. The diffusion of the gaseous fission products to the environment and the potential radiation risks to the population have been evaluated

  19. Supply Chain Risk Management: An Introduction to the Credible Threat

    Science.gov (United States)

    2016-08-01

    van.poindexter@dau.mil. Figure 3. Trusted Suppliers Source: “ Managing Information Communications Technology Global Supply Chain Risk Awareness...Defense AT&L: July-August 2016 18 Supply Chain Risk Management An Introduction to the Credible Threat Heath Ferry n Van Poindexter 19...cybersecurity breach. This article examines the elements of supply chain risk management , the national security risks associated with exploitation, and

  20. Spatial Accessibility to Health Care Services: Identifying under-Serviced Neighbourhoods in Canadian Urban Areas.

    Directory of Open Access Journals (Sweden)

    Tayyab Ikram Shah

    Full Text Available Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods.This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population, was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons. An integrated geocoding approach was used to establish PHC locations.The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs.The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood

  1. A methodological survey identified eight proposed frameworks for the adaptation of health related guidelines.

    Science.gov (United States)

    Darzi, Andrea; Abou-Jaoude, Elias A; Agarwal, Arnav; Lakis, Chantal; Wiercioch, Wojtek; Santesso, Nancy; Brax, Hneine; El-Jardali, Fadi; Schünemann, Holger J; Akl, Elie A

    2017-06-01

    Our objective was to identify and describe published frameworks for adaptation of clinical, public health, and health services guidelines. We included reports describing methods of adaptation of guidelines in sufficient detail to allow its reproducibility. We searched Medline and EMBASE databases. We also searched personal files, as well manuals and handbooks of organizations and professional societies that proposed methods of adaptation and adoption of guidelines. We followed standard systematic review methodology. Our search captured 12,021 citations, out of which we identified eight proposed methods of guidelines adaptation: ADAPTE, Adapted ADAPTE, Alberta Ambassador Program adaptation phase, GRADE-ADOLOPMENT, MAGIC, RAPADAPTE, Royal College of Nursing (RCN), and Systematic Guideline Review (SGR). The ADAPTE framework consists of a 24-step process to adapt guidelines to a local context taking into consideration the needs, priorities, legislation, policies, and resources. The Alexandria Center for Evidence-Based Clinical Practice Guidelines updated one of ADAPTE's tools, modified three tools, and added three new ones. In addition, they proposed optionally using three other tools. The Alberta Ambassador Program adaptation phase consists of 11 steps and focused on adapting good-quality guidelines for nonspecific low back pain into local context. GRADE-ADOLOPMENT is an eight-step process based on the GRADE Working Group's Evidence to Decision frameworks and applied in 22 guidelines in the context of national guideline development program. The MAGIC research program developed a five-step adaptation process, informed by ADAPTE and the GRADE approach in the context of adapting thrombosis guidelines. The RAPADAPTE framework consists of 12 steps based on ADAPTE and using synthesized evidence databases, retrospectively derived from the experience of producing a high-quality guideline for the treatment of breast cancer with limited resources in Costa Rica. The RCN outlines

  2. Credibility assessment of testimonies provided by victims with intellectual disabilities

    Directory of Open Access Journals (Sweden)

    Antonio L. MANZANERO

    2017-09-01

    Full Text Available One of the main obstacles in the way of access to justice for the victims with intellectual disability comes from the stereotypes referred to their ability to produce a statement at police legal procedures, with the consequence that some consider their statements less reliable than the rest of the victims, and others considerate their statements more reliable given their inability to create complex lies. This article reviews three of the most recent studies done by the UCM group of Psychology of Testimony, with the objective of analyzing the role of experience and intuition in the evaluation of credibility in people with intellectual disability (ID, and also it aims to prove whether the credibility analysis procedures such as Reality Monitoring (RM and Statement Validity Assessment (SVA would be valid procedures to discriminate between real and false statements within these collectives. From the results of these studies, it can be deducted that experience may not seem to be enough in order to discriminate between real and simulated victims, but analyzing the characteristics of the statements as the only indicator doesn’t seem to be enough either. As an alternative, the general procedure HELPT is proposed for the evaluation of credibility of people with ID.

  3. Empirical Bayes Credibility Models for Economic Catastrophic Losses by Regions

    Directory of Open Access Journals (Sweden)

    Jindrová Pavla

    2017-01-01

    Full Text Available Catastrophic events affect various regions of the world with increasing frequency and intensity. The number of catastrophic events and the amount of economic losses is varying in different world regions. Part of these losses is covered by insurance. Catastrophe events in last years are associated with increases in premiums for some lines of business. The article focus on estimating the amount of net premiums that would be needed to cover the total or insured catastrophic losses in different world regions using Bühlmann and Bühlmann-Straub empirical credibility models based on data from Sigma Swiss Re 2010-2016. The empirical credibility models have been developed to estimate insurance premiums for short term insurance contracts using two ingredients: past data from the risk itself and collateral data from other sources considered to be relevant. In this article we deal with application of these models based on the real data about number of catastrophic events and about the total economic and insured catastrophe losses in seven regions of the world in time period 2009-2015. Estimated credible premiums by world regions provide information how much money in the monitored regions will be need to cover total and insured catastrophic losses in next year.

  4. Automatic address validation and health record review to identify homeless Social Security disability applicants.

    Science.gov (United States)

    Erickson, Jennifer; Abbott, Kenneth; Susienka, Lucinda

    2018-06-01

    Homeless patients face a variety of obstacles in pursuit of basic social services. Acknowledging this, the Social Security Administration directs employees to prioritize homeless patients and handle their disability claims with special care. However, under existing manual processes for identification of homelessness, many homeless patients never receive the special service to which they are entitled. In this paper, we explore address validation and automatic annotation of electronic health records to improve identification of homeless patients. We developed a sample of claims containing medical records at the moment of arrival in a single office. Using address validation software, we reconciled patient addresses with public directories of homeless shelters, veterans' hospitals and clinics, and correctional facilities. Other tools annotated electronic health records. We trained random forests to identify homeless patients and validated each model with 10-fold cross validation. For our finished model, the area under the receiver operating characteristic curve was 0.942. The random forest improved sensitivity from 0.067 to 0.879 but decreased positive predictive value to 0.382. Presumed false positive classifications bore many characteristics of homelessness. Organizations could use these methods to prompt early collection of information necessary to avoid labor-intensive attempts to reestablish contact with homeless individuals. Annually, such methods could benefit tens of thousands of patients who are homeless, destitute, and in urgent need of assistance. We were able to identify many more homeless patients through a combination of automatic address validation and natural language processing of unstructured electronic health records. Copyright © 2018. Published by Elsevier Inc.

  5. Developing and testing an instrument for identifying performance incentives in the Greek health care sector

    Directory of Open Access Journals (Sweden)

    Paleologou Victoria

    2006-09-01

    Full Text Available Abstract Background In the era of cost containment, managers are constantly pursuing increased organizational performance and productivity by aiming at the obvious target, i.e. the workforce. The health care sector, in which production processes are more complicated compared to other industries, is not an exception. In light of recent legislation in Greece in which efficiency improvement and achievement of specific performance targets are identified as undisputable health system goals, the purpose of this study was to develop a reliable and valid instrument for investigating the attitudes of Greek physicians, nurses and administrative personnel towards job-related aspects, and the extent to which these motivate them to improve performance and increase productivity. Methods A methodological exploratory design was employed in three phases: a content development and assessment, which resulted in a 28-item instrument, b pilot testing (N = 74 and c field testing (N = 353. Internal consistency reliability was tested via Cronbach's alpha coefficient and factor analysis was used to identify the underlying constructs. Tests of scaling assumptions, according to the Multitrait-Multimethod Matrix, were used to confirm the hypothesized component structure. Results Four components, referring to intrinsic individual needs and external job-related aspects, were revealed and explain 59.61% of the variability. They were subsequently labeled: job attributes, remuneration, co-workers and achievement. Nine items not meeting item-scale criteria were removed, resulting in a 19-item instrument. Scale reliability ranged from 0.782 to 0.901 and internal item consistency and discriminant validity criteria were satisfied. Conclusion Overall, the instrument appears to be a promising tool for hospital administrations in their attempt to identify job-related factors, which motivate their employees. The psychometric properties were good and warrant administration to a larger

  6. Developing and testing an instrument for identifying performance incentives in the Greek health care sector.

    Science.gov (United States)

    Paleologou, Victoria; Kontodimopoulos, Nick; Stamouli, Aggeliki; Aletras, Vassilis; Niakas, Dimitris

    2006-09-13

    In the era of cost containment, managers are constantly pursuing increased organizational performance and productivity by aiming at the obvious target, i.e. the workforce. The health care sector, in which production processes are more complicated compared to other industries, is not an exception. In light of recent legislation in Greece in which efficiency improvement and achievement of specific performance targets are identified as undisputable health system goals, the purpose of this study was to develop a reliable and valid instrument for investigating the attitudes of Greek physicians, nurses and administrative personnel towards job-related aspects, and the extent to which these motivate them to improve performance and increase productivity. A methodological exploratory design was employed in three phases: a) content development and assessment, which resulted in a 28-item instrument, b) pilot testing (N = 74) and c) field testing (N = 353). Internal consistency reliability was tested via Cronbach's alpha coefficient and factor analysis was used to identify the underlying constructs. Tests of scaling assumptions, according to the Multitrait-Multimethod Matrix, were used to confirm the hypothesized component structure. Four components, referring to intrinsic individual needs and external job-related aspects, were revealed and explain 59.61% of the variability. They were subsequently labeled: job attributes, remuneration, co-workers and achievement. Nine items not meeting item-scale criteria were removed, resulting in a 19-item instrument. Scale reliability ranged from 0.782 to 0.901 and internal item consistency and discriminant validity criteria were satisfied. Overall, the instrument appears to be a promising tool for hospital administrations in their attempt to identify job-related factors, which motivate their employees. The psychometric properties were good and warrant administration to a larger sample of employees in the Greek healthcare system.

  7. Credible enough? Forward guidance and per-ceived National Bank of Poland’s policy rule

    OpenAIRE

    Pawel Baranowski; Pawel Gajewski

    2015-01-01

    Credible forward guidance should reduce the perceived impact of macroeconomic variables on the interest rate. Using a micro-level dataset we test the perception of monetary policy in Poland among professional forecasters and find evidence for forward guidance credibility.

  8. Identifying the barriers to conducting outcomes research in integrative health care clinic settings - a qualitative study

    Directory of Open Access Journals (Sweden)

    Findlay-Reece Barbara

    2010-01-01

    Full Text Available Abstract Background Integrative health care (IHC is an interdisciplinary blending of conventional medicine and complementary and alternative medicine (CAM with the purpose of enhancing patients' health. In 2006, we designed a study to assess outcomes that are relevant to people using such care. However, we faced major challenges in conducting this study and hypothesized that this might be due to the lack of a research climate in these clinics. To investigate these challenges, we initiated a further study in 2008, to explore the reasons why IHC clinics are not conducting outcomes research and to identify strategies for conducting successful in-house outcomes research programs. The results of the latter study are reported here. Methods A total of 25 qualitative interviews were conducted with key participants from 19 IHC clinics across Canada. Basic content analysis was used to identify key themes from the transcribed interviews. Results Barriers identified by participants fell into four categories: organizational culture, organizational resources, organizational environment and logistical challenges. Cultural challenges relate to the philosophy of IHC, organizational leadership and practitioner attitudes and beliefs. Participants also identified significant issues relating to their organization's lack of resources such as funding, compensation, infrastructure and partnerships/linkages. Environmental challenges such as the nature of a clinic's patient population and logistical issues such as the actual implementation of a research program and the applicability of research data also posed challenges to the conduct of research. Embedded research leadership, integration of personal and professional values about research, alignment of research activities and clinical workflow processes are some of the factors identified by participants that support IHC clinics' ability to conduct outcomes research. Conclusions Assessing and enhancing the broader

  9. Stakeholders Perspectives on the Success Drivers in Ghana's National Health Insurance Scheme - Identifying Policy Translation Issues.

    Science.gov (United States)

    Fusheini, Adam; Marnoch, Gordon; Gray, Ann Marie

    2016-10-01

    Ghana's National Health Insurance Scheme (NHIS), established by an Act of Parliament (Act 650), in 2003 and since replaced by Act 852 of 2012 remains, in African terms, unprecedented in terms of growth and coverage. As a result, the scheme has received praise for its associated legal reforms, clinical audit mechanisms and for serving as a hub for knowledge sharing and learning within the context of South-South cooperation. The scheme continues to shape national health insurance thinking in Africa. While the success, especially in coverage and financial access has been highlighted by many authors, insufficient attention has been paid to critical and context-specific factors. This paper seeks to fill that gap. Based on an empirical qualitative case study of stakeholders' views on challenges and success factors in four mutual schemes (district offices) located in two regions of Ghana, the study uses the concept of policy translation to assess whether the Ghana scheme could provide useful lessons to other African and developing countries in their quest to implement social/NHISs. In the study, interviewees referred to both 'hard and soft' elements as driving the "success" of the Ghana scheme. The main 'hard elements' include bureaucratic and legal enforcement capacities; IT; financing; governance, administration and management; regulating membership of the scheme; and service provision and coverage capabilities. The 'soft' elements identified relate to: the background/context of the health insurance scheme; innovative ways of funding the NHIS, the hybrid nature of the Ghana scheme; political will, commitment by government, stakeholders and public cooperation; social structure of Ghana (solidarity); and ownership and participation. Other developing countries can expect to translate rather than re-assemble a national health insurance programme in an incomplete and highly modified form over a period of years, amounting to a process best conceived as germination as opposed

  10. Plant identification credibility in ethnobotany: a closer look at Polish ethnographic studies

    Directory of Open Access Journals (Sweden)

    Łuczaj Łukasz J

    2010-12-01

    Full Text Available Abstract Background This paper is an attempt to estimate the percentage of erroneously identified taxa in ethnographic studies concerning the use of plants and to propose a code for recording credibility of identification in historical ethnobotany publications. Methods A sample of Polish-language ethnobotanical literature (45 published sources from 1874-2005 and four collections of voucher specimens (from 1894-1975 were analyzed. Errors were detected in the publications by comparing the data with existing knowledge on the distribution of plant names and species ranges. The voucher specimens were re-examined. A one-letter code was invented for quick identification of the credibility of data published in lists of species compiled from historical or ethnographic sources, according to the source of identification: voucher specimen, Latin binominal, botanical expert, obvious widespread name, folk name, mode of use, range, physical description or photograph. To test the use of the code an up-to-date list of wild food plants used in Poland was made. Results A significant difference between the ratio of mistakes in the voucher specimen collections and the ratio of detectable mistakes in the studies without herbarium documentation was found. At least 2.3% of taxa in the publications were identified erroneously (mean rate was 6.2% per publication, and in half of these mistakes even the genus was not correct. As many as 10.0% of voucher specimens (on average 9.2% per collection were originally erroneously identified, but three quarters of the identification mistakes remained within-genus. The species of the genera Thymus, Rumex and Rubus were most often confused within the genus. Not all of the invented credibility codes were used in the list of wild food plants, but they may be useful for other researchers. The most often used codes were the ones signifying identification by: voucher specimen, botanical expert and by a common name used throughout the

  11. Plant identification credibility in ethnobotany: a closer look at Polish ethnographic studies.

    Science.gov (United States)

    Łuczaj, Łukasz J

    2010-12-17

    This paper is an attempt to estimate the percentage of erroneously identified taxa in ethnographic studies concerning the use of plants and to propose a code for recording credibility of identification in historical ethnobotany publications. A sample of Polish-language ethnobotanical literature (45 published sources from 1874-2005) and four collections of voucher specimens (from 1894-1975) were analyzed. Errors were detected in the publications by comparing the data with existing knowledge on the distribution of plant names and species ranges. The voucher specimens were re-examined.A one-letter code was invented for quick identification of the credibility of data published in lists of species compiled from historical or ethnographic sources, according to the source of identification: voucher specimen, Latin binominal, botanical expert, obvious widespread name, folk name, mode of use, range, physical description or photograph. To test the use of the code an up-to-date list of wild food plants used in Poland was made. A significant difference between the ratio of mistakes in the voucher specimen collections and the ratio of detectable mistakes in the studies without herbarium documentation was found. At least 2.3% of taxa in the publications were identified erroneously (mean rate was 6.2% per publication), and in half of these mistakes even the genus was not correct. As many as 10.0% of voucher specimens (on average 9.2% per collection) were originally erroneously identified, but three quarters of the identification mistakes remained within-genus.The species of the genera Thymus, Rumex and Rubus were most often confused within the genus.Not all of the invented credibility codes were used in the list of wild food plants, but they may be useful for other researchers. The most often used codes were the ones signifying identification by: voucher specimen, botanical expert and by a common name used throughout the country. The results of this study support the rigorous use

  12. Examining the Effect of Endorser Credibility on the Consumers' Buying Intentions: An Empirical Study in Turkey

    OpenAIRE

    Sertoglu, Aysegul Ermec; Catlı, Ozlem; Korkmaz, Sezer

    2014-01-01

    The purpose of this study is to test whether the source credibility affects buying intention and measure the perceived credibility differences between created spokesperson and celebrity endorser. The influence that endorser credibility dimensions (i.e. attractiveness, trustworthiness and expertise) have on purchase intentions of 326 young consumers has been examined. The results showed that all of the three credibility dimensions for both celebrity endorser and created spokesperson have a pos...

  13. EXAMINING THE EFFECT OF ENDORSER CREDIBILITY ON THE CONSUMERS' BUYING INTENTIONS: AN EMPIRICAL STUDY IN TURKEY

    OpenAIRE

    Aysegul Ermec Sertoglu; Ozlem Catli; Sezer Korkmaz

    2014-01-01

    The purpose of this study is to test whether the source credibility affects buying intention and measure the perceived credibility differences between created spokesperson and celebrity endorser. The influence that endorser credibility dimensions (i.e. attractiveness, trustworthiness and expertise) have on purchase intentions of 326 young consumers has been examined. The results showed that all of the three credibility dimensions for both celebrity endorser and created spokesperson have a pos...

  14. Credible or not : A study on the factors influencing consumers' credibility assessment of product placements on Instagram

    OpenAIRE

    Kulin, Elin; Blomgren, Linnéa

    2016-01-01

    Background: To align with the new trend of using social media in the marketing mix, product placement has been adapted to social media platforms as one strategy to create attention. Especially on Instagram, product placements have gained popularity among companies. While scholars have focused on measuring the effectiveness of the strategy, suggesting that credibility is one component necessary for success, a gap in the research is illuminated when focusing on what makes a product placement on...

  15. Predictors of premature termination from psychotherapy for anorexia nervosa: Low treatment credibility, early therapy alliance, and self-transcendence.

    Science.gov (United States)

    Jordan, Jennifer; McIntosh, Virginia V W; Carter, Frances A; Joyce, Peter R; Frampton, Christopher M A; Luty, Suzanne E; McKenzie, Janice M; Carter, Janet D; Bulik, Cynthia M

    2017-08-01

    Failure to complete treatment for anorexia nervosa (AN) is- common, clinically concerning but difficult to predict. This study examines whether therapy-related factors (patient-rated pretreatment credibility and early therapeutic alliance) predict subsequent premature termination of treatment (PTT) alongside self-transcendence (a previously identified clinical predictor) in women with AN. 56 women aged 17-40 years participating in a randomized outpatient psychotherapy trial for AN. Treatment completion was defined as attending 15/20 planned sessions. Measures were the Treatment Credibility, Temperament and Character Inventory, Vanderbilt Therapeutic Alliance Scale and the Vanderbilt Psychotherapy Process Scale. Statistics were univariate tests, correlations, and logistic regression. Treatment credibility and certain early patient and therapist alliance/process subscales predicted PTT. Lower self-transcendence and lower early process accounted for 33% of the variance in predicting PTT. Routine assessment of treatment credibility and early process (comprehensively assessed from multiple perspectives) may help clinicians reduce PTT thereby enhancing treatment outcomes. © 2017 Wiley Periodicals, Inc.

  16. 8 CFR 1208.30 - Credible fear determinations involving stowaways and applicants for admission found inadmissible...

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Credible fear determinations involving..., DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS PROCEDURES FOR ASYLUM AND WITHHOLDING OF REMOVAL Credible Fear of Persecution § 1208.30 Credible fear determinations involving stowaways and applicants for...

  17. Insulin resistance in women's health: why it matters and how to identify it.

    Science.gov (United States)

    Legro, Richard S

    2009-08-01

    To examine the significance of insulin resistance in women's health and review methods for diagnosing it. Clinical phenotypes in conjunction with standard clinical biochemical assays, that is, the metabolic syndrome, remain the key method to diagnose insulin resistance in clinical practice. Candidate alleles from type 2 diabetes offer little predictive value for cardiovascular events beyond traditional risk factors. Simple environmental factors such as irregular meal frequency appear to increase the risk of the metabolic syndrome and require greater scrutiny. Pregnancy complications, particularly gestational diabetes and preeclampsia in the mother and preterm birth in the fetus are events that suggest elevated risk for future cardiovascular morbidity in those affected. Clinical phenotypes of insulin resistance identify women at risk for perinatal and reproductive complications.

  18. Identifying the Components of Effective Learning Environments Based on Health Students\\' Perception

    Directory of Open Access Journals (Sweden)

    Yousefi Afrashteh M

    2015-08-01

    Full Text Available Aims: Effective learning environment can lead to establish and strengthen the appropriate conditions of learning in higher education. This study aimed to identify and define the factors associated with effective learning environment in the field of health education. Participants & Methods: This qualitative study with content analysis approach was conducted in 2013. Participants were 9 graduate and 7 undergraduate students of health majors that were selected using purposive sampling method. Data were recorded by interview and were analyzed using qualitative content analysis. Findings: Analysis of the data revealed 4 themes and 13 classes active and interactive teaching (participating viewpoints of students in educational planning, engaging students in class discussions, providing practical examples to understand the content, relaxing about expressed thoughts, the possibility of constructive criticism master plan of activities and according to the conditions and individual differences between students, Joyful atmosphere (academic motivation, the joy of learning and attendance, a sense of acceptance and respect from teachers and classroom dynamics and vitality and fatigue, relation of courses with professional needs (knowledge of the needs of the job in training course content and related training to the needs of job opportunities and professors’ scientific and power and expert (expertise and scientific capabilities in the field of teaching. Conclusion: 4 major themes and their characteristics can help to organize the learning environment in medical education.

  19. Identifying Factors Associated with Risk Assessment Competencies of Public Health Emergency Responders.

    Science.gov (United States)

    Hao, Jiejing; Ren, Jiaojiao; Wu, Qunhong; Hao, Yanhua; Sun, Hong; Ning, Ning; Ding, Ding

    2017-06-04

    This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as "relatively low", contrasting with 21.4% rated as "relatively high". Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders.

  20. Pheochromocytoma in Denmark 1977-2016: Identifying a national cohort using patterns of health registrations

    DEFF Research Database (Denmark)

    Ebbehoj, A; Jacobsen, Sarah Forslund; Trolle, Christian

    for all persons living in the North and Central Regions of Denmark to validate the diagnosis of PPGL. We tested a number of algorithms for accurately identifying true cases of PPGL to maximize positive predictive values (PPV) and completeness. The best algorithm was validated in an external sample of 110...... algorithm-positive patients. Results: We identified 2626 persons with a PPGL diagnosis code in Denmark, including 787 (30.0%) in North and Central Denmark. We retrieved the health records of 771/787 (98.0%) persons and confirmed 198 incident PPGL patients (25.3%). By combining patterns of registrations, we...... created an algorithm with a PPV for PPGL of 93.1% (CI95%: 88.5-96.3) and completeness of 88.9% (CI95%: 83.7-92.9), thus creating a national PPGL cohort of 587 patients. PPV for the optimal algorithm was 94.3% (CI95%: 87.1-98.1) in the external validation sample. Conclusion: Diagnosis codes...

  1. Identifying Time Periods of Minimal Thermal Gradient for Temperature-Driven Structural Health Monitoring

    Directory of Open Access Journals (Sweden)

    John Reilly

    2018-03-01

    Full Text Available Temperature changes play a large role in the day to day structural behavior of structures, but a smaller direct role in most contemporary Structural Health Monitoring (SHM analyses. Temperature-Driven SHM will consider temperature as the principal driving force in SHM, relating a measurable input temperature to measurable output generalized strain (strain, curvature, etc. and generalized displacement (deflection, rotation, etc. to create three-dimensional signatures descriptive of the structural behavior. Identifying time periods of minimal thermal gradient provides the foundation for the formulation of the temperature–deformation–displacement model. Thermal gradients in a structure can cause curvature in multiple directions, as well as non-linear strain and stress distributions within the cross-sections, which significantly complicates data analysis and interpretation, distorts the signatures, and may lead to unreliable conclusions regarding structural behavior and condition. These adverse effects can be minimized if the signatures are evaluated at times when thermal gradients in the structure are minimal. This paper proposes two classes of methods based on the following two metrics: (i the range of raw temperatures on the structure, and (ii the distribution of the local thermal gradients, for identifying time periods of minimal thermal gradient on a structure with the ability to vary the tolerance of acceptable thermal gradients. The methods are tested and validated with data collected from the Streicker Bridge on campus at Princeton University.

  2. Identifying Time Periods of Minimal Thermal Gradient for Temperature-Driven Structural Health Monitoring.

    Science.gov (United States)

    Reilly, John; Glisic, Branko

    2018-03-01

    Temperature changes play a large role in the day to day structural behavior of structures, but a smaller direct role in most contemporary Structural Health Monitoring (SHM) analyses. Temperature-Driven SHM will consider temperature as the principal driving force in SHM, relating a measurable input temperature to measurable output generalized strain (strain, curvature, etc.) and generalized displacement (deflection, rotation, etc.) to create three-dimensional signatures descriptive of the structural behavior. Identifying time periods of minimal thermal gradient provides the foundation for the formulation of the temperature-deformation-displacement model. Thermal gradients in a structure can cause curvature in multiple directions, as well as non-linear strain and stress distributions within the cross-sections, which significantly complicates data analysis and interpretation, distorts the signatures, and may lead to unreliable conclusions regarding structural behavior and condition. These adverse effects can be minimized if the signatures are evaluated at times when thermal gradients in the structure are minimal. This paper proposes two classes of methods based on the following two metrics: (i) the range of raw temperatures on the structure, and (ii) the distribution of the local thermal gradients, for identifying time periods of minimal thermal gradient on a structure with the ability to vary the tolerance of acceptable thermal gradients. The methods are tested and validated with data collected from the Streicker Bridge on campus at Princeton University.

  3. Identifying paediatric nursing-sensitive outcomes in linked administrative health data

    Directory of Open Access Journals (Sweden)

    Wilson Sally

    2012-07-01

    Full Text Available Abstract Background There is increasing interest in the contribution of the quality of nursing care to patient outcomes. Due to different casemix and risk profiles, algorithms for administrative health data that identify nursing-sensitive outcomes in adult hospitalised patients may not be applicable to paediatric patients. The study purpose was to test adult algorithms in a paediatric hospital population and make amendments to increase the accuracy of identification of hospital acquired events. The study also aimed to determine whether the use of linked hospital records improved the likelihood of correctly identifying patient outcomes as nursing sensitive rather than being related to their pre-morbid conditions. Methods Using algorithms developed by Needleman et al. (2001, proportions and rates of records that identified nursing-sensitive outcomes for pressure ulcers, pneumonia and surgical wound infections were determined from administrative hospitalisation data for all paediatric patients discharged from a tertiary paediatric hospital in Western Australia between July 1999 and June 2009. The effects of changes to inclusion and exclusion criteria for each algorithm on the calculated proportion or rate in the paediatric population were explored. Linked records were used to identify comorbid conditions that increased nursing-sensitive outcome risk. Rates were calculated using algorithms revised for paediatric patients. Results Linked records of 129,719 hospital separations for 79,016 children were analysed. Identification of comorbid conditions was enhanced through access to prior and/or subsequent hospitalisation records (43% of children with pressure ulcers had a form of paralysis recorded only on a previous admission. Readmissions with a surgical wound infection were identified for 103 (4.8/1,000 surgical separations using linked data. After amendment of each algorithm for paediatric patients, rates of pressure ulcers and pneumonia reduced by

  4. Identifying paediatric nursing-sensitive outcomes in linked administrative health data.

    Science.gov (United States)

    Wilson, Sally; Bremner, Alexandra P; Hauck, Yvonne; Finn, Judith

    2012-07-20

    There is increasing interest in the contribution of the quality of nursing care to patient outcomes. Due to different casemix and risk profiles, algorithms for administrative health data that identify nursing-sensitive outcomes in adult hospitalised patients may not be applicable to paediatric patients. The study purpose was to test adult algorithms in a paediatric hospital population and make amendments to increase the accuracy of identification of hospital acquired events. The study also aimed to determine whether the use of linked hospital records improved the likelihood of correctly identifying patient outcomes as nursing sensitive rather than being related to their pre-morbid conditions. Using algorithms developed by Needleman et al. (2001), proportions and rates of records that identified nursing-sensitive outcomes for pressure ulcers, pneumonia and surgical wound infections were determined from administrative hospitalisation data for all paediatric patients discharged from a tertiary paediatric hospital in Western Australia between July 1999 and June 2009. The effects of changes to inclusion and exclusion criteria for each algorithm on the calculated proportion or rate in the paediatric population were explored. Linked records were used to identify comorbid conditions that increased nursing-sensitive outcome risk. Rates were calculated using algorithms revised for paediatric patients. Linked records of 129,719 hospital separations for 79,016 children were analysed. Identification of comorbid conditions was enhanced through access to prior and/or subsequent hospitalisation records (43% of children with pressure ulcers had a form of paralysis recorded only on a previous admission). Readmissions with a surgical wound infection were identified for 103 (4.8/1,000) surgical separations using linked data. After amendment of each algorithm for paediatric patients, rates of pressure ulcers and pneumonia reduced by 53% and 15% (from 1.3 to 0.6 and from 9.1 to 7.7 per

  5. Identifying Major Dietary Patterns Among the Elderly in Tehran Health Homes

    Directory of Open Access Journals (Sweden)

    Abdollahi

    2015-10-01

    Full Text Available Background Previous studies on diet have primarily focused on individual nutrients or foods. Recently, the analysis of dietary patterns has emerged as a possible approach for examining food consumption. A literature review revealed no studies of dietary patterns in elderly Iranians. Objectives Our objective was to identify the major dietary intake patterns among the elderly in the health homes located in Zone 5 of Tehran city, Iran. Patients and Methods In this cross-sectional study (descriptive, 368 elderly people (≥ 60 years old were randomly selected. Their usual dietary intake during the past year was assessed using a 168-item semiquantitative food frequency questionnaire. Major food patterns were derived using factor analysis after the classification of food items into 26 groups. Results Four major dietary patterns were identified in the studied population: 1 healthy pattern, characterized by a higher intake of vegetables, tomato and tomato sauce, vegetable oil, olive, and fruits; 2 unhealthy pattern, characterized by a higher intake of red meat, fast food, snacks, sugar, honey and jam, soft drinks, and high-fat dairy products; 3. traditional pattern characterized by intake of whole grains, hydrogenated oil and animal fat, beans, salt, and pickles; and 4 protein-rich pattern, characterized by intake of chicken and poultry, fish, grains, and organ meats. These four major dietary patterns explained 16.3%, 7.5%, 6.7%, and 5.7% of the total variance, respectively. Conclusions Four major dietary patterns were identified in the present studied population that can be used to provide tangible dietary advice for the elderly.

  6. Identifying areas of need relative to liver disease: geographic clustering within a health service district.

    Science.gov (United States)

    El-Atem, Nathan; Irvine, Katharine M; Valery, Patricia C; Wojcik, Kyle; Horsfall, Leigh; Johnson, Tracey; Janda, Monika; McPhail, Steven M; Powell, Elizabeth E

    2017-08-01

    Background Many people with chronic liver disease (CLD) are not detected until they present to hospital with advanced disease, when opportunities for intervention are reduced and morbidity is high. In order to build capacity and liver expertise in the community, it is important to focus liver healthcare resources in high-prevalence disease areas and specific populations with an identified need. The aim of the present study was to examine the geographic location of people seen in a tertiary hospital hepatology clinic, as well as ethnic and sociodemographic characteristics of these geographic areas. Methods The geographic locations of hepatology out-patients were identified via the out-patient scheduling database and grouped into statistical area (SA) regions for demographic analysis using data compiled by the Australian Bureau of Statistics. Results During the 3-month study period, 943 individuals from 71 SA Level 3 regions attended clinic. Nine SA Level 3 regions accounted for 55% of the entire patient cohort. Geographic clustering was seen especially for people living with chronic hepatitis B virus. There was a wide spectrum of socioeconomic advantage and disadvantage in areas with high liver disease prevalence. Conclusions The geographic area from which people living with CLD travel to access liver health care is extensive. However, the greatest demand for tertiary liver disease speciality care is clustered within specific geographic areas. Outreach programs targeted to these areas may enhance liver disease-specific health service resourcing. What is known about the topic? The demand for tertiary hospital clinical services in CLD is rising. However, there is limited knowledge about the geographic areas from which people living with CLD travel to access liver services, or the ethnic, socioeconomic and education characteristics of these areas. What does this paper add? The present study demonstrates that a substantial proportion of people living with CLD and

  7. Identifying malaria hotspots in Keur Soce health and demographic surveillance site in context of low transmission.

    Science.gov (United States)

    Ndiath, Mansour; Faye, Babacar; Cisse, Badara; Ndiaye, Jean Louis; Gomis, Jules François; Dia, Anta Tal; Gaye, Oumar

    2014-11-24

    Malaria is major public health problem in Senegal. In some parts of the country, it occurs almost permanently with a seasonal increase during the rainy season. There is evidence to suggest that the prevalence of malaria in Senegal has decreased considerably during the past few years. Recent data from the Senegalese National Malaria Control Programme (NMCP) indicates that the number of malaria cases decrease from 1,500,000 in 2006 to 174,339 in 2010. With the decline of malaria morbidity in Senegal, the characterization of the new epidemiological profile of this disease is crucial for public health decision makers. SaTScan™ software using the Kulldorf method of retrospective space-time permutation and the Bernoulli purely spatial model was used to identify malaria clusters using confirmed malaria cases in 74 villages. ArcMAp was used to map malaria hotspots. Logistic regression was used to investigate risk factors for malaria hotspots in Keur Soce health and demographic surveillance site. A total of 1,614 individuals in 440 randomly selected households were enrolled. The overall malaria prevalence was 12%. The malaria prevalence during the study period varied from less than 2% to more than 25% from one village to another. The results showed also that rooms located between 50 m to 100 m away from livestock holding place [adjusted O.R = 0.7, P = 0.044, 95% C.I (1.02 - 7.42)], bed net use [adjusted O.R = 1.2, P = 0.024, 95% C.I (1.02 -1.48)], are good predictors for malaria hotspots in the Keur Soce health and demographic surveillance site. The socio economic status of the household also predicted on hotspots patterns. The less poor household are 30% less likely to be classified as malaria hotspots area compared to the poorest household [adjusted O.R = 0.7, P = 0.014, 95% C.I (0.47 - 0.91)]. The study investigated risk factors for malaria hotspots in small communities in the Keur Soce site. The result showed considerable variation of malaria

  8. Facts, perception of facts, and the credibility of the process

    International Nuclear Information System (INIS)

    Rossin, A.D.

    1983-01-01

    This paper analyses nuclear opposition in the United States, in particular as concerns construction of new facilities. The US adopted in 1969 the National Environmental Policy Act and subsequently, other regulations designed to assure public access to the decision-making process. However nuclear opponents continue to use every level of legal recourse open which results in doubts, delays and erosion of the credibility of the regulatory process. The author concludes that the most important objective is the continued safe operation of nuclear power plants. (NEA) [fr

  9. Nuclear snow job: utilities struggle to avoid credibility meltdown

    International Nuclear Information System (INIS)

    Feeney, A.

    1979-01-01

    Electric utilities and the US nuclear industry are criticized for giving a public relations response to safety concerns following the accident at Three Mile Island and for passing the cost of the response on to utility customers. The large amounts of money budgeted by Babcock and Wilcox, Bechtel Power Corporation, the Atomic Industrial Forum, Electric Power Research Institute, Nuclear Energy Women, and others to minimize the incident and counter anti-nuclear arguments with media events are seen here by Feeney as evidence that the utilities and nuclear industry are afraid of political consequences as their technical credibility vanishes

  10. The public information challenge: confidence and credibility through communications

    International Nuclear Information System (INIS)

    Spence, H.J.M.

    1994-01-01

    Canada's Atomic Energy Control Board, considered the oldest independent nuclear regulatory body in the world, has made significant progress toward openness and visibility through public information policy initiatives and communications activities, particularly in the last five years. A number of public information projects are described, and successes as well as disappointments are outlined. The importance in terms of enhanced credibility and public confidence in the regulatory agency is stressed. In looking toward the future, the linking of communications to the operational functions and activities of the regulator is presented as a key requirement. (author)

  11. Framing Service, Benefit, and Credibility Through Images and Texts: A Content Analysis of Online Promotional Messages of Korean Medical Tourism Industry.

    Science.gov (United States)

    Jun, Jungmi

    2016-07-01

    This study examines how the Korean medical tourism industry frames its service, benefit, and credibility issues through texts and images of online brochures. The results of content analysis suggest that the Korean medical tourism industry attempts to frame their medical/health services as "excellence in surgeries and cancer care" and "advanced health technology and facilities." However, the use of cost-saving appeals was limited, which can be seen as a strategy to avoid consumers' association of lower cost with lower quality services, and to stress safety and credibility.

  12. Effects of argument quality, source credibility and self-reported diabetes knowledge on message attitudes: an experiment using diabetes related messages.

    Science.gov (United States)

    Lin, Tung-Cheng; Hwang, Lih-Lian; Lai, Yung-Jye

    2017-05-17

    Previous studies have reported that credibility and content (argument quality) are the most critical factors affecting the quality of health information and its acceptance and use; however, this causal relationship merits further investigation in the context of health education. Moreover, message recipients' prior knowledge may moderate these relationships. This study used the elaboration likelihood model to determine the main effects of argument quality, source credibility and the moderating effect of self-reported diabetes knowledge on message attitudes. A between-subjects experimental design using an educational message concerning diabetes for manipulation was applied to validate the effects empirically. A total of 181 participants without diabetes were recruited from the Department of Health, Taipei City Government. Four group messages were manipulated in terms of argument quality (high and low) × source credibility (high and low). Argument quality and source credibility of health information significantly influenced the attitude of message recipients. The participants with high self-reported knowledge participants exhibited significant disapproval for messages with low argument quality. Effective health information should provide objective descriptions and cite reliable sources; in addition, it should provide accurate, customised messages for recipients who have high background knowledge level and ability to discern message quality. © 2017 Health Libraries Group Health Information & Libraries Journal.

  13. Board-invited review: Using behavior to predict and identify ill health in animals.

    Science.gov (United States)

    Weary, D M; Huzzey, J M; von Keyserlingk, M A G

    2009-02-01

    We review recent research in one of the oldest and most important applications of ethology: evaluating animal health. Traditionally, such evaluations have been based on subjective assessments of debilitative signs; animals are judged ill when they appear depressed or off feed. Such assessments are prone to error but can be dramatically improved with training using well-defined clinical criteria. The availability of new technology to automatically record behaviors allows for increased use of objective measures; automated measures of feeding behavior and intake are increasingly available in commercial agriculture, and recent work has shown these to be valuable indicators of illness. Research has also identified behaviors indicative of risk of disease or injury. For example, the time spent standing on wet, concrete surfaces can be used to predict susceptibility to hoof injuries in dairy cattle, and time spent nuzzling the udder of the sow can predict the risk of crushing in piglets. One conceptual advance has been to view decreased exploration, feeding, social, sexual, and other behaviors as a coordinated response that helps afflicted individuals recover from illness. We argue that the sickness behaviors most likely to decline are those that provide longer-term fitness benefits (such as play), as animals divert resources to those functions of critical short-term value such as maintaining body temperature. We urge future research assessing the strength of motivation to express sickness behaviors, allowing for quantitative estimates of how sick an animal feels. Finally, we call for new theoretical and empirical work on behaviors that may act to signal health status, including behaviors that have evolved as honest (i.e., reliable) signals of condition for offspring-parent, inter- and intra-sexual, and predator-prey communication.

  14. The Promise of Standardized Data Collection: School Health Variables Identified by States

    Science.gov (United States)

    Johnson, Kathleen H.; Bergren, Martha Dewey; Westbrook, Linda Oakes

    2012-01-01

    A gap in data prevents measurement of the needs of school-age children and the influence of school nursing interventions on student health and education outcomes. Its remedy is in the data collected in school health rooms. A national clinical database describing school health will allow education and health leaders to build evidence-based programs…

  15. Chikungunya Fever Cases Identified in the Veterans Health Administration System, 2014.

    Directory of Open Access Journals (Sweden)

    Tara Perti

    2016-05-01

    Full Text Available During December 2013, the first locally transmitted chikungunya virus (CHIKV infections in the Americas were reported in the Caribbean. Although CHIKV infection is rarely fatal, risk for severe disease increases with age and medical comorbidities. Herein we describe characteristics of Veterans Health Administration (VHA patients with CHIKV infection and, among those with infections diagnosed in Puerto Rico, investigated risk factors for hospitalization.We queried VHA's national electronic medical records to identify patients with CHIKV testing during 2014. Demographics, clinical history, laboratory results, and outcomes were abstracted. We investigated risk factors for hospitalization among patients with laboratory-confirmed CHIKV infection in Puerto Rico.We identified 180 laboratory-confirmed CHIKV infections; 148 (82.2% were diagnosed in Puerto Rico, and 32 (17.8% were diagnosed among returning travelers elsewhere in the United States. In Puerto Rico, where more patients were hospitalized (55.4% versus 20.0% and died (4.1% versus 0%, risk for hospitalization increased with age (relative risk [RR]/each 10-year increase, 1.19; 95% confidence interval [CI], 1.06-1.32 and, adjusted for age, increased among patients with congestive heart failure (RR, 1.58; 95% CI, 1.25-1.99, chronic kidney disease (RR, 1.52; 95% CI, 1.19-1.94, diabetes mellitus (RR, 1.39; 95% CI, 1.06-1.84, or chronic lung disease (RR, 1.37; 95% CI, 1.03-1.82.CHIKV infection is an emerging problem among Veterans residing in or visiting areas with CHIKV transmission. Although overall mortality rates are low, clinicians in affected areas should be aware that older patients and patients with comorbidities may be at increased risk for severe disease.

  16. Identifying environmental safety and health requirements for the Fernald Environmental Restoration Management Corporation

    International Nuclear Information System (INIS)

    Beckman, W.H.; Cossel, S.C.; Alhadeff, N.; Lindamood, S.B.; Beers, J.A.

    1994-01-01

    This presentation will describe the Fernald Environmental Restoration Management Corporation's (FERMCO) Standards/Requirements Identification Documents (S/RlDs) Program, the unique process used to implement it, and the status of the program. We will also discuss the lessons learned as the program was implemented. The Department of Energy (DOE) established the Fernald site to produce uranium metals for the nation's defense programs in 1953. In 1989, DOE suspended production and, in 1991, the mission of the site was formally changed to one of environmental cleanup and restoration. The site was renamed the Fernald Environmental Management Project (FEMP). FERMCO's mission is to provide safe, early, and least-cost final clean-up of the site in compliance with all regulations and commitments. DOE has managed nuclear facilities primarily through its oversight of Management and Operating contractors. Comprehensive nuclear industry standards were absent when most DOE sites were first established, Management and Operating contractors had to apply existing non-nuclear industry standards and, in many cases, formulate new technical standards. Because it was satisfied with the operation of its facilities, DOE did not incorporate modern practices and standards as they became available. In March 1990, the Defense Nuclear Facilities Safety Board issued Recommendation 90-2, which called for DOE to identify relevant standards and requirements, conduct adequacy assessments of requirements in protecting environmental, public, and worker health and safety, and determine the extent to which the requirements are being implemented. The Environmental Restoration and Waste Management Office of DOE embraced the recommendation for facilities under its control. Strict accountability requirements made it essential that FERMCO and DOE clearly identify applicable requirements necessary, determine the requirements' adequacy, and assess FERMCO's level of compliance

  17. Evaluation of algorithms to identify incident cancer cases by using French health administrative databases.

    Science.gov (United States)

    Ajrouche, Aya; Estellat, Candice; De Rycke, Yann; Tubach, Florence

    2017-08-01

    Administrative databases are increasingly being used in cancer observational studies. Identifying incident cancer in these databases is crucial. This study aimed to develop algorithms to estimate cancer incidence by using health administrative databases and to examine the accuracy of the algorithms in terms of national cancer incidence rates estimated from registries. We identified a cohort of 463 033 participants on 1 January 2012 in the Echantillon Généraliste des Bénéficiaires (EGB; a representative sample of the French healthcare insurance system). The EGB contains data on long-term chronic disease (LTD) status, reimbursed outpatient treatments and procedures, and hospitalizations (including discharge diagnoses, and costly medical procedures and drugs). After excluding cases of prevalent cancer, we applied 15 algorithms to estimate the cancer incidence rates separately for men and women in 2012 and compared them to the national cancer incidence rates estimated from French registries by indirect age and sex standardization. The most accurate algorithm for men combined information from LTD status, outpatient anticancer drugs, radiotherapy sessions and primary or related discharge diagnosis of cancer, although it underestimated the cancer incidence (standardized incidence ratio (SIR) 0.85 [0.80-0.90]). For women, the best algorithm used the same definition of the algorithm for men but restricted hospital discharge to only primary or related diagnosis with an additional inpatient procedure or drug reimbursement related to cancer and gave comparable estimates to those from registries (SIR 1.00 [0.94-1.06]). The algorithms proposed could be used for cancer incidence monitoring and for future etiological cancer studies involving French healthcare databases. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  18. Why was this transfusion given? Identifying clinical indications for blood transfusion in health care data

    Directory of Open Access Journals (Sweden)

    van Hoeven LR

    2018-03-01

    Full Text Available Loan R van Hoeven,1,2 Aukje L Kreuger,3,4 Kit CB Roes,1 Peter F Kemper,2,4 Hendrik Koffijberg,5 Floris J Kranenburg,3,4,6 Jan MM Rondeel,7 Mart P Janssen1,2 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; 2Transfusion Technology Assessment Department, Sanquin Research, Amsterdam, the Netherlands; 3Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; 4Center for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands; 5Department of Health Technology & Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands; 6Department of Intensive Care, Leiden University Medical Center, Leiden, the Netherlands; 7Department of Clinical Chemistry, Isala, Zwolle, the Netherlands Background: To enhance the utility of transfusion data for research, ideally every transfusion should be linked to a primary clinical indication. In electronic patient records, many diagnostic and procedural codes are registered, but unfortunately, it is usually not specified which one is the reason for transfusion. Therefore, a method is needed to determine the most likely indication for transfusion in an automated way.Study design and methods: An algorithm to identify the most likely transfusion indication was developed and evaluated against a gold standard based on the review of medical records for 234 cases by 2 experts. In a second step, information on misclassification was used to fine-tune the initial algorithm. The adapted algorithm predicts, out of all data available, the most likely indication for transfusion using information on medical specialism, surgical procedures, and diagnosis and procedure dates relative to the transfusion date.Results: The adapted algorithm was able to predict 74.4% of indications in the sample correctly (extrapolated to the full data set 75.5%. A kappa

  19. A machine learning-based framework to identify type 2 diabetes through electronic health records.

    Science.gov (United States)

    Zheng, Tao; Xie, Wei; Xu, Liling; He, Xiaoying; Zhang, Ya; You, Mingrong; Yang, Gong; Chen, You

    2017-01-01

    To discover diverse genotype-phenotype associations affiliated with Type 2 Diabetes Mellitus (T2DM) via genome-wide association study (GWAS) and phenome-wide association study (PheWAS), more cases (T2DM subjects) and controls (subjects without T2DM) are required to be identified (e.g., via Electronic Health Records (EHR)). However, existing expert based identification algorithms often suffer in a low recall rate and could miss a large number of valuable samples under conservative filtering standards. The goal of this work is to develop a semi-automated framework based on machine learning as a pilot study to liberalize filtering criteria to improve recall rate with a keeping of low false positive rate. We propose a data informed framework for identifying subjects with and without T2DM from EHR via feature engineering and machine learning. We evaluate and contrast the identification performance of widely-used machine learning models within our framework, including k-Nearest-Neighbors, Naïve Bayes, Decision Tree, Random Forest, Support Vector Machine and Logistic Regression. Our framework was conducted on 300 patient samples (161 cases, 60 controls and 79 unconfirmed subjects), randomly selected from 23,281 diabetes related cohort retrieved from a regional distributed EHR repository ranging from 2012 to 2014. We apply top-performing machine learning algorithms on the engineered features. We benchmark and contrast the accuracy, precision, AUC, sensitivity and specificity of classification models against the state-of-the-art expert algorithm for identification of T2DM subjects. Our results indicate that the framework achieved high identification performances (∼0.98 in average AUC), which are much higher than the state-of-the-art algorithm (0.71 in AUC). Expert algorithm-based identification of T2DM subjects from EHR is often hampered by the high missing rates due to their conservative selection criteria. Our framework leverages machine learning and feature

  20. Identifying unmet clinical need in hypertrophic cardiomyopathy using national electronic health records.

    Directory of Open Access Journals (Sweden)

    Mar Pujades-Rodriguez

    Full Text Available To evaluate unmet clinical need in unselected hypertrophic cardiomyopathy (HCM patients to determine the risk of a wide range of subsequent cardiovascular disease endpoints and safety endpoints relevant for trial design.Population based cohort (CALIBER, linked primary care, hospital and mortality records in England, period 1997-2010, all people diagnosed with HCM were identified and matched by age, sex and general practice with ten randomly selected people without HCM. Random-effects Poisson models were used to assess the associations between HCM and cardiovascular diseases and bleeding.Among 3,290,455 eligible people a diagnosis of hypertrophic cardiomyopathy was found in 4 per 10,000. Forty-one percent of the 1,160 individuals with hypertrophic cardiomyopathy were women and the median age was 57 years. The median follow-up was 4.0 years. Compared to general population controls, people with HCM had higher risk of ventricular arrhythmia (incidence rate ratio = 23.53, [95% confidence interval 12.67-43.72], cardiac arrest or sudden cardiac death (6.33 [3.69-10.85], heart failure (4.31, [3.30-5.62], and atrial fibrillation (3.80 [3.04-4.75]. HCM was also associated with a higher incidence of myocardial infarction ([MI] 1.90 [1.27-2.84] and coronary revascularisation (2.32 [1.46-3.69].The absolute Kaplan-Meier risks at 3 years were 8.8% for the composite endpoint of cardiovascular death or heart failure, 8.4% for the composite of cardiovascular death, stroke or myocardial infarction, and 1.5% for major bleeding.Our study identified major unmet need in HCM and highlighted the importance of implementing improved cardiovascular prevention strategies to increase life-expectancy of the contemporary HCM population. They also show that national electronic health records provide an effective method for identifying outcomes and clinically relevant estimates of composite efficacy and safety endpoints essential for trial design in rare diseases.

  1. Identifying unmet clinical need in hypertrophic cardiomyopathy using national electronic health records.

    Science.gov (United States)

    Pujades-Rodriguez, Mar; Guttmann, Oliver P; Gonzalez-Izquierdo, Arturo; Duyx, Bram; O'Mahony, Constantinos; Elliott, Perry; Hemingway, Harry

    2018-01-01

    To evaluate unmet clinical need in unselected hypertrophic cardiomyopathy (HCM) patients to determine the risk of a wide range of subsequent cardiovascular disease endpoints and safety endpoints relevant for trial design. Population based cohort (CALIBER, linked primary care, hospital and mortality records in England, period 1997-2010), all people diagnosed with HCM were identified and matched by age, sex and general practice with ten randomly selected people without HCM. Random-effects Poisson models were used to assess the associations between HCM and cardiovascular diseases and bleeding. Among 3,290,455 eligible people a diagnosis of hypertrophic cardiomyopathy was found in 4 per 10,000. Forty-one percent of the 1,160 individuals with hypertrophic cardiomyopathy were women and the median age was 57 years. The median follow-up was 4.0 years. Compared to general population controls, people with HCM had higher risk of ventricular arrhythmia (incidence rate ratio = 23.53, [95% confidence interval 12.67-43.72]), cardiac arrest or sudden cardiac death (6.33 [3.69-10.85]), heart failure (4.31, [3.30-5.62]), and atrial fibrillation (3.80 [3.04-4.75]). HCM was also associated with a higher incidence of myocardial infarction ([MI] 1.90 [1.27-2.84]) and coronary revascularisation (2.32 [1.46-3.69]).The absolute Kaplan-Meier risks at 3 years were 8.8% for the composite endpoint of cardiovascular death or heart failure, 8.4% for the composite of cardiovascular death, stroke or myocardial infarction, and 1.5% for major bleeding. Our study identified major unmet need in HCM and highlighted the importance of implementing improved cardiovascular prevention strategies to increase life-expectancy of the contemporary HCM population. They also show that national electronic health records provide an effective method for identifying outcomes and clinically relevant estimates of composite efficacy and safety endpoints essential for trial design in rare diseases.

  2. The Credibility of Policy Reporting Across Learning Disciplines

    Energy Technology Data Exchange (ETDEWEB)

    Carley, S.; Youtie, J.; Solomon, G.; Porter, A.

    2016-07-01

    The notion of a credibility map argues that everyone has a distinctive map that dictates the preference given to different types and sources of information. When seeking to influence other academic fields, scholars will likely turn to scientific and technical information though other types, such as policy reports, may also be relevant. We draw on the credibility mapping concept to understand how a major policy report is taken up by the target academic community. The report, How People Learn, was published by the US National Academies in 2000, to expose the education community (mainly educational researchers but also knowledge-seeking practitioners) to major cognitive science research findings of relevance to learning. We applied several search strings to measure the take up of this report in the target community. We used Google Scholar to evince that that How People Learn was cited in nearly 15,000 publications, these citations grew particularly steeply from 2000 to 2008, and most were in education-related journal papers. We performed a similar analysis using the Web of Science, which showed that most of the citations were substantial as opposed to perfunctory. (Author)

  3. CredibleMeds.org: What does it offer?

    Science.gov (United States)

    Woosley, Raymond L; Black, Kristin; Heise, C William; Romero, Klaus

    2018-02-01

    Since the 1990s, when numerous non-cardiac drugs were first recognized to have the potential to prolong the QT interval and cause torsades de pointes (TdP), clinicians, drug regulators, drug developers, and clinical investigators have become aware of the complexities of assessing evidence and determining TdP causality for the many drugs being marketed or under development. To facilitate better understanding, the Arizona Center for Education and Research on Therapeutics, known as AZCERT, has developed the CredibleMeds.org website which includes QTdrugs, a listing of over 220 drugs placed in four risk categories based on their association with QT prolongation and TdP. Since the site was launched in 1999, it has become the single and most reliable source of information of its kind for patients, healthcare providers, and research scientists. Over 96,000 registered users rely on the QTdrugs database as their primary resource to inform their medication use, their prescribing or their clinical research into the impact of QT-prolonging drugs and drug-induced arrhythmias. The QTdrugs lists are increasingly used as the basis for clinical decision support systems in healthcare and for metrics of prescribing quality by healthcare insurers. A free smartphone app and an application program interface enable rapid and mobile access to the lists. Also, the CredibleMeds website offers numerous educational resources for patients, educators and healthcare providers that foster the safe use of medications. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Identifying cultural representations of families and the health team to improve the management of severe malnutrition in childhood.

    Science.gov (United States)

    Castillo-Carniglia, Alvaro; Weisstaub, Sergio Gerardo; Aguirre, Patricia; Aguilar, Ana María; Araya, Magdalena

    2010-04-01

    Severe childhood malnutrition is no longer a priority in Latin America, but mortality of hospitalized malnourished children continues to be high, especially in Bolivia. The objective of the present study was to identify cultural representations in mothers and in health personnel that might influence the relationship between the family and the provider's health care services, thus affecting the treatment of malnourished children. We applied a flexible qualitative model of cases and controls (mothers or caregivers of both under- and well-nourished children), and in addition, health personnel. Results were analyzed following semiotics of statements. Mothers and health professionals based their cultural representations on different conceptions of health. The mothers' mindset indicated that traditional Andean medicine and public health systems are complementary and not contradictory. Conversely, health personnel expressed a univocal vision, accepting only biomedicine. Furthermore, they also expressed a negative attitude toward mothers of severely malnourished children. Results should be considered to improve ongoing local health programs.

  5. Identifying Multi-Level Culturally Appropriate Smoking Cessation Strategies for Aboriginal Health Staff: A Concept Mapping Approach

    Science.gov (United States)

    Dawson, Anna P.; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

    2013-01-01

    Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco…

  6. Identifying consumer segments in health services markets: an application of conjoint and cluster analyses to the ambulatory care pharmacy market.

    Science.gov (United States)

    Carrol, N V; Gagon, J P

    1983-01-01

    Because of increasing competition, it is becoming more important that health care providers pursue consumer-based market segmentation strategies. This paper presents a methodology for identifying and describing consumer segments in health service markets, and demonstrates the use of the methodology by presenting a study of consumer segments in the ambulatory care pharmacy market.

  7. Navigating the Leadership Landscape: Creating an Inventory to Identify Leadership Education Programs for Health Professionals.

    Science.gov (United States)

    Gertler, Matthew; Verma, Sarita; Tassone, Maria; Seltzer, Jane; Careau, Emmanuelle

    2015-01-01

    As health systems become increasingly complex, there is growing emphasis on collaborative leadership education for health system change. The Canadian Interprofessional Health Leadership Collaborative conducted research on this phenomenon through a scoping and systematic review of the health leadership literature, key informant interviews and an inventory of health leadership programs in Canada. The inventory is unique, accounting for educational programming missed by traditional scholarly literature reviews. A major finding is that different health professions have access to health leadership education in different stages of their careers. This pioneering inventory suggests that needs may differ between health professions but also that there is a growing demand for multiple types of programs for specific targeted audiences, and a strategic need for collaborative leadership education in healthcare.

  8. Using Administrative Health Data to Identify Individuals with Intellectual and Developmental Disabilities: A Comparison of Algorithms

    Science.gov (United States)

    Lin, E.; Balogh, R.; Cobigo, V.; Ouellette-Kuntz, H.; Wilton, A. S.; Lunsky, Y.

    2013-01-01

    Background: Individuals with intellectual and developmental disabilities (IDD) experience high rates of physical and mental health problems; yet their health care is often inadequate. Information about their characteristics and health services needs is critical for planning efficient and equitable services. A logical source of such information is…

  9. Electronic Health Record Based Algorithm to Identify Patients with Autism Spectrum Disorder.

    Directory of Open Access Journals (Sweden)

    Todd Lingren

    Full Text Available Cohort selection is challenging for large-scale electronic health record (EHR analyses, as International Classification of Diseases 9th edition (ICD-9 diagnostic codes are notoriously unreliable disease predictors. Our objective was to develop, evaluate, and validate an automated algorithm for determining an Autism Spectrum Disorder (ASD patient cohort from EHR. We demonstrate its utility via the largest investigation to date of the co-occurrence patterns of medical comorbidities in ASD.We extracted ICD-9 codes and concepts derived from the clinical notes. A gold standard patient set was labeled by clinicians at Boston Children's Hospital (BCH (N = 150 and Cincinnati Children's Hospital and Medical Center (CCHMC (N = 152. Two algorithms were created: (1 rule-based implementing the ASD criteria from Diagnostic and Statistical Manual of Mental Diseases 4th edition, (2 predictive classifier. The positive predictive values (PPV achieved by these algorithms were compared to an ICD-9 code baseline. We clustered the patients based on grouped ICD-9 codes and evaluated subgroups.The rule-based algorithm produced the best PPV: (a BCH: 0.885 vs. 0.273 (baseline; (b CCHMC: 0.840 vs. 0.645 (baseline; (c combined: 0.864 vs. 0.460 (baseline. A validation at Children's Hospital of Philadelphia yielded 0.848 (PPV. Clustering analyses of comorbidities on the three-site large cohort (N = 20,658 ASD patients identified psychiatric, developmental, and seizure disorder clusters.In a large cross-institutional cohort, co-occurrence patterns of comorbidities in ASDs provide further hypothetical evidence for distinct courses in ASD. The proposed automated algorithms for cohort selection open avenues for other large-scale EHR studies and individualized treatment of ASD.

  10. Identifying primary care patients at risk for future diabetes and cardiovascular disease using electronic health records

    Directory of Open Access Journals (Sweden)

    Shrader Peter

    2009-09-01

    Full Text Available Abstract Background Prevention of diabetes and coronary heart disease (CHD is possible but identification of at-risk patients for targeting interventions is a challenge in primary care. Methods We analyzed electronic health record (EHR data for 122,715 patients from 12 primary care practices. We defined patients with risk factor clustering using metabolic syndrome (MetS characteristics defined by NCEP-ATPIII criteria; if missing, we used surrogate characteristics, and validated this approach by directly measuring risk factors in a subset of 154 patients. For subjects with at least 3 of 5 MetS criteria measured at baseline (2003-2004, we defined 3 categories: No MetS (0 criteria; At-risk-for MetS (1-2 criteria; and MetS (≥ 3 criteria. We examined new diabetes and CHD incidence, and resource utilization over the subsequent 3-year period (2005-2007 using age-sex-adjusted regression models to compare outcomes by MetS category. Results After excluding patients with diabetes/CHD at baseline, 78,293 patients were eligible for analysis. EHR-defined MetS had 73% sensitivity and 91% specificity for directly measured MetS. Diabetes incidence was 1.4% in No MetS; 4.0% in At-risk-for MetS; and 11.0% in MetS (p MetS vs No MetS = 6.86 [6.06-7.76]; CHD incidence was 3.2%, 5.3%, and 6.4% respectively (p Conclusion Risk factor clustering in EHR data identifies primary care patients at increased risk for new diabetes, CHD and higher resource utilization.

  11. Identifying and Intervening in Child Maltreatment and Implementing Related National Guidelines by Public Health Nurses in Finland and Japan

    Directory of Open Access Journals (Sweden)

    Kayoko Suzuki

    2017-01-01

    Full Text Available Aim. This study aimed to investigate how public health nurses identify, intervene in, and implement the guidelines on child maltreatment in Finland and Japan and to compare the data between the two countries. Method. This study employed a cross-sectional design. Public health nurses’ knowledge and skills with respect to child maltreatment prevention were assessed using a questionnaire consisting of three categories: identification, intervention, and implementation of guidelines. Public health nurses working in the area of maternal and child health care in Finland (n=193 and Japan (n=440 were the participants. Results. A significantly higher percentage of Japanese public health nurses identified child maltreatment compared to Finnish public health nurses, while Finnish nurses intervened in child maltreatment better than their Japanese counterparts. In both countries, public health nurses who had read and used the guidelines dealt with child maltreatment better than those who did not. Conclusion. The results suggest that effective training on child maltreatment and the use of guidelines are important to increase public health nurses’ knowledge and skills for identifying and intervening in child maltreatment.

  12. Identifying and defining the terms and elements related to a digital health innovation ecosystem

    CSIR Research Space (South Africa)

    Iyawa, G

    2016-12-01

    Full Text Available environment in which digital health systems have to be implemented in South Africa provides for specific challenges relating to environmental, community and physical challenges. By using an in-depth comparative case study within the design science..., Approaches and Experiences: Towards building a South African Digital Health Innovation Ecosystem 2 Strategies, Approaches and Experiences: Towards building a South African Digital Health Innovation Ecosystem First published in December 2016...

  13. Diagnostic accuracy of prostate health index to identify aggressive prostate cancer. An Institutional validation study.

    Science.gov (United States)

    Morote, J; Celma, A; Planas, J; Placer, J; Ferrer, R; de Torres, I; Pacciuci, R; Olivan, M

    2016-01-01

    New generations of tumor markers used to detect prostate cancer (PCa) should be able to discriminate men with aggressive PCa of those without PCa or nonaggressive tumors. The objective of this study has been to validate Prostate Health Index (PHI) as a marker of aggressive PCa in one academic institution. PHI was assessed in 357 men scheduled to prostatic biopsy between June of 2013 and July 2014 in one academic institution. Thereafter a subset of 183 men younger than 75 years and total PSA (tPSA) between 3.0 and 10.0 ng/mL, scheduled to it first prostatic biopsy, was retrospectively selected for this study. Twelve cores TRUS guided biopsy, under local anaesthesia, was performed in all cases. Total PSA, free PSA (fPSA), and [-2] proPSA (p2PSA) and prostate volume were determined before the procedure and %fPSA, PSA density (PSAd) and PHI were calculated. Aggressive tumors were considered if any Gleason 4 pattern was found. PHI was compared to %fPSA and PSAd through their ROC curves. Thresholds to detect 90%, 95% of all tumors and 95% and 100% of aggressive tumors were estimated and rates of unnecessary avoided biopsies were calculated and compared. The rate of PCa detection was 37.2% (68) and the rate of aggressive tumors was 24.6% (45). The PHI area under the curve was higher than those of %fPSA and PSAd to detect any PCa (0.749 vs 0.606 and 0.668 respectively) or to detect only aggressive tumors (0.786 vs 0.677 and 0.708 respectively), however, significant differences were not found. The avoided biopsy rates to detect 95% of aggressive tumors were 20.2% for PHI, 14.8% for %fPSA, and 23.5% for PSAd. Even more, to detect all aggressive tumors these rates dropped to 4.9% for PHI, 9.3% for %fPSA, and 7.9% for PSAd. PHI seems a good marker to PCa diagnosis. However, PHI was not superior to %fPSA and PSAd to identify at least 95% of aggressive tumors. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. 77 FR 22949 - Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier...

    Science.gov (United States)

    2012-04-17

    ... encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp... reported by hospitals: (1) prevention; (2) diagnosis; (3) treatment; and (4) management. Table 1 summarizes... care claims--Dental. ASC X12 837 P Health care claims-- Professional. ASC X12 837 I Health care claims...

  15. Identifying factors for job motivation of rural health workers in North Viet Nam

    NARCIS (Netherlands)

    Dieleman, Marjolein; Cuong, Pham Viet; Anh, Le Vu; Martineau, Tim

    2003-01-01

    BACKGROUND: In Viet Nam, most of the public health staff (84%) currently works in rural areas, where 80% of the people live. To provide good quality health care services, it is important to develop strategies influencing staff motivation for better performance. METHOD: An exploratory qualitative

  16. Identifying Students with Mental Health Issues: A Guide for Classroom Teachers

    Science.gov (United States)

    Marsh, Robbie J.

    2016-01-01

    Child and adolescent mental health is a growing concern in schools. Students suffering from mental health conditions struggle in the school environment if their needs are not being met. Teachers play an important role in the identification of these students. This article highlights the distinctions between externalizing and internalizing behaviors…

  17. Revisiting Organizational Credibility and Organizational Reputation – A Situational Crisis Communication Approach

    OpenAIRE

    Jamal Jamilah; Abu Bakar Hassan

    2017-01-01

    Organizational credibility, the extent of which an organization as the source of messages is perceived as trustworthy and reliable, is one important aspect to determine organization’s survival. The perceived credibility of the messages will either strengthen or worsen an organization reputation. The primary objective of this paper is to revisit the concept of organizational credibility and its interaction with organizational outcomes such as organizational reputation. Based on the situational...

  18. Credibility and Consumer Behavior of Islamic Bank in Indonesia: A Literature Review

    Directory of Open Access Journals (Sweden)

    Naufal BACHRI

    2016-06-01

    Full Text Available The concept “credibility” has become significant attention from academics and practitioners because it played an important role in creating and maintaining consumer behavior. This study uses twenty- seven references relates to credibility, customer value, satisfaction, and loyalty. Several studies have discussed the relationship between credibility and consumer behavior and also elaborated dimensions of credibility. It also presented the shortcomings of current research and the trends for future study in Islamic banking.

  19. Differences in health insurance and health service utilization among Asian Americans: method for using the NHIS to identify unique patterns between ethnic groups.

    Science.gov (United States)

    Ruy, Hosihn; Young, Wendy B; Kwak, Hoil

    2002-01-01

    The purpose of this study is to outline a method to identify the characteristics of socioeconomic variables in determining the differences in health insurance coverage and health services utilization patterns for different ethnic groups, using the behavioural model of health service utilization. A sample drawn from Asian American adult respondents to the 1992, 1993, and 1994 National Health Interview Surveys (NHIS) in the USA formed the data set. The results showed Asian Americans as not being homogeneous. There were distinctly different demographic and socioeconomic characteristics between six Asian American ethnic groups that affect health insurance coverage and health service utilization. The study method is useful for constructing health policy and services to address the general public need without adversely affecting smaller minority groups. Secondary analysis of well-constructed national data sets such as the specific Asian ethnic groups in NHIS, offers a rich method for predicting the differential impact of specific health policies on various ethnic groups.

  20. Public confidence in local management officials: organizational credibility and emergency behavior

    Energy Technology Data Exchange (ETDEWEB)

    Sorensen, J.H.

    1984-01-01

    Confidence issues create potential risks for the public in any emergency situation. They do so because credibility and associated perceptions of legitimacy and competency of organizations are determinants of human behavior in disasters. Credibility, however, is only one of numerous factors that shape response of people or organizations to a threatening event. The purposes of this paper are to review what is known about the way in which credibility and related constructs influence emergency response, discuss how this knowledge applies to radiological emergency planning, and suggest how credibility-induced risk can be minimized in emergency planning and response.

  1. Public confidence in local management officials: organizational credibility and emergency behavior

    International Nuclear Information System (INIS)

    Sorensen, J.H.

    1984-01-01

    Confidence issues create potential risks for the public in any emergency situation. They do so because credibility and associated perceptions of legitimacy and competency of organizations are determinants of human behavior in disasters. Credibility, however, is only one of numerous factors that shape response of people or organizations to a threatening event. The purposes of this paper are to review what is known about the way in which credibility and related constructs influence emergency response, discuss how this knowledge applies to radiological emergency planning, and suggest how credibility-induced risk can be minimized in emergency planning and response

  2. Identifying and Responding to Personal Stressors: Utilizing Photo Elicitation in Health Education Courses

    Science.gov (United States)

    Hunter, Theresa

    2014-01-01

    The "Photo Elicitation Project" teaching idea applies the techniques of photo elicitation to stress prevention and management. This activity is designed to help students identify their personal stressors and to determine which stress prevention strategies are most useful for them. Objectives: students will be able to (a) identify current…

  3. How close are we to definitively identifying the respiratory health effects of e-cigarettes?

    Science.gov (United States)

    Ratajczak, Alexsandra; Feleszko, Wojciech; Smith, Danielle M; Goniewicz, Maciej

    2018-07-01

    Use of electronic cigarettes (e-cigarettes) is frequently promoted as a less harmful alternative to cigarette smoking. The impact of repeated inhalation of e-cigarette aerosols on respiratory health is not well understood. Areas covered: Using results from laboratory, observational, and clinical studies, we synthesize evidence relevant to potential respiratory health effects that may result from inhalation of e-cigarette aerosols. Expert commentary: Chemical analyses reveal that e-cigarette aerosols contain numerous respiratory irritants and toxicants. There are documented cytotoxic effects of e-cigarette constituents on lung tissue. Studies among ex-smokers who switched to e-cigarettes note reduced exposure to numerous respiratory toxicants, reduced asthma exacerbations, and chronic obstructive pulmonary disease symptoms. Regular exposure to e-cigarette aerosols is associated with impaired respiratory functioning. Potential respiratory health risks resulting from secondhand e-cigarette aerosol exposure have not been sufficiently evaluated. Current evidence indicates that although e-cigarettes are not without risk, these products seemingly pose fewer respiratory health harms issues compared to tobacco cigarettes. Data from prospective studies and randomized controlled trials examining the impact of e-cigarette use on lung health are needed to better understand respiratory health risks tied to use of these products.

  4. Evaluation of Quality and Readability of Health Information Websites Identified through India's Major Search Engines.

    Science.gov (United States)

    Raj, S; Sharma, V L; Singh, A J; Goel, S

    2016-01-01

    Background. The available health information on websites should be reliable and accurate in order to make informed decisions by community. This study was done to assess the quality and readability of health information websites on World Wide Web in India. Methods. This cross-sectional study was carried out in June 2014. The key words "Health" and "Information" were used on search engines "Google" and "Yahoo." Out of 50 websites (25 from each search engines), after exclusion, 32 websites were evaluated. LIDA tool was used to assess the quality whereas the readability was assessed using Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and SMOG. Results. Forty percent of websites (n = 13) were sponsored by government. Health On the Net Code of Conduct (HONcode) certification was present on 50% (n = 16) of websites. The mean LIDA score (74.31) was average. Only 3 websites scored high on LIDA score. Only five had readability scores at recommended sixth-grade level. Conclusion. Most health information websites had average quality especially in terms of usability and reliability and were written at high readability levels. Efforts are needed to develop the health information websites which can help general population in informed decision making.

  5. Implementing new routines in adult mental health care to identify and support children of mentally ill parents

    OpenAIRE

    Lauritzen, Camilla; Reedtz, Charlotte; Van Doesum, Karin TM; Martinussen, Monica

    2014-01-01

    Background: Mental health problems are often transmitted from one generation to the next. This knowledge has led to changes in Norwegian legislation, making it mandatory to assess whether or not patients have children, and to provide necessary support for the children of mentally ill patients. The main purpose of this study was to evaluate the process of implementing new routines in adult mental health services to identify and support children of mentally ill parents. Methods: The design w...

  6. WORKSHOP TO IDENTIFY CRITICAL WINDOWS OF EXPOSURE FOR CHILDREN'S HEALTH: REPRODUCTIVE HEALTH IN CHILDREN AND ADOLESCENTS WORK GROUP SUMMARY

    Science.gov (United States)

    This workgroup report addresses the central question: what are the critical windows during development (pre-conception through puberty) when exposure to xenobiotics may have the greatest adverse impact on subsequent reproductive health. The reproductive system develops in stages...

  7. Identifying Barriers in the Use of Electronic Health Records in Hawai‘i

    Science.gov (United States)

    Hamamura, Faith D; Hughes, Kira

    2017-01-01

    Hawai‘i faces unique challenges to Electronic Health Record (EHR) adoption due to physician shortages, a widespread distribution of Medically Underserved Areas and Populations (MUA/P), and a higher percentage of small independent practices. However, research on EHR adoption in Hawai‘i is limited. To address this gap, this article examines the current state of EHR in Hawai‘i, the barriers to adoption, and the future of Health Information Technology (HIT) initiatives to improve the health of Hawai‘i's people. Eight focus groups were conducted on Lana‘i, Maui, Hawai‘i Island, Kaua‘i, Moloka‘i, and O‘ahu. In these groups, a total of 51 diverse health professionals were asked about the functionality of EHR systems, barriers to use, facilitators of use, and what EHRs would look like in a perfect world. Responses were summarized and analyzed based on constant comparative analysis techniques. Responses were then clustered into thirteen themes: system compatibility, loss of productivity, poor interface, IT support, hardware/software, patient factors, education/training, noise in the system, safety, data quality concerns, quality metrics, workflow, and malpractice concerns. Results show that every group mentioned system compatibility. In response to these findings, the Health eNet Community Health Record initiative — which allows providers web-based access to patient health information from the patient's provider network— was developed as a step toward alleviating some of the barriers to sharing information between different EHRs. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) legislation will introduce a new payment model in 2017 that is partially based on EHR utilization. Therefore, more research should be done to understand EHR adoption and how this ruling will affect providers in Hawai‘i. PMID:28435756

  8. Uncertainty quantification's role in modeling and simulation planning, and credibility assessment through the predictive capability maturity model

    Energy Technology Data Exchange (ETDEWEB)

    Rider, William J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Witkowski, Walter R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mousseau, Vincent Andrew [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-04-13

    The importance of credible, trustworthy numerical simulations is obvious especially when using the results for making high-consequence decisions. Determining the credibility of such numerical predictions is much more difficult and requires a systematic approach to assessing predictive capability, associated uncertainties and overall confidence in the computational simulation process for the intended use of the model. This process begins with an evaluation of the computational modeling of the identified, important physics of the simulation for its intended use. This is commonly done through a Phenomena Identification Ranking Table (PIRT). Then an assessment of the evidence basis supporting the ability to computationally simulate these physics can be performed using various frameworks such as the Predictive Capability Maturity Model (PCMM). There were several critical activities that follow in the areas of code and solution verification, validation and uncertainty quantification, which will be described in detail in the following sections. Here, we introduce the subject matter for general applications but specifics are given for the failure prediction project. In addition, the first task that must be completed in the verification & validation procedure is to perform a credibility assessment to fully understand the requirements and limitations of the current computational simulation capability for the specific application intended use. The PIRT and PCMM are tools used at Sandia National Laboratories (SNL) to provide a consistent manner to perform such an assessment. Ideally, all stakeholders should be represented and contribute to perform an accurate credibility assessment. PIRTs and PCMMs are both described in brief detail below and the resulting assessments for an example project are given.

  9. Identifying health promotion needs among prison staff in three English prisons: results from a qualitative study.

    Science.gov (United States)

    Woodall, James

    2013-03-01

    Prisons are seen as a (temporary) home and community for offenders, yet they also have a dual role as a workplace for prison staff. This article explores how the "healthy settings" philosophy, commonly used in schools, applies in the prison environment. The article explores the concept of the health-promoting prison from the perspective of prison staff using semistructured interviews in three English prisons. Data were analyzed using Attride-Stirling's thematic network approach. The findings indicate that working in a prison can be highly stressful and can have a negative impact on physical and mental health. Staff perceived that the focus of health promotion efforts was in many cases exclusively focused on prisoners, and many suggested that prison staff needs were being overlooked. The article argues that the theory and practice of a health-promoting prison have developed rapidly in recent years but still lag behind developments in other organizations. The article suggests that health promotion policy and practice in prison settings may need to be reconfigured to ensure that the needs of all those who live and work there are recognized.

  10. Expert searching in health librarianship: a literature review to identify international issues and Australian concerns.

    Science.gov (United States)

    Lasserre, Kaye

    2012-03-01

    The traditional role of health librarians as expert searchers is under challenge. The purpose of this review is to establish health librarians' views, practices and educational processes on expert searching. The search strategy was developed in LISTA and then customised for ten other databases: ALISA, PubMed, Embase, Scopus, Web of Science, CINAHL, ERIC, PsycINFO, Cochrane Library and Google Scholar. The search terms were (expert search* OR expert retriev* OR mediated search* OR information retriev*) AND librar*. The searches, completed in December 2010 and repeated in May 2011, were limited to English language publications from 2000 to 2011 (unless seminal works). Expert searching remains a key role for health librarians, especially for those supporting systematic reviews or employed as clinical librarians answering clinical questions. Although clients tend to be satisfied with searches carried out for them, improvements are required to effectively position the profession. Evidence-based guidelines, adherence to transparent standards, review of entry-level education requirements and a commitment to accredited, rigorous, ongoing professional development will ensure best practice. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

  11. Sex trafficking and health care in Metro Manila: identifying social determinants to inform an effective health system response.

    Science.gov (United States)

    Williams, Timothy P; Alpert, Elaine J; Ahn, Roy; Cafferty, Elizabeth; Konstantopoulos, Wendy Macias; Wolferstan, Nadya; Castor, Judith Palmer; McGahan, Anita M; Burke, Thomas F

    2010-12-15

    This social science case study examines the sex trafficking of women and girls in Metro Manila through a public health lens. Through key informant interviews with 51 health care and anti-trafficking stakeholders in Metro Manila, this study reports on observations about sex trafficking in Metro Manila that provide insight into understanding of risk factors for sex trafficking at multiple levels of the social environment: individual (for example, childhood abuse), socio-cultural (for example, gender inequality and a "culture of migration"), and macro (for example, profound poverty caused, inter alia, by environmental degradation disrupting traditional forms of labor). It describes how local health systems currently assist sex-trafficking victims, and provides a series of recommendations, ranging from prevention to policy, for how health care might play a larger role in promoting the health and human rights of this vulnerable population. Copyright © 2010 Williams, Alpert, Ahn, Cafferty, Konstantopoulos, Wolferstan, Castor, McGahan, and Burke. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  12. Identifying dietary patterns and associated health-related lifestyle factors in the adult Danish population

    DEFF Research Database (Denmark)

    Knudsen, Vibeke Kildegaard; Matthiessen, Jeppe; Biltoft-Jensen, Anja Pia

    2014-01-01

    , potatoes and gravy, and cake and biscuits; a 'health-conscious' pattern correlated with coarse bread, fruit, vegetables, low-fat dairy, nuts, water and tea; and a 'fast food' pattern correlated with pizza, hamburger/spring rolls, crisps, rice and pasta, sugar-sweetened soft drinks and sweets...

  13. From Nutrients to Wellbeing Identifying Discourses of Food in Relation to Health in Syllabi

    Science.gov (United States)

    Oljans, Emma; Elmståhl, Helena; Mattsson Sydner, Ylva; Hjälmeskog, Karin

    2018-01-01

    Food and health have long had dominant position within the subject of Home Economics (HE) in Sweden. However, what constitutes a proper diet, and how it is associated with a healthy lifestyle changes over time. In this article, a discourse analytic approach combined with a didactic perspective are used as the theoretical frame. The aim is to…

  14. Towards a new procedure for identifying causes of health and comfort problems in office buildings

    NARCIS (Netherlands)

    Bluyssen, P.M.; Fossati, S.; Mandin, C.; Cattaneo, A.; Carrer, P.

    2012-01-01

    In the European project OFFICAIR a procedure has been prepared for the inventory and identification of associations between possible characteristics of European modern offices (building, sources and events) and health and comfort of office workers, via a questionnaire and a checklist including

  15. Identifying and Addressing the Mental Health Needs of Online Students in Higher Education

    Science.gov (United States)

    Barr, Bonny

    2014-01-01

    89% of colleges and universities in the United States offer online courses and of those institutions 58% offer degree programs that are completely online (Parker, Lenhart & Moore, 2011).Providing online student services is an important component of these distance programs and is often required by accrediting bodies. Health and wellness…

  16. Hearing Screening Follow-Up: Completing the Process to Identify Hearing Health Needs

    Science.gov (United States)

    Eiserman, William; Shisler, Lenore; Hoffman, Jeff

    2015-01-01

    Hearing is at the heart of language development and school readiness; increasing numbers of Early Head Start programs have come to rely on otoacoustic emissions (OAE) technology to screen all infants and toddlers for hearing loss. Successful identification of hearing health needs is dependent not only on an appropriate screening method, but also…

  17. Between Pregnancy and Motherhood: Identifying Unmet Mental Health Needs in Pregnant Women with Lifetime Adversity

    Science.gov (United States)

    Narayan, Angela J.; Thomas, Melanie; Nau, Melissa; Rivera, Luisa M.; Harris, William W.; Bernstein, Rosemary E.; Castro, Gloria; Lieberman, Alicia F.; Gantt, Tahnee

    2017-01-01

    The prenatal period represents an opportunity to buffer the intergenerational transmission of adversity through integrated, comprehensive perinatal health services for women experiencing high levels of adversity and clinical symptoms. This article presents preliminary descriptive data, drawn from an ongoing clinical research study, on prenatal…

  18. Using the WHO-5 Well-Being Index to Identify College Students at Risk for Mental Health Problems

    Science.gov (United States)

    Downs, Andrew; Boucher, Laura A.; Campbell, Duncan G.; Polyakov, Anita

    2017-01-01

    There is a clear need for colleges to do a better job of identifying students who may benefit from treatment and encouraging those students to actually seek help (Hunt & Eisenberg, 2010). Indeed, research suggests that population-based screening can encourage college students who are at risk for mental health problems to seek treatment (Kim,…

  19. Costs, equity, efficiency and feasibility of identifying the poor in Ghana's National Health Insurance Scheme: empirical analysis of various strategies.

    NARCIS (Netherlands)

    Aryeetey, G.C.N.O.; Jehu-Appiah, C.; Spaan, E.; Agyepong, I.; Baltussen, R.M.

    2012-01-01

    Objectives To analyse the costs and evaluate the equity, efficiency and feasibility of four strategies to identify poor households for premium exemptions in Ghana's National Health Insurance Scheme (NHIS): means testing (MT), proxy means testing (PMT), participatory wealth ranking (PWR) and

  20. Stability of Early Identified Aggressive Victim Status in Elementary School and Associations with Later Mental Health Problems and Functional Impairments

    Science.gov (United States)

    Burk, Linnea R.; Armstrong, Jeffrey M.; Park, Jong-Hyo; Zahn-Waxler, Carolyn; Klein, Marjorie H.; Essex, Marilyn J.

    2011-01-01

    Aggressive victims--children who are both perpetrators and victims of peer aggression--experience greater concurrent mental health problems and impairments than children who are only aggressive or only victimized. The stability of early identified aggressive victim status has not been evaluated due to the fact that most studies of aggressor/victim…

  1. Building confidence and credibility amid growing model and computing complexity

    Science.gov (United States)

    Evans, K. J.; Mahajan, S.; Veneziani, C.; Kennedy, J. H.

    2017-12-01

    As global Earth system models are developed to answer an ever-wider range of science questions, software products that provide robust verification, validation, and evaluation must evolve in tandem. Measuring the degree to which these new models capture past behavior, predict the future, and provide the certainty of predictions is becoming ever more challenging for reasons that are generally well known, yet are still challenging to address. Two specific and divergent needs for analysis of the Accelerated Climate Model for Energy (ACME) model - but with a similar software philosophy - are presented to show how a model developer-based focus can address analysis needs during expansive model changes to provide greater fidelity and execute on multi-petascale computing facilities. A-PRIME is a python script-based quick-look overview of a fully-coupled global model configuration to determine quickly if it captures specific behavior before significant computer time and expense is invested. EVE is an ensemble-based software framework that focuses on verification of performance-based ACME model development, such as compiler or machine settings, to determine the equivalence of relevant climate statistics. The challenges and solutions for analysis of multi-petabyte output data are highlighted from the aspect of the scientist using the software, with the aim of fostering discussion and further input from the community about improving developer confidence and community credibility.

  2. Does Exonerating an Accused Researcher Restore the Researcher's Credibility?

    Directory of Open Access Journals (Sweden)

    Tobias Greitemeyer

    Full Text Available Scientific misconduct appears to be on the rise. However, an accused researcher may later be exonerated. The present research examines to what extent participants adhere to their attitude toward a researcher who allegedly committed academic misconduct after learning that the researcher is innocent. In two studies, participants in an exoneration and an uncorrected accusation condition learned that the ethics committee of a researcher's university demanded the retraction of one of the researcher's articles, whereas participants in a control condition did not receive this information. As intended, this manipulation led to a more favorable attitude toward the researcher in the control compared to the exoneration and the uncorrected accusation conditions (pre-exoneration attitude. Then, participants in the exoneration condition learned that the researcher was exonerated and that the article was not retracted. Participants in the uncorrected accusation and the control condition were not informed about the exoneration. Results revealed that the exoneration effectively worked, in that participants in the exoneration condition had a more favorable attitude (post-exoneration attitude toward the researcher than did participants in the uncorrected accusation condition. Moreover, the post-exoneration attitude toward the researcher was similar in the exoneration and the control conditions. Finally, in the exoneration condition only, participants' post-exoneration attitude was more favorable than their pre-exoneration attitude. These findings suggest that an exoneration of an accused researcher restores the researcher's credibility.

  3. Does Exonerating an Accused Researcher Restore the Researcher's Credibility?

    Science.gov (United States)

    Greitemeyer, Tobias; Sagioglou, Christina

    2015-01-01

    Scientific misconduct appears to be on the rise. However, an accused researcher may later be exonerated. The present research examines to what extent participants adhere to their attitude toward a researcher who allegedly committed academic misconduct after learning that the researcher is innocent. In two studies, participants in an exoneration and an uncorrected accusation condition learned that the ethics committee of a researcher's university demanded the retraction of one of the researcher's articles, whereas participants in a control condition did not receive this information. As intended, this manipulation led to a more favorable attitude toward the researcher in the control compared to the exoneration and the uncorrected accusation conditions (pre-exoneration attitude). Then, participants in the exoneration condition learned that the researcher was exonerated and that the article was not retracted. Participants in the uncorrected accusation and the control condition were not informed about the exoneration. Results revealed that the exoneration effectively worked, in that participants in the exoneration condition had a more favorable attitude (post-exoneration attitude) toward the researcher than did participants in the uncorrected accusation condition. Moreover, the post-exoneration attitude toward the researcher was similar in the exoneration and the control conditions. Finally, in the exoneration condition only, participants' post-exoneration attitude was more favorable than their pre-exoneration attitude. These findings suggest that an exoneration of an accused researcher restores the researcher's credibility.

  4. Resonant communicators, effective communicators. Communicator’s flow and credibility

    Directory of Open Access Journals (Sweden)

    Irene García-Ureta, Ph.D

    2012-01-01

    Full Text Available Communication studies have been integrating the latest developments in cognitive sciences and acknowledging the importance of understanding the subjective processes involved in communication. This article argues that communication studies should also take into account the psychology of the communicator. This article presents the theoretical basis and the results of a training programme designed for audiovisual communicators. The programme is based on the theories of self-efficacy and flow and seeks to improve students’ communication competencies through the use of presentation techniques and psychological skills to tackle communication apprehension. The programme involves an active methodology that is based on modelling, visualisation, immediate feedback and positive reinforcement. A repeated-measures ANOVA shows that the programme successfully decreases the level of communication apprehension, improves the perceived self-efficacy, improves the psychological state needed to perform better in front of the cameras (flow, and improves students’ communication skills. A path analysis proved that the perceived self-efficacy and anxiety levels predict the level of flow during the communication act. At the end of the training programme, those who experienced higher levels of flow and enjoyment during the communication task achieved higher quality levels in their communication exercise. It is concluded that the concepts of self-efficacy and flow facilitate advancing in the understanding of the factors that determine a communicator’s credibility and ability to connect with the audience.

  5. Crisis of confidence: utilities, public relations, and credibility

    Energy Technology Data Exchange (ETDEWEB)

    Sullivan, F.C.

    1977-01-01

    This book deals principally with the role of the public utility in the business sector and specifically with its patterns of communications in this turbulent era of changing public opinion. Offering the premise that time has almost run out to achieve public understanding in today's mounting energy crisis, Frank C. Sullivan diagnoses the problems, examines available communication techniques, and offers a pragmatic approach to action which will stimulate and challenge neophyte and professional alike. The book touches on the history of public relations, discusses its functions and role in utility management, and provides practical suggestions and sound advice on corporate credibility and accounting. Following a ''Rationale for Action'' the book's twenty-two chapters are grouped in four major sections: Public Relations and the Utility; Planning for Rate Increases; The Utility and its Publics, and Private vs. Public Ownership. In his epilogue, ''The Dimensions of Disbelief,'' the author sets forth his candid and provocative thesis for action and change.

  6. Credibility and Authenticity of Digitally Signed Videos in Traffic

    Directory of Open Access Journals (Sweden)

    Ivan Grgurević

    2008-11-01

    Full Text Available The paper presents the possibilities of insuring the credibilityand authenticity of the surveillance camera video by digitalsigning, using the public key infrastructure as part of interoperabletraffic and information system in the future intelligenttransport systems. The surveillance camera video is a sequenceof individual frames and a unique digital print, i. e. hash valueis calculated for each of these. By encryption of the hash valuesof the frames using private encryption key of the surveillancecentre, digital signatures are created and they are stored in thedatabase. The surveillance centre can issue a copy of the videoto all the interested subjects for scientific and research workand investigation. Regardless of the scope, each subsequentmanipulation of the video copy contents will certainly changethe hash value of all the frames. The procedure of determiningthe authenticity and credibility of videos is reduced to the comparisonof the hash values of the frames stored in the databaseof the surveillance centre with the values obtained from the interestedsubjects such as the traffic experts and investigators,surveillance-security services etc.

  7. Use of Credibility Heuristics in a Social Question-Answering Service

    Science.gov (United States)

    Matthews, Paul

    2015-01-01

    Introduction: This study looked at the effect of community peripheral cues (specifically voting score and answerer's reputation) on the user's credibility rating of answers. Method: Students in technology and philosophy were asked to assess the credibility of answers to questions posted on a social question-answering platform. Through the use of a…

  8. The Importance of Being…Social? Instructor Credibility and the Millennials

    Science.gov (United States)

    Gerhardt, Megan W.

    2016-01-01

    Using the framework of generational identity, the current study explores how a range of characteristics impact Millennial perceptions of instructor credibility. Millennial Generation student ratings of the impact of competence, character, and sociability on instructor credibility were compared to faculty ratings of the same characteristics.…

  9. Effects of message repetition and negativity on credibility judgments and political attitudes

    NARCIS (Netherlands)

    Ernst, N.; Kühne, R.; Wirth, W.

    2017-01-01

    Research on the truth effect has demonstrated that statements are rated as more credible when they are repeatedly presented. However, current research indicates that there are limits to the truth effect and that too many repetitions can decrease message credibility. This study investigates whether

  10. Credible enough? Forward guidance and perceived National Bank of Poland’s policy rule

    OpenAIRE

    Baranowski, Paweł; Gajewski, Paweł

    2015-01-01

    Credible forward guidance should bring down the perceived impact of macroeconomic variables on the interest rate. Using a micro-level dataset we test the perception of monetary policy in Poland among professional forecasters and find evidence for forward guidance credibility.

  11. In Your Facebook: Examining Facebook Usage as Misbehavior on Perceived Teacher Credibility

    Science.gov (United States)

    Hutchens, Jason S.; Hayes, Timothy

    2014-01-01

    Teachers sometimes do things that negatively impact their own credibility in classroom settings. One way instructors maintain credibility among students is by keeping a veil between their personal and professional personas. The advent of Facebook presents new challenges for instructors seeking to keep their personal lives private in order to…

  12. Identifying organisational principles and management practices important to the quality of health care services for chronic conditions

    DEFF Research Database (Denmark)

    Frølich, Anne

    2012-01-01

    are limited, it is necessary to identify efficient methods to improve the quality of care. Comparing health care systems is a well-known method for identifying new knowledge regarding, for instance, organisational methods and principles. Kaiser Permanente (KP), an integrated health care delivery system...... in the U.S., is recognized as providing high-quality chronic care; to some extent, this is due to KP's implementation of the chronic care model (CCM). This model recommends a range of evidence-based management practices that support the implementation of evidence-based medicine. However, it is not clear...... which management practices in the CCM are most efficient and in what combinations. In addition, financial incentives and public reporting of performance are often considered effective at improving the quality of health care services, but this has not yet been definitively proved....

  13. Aligning Education With Health Care Transformation: Identifying a Shared Mental Model of "New" Faculty Competencies for Academic Faculty.

    Science.gov (United States)

    Gonzalo, Jed D; Ahluwalia, Amarpreet; Hamilton, Maria; Wolf, Heidi; Wolpaw, Daniel R; Thompson, Britta M

    2018-02-01

    To develop a potential competency framework for faculty development programs aligned with the needs of faculty in academic health centers (AHCs). In 2014 and 2015, the authors interviewed 23 health system leaders and analyzed transcripts using constant comparative analysis and thematic analysis. They coded competencies and curricular concepts into subcategories. Lead investigators reviewed drafts of the categorization themes and subthemes related to gaps in faculty knowledge and skills, collapsed and combined competency domains, and resolved disagreements via discussion. Through analysis, the authors identified four themes. The first was core functional competencies and curricular domains for conceptual learning, including patient-centered care, health care processes, clinical informatics, population and public health, policy and payment, value-based care, and health system improvement. The second was the need for foundational competency domains, including systems thinking, change agency/management, teaming, and leadership. The third theme was paradigm shifts in how academic faculty should approach health care, categorized into four areas: delivery, transformation, provider characteristics and skills, and education. The fourth theme was the need for faculty to be aware of challenges in the culture of AHCs as an influential context for change. This broad competency framework for faculty development programs expands existing curricula by including a comprehensive scope of health systems science content and skills. AHC leaders can use these results to better align faculty education with the real-time needs of their health systems. Future work should focus on optimal prioritization and methods for teaching.

  14. Identifying and Understanding the Health Information Experiences and Preferences of Individuals With TBI, SCI, and Burn Injuries

    Directory of Open Access Journals (Sweden)

    Nathan T Coffey MPH

    2016-09-01

    Full Text Available Introduction: Traumatic brain injury, spinal cord injury, and burn injury can cause lifelong disability and changes in quality of life. In order to meet the challenges of postinjury life, various types of health information are needed. We sought to identify preferred sources of health information and services for persons with these injuries and discover how accessibility could be improved. Methods: Thirty-three persons with injury participated in semistructured interviews. Responses to interview questions were coded using NVivo. Results: Participants’ difficulties accessing health information varied by injury type and individually. The majority of respondents found information via the Internet and advocated its use when asked to describe their ideal health information system. Nearly all participants supported the development of a comprehensive care website. When searching for health information, participants sought doctor and support group networks, long-term health outcomes, and treatments specific to their injury. Conclusion: To optimize the quality of health information resources, Internet-based health-care platforms should add or highlight access points to connect patients to medical professionals and support networks while aggregating specialized, injury-specific research and treatment information.

  15. Occupational health surveillance: a means to identify work-related risks.

    Science.gov (United States)

    Froines, J R; Dellenbaugh, C A; Wegman, D H

    1986-09-01

    The lack of successful disease surveillance methods has resulted in few reliable estimates of workplace-related disease. Hazard surveillance--the ongoing assessment of chemical use and worker exposure to the chemicals--is presented as a way to supplement occupational disease surveillance. Existing OSHA (Occupational Safety and Health Administration) and NIOSH (National Institute for Occupational Health) data systems are adapted to this function to characterize the distribution and type of hazardous industry in Los Angeles County. A new method is developed for ranking potentially hazardous industries in the county using actual exposure measurements from federal OSHA compliance inspections. The strengths of the different systems are presented along with considerations of industrial employment and types of specific chemical exposures. Applications for information from hazard surveillance are discussed in terms of intervention, monitoring exposure control, planning, research, and as a complement to disease surveillance.

  16. Workplace telecommunications technology to identify mental health disorders and facilitate self-help or professional referrals.

    Science.gov (United States)

    Farzanfar, Ramesh; Locke, Steven E; Heeren, Timothy C; Stevens, Allison; Vachon, Louis; Thi Nguyen, Mai Khoa; Friedman, Robert H

    2011-01-01

    Test the feasibility and impact of an automated workplace mental health assessment and intervention. Efficacy was evaluated in a randomized control trial comparing employees who received screening and intervention with those who received only screening. Workplace. 463 volunteers from Boston Medical Center, Boston University, and EMC and other employed adults, among whom 164 were randomized to the intervention (N  =  87) and control (N  =  77) groups. The system administers a panel of telephonic assessment instruments followed by tailored information, education, and referrals. The Work Limitation Questionnaire, the Medical Outcomes Questionnaire Short Form-12, the Patient Health Questionnaire-9, question 10 from the Patient Health Questionnaire to measure functional impairment, and the Perceived Stress Scale-4 and questions written by study psychiatrists to measure emotional distress and social support respectively. The WHO-Five Well-being Index was administered to measure overall well-being. Independent sample t-tests and χ(2) tests as well as mean change were used to compare the data. No significant differences on 16 of the 20 comparisons at 3- and 6-month time points. The intervention group showed a significant improvement in depression (p ≤ .05) at 3 months and on two Work Limitation Questionnaire subscales, the Mental-Interpersonal Scale (p ≤ .05) and the Time and Scheduling Scale (p ≤ .05), at 3 and 6 months respectively with a suggestive improvement in mental health at 6 months (p ≤ .10). This is a potentially fruitful area for research with important implications for workplace behavioral interventions.

  17. Identifying Persuasive Public Health Messages to Change Community Knowledge and Attitudes About Bulimia Nervosa.

    Science.gov (United States)

    McLean, Siân A; Paxton, Susan J; Massey, Robin; Hay, Phillipa J; Mond, Jonathan M; Rodgers, Bryan

    2016-01-01

    Addressing stigma through social marketing campaigns has the potential to enhance currently low rates of treatment seeking and improve the well-being of individuals with the eating disorder bulimia nervosa. This study aimed to evaluate the persuasiveness of health messages designed to reduce stigma and improve mental health literacy about this disorder. A community sample of 1,936 adults (48.2% male, 51.8% female) from Victoria, Australia, provided (a) self-report information on knowledge and stigma about bulimia nervosa and (b) ratings of the persuasiveness of 9 brief health messages on dimensions of convincingness and likelihood of changing attitudes. Messages were rated moderately to very convincing and a little to moderately likely to change attitudes toward bulimia nervosa. The most persuasive messages were those that emphasized that bulimia nervosa is a serious mental illness and is not attributable to personal failings. Higher ratings of convincingness were associated with being female, with having more knowledge about bulimia nervosa, and with lower levels of stigma about bulimia nervosa. Higher ratings for likelihood of changing attitudes were associated with being female and with ratings of the convincingness of the corresponding message. This study provides direction for persuasive content to be included in social marketing campaigns to reduce stigma toward bulimia nervosa.

  18. Dissemination of health technology assessments: identifying the visions guiding an evolving policy innovation in Canada.

    Science.gov (United States)

    Lehoux, Pascale; Denis, Jean-Louis; Tailliez, Stéphanie; Hivon, Myriam

    2005-08-01

    Health technology assessment (HTA) has received increasing support over the past twenty years in both North America and Europe. The justification for this field of policy-oriented research is that evidence about the efficacy, safety, and cost-effectiveness of technology should contribute to decision and policy making. However, concerns about the ability of HTA producers to increase the use of their findings by decision makers have been expressed. Although HTA practitioners have recognized that dissemination activities need to be intensified, why and how particular approaches should be adopted is still under debate. Using an institutional theory perspective, this article examines HTA as a means of implementing knowledge-based change within health care systems. It presents the results of a case study on the dissemination strategies of six Canadian HTA agencies. Chief executive officers and executives (n = 11), evaluators (n = 19), and communications staff (n = 10) from these agencies were interviewed. Our results indicate that the target audience of HTA is frequently limited to policy makers, that three conflicting visions of HTA dissemination coexist, that active dissemination strategies have only occasionally been applied, and that little attention has been paid to the management of diverging views about the value of health technology. Our discussion explores the strengths, limitations, and trade-offs associated with the three visions. Further efforts should be deployed within agencies to better articulate a shared vision and to devise dissemination strategies that are consistent with this vision.

  19. The value of structured data elements from electronic health records for identifying subjects for primary care clinical trials.

    Science.gov (United States)

    Ateya, Mohammad B; Delaney, Brendan C; Speedie, Stuart M

    2016-01-11

    An increasing number of clinical trials are conducted in primary care settings. Making better use of existing data in the electronic health records to identify eligible subjects can improve efficiency of such studies. Our study aims to quantify the proportion of eligibility criteria that can be addressed with data in electronic health records and to compare the content of eligibility criteria in primary care with previous work. Eligibility criteria were extracted from primary care studies downloaded from the UK Clinical Research Network Study Portfolio. Criteria were broken into elemental statements. Two expert independent raters classified each statement based on whether or not structured data items in the electronic health record can be used to determine if the statement was true for a specific patient. Disagreements in classification were discussed until 100 % agreement was reached. Statements were also classified based on content and the percentages of each category were compared to two similar studies reported in the literature. Eligibility criteria were retrieved from 228 studies and decomposed into 2619 criteria elemental statements. 74 % of the criteria elemental statements were considered likely associated with structured data in an electronic health record. 79 % of the studies had at least 60 % of their criteria statements addressable with structured data likely to be present in an electronic health record. Based on clinical content, most frequent categories were: "disease, symptom, and sign", "therapy or surgery", and "medication" (36 %, 13 %, and 10 % of total criteria statements respectively). We also identified new criteria categories related to provider and caregiver attributes (2.6 % and 1 % of total criteria statements respectively). Electronic health records readily contain much of the data needed to assess patients' eligibility for clinical trials enrollment. Eligibility criteria content categories identified by our study can be

  20. Identifying community risk factors for HIV among South African adolescents with mental health problems: a qualitative study of parental perceptions.

    Science.gov (United States)

    Kagee, Ashraf; Donenberg, Geri; Davids, Alicia; Vermaak, Redwaan; Simbayi, Leickness; Ward, Catherine; Naidoo, Pamela; Mthembu, Jacky

    2014-01-01

    High risk sexual behaviour, alcohol and drug use, and mental health problems combine to yield high levels of HIV-risk behaviour among adolescents with mental health problems. In South Africa, little research has been conducted on parental perspectives of HIV-risk among this population. We conducted a series of focus group discussions with 28 mothers of adolescents receiving services at two mental health clinics in South Africa to identify, from their perspectives, the key community problems facing their children. Participants indicated that HIV remained a serious threat to their adolescent children's well-being, in addition to substance abuse, early sexual debut, and teenage pregnancy. These social problems were mentioned as external to their household dynamics, and thus seemingly beyond the purview of the parent-adolescent relationship. These data have implications for the design of family-based interventions to ameliorate the factors associated with HIV-risk among youth receiving mental health services.

  1. Identifying environmental safety and health requirements for an Environmental Restoration Management Contractor

    International Nuclear Information System (INIS)

    Beckman, W.H.; Cossel, S.C.; Alhadeff, N.; Lindamood, S.B.; Beers, J.A.

    1993-10-01

    The purpose of the Standards/Requirements Identification Program, developed partially in response to the Defense Nuclear Facilities Safety Board Recommendation 90-2, was to identify applicable requirements that established the Environmental Restoration Management Contractor's (ERMC) responsibilities and authorities under the Environmental Restoration Management Contract, determine the adequacy of these requirements, ascertain a baseline level of compliance with them, and implement a maintenance program that would keep the program current as requirements or compliance levels change. The resultant Standards/Requirements Identification Documents (S/RIDs) consolidate the applicable requirements. These documents govern the development of procedures and manuals to ensure compliance with the requirements. Twenty-four such documents, corresponding with each functional area identified at the site, are to be issued. These requirements are included in the contractor's management plan

  2. [Perceptions on healthcare in people with self-identified mental health problems in the rural areas of Peru].

    Science.gov (United States)

    Saavedra, Javier E; Uchofen-Herrera, Verousckha

    2016-01-01

    Person-centered health and community health perspectives on its needs and resources are mandatory in healthcare policies in highly cultural diverse contexts. From this point of view, epidemiology needs to be centered not only on the disease, but also on the health diagnosis and its context, including the points of view of people and the community about their problems and needs. This article describes and qualitatively analyzes the views of adults with self-identified mental health disorders (MHD) in rural regions on the coast, highlands, and jungle of Peru, as causal factors, personal resources, and healthcare expectations from health facilities, using the narrative approach of ideographic formulation proposed by the World Psychiatric Association. The database of mental health epidemiological studies from the National Mental Health Institute was used. The qualitative analysis on answers from 235 people reveals that a large part of MHD is linked to the dynamics of troubled families and to the loss of loved ones. The presence of scarce community resources that help overcome these problems is noted. Counseling is stressed among the expectations of healthcare at facilities; nevertheless, many people do not know what to expect from such healthcare. We believe that the narrative approach is an important tool as regards to community- and person-centered medicine and intervention strategy planning.

  3. Identifying health insurance predictors and the main reported reasons for being uninsured among US immigrants by legal authorization status.

    Science.gov (United States)

    Vargas Bustamante, Arturo; Chen, Jie; Fang, Hai; Rizzo, John A; Ortega, Alexander N

    2014-01-01

    This study identifies differences in health insurance predictors and investigates the main reported reasons for lacking health insurance coverage between short-stayed (≤ 10 years) and long-stayed (>10 years) US immigrant adults to parse the possible consequences of the Affordable Care Act among immigrants by length of stay and documentation status. Foreign-born adults (18-64 years of age) from the 2009 California Health Interview Survey are the study population. Health insurance coverage predictors and the main reasons for being uninsured are compared across cohorts and by documentation status. A logistic-regression two-part multivariate model is used to adjust for confounding factors. The analyses determine that legal status is a strong health insurance predictor, particularly among long-stayed undocumented immigrants. Immigration status is the main reported reason for lacking health insurance. Although long-stayed documented immigrants are likely to benefit from the Affordable Care Act implementation, undocumented immigrants and short-stayed documented immigrants may encounter difficulties getting health insurance coverage. Copyright © 2013 John Wiley & Sons, Ltd.

  4. Identifying Ethical Issues in Mental Health Research with Minors Adolescents: Results of a Delphi Study

    Directory of Open Access Journals (Sweden)

    Elisabeta Ioana Hiriscau

    2016-05-01

    Full Text Available Research with minors, especially for preventive purposes, e.g., suicide prevention, investigating risk or self-destructive behaviors such as deviance, drug abuse, or suicidal behavior, is ethically sensitive. We present a Delphi study exploring the ethical implications of the needs formulated by researchers in an international pre-conference who would benefit from ethics support and guidance in conducting Mental Health Research with minors. The resulting List of Ethical Issues (LEI was submitted to a 2-rounds Delphi process via the Internet, including 34 multidisciplinary experts. In the first round, the experts reviewed the LEI and completed a questionnaire. Results from this round were analyzed and grouped in nine categories comprising 40 items. In the second round, the experts had to agree/disagree with the needs expressed in the LEI leading to a final list of 25 ethical issues considered relevant for Mental Health Research with minors such as: confidentiality of the sensitive data, competence for consenting alone and risk of harm and stigma related to the methodology used in research. It was shown that studies like SEYLE (Saving and Empowering Young Lives in Europe trigger among researchers wishes to obtain specific recommendations helping to comply with standards for good practice in conducting research with minors.

  5. Identifying Ethical Issues in Mental Health Research with Minors Adolescents: Results of a Delphi Study.

    Science.gov (United States)

    Hiriscau, Elisabeta Ioana; Stingelin-Giles, Nicola; Wasserman, Danuta; Reiter-Theil, Stella

    2016-05-11

    Research with minors, especially for preventive purposes, e.g., suicide prevention, investigating risk or self-destructive behaviors such as deviance, drug abuse, or suicidal behavior, is ethically sensitive. We present a Delphi study exploring the ethical implications of the needs formulated by researchers in an international pre-conference who would benefit from ethics support and guidance in conducting Mental Health Research with minors. The resulting List of Ethical Issues (LEI) was submitted to a 2-rounds Delphi process via the Internet, including 34 multidisciplinary experts. In the first round, the experts reviewed the LEI and completed a questionnaire. Results from this round were analyzed and grouped in nine categories comprising 40 items. In the second round, the experts had to agree/disagree with the needs expressed in the LEI leading to a final list of 25 ethical issues considered relevant for Mental Health Research with minors such as: confidentiality of the sensitive data, competence for consenting alone and risk of harm and stigma related to the methodology used in research. It was shown that studies like SEYLE (Saving and Empowering Young Lives in Europe) trigger among researchers wishes to obtain specific recommendations helping to comply with standards for good practice in conducting research with minors.

  6. Identifying Challenging Job and Environmental Demands of Older Nurses Within the National Health Service.

    Science.gov (United States)

    Durosaiye, Isaiah Oluremi; Hadjri, Karim; Liyanage, Champika Lasanthi

    2016-04-01

    To explore the existing theoretical contexts of the job and environmental demands of the nursing profession in the National Health Service (NHS) and to investigate how these job and environmental demands impact on the personal constructs of older nurses within the NHS. Nursing is the single most widely practiced profession in the healthcare sector in the United Kingdom. However, nurses contend with challenging job and environmental demands on a daily basis, which deplete them of personal constructs (or resources) required to stay in the profession. A multilevel exploratory qualitative research design was employed. Ten managers were interviewed for the preliminary study, based on which the three characteristics of an age-friendly NHS workplace were established: health, retirement, and flexibility. Then an in-depth literature review revealed that the most adversely affected job within the NHS was the nursing profession. Finally, a focus group study was undertaken with six older nurses working in the NHS. The most compelling finding of this study is that older nurses would generally not want to stay on the job if they had to work in the ward area. The physical, cognitive, and sensory constructs of older nurses are negatively affected by the job and environmental demands of the ward areas. Understanding how these job and environmental demands of the workplace affect an older nurse's personal constructs may help support a better design of nurse work and the wards and help extend the working lives of older nurses in the NHS. © The Author(s) 2015.

  7. Identifying Ethical Issues in Mental Health Research with Minors Adolescents: Results of a Delphi Study

    Science.gov (United States)

    Hiriscau, Elisabeta Ioana; Stingelin-Giles, Nicola; Wasserman, Danuta; Reiter-Theil, Stella

    2016-01-01

    Research with minors, especially for preventive purposes, e.g., suicide prevention, investigating risk or self-destructive behaviors such as deviance, drug abuse, or suicidal behavior, is ethically sensitive. We present a Delphi study exploring the ethical implications of the needs formulated by researchers in an international pre-conference who would benefit from ethics support and guidance in conducting Mental Health Research with minors. The resulting List of Ethical Issues (LEI) was submitted to a 2-rounds Delphi process via the Internet, including 34 multidisciplinary experts. In the first round, the experts reviewed the LEI and completed a questionnaire. Results from this round were analyzed and grouped in nine categories comprising 40 items. In the second round, the experts had to agree/disagree with the needs expressed in the LEI leading to a final list of 25 ethical issues considered relevant for Mental Health Research with minors such as: confidentiality of the sensitive data, competence for consenting alone and risk of harm and stigma related to the methodology used in research. It was shown that studies like SEYLE (Saving and Empowering Young Lives in Europe) trigger among researchers wishes to obtain specific recommendations helping to comply with standards for good practice in conducting research with minors. PMID:27187425

  8. Overfat Adults and Children in Developed Countries: The Public Health Importance of Identifying Excess Body Fat

    Directory of Open Access Journals (Sweden)

    Philip B. Maffetone

    2017-07-01

    Full Text Available The global overfat pandemic is a serious public health crisis that places a substantial burden on economic resources in developed countries. The term overfat refers to the presence of excess body fat that can impair health, even for normal weight non-obese individuals. Excess body fat is associated with cardiometabolic dysfunction, a clinical situation that can progressively worsen, potentially leading to various common disease risk factors, chronic diseases, increased morbidity and mortality, and reduced quality of life. The prevalence of overfat populations in 30 of the world’s most developed countries is substantially higher than recent global estimations, with the largest growth due to a relatively recent increased number of people with excess abdominal fat. Abdominal overfat is the most unhealthful form of this condition, so it is concerning that average waist circumference measures, generally indicative of abdominal overfat, have increased. Despite a leveling off appearance of being overweight and/or obese in some developed countries, the overfat pandemic continues to grow.

  9. Root Cause Analyses of Suicides of Mental Health Clients: Identifying Systematic Processes and Service-Level Prevention Strategies.

    Science.gov (United States)

    Gillies, Donna; Chicop, David; O'Halloran, Paul

    2015-01-01

    The ability to predict imminent risk of suicide is limited, particularly among mental health clients. Root cause analysis (RCA) can be used by health services to identify service-wide approaches to suicide prevention. To (a) develop a standardized taxonomy for RCAs; (b) to quantitate service-related factors associated with suicides; and (c) to identify service-related suicide prevention strategies. The RCAs of all people who died by suicide within 1 week of contact with the mental health service over 5 years were thematically analyzed using a data collection tool. Data were derived from RCAs of all 64 people who died by suicide between 2008 and 2012. Major themes were categorized as individual, situational, and care-related factors. The most common factor was that clients had recently denied suicidality. Reliance on carers, recent changes in medication, communication problems, and problems in follow-through were also commonly identified. Given the difficulty in predicting suicide in people whose expressions of suicidal ideation change so rapidly, services may consider the use of strategies aimed at improving the individual, stressor, support, and care factors identified in this study.

  10. Identifying Natural Alignments Between Ambulatory Surgery Centers and Local Health Systems: Building Broader Communities of Surgical Care.

    Science.gov (United States)

    Funk, Russell J; Owen-Smith, Jason; Landon, Bruce E; Birkmeyer, John D; Hollingsworth, John M

    2017-02-01

    To develop and compare methods for identifying natural alignments between ambulatory surgery centers (ASCs) and hospitals that anchor local health systems. Using all-payer data from Florida's State Ambulatory Surgery and Inpatient Databases (2005-2009), we developed 3 methods for identifying alignments between ASCS and hospitals. The first, a geographic proximity approach, used spatial data to assign an ASC to its nearest hospital neighbor. The second, a predominant affiliation approach, assigned an ASC to the hospital with which it shared a plurality of surgeons. The third, a network community approach, linked an ASC with a larger group of hospitals held together by naturally occurring physician networks. We compared each method in terms of its ability to capture meaningful and stable affiliations and its administrative simplicity. Although the proximity approach was simplest to implement and produced the most durable alignments, ASC surgeon's loyalty to the assigned hospital was low with this method. The predominant affiliation and network community approaches performed better and nearly equivalently on these metrics, capturing more meaningful affiliations between ASCs and hospitals. However, the latter's alignments were least durable, and it was complex to administer. We describe 3 methods for identifying natural alignments between ASCs and hospitals, each with strengths and weaknesses. These methods will help health system managers identify ASCs with which to partner. Moreover, health services researchers and policy analysts can use them to study broader communities of surgical care.

  11. Mind the Gap. A systematic review to identify usability and safety challenges and practices during electronic health record implementation.

    Science.gov (United States)

    Ratwani, Raj; Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

    2016-11-16

    Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders' perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders' perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical workflow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation.

  12. The contribution of parent and youth information to identify mental health disorders or problems in adolescents

    DEFF Research Database (Denmark)

    Aebi, Marcel; Kuhn, Christine; Banaschewski, Tobias

    2017-01-01

    were used to predict any problems/disorders, emotional problems/disorders and behavioural problems/disorders in a community sample (n = 252) and in a clinic sample (n = 95). RESULTS: The findings were strikingly similar in both samples. Parent and youth SDQ scales were related to any problem/disorder......BACKGROUND: Discrepancies between multiple informants often create considerable uncertainties in delivering services to youth. The present study assessed the ability of the parent and youth scales of the Strength and Difficulties Questionnaire (SDQ) to predict mental health problems/disorders....... Youth SDQ symptom and impact had the strongest association with emotional problems/disorder and parent SDQ symptom score were most strongly related to behavioural problems/disorders. Both the SDQ total and the impact scores significantly predicted emotional problems/disorders in males whereas...

  13. Bayesian distributed lag interaction models to identify perinatal windows of vulnerability in children's health.

    Science.gov (United States)

    Wilson, Ander; Chiu, Yueh-Hsiu Mathilda; Hsu, Hsiao-Hsien Leon; Wright, Robert O; Wright, Rosalind J; Coull, Brent A

    2017-07-01

    Epidemiological research supports an association between maternal exposure to air pollution during pregnancy and adverse children's health outcomes. Advances in exposure assessment and statistics allow for estimation of both critical windows of vulnerability and exposure effect heterogeneity. Simultaneous estimation of windows of vulnerability and effect heterogeneity can be accomplished by fitting a distributed lag model (DLM) stratified by subgroup. However, this can provide an incomplete picture of how effects vary across subgroups because it does not allow for subgroups to have the same window but different within-window effects or to have different windows but the same within-window effect. Because the timing of some developmental processes are common across subpopulations of infants while for others the timing differs across subgroups, both scenarios are important to consider when evaluating health risks of prenatal exposures. We propose a new approach that partitions the DLM into a constrained functional predictor that estimates windows of vulnerability and a scalar effect representing the within-window effect directly. The proposed method allows for heterogeneity in only the window, only the within-window effect, or both. In a simulation study we show that a model assuming a shared component across groups results in lower bias and mean squared error for the estimated windows and effects when that component is in fact constant across groups. We apply the proposed method to estimate windows of vulnerability in the association between prenatal exposures to fine particulate matter and each of birth weight and asthma incidence, and estimate how these associations vary by sex and maternal obesity status in a Boston-area prospective pre-birth cohort study. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Identifying the poor for premium exemption: a critical step towards universal health coverage in Sub-Saharan Africa.

    Science.gov (United States)

    Umeh, Chukwuemeka A

    2017-01-01

    Premium exemption for the poor is a critical step towards achieving universal health coverage in sub-Saharan Africa due to the large proportion of the population living in extreme poverty who cannot pay premium. However, identifying the poor for premium exemption has been a big challenge for SSA countries. This paper is a succinct review of four methods available for identifying the poor, outlining the ideal conditions under which each of the methods should be used and the drawbacks associated with using each of the methods.

  15. Factor Analysis of Therapist-Identified Treatment Targets in Community-Based Children's Mental Health.

    Science.gov (United States)

    Love, Allison R; Okado, Izumi; Orimoto, Trina E; Mueller, Charles W

    2018-01-01

    The present study used exploratory and confirmatory factor analyses to identify underlying latent factors affecting variation in community therapists' endorsement of treatment targets. As part of a statewide practice management program, therapist completed monthly reports of treatment targets (up to 10 per month) for a sample of youth (n = 790) receiving intensive in-home therapy. Nearly 75 % of youth were diagnosed with multiple co-occurring disorders. Five factors emerged: Disinhibition, Societal Rules Evasion, Social Engagement Deficits, Emotional Distress, and Management of Biodevelopmental Outcomes. Using logistic regression, primary diagnosis predicted therapist selection of Disinhibition and Emotional Distress targets. Client age predicted endorsement of Societal Rules Evasion targets. Practice-to-research implications are discussed.

  16. Identifying organisational principles and management practices important to the quality of health care services for chronic conditions.

    Science.gov (United States)

    Frølich, Anne

    2012-02-01

    The quality of health care services offered to people suffering from chronic diseases often fails to meet standards in Denmark or internationally. The population consisting of people with chronic diseases is large and accounts for about 70% of total health care expenses. Given that resources are limited, it is necessary to identify efficient methods to improve the quality of care. Comparing health care systems is a well-known method for identifying new knowledge regarding, for instance, organisational methods and principles. Kaiser Permanente (KP), an integrated health care delivery system in the U.S., is recognized as providing high-quality chronic care; to some extent, this is due to KP's implementation of the chronic care model (CCM). This model recommends a range of evidence-based management practices that support the implementation of evidence-based medicine. However, it is not clear which management practices in the CCM are most efficient and in what combinations. In addition, financial incentives and public reporting of performance are often considered effective at improving the quality of health care services, but this has not yet been definitively proved. The aim of this dissertation is to describe the effect of determinants, such as organisational structures and management practices including two selected incentives, on the quality of care in chronic diseases. The dissertation is based on four studies with the following purposes: 1) macro- or healthcare system-level identification of organisational structures and principles that affect the quality of health care services, based on a comparison of KP and the Danish health care system; 2) meso- or organisation-level identification of management practices with positive effects on screening rates for hemoglobin A1c and lipid profile in diabetes; 3) evaluation of the effect of the CCM on quality of health care services and continuity of care in a Danish setting; 4) micro- or practice-level evaluation of the

  17. How Experienced SoTL Researchers Develop the Credibility of Their Work

    Directory of Open Access Journals (Sweden)

    Jennie Billot

    2017-03-01

    Full Text Available Teaching and learning research in higher education, often referred to as the Scholarship of Teaching and Learning (SoTL, is still relatively novel in many academic contexts compared to the mainstay of disciplinary research. One indication of this is the challenges those who engage in SoTL report in terms of how this work is valued or considered credible amongst disciplinary colleagues and in the face of institutional policies and practices. This paper moves beyond the literature that describes these specific challenges to investigate how 23 experienced SoTL researchers from five different countries understood the notion of credibility in relationship to their SoTL research and how they went about developing credibility for their work. Semi-structured interviews were facilitated and analyzed using inductive analysis. Findings indicate that notions of credibility encompassed putting SoTL research into action and building capacity and community around research findings, as well as gaining external validation through traditional indicators such as publishing. SoTL researchers reported a variety of strategies and approaches they were using, both formal and informal, to develop credibility for their work. The direct focus of this paper on credibility of SoTL work as perceived by experienced SoTL researchers, and how they go about developing credibility, is a distinct contribution to the discussions about the valuing of SoTL work.

  18. Proactive prevention in occupational safety and health: how to identify tomorrow's prevention priorities and preventive measures.

    Science.gov (United States)

    Hauke, Angelika; Flaspöler, Eva; Reinert, Dietmar

    2018-04-17

    Global trends such as digitalisation, globalisation and demographic change are changing workplaces, and accordingly occupational safety and health (OSH) needs. To better prepare for the future and to foster proactive prevention, the German Social Accident Insurance (DGUV) established an OSH risk observatory (RO OSH). The RO OSH relies on an online survey and calls upon the expertise of labour inspectors. 398 labour inspectors participated in the first RO OSH enquiry. They rated developments with regard to their sector-specific relevance for OSH in the near future. The RO OSH also provides ideas for preventive measures that can be implemented by the German Social Accident Insurance Institutions. Work intensity, demographic aspects, and digitalisation play a major role for most or all sectors. However, familiar OSH issues such as musculoskeletal strain and noise also continue to be of major importance and require further consideration and specific solutions in prevention. For the DGUV, training and consulting bear great potential for proactive prevention in the above priority areas, e.g. by fostering a prevention culture and supporting companies in (psychosocial) risk assessment (also for mobile work). For instance, concepts for increasing physical activity at sedentary workplaces, and data security require continued research.

  19. Use of a spatial scan statistic to identify clusters of births occurring outside Ghanaian health facilities for targeted intervention.

    Science.gov (United States)

    Bosomprah, Samuel; Dotse-Gborgbortsi, Winfred; Aboagye, Patrick; Matthews, Zoe

    2016-11-01

    To identify and evaluate clusters of births that occurred outside health facilities in Ghana for targeted intervention. A retrospective study was conducted using a convenience sample of live births registered in Ghanaian health facilities from January 1 to December 31, 2014. Data were extracted from the district health information system. A spatial scan statistic was used to investigate clusters of home births through a discrete Poisson probability model. Scanning with a circular spatial window was conducted only for clusters with high rates of such deliveries. The district was used as the geographic unit of analysis. The likelihood P value was estimated using Monte Carlo simulations. Ten statistically significant clusters with a high rate of home birth were identified. The relative risks ranged from 1.43 ("least likely" cluster; P=0.001) to 1.95 ("most likely" cluster; P=0.001). The relative risks of the top five "most likely" clusters ranged from 1.68 to 1.95; these clusters were located in Ashanti, Brong Ahafo, and the Western, Eastern, and Greater regions of Accra. Health facility records, geospatial techniques, and geographic information systems provided locally relevant information to assist policy makers in delivering targeted interventions to small geographic areas. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  20. Comparison of Medicare claims versus physician adjudication for identifying stroke outcomes in the Women's Health Initiative.

    Science.gov (United States)

    Lakshminarayan, Kamakshi; Larson, Joseph C; Virnig, Beth; Fuller, Candace; Allen, Norrina Bai; Limacher, Marian; Winkelmayer, Wolfgang C; Safford, Monika M; Burwen, Dale R

    2014-03-01

    Many studies use medical record review for ascertaining outcomes. One large, longitudinal study, the Women's Health Initiative (WHI), ascertains strokes using participant self-report and subsequent physician review of medical records. This is resource-intensive. Herein, we assess whether Medicare data can reliably assess stroke events in the WHI. Subjects were WHI participants with fee-for-service Medicare. Four stroke definitions were created for Medicare data using discharge diagnoses in hospitalization claims: definition 1, stroke codes in any position; definition 2, primary position stroke codes; and definitions 3 and 4, hemorrhagic and ischemic stroke codes, respectively. WHI data were randomly split into training (50%) and test sets. A concordance matrix was used to examine the agreement between WHI and Medicare stroke diagnosis. A WHI stroke and a Medicare stroke were considered a match if they occurred within ±7 days of each other. Refined analyses excluded Medicare events when medical records were unavailable for comparison. Training data consisted of 24 428 randomly selected participants. There were 577 WHI strokes and 557 Medicare strokes using definition 1. Of these, 478 were a match. With regard to algorithm performance, specificity was 99.7%, negative predictive value was 99.7%, sensitivity was 82.8%, positive predictive value was 85.8%, and κ=0.84. Performance was similar for test data. Whereas specificity and negative predictive value exceeded 99%, sensitivity ranged from 75% to 88% and positive predictive value ranged from 80% to 90% across stroke definitions. Medicare data seem useful for population-based stroke research; however, performance characteristics depend on the definition selected.

  1. A rapid assessment scorecard to identify informal settlements at higher maternal and child health risk in Mumbai.

    Science.gov (United States)

    Osrin, David; Das, Sushmita; Bapat, Ujwala; Alcock, Glyn A; Joshi, Wasundhara; More, Neena Shah

    2011-10-01

    predictive value. The scorecard needs further testing in a range of urban contexts, but we intend to use it to identify informal settlements in particular need of family health interventions in a subsequent program.

  2. Regulatory theory: commercially sustainable markets rely upon satisfying the public interest in obtaining credible goods.

    Science.gov (United States)

    Warren-Jones, Amanda

    2017-10-01

    Regulatory theory is premised on the failure of markets, prompting a focus on regulators and industry from economic perspectives. This article argues that overlooking the public interest in the sustainability of commercial markets risks markets failing completely. This point is exemplified through health care markets - meeting an essential need - and focuses upon innovative medicines as the most desired products in that market. If this seemingly invulnerable market risks failure, there is a pressing need to consider the public interest in sustainable markets within regulatory literature and practice. Innovative medicines are credence goods, meaning that the sustainability of the market fundamentally relies upon the public trusting regulators to vouch for product quality. Yet, quality is being eroded by patent bodies focused on economic benefits from market growth, rather than ensuring innovatory value. Remunerative bodies are not funding medicines relative to market value, and market authorisation bodies are not vouching for robust safety standards or confining market entry to products for 'unmet medical need'. Arguably, this failure to assure quality heightens the risk of the market failing where it cannot be substituted by the reputation or credibility of providers of goods and/or information such as health care professionals/institutions, patient groups or industry.

  3. Identifying the gaps in Nepalese migrant workers' health and well-being: a review of the literature.

    Science.gov (United States)

    Simkhada, Padam P; Regmi, Pramod R; van Teijlingen, Edwin; Aryal, Nirmal

    2017-07-01

    The health and well-being of migrant workers from low-income countries is often neglected in travel medicine. This article uses Nepal as a case study to highlight key issues affecting this particular group of international travellers. This narrative review used a comprehensive systematic literature search to identify relevant studies on Nepal. The included articles were thematically analysed leading to four key themes or risk factors. The search found 18 articles from which we identified 3 key themes related directly to migrant workers: (1) sexual risk taking; (2) occupational health and (3) lifestyles, and a fourth theme related to partners and family of migrant workers who are left behind in Nepal. Of the 18 included articles, 11 articles discussed sexual risk taking and HIV, whilst considerably fewer focused on work-related risk factors and lifestyle factors in migrant workers. Migrant workers who are generally healthy appear to be similar to tourist travellers in regarding sexual health as a key issue related to being abroad. Risky sexual behaviour increases in individuals separated from their usual sexual partners, away from their own communities and families, leading to the so-called 'situational disinhibition'. Considering the recent media coverage of deaths and injuries among migrant workers in the Middle East, it is interesting to see that their sexual health is more prevalent in the research literature. This article argues that travel medicine should provide more emphasis to the health and well-being of migrant workers as a highly vulnerable group of travellers with additional impact on the health of those left behind. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  4. Information credibility for radiation contamination of foods after the Fukushima nuclear accident (3). Undergraduates panel data from one and four months after

    International Nuclear Information System (INIS)

    Kusumi, Takashi; Miura, Asako; Ogura, Kanayo

    2011-01-01

    We examined the changes in information credibility, attitude of mass media, and risk perception concerning radiation contamination of foods after the Fukushima nuclear accident. We used a two-wave panel data of 277 undergraduates who completed the scales twice, one month and four months after the accident. Our findings indicated that the information credibility of optimistic experts, citizens' web pages and government press conferences decreased with time. On the other hand, the credibility of newspaper and TV news programs increased. In addition, while the critical attitude of mass media and the knowledge of radiation health effects increased after four months, the risk perception for foods under legal limits of radiation contamination decreased. A causal analysis carried out with the panel data found that (1) critical thinking attitude affected media literacy. In turn, (2) media literacy affected bias perception of mass media, information credibility, active information search, and risk perception of contamination foods. Finally, (3) this causal relationship was constant from the first to the fourth month after the accident. (author)

  5. Identifying the content of home-based health behaviour change interventions for frail older people: a systematic review protocol.

    Science.gov (United States)

    Jovicic, Ana; Gardner, Benjamin; Belk, Celia; Kharicha, Kalpa; Iliffe, Steve; Manthorpe, Jill; Goodman, Claire; Drennan, Vari; Walters, Kate

    2015-11-04

    Meeting the needs of the growing number of older people is a challenge for health and social care services. Home-based interventions aiming to modify health-related behaviours of frail older people have the potential to improve functioning and well-being. Previous reviews have focused on whether such interventions are effective, rather than what might make them effective. Recent advances in behavioural science make possible the identification of potential 'active ingredients' of effective interventions, such as component behaviour change techniques (BCTs), and intended intervention functions (IFs; e.g. to educate, to impart skills). This paper reports a protocol for a systematic review that seeks to (a) identify health behaviour change interventions for older frail people, (b) describe the content of these interventions, and (c) explore links between intervention content and effectiveness. The protocol is reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) 2015 guidelines. Studies will be identified through a systematic search of 15 electronic databases, supplemented by citation tracking. Studies will be retained for review where they report randomised controlled trials focusing on home-based health promotion delivered by a health professional for frail older people in community settings, written in English, and either published from 1980 onwards, or, for registered trials only, unpublished but completed with results obtainable from authors. Interventions will be coded for their content (BCTs, IFs) and for evidence of effectiveness (outcome data relating to behavioural and health outcomes). Analyses will describe characteristics of all interventions. Interventions for which effectiveness data are available will be categorised into those showing evidence of effectiveness versus those showing no such evidence. The potential for each intervention characteristic to contribute to change in behaviour or

  6. A decision support tool for identifying abuse of controlled substances by ForwardHealth Medicaid members.

    Science.gov (United States)

    Mailloux, Allan T; Cummings, Stephen W; Mugdh, Mrinal

    2010-01-01

    Our objective was to use Wisconsin's Medicaid Evaluation and Decision Support (MEDS) data warehouse to develop and validate a decision support tool (DST) that (1) identifies Wisconsin Medicaid fee-for-service recipients who are abusing controlled substances, (2) effectively replicates clinical pharmacist recommendations for interventions intended to curb abuse of physician and pharmacy services, and (3) automates data extraction, profile generation and tracking of recommendations and interventions. From pharmacist manual reviews of medication profiles, seven measures of overutilization of controlled substances were developed, including (1-2) 6-month and 2-month "shopping" scores, (3-4) 6-month and 2-month forgery scores, (5) duplicate/same day prescriptions, (6) count of controlled substance claims, and the (7) shopping 6-month score for the individual therapeutic class with the highest score. The pattern analysis logic for the measures was encoded into SQL and applied to the medication profiles of 190 recipients who had already undergone manual review. The scores for each measure and numbers of providers were analyzed by exhaustive chi-squared automatic interaction detection (CHAID) to determine significant thresholds and combinations of predictors of pharmacist recommendations, resulting in a decision tree to classify recipients by pharmacist recommendations. The overall correct classification rate of the decision tree was 95.3%, with a 2.4% false positive rate and 4.0% false negative rate for lock-in versus prescriber-alert letter recommendations. Measures used by the decision tree include the 2-month and 6-month shopping scores, and the number of pharmacies and prescribers. The number of pharmacies was the best predictor of abuse of controlled substances. When a Medicaid recipient receives prescriptions for controlled substances at 8 or more pharmacies, the likelihood of a lock-in recommendation is 90%. The availability of the Wisconsin MEDS data warehouse has

  7. Training tomorrow's global health leaders: applying a transtheoretical model to identify behavior change stages within an intervention for health leadership development.

    Science.gov (United States)

    Daniels, Joseph; Farquhar, Carey; Nathanson, Neal; Mashalla, Yohana; Petracca, Frances; Desmond, Michelle; Green, Wendy; Davies, Luke; O'Malley, Gabrielle

    2014-12-01

    Training health professionals in leadership and management skills is a key component of health systems strengthening in low-resource settings. The importance of evaluating the effectiveness of these programs has received increased attention over the past several years, although such evaluations continue to pose significant challenges. This article presents evaluation data from the pilot year of the Afya Bora Fellowship, an African-based training program to increase the leadership capacity of health professionals. Firstly, we describe the goals of the Afya Bora Fellowship. Then, we present an adaptation of the transtheoretical model for behavior change called the Health Leadership Development Model, as an analytical lens to identify and describe evidence of individual leadership behavior change among training participants during and shortly after the pilot year of the program. The Health Leadership Development Model includes the following: pre-contemplation (status quo), contemplation (testing and internalizing leadership), preparation - (moving toward leadership), action (leadership in action), and maintenance (effecting organizational change). We used data from surveys, in-depth interviews, journal entries and course evaluations as data points to populate the Health Leadership Development Model. In the short term, fellows demonstrated increased leadership development during and shortly after the intervention and reflected the contemplation, preparation and action stages of the Health Leadership Development Model. However, expanded interventions and/or additional time may be needed to support behavior change toward the maintenance stages. We conclude that the Health Leadership Development Model is useful for informing health leadership training design and evaluation to contribute to sustainable health organizational change. © The Author(s) 2014.

  8. Identifying the relationship between spiritual quotient and mental health in the students of Lorestan university of medical sciences

    Directory of Open Access Journals (Sweden)

    sharareh khodabakhshi

    2014-06-01

    Full Text Available Background: In recent years, the students' mental health has attracted a lot of attention. Many factors effect on the mental health. Nowadays, spirituality is considered as one of the important aspects of the humanistic action, which has a permanent relation with health and recovery, so the main goal of this investigation is to identify the relationship between spiritual Quotient and mental health of the students of Lorestan university of medical sciences. Materials and Methods: The descriptive correlation method was applied in this investigation. The statistical population of this research consistsed of all the students (2238 of Lorestan university of medical sciences. Cochran's formula was used to determine the sample size, and 330 students were selected by the arbitrary relative categorized method. The instruments for data gathering were Goldberg's GHa-23 (1972 and spiritual intelligence of Badie et al. The instruments credit was measured through content validty and the reliability of the questionnaires using Cronbach's alpha method. Besides the indexes of the descriptive statistics such as mean and standard deviation, inferential statistics tests such as Pearson's coefficient correlation and multiple regression analysis and independent T test were utilized to analyze the data and testing the research hypothesizes. Results: The results showed that there is a positive relationship between spiritual quotient and the dimensions of the mental health (community orientation and moral dimension. "The ability to confront and deal with the problem", "moral virtues", "self-consciousness, love and interest". The dimension of "self-consciousness, love and interest" and "community orientation" have a significant role in predicting the mental health. Conclusion: Spiritual quotient has a positive influence on the individuals' mental health. The results show that people with a moral life are more healthy from the viewpoint of phycology.

  9. Integration of health into urban spatial planning through impact assessment: Identifying governance and policy barriers and facilitators

    International Nuclear Information System (INIS)

    Carmichael, Laurence; Barton, Hugh; Gray, Selena; Lease, Helen; Pilkington, Paul

    2012-01-01

    This article presents the results of a review of literature examining the barriers and facilitators in integrating health in spatial planning at the local, mainly urban level, through appraisals. Our literature review covered the UK and non UK experiences of appraisals used to consider health issues in the planning process. We were able to identify four main categories of obstacles and facilitators including first the different knowledge and conceptual understanding of health by different actors/stakeholders, second the types of governance arrangements, in particular partnerships, in place and the political context, third the way institutions work, the responsibilities they have and their capacity and resources and fourth the timeliness, comprehensiveness and inclusiveness of the appraisal process. The findings allowed us to draw some lessons on the governance and policy framework regarding the integration of health impact into spatial planning, in particular considering the pros and cons of integrating health impact assessment (HIA) into other forms of impact assessment of spatial planning decisions such as environmental impact assessment (EIA) and strategic environment assessment (SEA). In addition, the research uncovered a gap in the literature that tends to focus on the mainly voluntary HIA to assess health outcomes of planning decisions and neglect the analysis of regulatory mechanisms such as EIA and SEA. - Highlights: ► Governance and policy barriers and facilitators to the integration of health into urban planning. ► Review of literature on impact assessment methods used across the world. ► Knowledge, partnerships, management/resources and processes can impede integration. ► HIA evaluations prevail uncovering research opportunities for evaluating other techniques.

  10. Credible knowledge: A pilot evaluation of a modified GRADE method using parent-implemented interventions for children with autism

    Directory of Open Access Journals (Sweden)

    Perry Adrienne

    2011-03-01

    Full Text Available Abstract Background Decision-making in child and youth mental health (CYMH care requires recommendations that are developed through an efficient and effective method and are based on credible knowledge. Credible knowledge is informed by two sources: scientific evidence, and practice-based evidence, that reflects the "real world" experience of service providers. Current approaches to developing these recommendations in relation to CYMH will typically include evidence from one source or the other but do not have an objective method to combine the two. To this end, a modified version of the Grading Recommendations Assessment, Development and Evaluation (GRADE approach was pilot-tested, a novel method for the CYMH field. Methods GRADE has an explicit methodology that relies on input from scientific evidence as well as a panel of experts. The panel established the quality of evidence and derived detailed recommendations regarding the organization and delivery of mental health care for children and youth or their caregivers. In this study a modified GRADE method was used to provide precise recommendations based on a specific CYMH question (i.e. What is the current credible knowledge concerning the effects of parent-implemented, early intervention with their autistic children?. Results Overall, it appeared that early, parent-implemented interventions for autism result in positive effects that outweigh any undesirable effects. However, as opposed to overall recommendations, the heterogeneity of the evidence required that recommendations be specific to particular interventions, based on the questions of whether the benefits of a particular intervention outweighs its harms. Conclusions This pilot project provided evidence that a modified GRADE method may be an effective and practical approach to making recommendations in CYMH, based on credible knowledge. Key strengths of the process included separating the assessments of the quality of the evidence and

  11. Identifying educator behaviours for high quality verbal feedback in health professions education: literature review and expert refinement.

    Science.gov (United States)

    Johnson, Christina E; Keating, Jennifer L; Boud, David J; Dalton, Megan; Kiegaldie, Debra; Hay, Margaret; McGrath, Barry; McKenzie, Wendy A; Nair, Kichu Balakrishnan R; Nestel, Debra; Palermo, Claire; Molloy, Elizabeth K

    2016-03-22

    Health professions education is characterised by work-based learning and relies on effective verbal feedback. However the literature reports problems in feedback practice, including lack of both learner engagement and explicit strategies for improving performance. It is not clear what constitutes high quality, learner-centred feedback or how educators can promote it. We hoped to enhance feedback in clinical practice by distinguishing the elements of an educator's role in feedback considered to influence learner outcomes, then develop descriptions of observable educator behaviours that exemplify them. An extensive literature review was conducted to identify i) information substantiating specific components of an educator's role in feedback asserted to have an important influence on learner outcomes and ii) verbal feedback instruments in health professions education, that may describe important educator activities in effective feedback. This information was used to construct a list of elements thought to be important in effective feedback. Based on these elements, descriptions of observable educator behaviours that represent effective feedback were developed and refined during three rounds of a Delphi process and a face-to-face meeting with experts across the health professions and education. The review identified more than 170 relevant articles (involving health professions, education, psychology and business literature) and ten verbal feedback instruments in health professions education (plus modified versions). Eighteen distinct elements of an educator's role in effective feedback were delineated. Twenty five descriptions of educator behaviours that align with the elements were ratified by the expert panel. This research clarifies the distinct elements of an educator's role in feedback considered to enhance learner outcomes. The corresponding set of observable educator behaviours aim to describe how an educator could engage, motivate and enable a learner to

  12. Mapping International University Partnerships Identified by East African Universities as Strengthening Their Medicine, Nursing, and Public Health Programs.

    Science.gov (United States)

    Yarmoshuk, Aaron N; Guantai, Anastasia Nkatha; Mwangu, Mughwira; Cole, Donald C; Zarowsky, Christina

    International university partnerships are recommended for increasing the capacity of sub-Saharan African universities. Many publications describe individual partnerships and projects, and tools are available for guiding collaborations, but systematic mappings of the basic, common characteristics of partnerships are scarce. To document and categorize the international interuniversity partnerships deemed significant to building the capacity of medicine, nursing, and public health programs of 4 East African universities. Two universities in Kenya and 2 in Tanzania were purposefully selected. Key informant interviews, conducted with 42 senior representatives of the 4 universities, identified partnerships they considered significant for increasing the capacity of their institutions' medicine, nursing, and public health programs in education, research, or service. Interviews were transcribed and analyzed. Partners were classified by country of origin and corresponding international groupings, duration, programs, and academic health science components. One hundred twenty-nine university-to-university partnerships from 23 countries were identified. Each university reported between 25 and 36 international university partners. Seventy-four percent of partnerships were with universities in high-income countries, 15% in low- and middle-income countries, and 11% with consortia. Seventy percent included medicine, 37% nursing, and 45% public health; 15% included all 3 programs. Ninety-two percent included an education component, 47% research, and 24% service; 12% included all 3 components. This study confirms the rapid growth of interuniversity cross-border health partnerships this century. It also finds, however, that there is a pool of established international partnerships from numerous countries at each university. Most partnerships that seek to strengthen universities in East Africa should likely ensure they have a significant education component. Universities should make

  13. Labonté Identifies Key Issues for Health Promoters in the New World Order Comment on "Health Promotion in an Age of Normative Equity and Rampant Inequality".

    Science.gov (United States)

    Raphael, Dennis Raphael

    2016-11-02

    For over 35 years Ronald Labonté has been critically analyzing the state of health promotion in Canada and the world. In 1981, he identified the shortcomings of the groundbreaking Lalonde Report by warning of the seductive appeal of so-called lifestyle approaches to health. Since then, he has left a trail of critical work identifying the barriers to - and opportunities for -health promotion work. More recently, he has shown how the rise of economic globalization and acceptance of neo-liberal ideology has come to threaten the health of those in both developed and developing nations. In his recent commentary, Labonté shows how the United Nations' 2015 Sustainable Development Goals (SDGs) can offer a new direction for health promoters in these difficult times. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  14. Identifying factors for optimal development of health-related websites: a delphi study among experts and potential future users.

    Science.gov (United States)

    Schneider, Francine; van Osch, Liesbeth; de Vries, Hein

    2012-02-14

    The Internet has become a popular medium for offering tailored and targeted health promotion programs to the general public. However, suboptimal levels of program use in the target population limit the public health impact of these programs. Optimizing program development is considered as one of the main processes to increase usage rates. To distinguish factors potentially related to optimal development of health-related websites by involving both experts and potential users. By considering and incorporating the opinions of experts and potential users in the development process, involvement in the program is expected to increase, consequently resulting in increased appreciation, lower levels of attrition, and higher levels of sustained use. We conducted a systematic three-round Delphi study through the Internet. Both national and international experts (from the fields of health promotion, health psychology, e-communication, and technical Web design) and potential users were invited via email to participate. During this study an extensive list of factors potentially related to optimal development of health-related websites was identified, by focusing on factors related to layout, general and risk information provision, questionnaire use, additional services, and ease of use. Furthermore, we assessed the extent to which experts and potential users agreed on the importance of these factors. Differences as well as similarities among experts and potentials users were deduced. In total, 20 of 62 contacted experts participated in the first round (32% response rate); 60 of 200 contacted experts (30% response rate) and 210 potential users (95% response rate) completed the second-round questionnaire, and 32 of 60 contacted experts completed the third round (53% response rate). Results revealed important factors consented upon by experts and potential users (eg, ease of use, clear structure, and detailed health information provision), as well as differences regarding

  15. Consider the source: persuasion of implicit evaluations is moderated by source credibility.

    Science.gov (United States)

    Smith, Colin Tucker; De Houwer, Jan; Nosek, Brian A

    2013-02-01

    The long history of persuasion research shows how to change explicit, self-reported evaluations through direct appeals. At the same time, research on how to change implicit evaluations has focused almost entirely on techniques of retraining existing evaluations or manipulating contexts. In five studies, we examined whether direct appeals can change implicit evaluations in the same way as they do explicit evaluations. In five studies, both explicit and implicit evaluations showed greater evidence of persuasion following information presented by a highly credible source than a source low in credibility. Whereas cognitive load did not alter the effect of source credibility on explicit evaluations, source credibility had an effect on the persuasion of implicit evaluations only when participants were encouraged and able to consider information about the source. Our findings reveal the relevance of persuasion research for changing implicit evaluations and provide new ideas about the processes underlying both types of evaluation.

  16. The effects of stakeholder involvement on perceptions of an evaluation's credibility.

    Science.gov (United States)

    Jacobson, Miriam R; Azzam, Tarek

    2018-06-01

    This article presents a study of the effects of stakeholder involvement on perceptions of an evaluation's credibility. Crowdsourced members of the public and a group of educational administrators read a description of a hypothetical program and two evaluations of the program: one conducted by a researcher and one conducted by program staff (i.e. program stakeholders). Study participants were randomly assigned versions of the scenario with different levels of stakeholder credibility and types of findings. Results showed that both samples perceived the researcher's evaluation findings to be more credible than the program staff's, but that this difference was significantly reduced when the program staff were described to be highly credible. The article concludes with implications for theory and research on evaluation dissemination and stakeholder involvement. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Cultural Variation in Situation Assessment: Influence of Source Credibility and Rank Status

    National Research Council Canada - National Science Library

    Heacox, N

    2000-01-01

    .... Although information content, rank status, and source credibility have received much attention by researchers in command and control decision-making, cultural variations in these factors have seldom been studied...

  18. Deposit Insurance Coverage, Credibility of Non-insurance, and Banking Crises

    DEFF Research Database (Denmark)

    Angkinand, Apanard; Wihlborg, Clas

    2005-01-01

    level require analyses of institutional factors affecting the credibility of non-insurance. In particular, the implementation of effective distress resolution procedures for banks would allow governments to reduce explicit deposit insurance coverage and, thereby, to strengthen market discipline......The ambiguity in existing empirical work with respect to effects of deposit insurance schemes on banks' risk-taking can be resolved if it is recognized that absence of deposit insurance is rarely credible and that the credibility of non-insurance can be enhanced by explicit deposit insurance...... schemes. We show that under reasonable conditions for effects on risk-taking of creditor protection in banking, and for effects on credibility of non-insurance of explicit coverage of deposit insurance schemes, there exists a partial level of coverage that maximizes market discipline and minimizes moral...

  19. Public Affairs: An Operational Planning Function to Safeguard Credibility and Public Opinion

    National Research Council Canada - National Science Library

    Cutler, Dawn

    2004-01-01

    ... context throughout all phases of conflict. Although the target audiences may differ when a commander is considering message dissemination through either the PA or IC channel, the consistency of the messages is important to credibility...

  20. EXAMINING THE EFFECT OF ENDORSER CREDIBILITY ON THE CONSUMERS' BUYING INTENTIONS: AN EMPIRICAL STUDY IN TURKEY

    Directory of Open Access Journals (Sweden)

    Aysegul Ermec Sertoglu

    2014-01-01

    Full Text Available The purpose of this study is to test whether the source credibility affects buying intention and measure the perceived credibility differences between created spokesperson and celebrity endorser. The influence that endorser credibility dimensions (i.e. attractiveness, trustworthiness and expertise have on purchase intentions of 326 young consumers has been examined. The results showed that all of the three credibility dimensions for both celebrity endorser and created spokesperson have a positive relationship with purchase intention. Created spokesperson is perceived to be more trustworthy and competent whereas the celebrity endorser is found to be more attractive by the respondents. This study is unique in a way that it covers fairly new and rapidly growing Turkish market. One factor that makes this study unique in Turkey, in which the usage of celebrity endorsers holds significant part in the marketing of products, is the lack of studies that would measure the effectiveness of this method.

  1. Attitude Similarity and Therapist Credibility as Predictors of Attitude Change and Improvement in Psychotherapy

    Science.gov (United States)

    Beutler, Larry E.; And Others

    1975-01-01

    This study attempts to (1) assess the effects of therapist credibility and patient-therapist similarity on interpersonal persuasion; and (2) to further assess the relationship between patient attitude change and psychotherapy outcome. (HMV)

  2. A comparison of inflation expectations and inflation credibility in South Africa: results from survey data

    Directory of Open Access Journals (Sweden)

    Jannie Rossouw

    2011-08-01

    Full Text Available This paper reports a comparison of South African household inflation expectations and inflation credibility surveys undertaken in 2006 and 2008. It tests for possible feed-through between inflation credibility and inflation expectations. It supplements earlier research that focused only on the 2006 survey results. The comparison shows that inflation expectations differed between different income groups in both 2006 and 2008. Inflation credibility differed between male and female respondents, but this difference did not feed through to inflation expectations. More periodic survey data will be required for developing final conclusions on the possibility of feed-through effects. To this end the structure of credibility surveys should be reconsidered, as a large percentage of respondents indicated that they ‘don’t know’ whether the historic rate of inflation is an accurate indication of price increases.

  3. Rupture, resilience, and risk: relationships between mental health and migration among gay-identified men in North America.

    Science.gov (United States)

    Lewis, Nathaniel M

    2014-05-01

    An established body of research in psychology, psychiatry and epidemiology links social stigma and stress with poor mental and sexual health outcomes among gay-identified men. Less work considers how these linkages are mediated by place and almost none considers the role of movement across places. This qualitative study, based on the migration narratives of 48 gay-identified men living in Ottawa, Ontario, Canada, and Washington, D.C., U.S.A. gives more careful consideration to the ways in which mental and emotional health issues (e.g., anxiety, depression, substance use) in this population both precipitate migration and stem from migration. The narratives show that decisions to migrate often emerge from men׳s experiences of place-based minority stress and associated health outcomes. At the same time, moving to urban gay communities, when coupled with other life circumstances, can create or reinforce physical and emotional insecurities that lead to low self-esteem, substance use and sexual risk-taking. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Identifying evidence for public health guidance: a comparison of citation searching with Web of Science and Google Scholar.

    Science.gov (United States)

    Levay, Paul; Ainsworth, Nicola; Kettle, Rachel; Morgan, Antony

    2016-03-01

    To examine how effectively forwards citation searching with Web of Science (WOS) or Google Scholar (GS) identified evidence to support public health guidance published by the National Institute for Health and Care Excellence. Forwards citation searching was performed using GS on a base set of 46 publications and replicated using WOS. WOS and GS were compared in terms of recall; precision; number needed to read (NNR); administrative time and costs; and screening time and costs. Outcomes for all publications were compared with those for a subset of highly important publications. The searches identified 43 relevant publications. The WOS process had 86.05% recall and 1.58% precision. The GS process had 90.7% recall and 1.62% precision. The NNR to identify one relevant publication was 63.3 with WOS and 61.72 with GS. There were nine highly important publications. WOS had 100% recall, 0.38% precision and NNR of 260.22. GS had 88.89% recall, 0.33% precision and NNR of 300.88. Administering the WOS results took 4 h and cost £88-£136, compared with 75 h and £1650-£2550 with GS. WOS is recommended over GS, as citation searching was more effective, while the administrative and screening times and costs were lower. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Identifying Challenges Associated With the Care Transition Workflow From Hospital to Skilled Home Health Care: Perspectives of Home Health Care Agency Providers.

    Science.gov (United States)

    Nasarwanji, Mahiyar; Werner, Nicole E; Carl, Kimberly; Hohl, Dawn; Leff, Bruce; Gurses, Ayse P; Arbaje, Alicia I

    2015-01-01

    Older adults discharged from the hospital to skilled home health care (SHHC) are at high risk for experiencing suboptimal transitions. Using the human factors approach of shadowing and contextual inquiry, we studied the workflow for transitioning older adults from the hospital to SHHC. We created a representative diagram of the hospital to SHHC transition workflow, we examined potential workflow variations, we categorized workflow challenges, and we identified artifacts developed to manage variations and challenges. We identified three overarching challenges to optimal care transitions-information access, coordination, and communication/teamwork. Future investigations could test whether redesigning the transition from hospital to SHHC, based on our findings, improves workflow and care quality.

  6. How influencers’ credibility on Instagram is perceived by consumers and its impact on purchase intention

    OpenAIRE

    Rebelo, Marta Figueiredo

    2017-01-01

    The purpose of this thesis is to understand the perception Instagram users, in other words consumers, have of influencers they follow on Instagram. Consumer perceived credibility of influencers, and its impact on the purchase intention, is therefore studied. This dissertation aims to highlight which credibility dimensions better explain the purchase intention. Gender is also explored to verify behavior differences between female and male consumers. To better analyze the perc...

  7. Pengaruh Brand Credibility Terhadap Information Efficiency Dan Risk Reduction, Serta Dampaknya Atas Repurchase Intention

    OpenAIRE

    Faisal, Aekram

    2015-01-01

    This research conducted to know the influence of Brand Credibility to Information efficiency and Risk reduction, also the influence of Information efficiency and Risk reduction to Repurchase intention. This research aimed to know the influence of Brand Credibility to Repurchase intention that mediated by Information efficiency and Risk reduction. The methodology of this research is testing hypothesis research. The sample collecting by questionnaire of 150 respondents from Starb...

  8. Vote Buying or Campaign Promises? Electoral Strategies When Party Credibility is Limited

    OpenAIRE

    Hanusch, Marek; Keefer, Philip; Vlaicu, Razvan

    2016-01-01

    What explains significant variation across countries in the use of vote buying instead of campaign promises to secure voter support? This paper explicitly models the tradeoff parties face between engaging in vote buying and making campaign promises, and explores the distributional consequences of this decision, in a setting where party credibility can vary. When parties are less credible they spend more on vote buying and target vote buying more heavily toward groups that do not believe campa...

  9. Identifying important and feasible policies and actions for health at community sports clubs: a consensus-generating approach.

    Science.gov (United States)

    Kelly, Bridget; King, Lesley; Bauman, Adrian E; Baur, Louise A; Macniven, Rona; Chapman, Kathy; Smith, Ben J

    2014-01-01

    Children's high participation in organised sport in Australia makes sport an ideal setting for health promotion. This study aimed to generate consensus on priority health promotion objectives for community sports clubs, based on informed expert judgements. Delphi survey using three structured questionnaires. Forty-six health promotion, nutrition, physical activity and sport management/delivery professionals were approached to participate in the survey. Questionnaires used an iterative process to determine aspects of sports clubs deemed necessary for developing healthy sporting environments for children. Initially, participants were provided with a list of potential standards for a range of health promotion areas and asked to rate standards based on their importance and feasibility, and any barriers to implementation. Subsequently, participants were provided with information that summarised ratings for each standard to indicate convergence of the group, and asked to review and potentially revise their responses where they diverged. In a third round, participants ranked confirmed standards by priority. 26 professionals completed round 1, 21 completed round 2, and 18 completed round 3. The highest ranked standards related to responsible alcohol practices, availability of healthy food and drinks at sports canteens, smoke-free club facilities, restricting the sale and consumption of alcohol during junior sporting activities, and restricting unhealthy food and beverage company sponsorship. Identifying and prioritising health promotion areas that are relevant to children's sports clubs assists in focusing public health efforts and may guide future engagement of sports clubs. Approaches for providing informational and financial support to clubs to operationalise these standards are proposed. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  10. Genomics and infectious disease: a call to identify the ethical, legal and social implications for public health and clinical practice.

    Science.gov (United States)

    Geller, Gail; Dvoskin, Rachel; Thio, Chloe L; Duggal, Priya; Lewis, Michelle H; Bailey, Theodore C; Sutherland, Andrea; Salmon, Daniel A; Kahn, Jeffrey P

    2014-01-01

    Advances in genomics are contributing to the development of more effective, personalized approaches to the prevention and treatment of infectious diseases. Genetic sequencing technologies are furthering our understanding of how human and pathogen genomic factors - and their interactions - contribute to individual differences in immunologic responses to vaccines, infections and drug therapies. Such understanding will influence future policies and procedures for infectious disease management. With the potential for tailored interventions for particular individuals, populations or subpopulations, ethical, legal and social implications (ELSIs) may arise for public health and clinical practice. Potential considerations include balancing health-related benefits and harms between individuals and the larger community, minimizing threats to individual privacy and autonomy, and ensuring just distribution of scarce resources. In this Opinion, we consider the potential application of pathogen and host genomic information to particular viral infections that have large-scale public health consequences but differ in ELSI-relevant characteristics such as ease of transmission, chronicity, severity, preventability and treatability. We argue for the importance of anticipating these ELSI issues in advance of new scientific discoveries, and call for the development of strategies for identifying and exploring ethical questions that should be considered as clinical, public health and policy decisions are made.

  11. Identifying New Strategies to Assess and Promote Online Health Communication and Social Media Outreach: An Application in Bullying Prevention.

    Science.gov (United States)

    Edgerton, Elizabeth; Reiney, Erin; Mueller, Siobhan; Reicherter, Barry; Curtis, Katherine; Waties, Stephanie; Limber, Susan P

    2016-05-01

    Every day in classrooms, playgrounds and school hallways, through text messages and mobile technology apps, children are bullied by other children. Conversations about this bullying-what it is, who is involved, and how to stop it-are taking place online. To fill a need for relevant, research-based materials on bullying, the U.S. Department of Health and Human Services' Health Resources and Services Administration worked with Widmeyer Communications to investigate the scope of media conversations about bullying and discover new strategies for promoting appropriate public health messages about bullying to intended audiences. Key components of the methodology included: analyzing common search terms and aligning social media content with terms used in searches rather than technical language; identifying influencers in social media spheres, cultivating relationships with them, and sharing their positive, relevant content; examining which digital formats are most popular for sharing and creating content across platforms; tracking and reporting on a wide variety of metrics (such as click-through and engagement rates and reach, resonance, relevance, and Klout scores) to understand conversations around bullying; and looking at online conversations and engaging participants using applicable resources and calls to action. A key finding included a significant gap between search terms and online content and has led to recommendations and comprehensive ideas for improving the reach and resonance of StopBullying.gov content and communications. © 2016 Society for Public Health Education.

  12. Identifying Adolescent Patients at Risk for Sexually Transmitted Infections: Development of a Brief Sexual Health Screening Survey.

    Science.gov (United States)

    Victor, Elizabeth C; Chung, Richard; Thompson, Robert J

    2015-08-01

    This study examined the association between survey responses to health behaviors, personality/psychosocial factors, and self-reported sexually transmitted infections (STIs) to create a brief survey to identify youth at risk for contracting STIs. Participants included 200 racially diverse 14- to 18-year-old patients from a pediatric primary care clinic. Two sexual behavior variables and one peer norm variable were used to differentiate subgroups of individuals at risk of contracting a STI based on reported history of STIs using probability (decision tree) analyses. These items, as well as sexual orientation and having ever had oral sex, were used to create a brief sexual health screening (BSHS) survey. Each point increase in total BSHS score was associated with exponential growth in the percentage of sexually active adolescents reporting STIs. Findings suggest that the BSHS could serve as a useful tool for clinicians to quickly and accurately detect sexual risk among adolescent patients. © The Author(s) 2014.

  13. Environmental Health Related Socio-Spatial Inequalities: Identifying “Hotspots” of Environmental Burdens and Social Vulnerability

    Science.gov (United States)

    Shrestha, Rehana; Flacke, Johannes; Martinez, Javier; van Maarseveen, Martin

    2016-01-01

    Differential exposure to multiple environmental burdens and benefits and their distribution across a population with varying vulnerability can contribute heavily to health inequalities. Particularly relevant are areas with high cumulative burdens and high social vulnerability termed as “hotspots”. This paper develops an index-based approach to assess these multiple burdens and benefits in combination with vulnerability factors at detailed intra-urban level. The method is applied to the city of Dortmund, Germany. Using non-spatial and spatial methods we assessed inequalities and identified “hotspot” areas in the city. We found modest inequalities burdening higher vulnerable groups in Dortmund (CI = −0.020 at p vulnerability, is essential to inform environmental justice debates and to mobilize local stakeholders. Locating “hotspot” areas at this detailed spatial level can serve as a basis to develop interventions that target vulnerable groups to ensure a health conducive equal environment. PMID:27409625

  14. Revisiting Organizational Credibility and Organizational Reputation – A Situational Crisis Communication Approach

    Directory of Open Access Journals (Sweden)

    Jamal Jamilah

    2017-01-01

    Full Text Available Organizational credibility, the extent of which an organization as the source of messages is perceived as trustworthy and reliable, is one important aspect to determine organization’s survival. The perceived credibility of the messages will either strengthen or worsen an organization reputation. The primary objective of this paper is to revisit the concept of organizational credibility and its interaction with organizational outcomes such as organizational reputation. Based on the situational crisis communication theory (SCCT, this paper focuses on the impact of organizational credibility on organizational reputation following a crisis. Even though the SCCT has been widely used in crisis communication research, the theory still has its own limitations in explaining factors that could potentially affect the reputation of an organization. This study proposes a model by integrating organizational credibility in the SCCT theoretical framework. Derived from the theoretical framework, three propositions are advanced to determine the relationships between organizational credibility with crisis responsibility and perceived organizational reputation. This paper contributes to further establishing the SCCT and posits key attributes in the organizational reputation processes..

  15. Can Simulation Credibility Be Improved Using Sensitivity Analysis to Understand Input Data Effects on Model Outcome?

    Science.gov (United States)

    Myers, Jerry G.; Young, M.; Goodenow, Debra A.; Keenan, A.; Walton, M.; Boley, L.

    2015-01-01

    Model and simulation (MS) credibility is defined as, the quality to elicit belief or trust in MS results. NASA-STD-7009 [1] delineates eight components (Verification, Validation, Input Pedigree, Results Uncertainty, Results Robustness, Use History, MS Management, People Qualifications) that address quantifying model credibility, and provides guidance to the model developers, analysts, and end users for assessing the MS credibility. Of the eight characteristics, input pedigree, or the quality of the data used to develop model input parameters, governing functions, or initial conditions, can vary significantly. These data quality differences have varying consequences across the range of MS application. NASA-STD-7009 requires that the lowest input data quality be used to represent the entire set of input data when scoring the input pedigree credibility of the model. This requirement provides a conservative assessment of model inputs, and maximizes the communication of the potential level of risk of using model outputs. Unfortunately, in practice, this may result in overly pessimistic communication of the MS output, undermining the credibility of simulation predictions to decision makers. This presentation proposes an alternative assessment mechanism, utilizing results parameter robustness, also known as model input sensitivity, to improve the credibility scoring process for specific simulations.

  16. Identifying the conditions needed for integrated knowledge translation (IKT) in health care organizations: qualitative interviews with researchers and research users.

    Science.gov (United States)

    Gagliardi, Anna R; Dobrow, Mark J

    2016-07-12

    Collaboration among researchers and research users, or integrated knowledge translation (IKT), enhances the relevance and uptake of evidence into policy and practice. However, it is not widely practiced and, even when well-resourced, desired impacts may not be achieved. Given that large-scale investment is not the norm, further research is needed to identify how IKT can be optimized. Interviews were conducted with researchers and research users (clinicians, managers) in a health care delivery (HCDO) and health care monitoring (HCMO) organization that differed in size and infrastructure, and were IKT-naïve. Basic qualitative description was used. Participants were asked about IKT activities and challenges, and recommendations for optimizing IKT. Data were analysed inductively using constant comparative technique. Forty-three interviews were conducted (28 HCDO, 15 HCMO) with 13 researchers, 8 clinicians, and 22 managers. Little to no IKT took place. Participants articulated similar challenges and recommendations revealing that a considerable number of changes were needed at the organizational, professional and individual levels. Given the IKT-absent state of participating organizations, this research identified a core set of conditions which must be addressed to prepare an environment conducive to IKT. These conditions were compiled into a framework by which organizations can plan for, or evaluate their capacity for IKT. The IKT capacity framework is relevant for organizations in which there is no current IKT activity. Use of the IKT framework may result in more organizations that are ready to initiate and establish IKT, perhaps ultimately leading to more, and higher-quality collaboration for health system innovation. Further research is needed to confirm these findings in other organizations not yet resourced for, or undertaking IKT, and to explore the resource implications and mechanisms for establishing the conditions identified here as essential to preparing for

  17. Integrated Medical Model (IMM) Project Verification, Validation, and Credibility (VVandC)

    Science.gov (United States)

    Walton, M.; Boley, L.; Keenan, L.; Kerstman, E.; Shah, R.; Young, M.; Saile, L.; Garcia, Y.; Meyers, J.; Reyes, D.

    2015-01-01

    The Integrated Medical Model (IMM) Project supports end user requests by employing the Integrated Medical Evidence Database (iMED) and IMM tools as well as subject matter expertise within the Project. The iMED houses data used by the IMM. The IMM is designed to forecast relative changes for a specified set of crew health and mission success risk metrics by using a probabilistic model based on historical data, cohort data, and subject matter expert opinion. A stochastic approach is taken because deterministic results would not appropriately reflect the uncertainty in the IMM inputs. Once the IMM was conceptualized, a plan was needed to rigorously assess input information, framework and code, and output results of the IMM, and ensure that end user requests and requirements were considered during all stages of model development and implementation, as well as lay the foundation for external review and application. METHODS: In 2008, the Project team developed a comprehensive verification and validation (VV) plan, which specified internal and external review criteria encompassing 1) verification of data and IMM structure to ensure proper implementation of the IMM, 2) several validation techniques to confirm that the simulation capability of the IMM appropriately represents occurrences and consequences of medical conditions during space missions, and 3) credibility processes to develop user confidence in the information derived from the IMM. When the NASA-STD-7009 (7009) [1] was published, the Project team updated their verification, validation, and credibility (VVC) project plan to meet 7009 requirements and include 7009 tools in reporting VVC status of the IMM. Construction of these tools included meeting documentation and evidence requirements sufficient to meet external review success criteria. RESULTS: IMM Project VVC updates are compiled recurrently and include updates to the 7009 Compliance and Credibility matrices. Reporting tools have evolved over the lifetime of

  18. Public Affairs: Maintaining Credibility While Evolving with Strategic Communication

    National Research Council Canada - National Science Library

    McCarthy, Carla M

    2007-01-01

    Public affairs has been identified as a key component of strategic communication, but incorporating public affairs within a strategic communication framework within the military, without compromising...

  19. Identifying determinants of medication adherence following myocardial infarction using the Theoretical Domains Framework and the Health Action Process Approach.

    Science.gov (United States)

    Presseau, Justin; Schwalm, J D; Grimshaw, Jeremy M; Witteman, Holly O; Natarajan, Madhu K; Linklater, Stefanie; Sullivan, Katrina; Ivers, Noah M

    2017-10-01

    Despite evidence-based recommendations, adherence with secondary prevention medications post-myocardial infarction (MI) remains low. Taking medication requires behaviour change, and using behavioural theories to identify what factors determine adherence could help to develop novel adherence interventions. Compare the utility of different behaviour theory-based approaches for identifying modifiable determinants of medication adherence post-MI that could be targeted by interventions. Two studies were conducted with patients 0-2, 3-12, 13-24 or 25-36 weeks post-MI. Study 1: 24 patients were interviewed about barriers and facilitators to medication adherence. Interviews were conducted and coded using the Theoretical Domains Framework. Study 2: 201 patients answered a telephone questionnaire assessing Health Action Process Approach constructs to predict intention and medication adherence (MMAS-8). Study 1: domains identified: Beliefs about Consequences, Memory/Attention/Decision Processes, Behavioural Regulation, Social Influences and Social Identity. Study 2: 64, 59, 42 and 58% reported high adherence at 0-2, 3-12, 13-24 and 25-36 weeks. Social Support and Action Planning predicted adherence at all time points, though the relationship between Action Planning and adherence decreased over time. Using two behaviour theory-based approaches provided complimentary findings and identified modifiable factors that could be targeted to help translate Intention into action to improve medication adherence post-MI.

  20. Sustainability in Health care by Allocating Resources Effectively (SHARE) 2: identifying opportunities for disinvestment in a local healthcare setting.

    Science.gov (United States)

    Harris, Claire; Allen, Kelly; King, Richard; Ramsey, Wayne; Kelly, Cate; Thiagarajan, Malar

    2017-05-05

    This is the second in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Rising healthcare costs, continuing advances in health technologies and recognition of ineffective practices and systematic waste are driving disinvestment of health technologies and clinical practices that offer little or no benefit in order to maximise outcomes from existing resources. However there is little information to guide regional health services or individual facilities in how they might approach disinvestment locally. This paper outlines the investigation of potential settings and methods for decision-making about disinvestment in the context of an Australian health service. Methods include a literature review on the concepts and terminology relating to disinvestment, a survey of national and international researchers, and interviews and workshops with local informants. A conceptual framework was drafted and refined with stakeholder feedback. There is a lack of common terminology regarding definitions and concepts related to disinvestment and no guidance for an organisation-wide systematic approach to disinvestment in a local healthcare service. A summary of issues from the literature and respondents highlight the lack of theoretical knowledge and practical experience and provide a guide to the information required to develop future models or methods for disinvestment in the local context. A conceptual framework was developed. Three mechanisms that provide opportunities to introduce disinvestment decisions into health service systems and processes were identified. Presented in order of complexity, time to achieve outcomes and resources required they include 1) Explicit consideration of potential disinvestment in routine decision-making, 2) Proactive decision-making about disinvestment driven by available evidence from published research and local data, and 3) Specific exercises in

  1. Identification of elements at risk for a credible tsunami event for Istanbul

    Directory of Open Access Journals (Sweden)

    U. Hancilar

    2012-01-01

    Full Text Available Physical and social elements at risk are identified for a credible tsunami event for Istanbul. For this purpose, inundation maps resulting from probabilistic tsunami hazard analysis for a 10% probability of exceedance in 50 yr are utilised in combination with the geo-coded inventories of building stock, lifeline systems and demographic data. The built environment on Istanbul's shorelines that is exposed to tsunami inundation comprises residential, commercial, industrial, public (governmental/municipal, schools, hospitals, sports and religious, infrastructure (car parks, garages, fuel stations, electricity transformer buildings and military buildings, as well as piers and ports, gas tanks and stations and other urban elements (e.g., recreational facilities. Along the Marmara Sea shore, Tuzla shipyards and important port and petrochemical facilities at Ambarlı are expected to be exposed to tsunami hazard. Significant lifeline systems of the city of Istanbul such as natural gas, electricity, telecommunication and sanitary and waste-water transmission, are also under the threat of tsunamis. In terms of social risk, it is estimated that there are about 32 000 inhabitants exposed to tsunami hazard.

  2. Identification of elements at risk for a credible tsunami event for Istanbul

    Science.gov (United States)

    Hancilar, U.

    2012-01-01

    Physical and social elements at risk are identified for a credible tsunami event for Istanbul. For this purpose, inundation maps resulting from probabilistic tsunami hazard analysis for a 10% probability of exceedance in 50 yr are utilised in combination with the geo-coded inventories of building stock, lifeline systems and demographic data. The built environment on Istanbul's shorelines that is exposed to tsunami inundation comprises residential, commercial, industrial, public (governmental/municipal, schools, hospitals, sports and religious), infrastructure (car parks, garages, fuel stations, electricity transformer buildings) and military buildings, as well as piers and ports, gas tanks and stations and other urban elements (e.g., recreational facilities). Along the Marmara Sea shore, Tuzla shipyards and important port and petrochemical facilities at Ambarlı are expected to be exposed to tsunami hazard. Significant lifeline systems of the city of Istanbul such as natural gas, electricity, telecommunication and sanitary and waste-water transmission, are also under the threat of tsunamis. In terms of social risk, it is estimated that there are about 32 000 inhabitants exposed to tsunami hazard.

  3. Identifying common impairments in frail and dependent older people: validation of the COPE assessment for non-specialised health workers in low resource primary health care settings.

    Science.gov (United States)

    A T, Jotheeswaran; Dias, Amit; Philp, Ian; Beard, John; Patel, Vikram; Prince, Martin

    2015-10-14

    Frail and dependent older people in resource-poor settings are poorly served by health systems that lack outreach capacity. The COPE (Caring for Older PEople) multidimensional assessment tool is designed to help community health workers (CHWs) identify clinically significant impairments and deliver evidence-based interventions Older people (n = 150) identified by CHWs as frail or dependent, were assessed at home by the CHW using the structured COPE assessment tool, generating information on impairments in nutrition, mobility, vision, hearing, continence, cognition, mood and behaviour. The older people were reassessed by local physicians who reached a clinical judgment regarding the presence or absence of the same impairments based upon clinical examination guided by the EASY-Care assessment tool. The COPE tool was considered easy to administer, and gave CHWs a sense of empowerment to understand and act upon the needs of older people. Agreement between COPE assessment by CHW and clinician assessors was modest (ranged from 45.8 to 91.3 %) for most impairments. However, the prevalence of impairments was generally higher according to clinicians, particularly for visual impairment (98.7 vs 45.8 %), cognitive impairment (78.4 vs. 38.2 %) and depression (82.0 vs. 59.9 %). Most cases identified by WHO-COPE were clinician confirmed (positive predictive values - 72.2 to 98.5 %), and levels of disability and needs for care among those identified by COPE were higher than those additionally identified by the clinician alone. The COPE is a feasible tool for the identification of specific impairments in frail dependent older people in the community. Those identified are likely to be confirmed as having clinically relevant problems by clinicians working in the same service, and the COPE may be particularly effective at targeting attention upon those with the most substantial unmet needs.

  4. The readmission risk flag: using the electronic health record to automatically identify patients at risk for 30-day readmission.

    Science.gov (United States)

    Baillie, Charles A; VanZandbergen, Christine; Tait, Gordon; Hanish, Asaf; Leas, Brian; French, Benjamin; Hanson, C William; Behta, Maryam; Umscheid, Craig A

    2013-12-01

    Identification of patients at high risk for readmission is a crucial step toward improving care and reducing readmissions. The adoption of electronic health records (EHR) may prove important to strategies designed to risk stratify patients and introduce targeted interventions. To develop and implement an automated prediction model integrated into our health system's EHR that identifies on admission patients at high risk for readmission within 30 days of discharge. Retrospective and prospective cohort. Healthcare system consisting of 3 hospitals. All adult patients admitted from August 2009 to September 2012. An automated readmission risk flag integrated into the EHR. Thirty-day all-cause and 7-day unplanned healthcare system readmissions. Using retrospective data, a single risk factor, ≥ 2 inpatient admissions in the past 12 months, was found to have the best balance of sensitivity (40%), positive predictive value (31%), and proportion of patients flagged (18%), with a C statistic of 0.62. Sensitivity (39%), positive predictive value (30%), proportion of patients flagged (18%), and C statistic (0.61) during the 12-month period after implementation of the risk flag were similar. There was no evidence for an effect of the intervention on 30-day all-cause and 7-day unplanned readmission rates in the 12-month period after implementation. An automated prediction model was effectively integrated into an existing EHR and identified patients on admission who were at risk for readmission within 30 days of discharge. © 2013 Society of Hospital Medicine.

  5. Development and testing of a medline search filter for identifying patient and public involvement in health research.

    Science.gov (United States)

    Rogers, Morwenna; Bethel, Alison; Boddy, Kate

    2017-06-01

    Research involving the public as partners often proves difficult to locate due to the variations in terms used to describe public involvement, and inability of medical databases to index this concept effectively. To design a search filter to identify literature where patient and public involvement (PPI) was used in health research. A reference standard of 172 PPI papers was formed. The references were divided into a development set and a test set. Search terms were identified from common words, phrases and synonyms in the development set. These terms were combined as a search strategy for medline via OvidSP, which was then tested for sensitivity against the test set. The resultant search filter was then assessed for sensitivity, specificity and precision using a previously published systematic review. The search filter was found to be highly sensitive 98.5% in initial testing. When tested against results generated by a 'real-life' systematic review, the filter had a specificity of 81%. However, sensitivity dropped to 58%. Adjustments to the population group of terms increased the sensitivity to 73%. The PPI filter designed for medline via OvidSP could aid information specialists and researchers trying to find literature specific to PPI. © 2016 Health Libraries Group.

  6. The use of concept mapping to identify community-driven intervention strategies for physical and mental health.

    Science.gov (United States)

    Vaughn, Lisa M; Jacquez, Farrah; McLinden, Daniel

    2013-09-01

    Research that partners with youth and community stakeholders increases contextual relevance and community buy-in and therefore maximizes the chance for intervention success. Concept mapping is a mixed-method participatory research process that accesses the input of the community in a collaborative manner. After a school-wide health needs assessment at a low-income, minority/immigrant K-8 school identified bullying and obesity as the most important health issues, concept mapping was used to identify and prioritize specific strategies to address these two areas. Stakeholders including 160 K-8 students, 33 college students working in the school, 35 parents, 20 academic partners, and 22 teachers/staff brainstormed strategies to reduce and prevent obesity and bullying. A smaller group of stakeholders worked individually to complete an unstructured sorting of these strategies into groups of similar ideas, once for obesity and again for bullying. Multidimensional scaling and cluster analysis was applied to the sorting data to produce a series of maps that illustrated the stakeholders' conceptual thinking about obesity and bullying prevention strategies. The maps for both obesity and bullying organized specific strategies into themes that included education, parental role, teacher/school supervision, youth role, expert/professional role, and school structure/support.

  7. The CARPEDIEM Algorithm: A Rule-Based System for Identifying Heart Failure Phenotype with a Precision Public Health Approach

    Directory of Open Access Journals (Sweden)

    Michela Franchini

    2018-01-01

    Full Text Available Modern medicine remains dependent on the accurate evaluation of a patient’s health state, recognizing that disease is a process that evolves over time and interacts with many factors unique to that patient. The CARPEDIEM project represents a concrete attempt to address these issues by developing reproducible algorithms to support the accuracy in detection of complex diseases. This study aims to establish and validate the CARPEDIEM approach and algorithm for identifying those patients presenting with or at risk of heart failure (HF by studying 153,393 subjects in Italy, based on patient information flow databases and is not reliant on the electronic health record to accomplish its goals. The resulting algorithm has been validated in a two-stage process, comparing predicted results with (1 HF diagnosis as identified by general practitioners (GPs among the reference cohort and (2 HF diagnosis as identified by cardiologists within a randomly sampled subpopulation of 389 patients. The sources of data used to detect HF cases are numerous and were standardized for this study. The accuracy and the predictive values of the algorithm with respect to the GPs and the clinical standards are highly consistent with those from previous studies. In particular, the algorithm is more efficient in detecting the more severe cases of HF according to the GPs’ validation (specificity increases according to the number of comorbidities and external validation (NYHA: II–IV; HF severity index: 2, 3. Positive and negative predictive values reveal that the CARPEDIEM algorithm is most consistent with clinical evaluation performed in the specialist setting, while it presents a greater ability to rule out false-negative HF cases within the GP practice, probably as a consequence of the different HF prevalence in the two different care settings. Further development includes analyzing the clinical features of false-positive and -negative predictions, to explore the natural

  8. Using aggregated, de-identified electronic health record data for multivariate pharmacosurveillance: a case study of azathioprine.

    Science.gov (United States)

    Patel, Vishal N; Kaelber, David C

    2014-12-01

    To demonstrate the use of aggregated and de-identified electronic health record (EHR) data for multivariate post-marketing pharmacosurveillance in a case study of azathioprine (AZA). Using aggregated, standardized, normalized, and de-identified, population-level data from the Explore platform (Explorys, Inc.) we searched over 10 million individuals, of which 14,580 were prescribed AZA based on RxNorm drug orders. Based on logical observation identifiers names and codes (LOINC) and vital sign data, we examined the following side effects: anemia, cell lysis, fever, hepatotoxicity, hypertension, nephrotoxicity, neutropenia, and neutrophilia. Patients prescribed AZA were compared to patients prescribed one of 11 other anti-rheumatologic drugs to determine the relative risk of side effect pairs. Compared to AZA case report trends, hepatotoxicity (marked by elevated transaminases or elevated bilirubin) did not occur as an isolated event more frequently in patients prescribed AZA than other anti-rheumatic agents. While neutropenia occurred in 24% of patients (RR 1.15, 95% CI 1.07-1.23), neutrophilia was also frequent (45%) and increased in patients prescribed AZA (RR 1.28, 95% CI 1.22-1.34). After constructing a pairwise side effect network, neutropenia had no dependencies. A reduced risk of neutropenia was found in patients with co-existing elevations in total bilirubin or liver transaminases, supporting classic clinical knowledge that agranulocytosis is a largely unpredictable phenomenon. Rounding errors propagated in the statistically de-identified datasets for cohorts as small as 40 patients only contributed marginally to the calculated risk. Our work demonstrates that aggregated, standardized, normalized and de-identified population level EHR data can provide both sufficient insight and statistical power to detect potential patterns of medication side effect associations, serving as a multivariate and generalizable approach to post-marketing drug surveillance

  9. Initiatives on early detection and intervention to proactively identify health and social problems in older people: experiences from the Netherlands.

    Science.gov (United States)

    Lette, Manon; Baan, Caroline A; van den Berg, Matthijs; de Bruin, Simone R

    2015-10-30

    Over the last years, several initiatives on early detection and intervention have been put in place to proactively identify health and social problems in (frail) older people. An overview of the initiatives currently available in the Netherlands is lacking, and it is unknown whether they meet the preferences and needs of older people. Therefore, the objectives of this study were threefold: 1. To identify initiatives on early detection and intervention for older people in the Netherlands and compare their characteristics; 2. To explore the experiences of professionals with these initiatives; and 3. To explore to what extent existing initiatives meet the preferences and needs of older people. We performed a qualitative descriptive study in which we conducted semi-structured interviews with seventeen experts in preventive elderly care and three group interviews with volunteer elderly advisors. Data were analysed using the framework analysis method. We identified eight categories of initiatives based on the setting (e.g. general practitioner practice, hospital, municipality) in which they were offered. Initiatives differed in their aims and target groups. The utilization of peers to identify problems and risks, as was done by some initiatives, was seen as a strength. Difficulties were experienced with identifying the target group that would benefit from proactive delivery of care and support most, and with addressing prevalent issues among older people (e.g. psychosocial issues, self-reliance issues). Although there is a broad array of initiatives available, there is a discrepancy between supply and demand. Current initiatives insufficiently address needs of (frail) older people. More insight is needed in "what should be done by whom, for which target group and at what moment", in order to improve current practice in preventive elderly care.

  10. Application of Satellite Remote Sensing to Identify Climatic and Anthropogenic Changes Related to Water and Health Conditions in Emerging Megacities

    Science.gov (United States)

    Akanda, A. S.; Serman, E. A.; Jutla, A.

    2014-12-01

    By 2050, more than 70% of the world's population is expected to be living in a city. In many of the urbanizing regions in Asia and Africa, most new development is taking place without adequate urban or regional planning, and a majority population is crowded into densely populated unplanned settlements, also known as slums. During the same period, precipitation and temperature patterns are likely to see significant changes in many of these regions while coastal megacities will have to accommodate sea-level rise in their ecosystems. The rapid increase in population is usually observed in fringes of the urban sprawl without adequate water or sanitation facilities or access to other municipal amenities (such as utilities, healthcare, and education). Collectively, these issues make the ever increasing slum dwellers in emerging megacities significantly vulnerable to a combination of climatic and anthropogenic threats. However, how the growth of unplanned urban and peri-urban sprawl and simultaneous change in climatic patterns have impacted public health in the emerging megacities remain largely unexplored due to lack of readily available and usable data. We employ a number of Remote Sensing products (GRACE, LANDSAT, MODIS) to bridge above knowledge gaps and to identify relevant hydrologic and anthropogenic changes in emerging megacities that are most vulnerable due to the climate-water-health nexus. We explore one of the largest and the fastest growing megacities in the world - Dhaka, Bangladesh - on identifying and investigating the changes in the water environment and growth of slum areas, and impact on water services and health outcomes. The hydroclimatology of South Asia is highly seasonal and the asymmetric availability of water affects vast areas of Bangladesh differently in space and time, exposing the population of Dhaka region to both droughts and floods and periodic spring-fall outbreaks of diarrheal diseases, such as cholera and rotavirus. This research

  11. A retrospective observational analysis to identify patient and treatment-related predictors of outcomes in a community mental health programme.

    Science.gov (United States)

    Green, Stuart A; Honeybourne, Emmi; Chalkley, Sylvia R; Poots, Alan J; Woodcock, Thomas; Price, Geraint; Bell, Derek; Green, John

    2015-05-20

    This study aims to identify patient and treatment factors that affect clinical outcomes of community psychological therapy through the development of a predictive model using historic data from 2 services in London. In addition, the study aims to assess the completeness of data collection, explore how treatment outcomes are discriminated using current criteria for classifying recovery, and assess the feasibility and need for undertaking a future larger population analysis. Observational, retrospective discriminant analysis. 2 London community mental health services that provide psychological therapies for common mental disorders including anxiety and depression. A total of 7388 patients attended the services between February 2009 and May 2012, of which 4393 (59%) completed therapy, or there was an agreement to end therapy, and were included in the study. Different combinations of the clinical outcome scores for anxiety Generalised Anxiety Disorder-7 and depression Patient Health Questionnaire-9 were used to construct different treatment outcomes. The predictive models were able to assign a positive or negative clinical outcome to each patient based on 5 independent pre-treatment variables, with an accuracy of 69.4% and 79.3%, respectively: initial severity of anxiety and depression, ethnicity, deprivation and gender. The number of sessions attended/missed were also important factors identified in recovery. Predicting whether patients are likely to have a positive outcome following treatment at entry might allow suitable modification of scheduled treatment, possibly resulting in improvements in outcomes. The model also highlights factors not only associated with poorer outcomes but inextricably linked to prevalence of common mental disorders, emphasising the importance of social determinants not only in poor health but also poor recovery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  12. Maternal and child health care in an underprivileged area of Bangalore city: Identifying the gaps in the continuum of care

    Directory of Open Access Journals (Sweden)

    Avita R Johnson

    2015-01-01

    Full Text Available Background With over 100 million Indians living in urban slums and high child mortality among low-income groups, focusing on maternal and child health (MCH among urban underprivileged is vital, if India is to achieve the fourth and fifth Millennium Development goals. Objectives To identify the gaps in the MCH Continuum of care, by assessing coverage and quality of Maternal and Child Health Services in an urban underprivileged area of Bangalore City. Methods A survey was conducted in an urban slum of Bangalore City, using systematic random sampling. A total of 178 subjects were interviewed with a pre-tested questionnaire. 88 were mothers who delivered in the last one year (to assess maternal care services, and 90 were mothers of a child aged 12-23 months (to assess immunization coverage. Breastfeeding practices and care during childhood illness were documented in both groups. Results Though institutional delivery rate was 97.7%, only 34.1% mothers had received full antenatal care. The quality of antenatal and postnatal services was poor, practices like prelacteal feeds and delayed initiation of breastfeeding were common. Less than 40 % of children were exclusively breastfed for at least 6 months. Only 53% of children aged 12-23 months were fully immunised. Primary immunisation drop-out rates were high. Mothers’ knowledge regarding vaccines was poor. Children with diarrhea received less fluids and food and only 61% received ORS. Conclusion This study identified the following gaps in the MCH Continuum of Care- lack of IFA consumption, poor quality of antenatal and postnatal care, high immunisation dropout rates, erroneous breastfeeding practices and inadequate care during diarrhoea. Further research may identify potential solutions to bridging these gaps in MCH care.

  13. Maternal and child health care in an underprivileged area of Bangalore city: Identifying the gaps in the continuum of care

    Directory of Open Access Journals (Sweden)

    Avita R Johnson

    2015-10-01

    Full Text Available Background With over 100 million Indians living in urban slums and high child mortality among low-­‐income groups, focusing on maternal and child health (MCH among urban underprivileged is vital, if India is to achieve the fourth and fifth Millennium Development goals. Objectives To identify the gaps in the MCH Continuum of care, by assessing coverage and quality of Maternal and Child Health Services in an urban underprivileged area of Bangalore City. Methods A survey was conducted in an urban slum of Bangalore City, using systematic random sampling. A total of 178 subjects were interviewed with a pre-­‐tested questionnaire. 88 were mothers who delivered in the last one year (to assess maternal care services, and 90 were mothers of a child aged 12-­‐23 months (to assess immunization coverage. Breastfeeding practices and care during childhood illness were documented in both groups. Results Though institutional delivery rate was 97.7%, only 34.1% mothers had received full antenatal care. The quality of antenatal and postnatal services was poor, practices like prelacteal feeds and delayed initiation of breastfeeding were common. Less than 40 % of children were exclusively breastfed for at least 6 months. Only 53% of children aged 12-­‐23 months were fully immunised. Primary immunisation drop-­‐out rates were high. Mothers’ knowledge regarding vaccines was poor. Children with diarrhea received less fluids and food and only 61% received ORS. Conclusion This study identified the following gaps in the MCH Continuum of Care-­‐ lack of IFA consumption, poor quality of antenatal and postnatal care, high immunisation dropout rates, erroneous breastfeeding practices and inadequate care during diarrhoea. Further research may identify potential solutions to bridging these gaps in MCH care.

  14. Structural health monitoring (vibration) as a tool for identifying structural alterations of the lumbar spine: a twin control study.

    Science.gov (United States)

    Kawchuk, Gregory N; Hartvigsen, Jan; Edgecombe, Tiffany; Prasad, Narasimha; van Dieen, Jaap H

    2016-03-11

    Structural health monitoring (SHM) is an engineering technique used to identify mechanical abnormalities not readily apparent through other means. Recently, SHM has been adapted for use in biological systems, but its invasive nature limits its clinical application. As such, the purpose of this project was to determine if a non-invasive form of SHM could identify structural alterations in the spines of living human subjects. Lumbar spines of 10 twin pairs were visualized by magnetic resonance imaging then assessed by a blinded radiologist to determine whether twin pairs were structurally concordant or discordant. Vibration was then applied to each subject's spine and the resulting response recorded from sensors overlying lumbar spinous processes. The peak frequency, area under the curve and the root mean square were computed from the frequency response function of each sensor. Statistical analysis demonstrated that in twins whose structural appearance was discordant, peak frequency was significantly different between twin pairs while in concordant twins, no outcomes were significantly different. From these results, we conclude that structural changes within the spine can alter its vibration response. As such, further investigation of SHM to identify spinal abnormalities in larger human populations is warranted.

  15. Evaluating the quality of Websites related to Hospital-Based Home Care: The Credibility Indicator as a prognostic factor

    Directory of Open Access Journals (Sweden)

    María Sanz-Lorente

    2017-04-01

    Full Text Available Objective: To evaluate the documental quality of websites related to Home Care Services. Method: This is a descriptive cross-sectional study of websites based on Home Care Services, using searches on Google to access the study population. The “fallacy sample” of this search engine was take into account. The quality was studied thought the 8 variables of the Credibility Indicator (CI. Results: A total of 215 active websites, mainly belonging to the media, were evaluated. None of the websites met all 8 items in the CI. Mean of 2,12 ± 0,07; Minimum of 0 and Maximum of 5; Median equal to 3. Within the studied websites, 74 (34,42% presented both authorship and affiliation. There was an association between the CI accomplishment and websites that had these 2 variables (p <0.001. Conclusions: The quality of websites covering issues of Hospital-Based Home Care services is still poor. It is confirmed that identifying authorship and affiliation is an important factor in predicting the quality of the information. The Credibility Indicator is a useful aid when determining the quality of a website.

  16. Implementing new routines in adult mental health care to identify and support children of mentally ill parents.

    Science.gov (United States)

    Lauritzen, Camilla; Reedtz, Charlotte; Van Doesum, Karin T M; Martinussen, Monica

    2014-02-07

    Mental health problems are often transmitted from one generation to the next. This knowledge has led to changes in Norwegian legislation, making it mandatory to assess whether or not patients have children, and to provide necessary support for the children of mentally ill patients. The main purpose of this study was to evaluate the process of implementing new routines in adult mental health services to identify and support children of mentally ill parents. The design was a pre-test post-test study. The sample (N = 219 at pre-test and N = 185 at post-test) included mental health professionals in the largest hospital in the region, who responded to a web-based survey on the routines of the services, attitudes within the workforce capacity, worker's knowledge on the impact of parental mental illness on children, knowledge on legislation concerning children of patients, and demographic variables. The results of this study indicated that some changes are taking place in clinical practice in terms of increased identification of children. Adult mental health services providing support for the children was however not fully implemented as a new practice. The main finding in this study is that the identification frequency had increased significantly according to self-reported data since the Family Assessment Form was implemented. The increase in self-reported identification behavior is however taking place very slowly. Three years after the legislation was changed to making it mandatory to assess whether or not patients have children, it was still not fully incorporated in the routines of the entire workforce. In terms of support for the families affected by parental mental illness, the changes are not yet significant.

  17. Stakeholders Perspectives on the Success Drivers in Ghana’s National Health Insurance Scheme – Identifying Policy Translation Issues

    Science.gov (United States)

    Fusheini, Adam; Marnoch, Gordon; Gray, Ann Marie

    2017-01-01

    Background: Ghana’s National Health Insurance Scheme (NHIS), established by an Act of Parliament (Act 650), in 2003 and since replaced by Act 852 of 2012 remains, in African terms, unprecedented in terms of growth and coverage. As a result, the scheme has received praise for its associated legal reforms, clinical audit mechanisms and for serving as a hub for knowledge sharing and learning within the context of South-South cooperation. The scheme continues to shape national health insurance thinking in Africa. While the success, especially in coverage and financial access has been highlighted by many authors, insufficient attention has been paid to critical and context-specific factors. This paper seeks to fill that gap. Methods: Based on an empirical qualitative case study of stakeholders’ views on challenges and success factors in four mutual schemes (district offices) located in two regions of Ghana, the study uses the concept of policy translation to assess whether the Ghana scheme could provide useful lessons to other African and developing countries in their quest to implement social/NHISs. Results: In the study, interviewees referred to both ‘hard and soft’ elements as driving the "success" of the Ghana scheme. The main ‘hard elements’ include bureaucratic and legal enforcement capacities; IT; financing; governance, administration and management; regulating membership of the scheme; and service provision and coverage capabilities. The ‘soft’ elements identified relate to: the background/context of the health insurance scheme; innovative ways of funding the NHIS, the hybrid nature of the Ghana scheme; political will, commitment by government, stakeholders and public cooperation; social structure of Ghana (solidarity); and ownership and participation. Conclusion: Other developing countries can expect to translate rather than re-assemble a national health insurance programme in an incomplete and highly modified form over a period of years

  18. Stakeholders Perspectives on the Success Drivers in Ghana’s National Health Insurance Scheme – Identifying Policy Translation Issues

    Directory of Open Access Journals (Sweden)

    Adam Fusheini

    2017-05-01

    Full Text Available Background Ghana’s National Health Insurance Scheme (NHIS, established by an Act of Parliament (Act 650, in 2003 and since replaced by Act 852 of 2012 remains, in African terms, unprecedented in terms of growth and coverage. As a result, the scheme has received praise for its associated legal reforms, clinical audit mechanisms and for serving as a hub for knowledge sharing and learning within the context of South-South cooperation. The scheme continues to shape national health insurance thinking in Africa. While the success, especially in coverage and financial access has been highlighted by many authors, insufficient attention has been paid to critical and context-specific factors. This paper seeks to fill that gap. Methods Based on an empirical qualitative case study of stakeholders’ views on challenges and success factors in four mutual schemes (district offices located in two regions of Ghana, the study uses the concept of policy translation to assess whether the Ghana scheme could provide useful lessons to other African and developing countries in their quest to implement social/NHISs. Results In the study, interviewees referred to both ‘hard and soft’ elements as driving the “success” of the Ghana scheme. The main ‘hard elements’ include bureaucratic and legal enforcement capacities; IT; financing; governance, administration and management; regulating membership of the scheme; and service provision and coverage capabilities. The ‘soft’ elements identified relate to: the background/context of the health insurance scheme; innovative ways of funding the NHIS, the hybrid nature of the Ghana scheme; political will, commitment by government, stakeholders and public cooperation; social structure of Ghana (solidarity; and ownership and participation. Conclusion Other developing countries can expect to translate rather than re-assemble a national health insurance programme in an incomplete and highly modified form over a period

  19. Using hazard maps to identify and eliminate workplace hazards: a union-led health and safety training program.

    Science.gov (United States)

    Anderson, Joe; Collins, Michele; Devlin, John; Renner, Paul

    2012-01-01

    The Institute for Sustainable Work and Environment and the Utility Workers Union of America worked with a professional evaluator to design, implement, and evaluate the results of a union-led system of safety-based hazard identification program that trained workers to use hazard maps to identify workplace hazards and target them for elimination. The evaluation documented program implementation and impact using data collected from both qualitative interviews and an on-line survey from worker trainers, plant managers, and health and safety staff. Managers and workers reported that not only were many dangerous hazards eliminated as a result of hazard mapping, some of which were long-standing, difficult-to-resolve issues, but the evaluation also documented improved communication between union members and management that both workers and managers agreed resulted in better, more sustainable hazard elimination.

  20. Veterans' voices: use of the American Customer Satisfaction Index (ACSI) Survey to identify My HealtheVet personal health record users' characteristics, needs, and preferences.

    Science.gov (United States)

    Nazi, Kim M

    2010-01-01

    Consumer research reveals considerable interest in the use of Personal Health Records (PHRs), yet adoption remains relatively low. Both adopters and nonadopters represent important perspectives from which to understand this paradox. This study focuses on direct feedback from adopters obtained using the American Customer Satisfaction Index (ACSI) survey on the My HealtheVet PHR portal (http://www.myhealth.va.gov) of the Veterans Health Administration (VHA). The results represent a source of direct feedback with which to better understand veterans' needs and preferences. The ACSI Survey was implemented in October 2007 to measure satisfaction and elicit information about characteristics and preferences of My HealtheVet PHR adopters. The data represent a continuous random sample of site visitors who have navigated at least four pages on the site. A total of 100 617 surveys were completed (17.2%). Satisfaction with My HealtheVet is high (8.3/10.0), and users are highly likely to return to the site (8.6/10.0) and recommend the site to other veterans (9.1/10.0). The majority of system adopters are male (91%), between the ages of 51 and 70 (68%), and served in the Vietnam War (60%). Most veterans currently visit the site to utilize pharmacy-related features. VHA has used the ACSI to monitor satisfaction, and to better understand the characteristics, needs, and preferences of early adopters. The data provide an important source of direct feedback to inform program development. Future research will include monitoring the impact of enhancements and new features on satisfaction, and conducting additional research with nonadopters to identify barriers to adoption and use.

  1. Veterans' voices: use of the American Customer Satisfaction Index (ACSI) Survey to identify My HealtheVet personal health record users' characteristics, needs, and preferences

    Science.gov (United States)

    2010-01-01

    Background Consumer research reveals considerable interest in the use of Personal Health Records (PHRs), yet adoption remains relatively low. Both adopters and nonadopters represent important perspectives from which to understand this paradox. Objective This study focuses on direct feedback from adopters obtained using the American Customer Satisfaction Index (ACSI) survey on the My HealtheVet PHR portal (http://www.myhealth.va.gov) of the Veterans Health Administration (VHA). The results represent a source of direct feedback with which to better understand veterans' needs and preferences. Methods The ACSI Survey was implemented in October 2007 to measure satisfaction and elicit information about characteristics and preferences of My HealtheVet PHR adopters. The data represent a continuous random sample of site visitors who have navigated at least four pages on the site. A total of 100 617 surveys were completed (17.2%). Results Satisfaction with My HealtheVet is high (8.3/10.0), and users are highly likely to return to the site (8.6/10.0) and recommend the site to other veterans (9.1/10.0). The majority of system adopters are male (91%), between the ages of 51 and 70 (68%), and served in the Vietnam War (60%). Most veterans currently visit the site to utilize pharmacy-related features. Conclusion VHA has used the ACSI to monitor satisfaction, and to better understand the characteristics, needs, and preferences of early adopters. The data provide an important source of direct feedback to inform program development. Future research will include monitoring the impact of enhancements and new features on satisfaction, and conducting additional research with nonadopters to identify barriers to adoption and use. PMID:20190065

  2. Gender as an Influencer of Online Health Information-Seeking and Evaluation Behavior

    OpenAIRE

    Rowley, J.; Johnson, F.; Sbaffi, L.

    2016-01-01

    This article contributes to the growing body of research that explores the significance of context in health information behavior. Specifically, through the lens of trust judgments, it demonstrates that gender is a determinant of the information evaluation process. A questionnaire-based survey collected data from adults regarding the factors that influence their judgment of the trustworthiness of online health information. Both men and women identified credibility, recommendation, ease of use...

  3. Looking into the Credibility of Appearance: Exploring the Role of Color in Interface Aesthetics and How it Affects our Perception on System’s Credibility

    Directory of Open Access Journals (Sweden)

    Achmad Syarief

    2007-03-01

    Full Text Available Dalam penelitian  ini dikaji hasil tiga eksperimen sebagai kelanjutan studi yang pernah dilakukan oleh Kurosu-Kashimura [1] dan Noam Tractinsky [2] tentang  relasi antara persepsi pengguna dengan kualitas estetik dan usability tampilan interface. Berdasar dua premis utama yaitu bahwa persepsi estetik dipengaruhi latar belakang kultural serta tampilan yang atraktif dapat mempengaruhi persepsi kehandalan sebuah produk., Dalam penelitian ini dievaluasi bagaimana persepsi pengguna migran (:orang Indonesia yang berada di Jepang terhadap relasi antara tampilan estetik  dan apparent usability pada sebuah interface produk. Dalam eksperimen dilakukan investigasi efek tampilan warna pada sebuah interface produk terhadap persepsi trustworthy (tingkat kepercayaan dan credibility (tingkat kredibilitas produk secara umum. Sebagai stimulus, digunakan tampilan  layout-utama (hasil modifikasi layar ATM bank di Jepang. Hasil eksperimen menunjukkan bahwa nilai estetik tampilan interface mempengaruhi persepsi user atas credibility (tingkat kredibilitas dan trustworthy (tingkat kepercayaan sebuah objek. Latar belakang budaya pengguna tidak memiliki pengaruh signifikan terhadap persepsi estetik tampilan interface apabila pengguna telah melakukan adaptasi eksperiential  atau memiliki pengalaman interaksi dengan produk dengan komposisi layout sejenis. Lebih lanjut hasil penelitian menunjukkan bahwa warna memiliki pengaruh penting dalam meningkatkan kualitas ke-atraktif-an, persepsi kredibiltas (credibility, dan tingkat penerimaan (acceptability pengguna (user. Eksperimen lebih lanjut perlu dilakukan untuk mengetahui bagaimana dan seperti apa sebuah kombinasi warna pada sebuah tampilan interface, dapat memiliki pengaruh yang bermakna  pada keterpakaian sebuah  produk.

  4. Identifying Measures Used for Assessing Quality of YouTube Videos with Patient Health Information: A Review of Current Literature.

    Science.gov (United States)

    Gabarron, Elia; Fernandez-Luque, Luis; Armayones, Manuel; Lau, Annie Ys

    2013-02-28

    Recent publications on YouTube have advocated its potential for patient education. However, a reliable description of what could be considered quality information for patient education on YouTube is missing. To identify topics associated with the concept of quality information for patient education on YouTube in the scientific literature. A literature review was performed in MEDLINE, ISI Web of Knowledge, Scopus, and PsychINFO. Abstract selection was first conducted by two independent reviewers; discrepancies were discussed in a second abstract review with two additional independent reviewers. Full text of selected papers were analyzed looking for concepts, definitions, and topics used by its authors that focused on the quality of information on YouTube for patient education. In total, 456 abstracts were extracted and 13 papers meeting eligibility criteria were analyzed. Concepts identified related to quality of information for patient education are categorized as expert-driven, popularity-driven, or heuristic-driven measures. These include (in descending order): (1) quality of content in 10/13 (77%), (2) view count in 9/13 (69%), (3) health professional opinion in 8/13 (62%), (4) adequate length or duration in 6/13 (46%), (5) public ratings in 5/13 (39%), (6) adequate title, tags, and description in 5/13 (39%), (7) good description or a comprehensive narrative in 4/13 (31%), (8) evidence-based practices included in video in 4/13 (31%), (9) suitability as a teaching tool in 4/13 (31%), (10) technical quality in 4/13 (31%), (11) credentials provided in video in 4/13 (31%), (12) enough amount of content to identify its objective in 3/13 (23%), and (13) viewership share in 2/13 (15%). Our review confirms that the current topics linked to quality of information for patient education on YouTube are unclear and not standardized. Although expert-driven, popularity-driven, or heuristic-driven measures are used as proxies to estimate the quality of video information

  5. Change your ways : Fostering health attitudes toward change through selective exposure to online health messages

    NARCIS (Netherlands)

    Westerwick, Axel; Johnson, Benjamin K.; Knobloch-Westerwick, Silvia

    2017-01-01

    Health information is often sought online, despite varying credibility of online sources, and may shape health behaviors. This investigation builds on the Selective Exposure Self- and Affect-Management model to examine selective exposure to online health information from low- and high-credibility

  6. The Influence of Peer Reviews on Source Credibility and Purchase Intention

    Directory of Open Access Journals (Sweden)

    Kristine L. Nowak

    2014-12-01

    Full Text Available Electronic Word of Mouth (eWOM is information shared on the Internet about a product, which allows people to receive information from others they may not otherwise encounter. Online product reviews are a type of eWOM where a user posts a comment about a product and selects an image to represent the self. The perception of the image and the text in the product review can influence source credibility and the perception of the product, as well as the likelihood that someone will purchase the product. This study examines the effect of the product reviews and their different images and text on perceived credibility, source trustworthiness and purchase intention. Consistent with predictions based on the information processing theory, perceived anthropomorphism influences perceived credibility, source trust, and purchase intention.

  7. Estimation of maximum credible atmospheric radioactivity concentrations and dose rates from nuclear tests

    International Nuclear Information System (INIS)

    Telegadas, K.

    1979-01-01

    A simple technique is presented for estimating maximum credible gross beta air concentrations from nuclear detonations in the atmosphere, based on aircraft sampling of radioactivity following each Chinese nuclear test from 1964 to 1976. The calculated concentration is a function of the total yield and fission yield, initial vertical radioactivity distribution, time after detonation, and rate of horizontal spread of the debris with time. calculated maximum credible concentrations are compared with the highest concentrations measured during aircraft sampling. The technique provides a reasonable estimate of maximum air concentrations from 1 to 10 days after a detonation. An estimate of the whole-body external gamma dose rate corresponding to the maximum credible gross beta concentration is also given. (author)

  8. Credibility of the emotional witness: a study of ratings by court judges.

    Science.gov (United States)

    Wessel, Ellen; Drevland, Guri C B; Eilertsen, Dag Erik; Magnussen, Svein

    2006-04-01

    Previous studies have shown that the emotional behavior displayed during testimony may affect the perceived credibility of the witness. The present study compares credibility ratings by Norwegian court judges with those made by lay people. The participants viewed one of three video-recorded versions of a rape victim's statement, role played by a professional actress. The statement was given in a free-recall manner with one of three kinds of emotions displayed, termed congruent, neutral, and incongruent emotional expression. The results show that, in contrast to lay people, the credibility ratings of court judges and their votes for a guilty verdict were not influenced by the emotions displayed by the witness. Results are discussed in terms of professional expertise.

  9. Source credibility and evidence format: examining the effectiveness of HIV/AIDS messages for young African Americans.

    Science.gov (United States)

    Major, Lesa Hatley; Coleman, Renita

    2012-01-01

    Using experimental methodology, this study tests the effectiveness of HIV/AIDS prevention messages tailored specifically to college-aged African Americans. To test interaction effects, it intersects source role and evidence format. The authors used gain-framed and loss-framed information specific to young African Americans and HIV to test message effectiveness between statistical and emotional evidence formats, and for the first time, a statistical/emotional combination format. It tests which source--physician or minister--that young African Americans believe is more effective when delivering HIV/AIDS messages to young African Americans. By testing the interaction between source credibility and evidence format, this research expands knowledge on creating effective health messages in several major areas. Findings include a significant interaction between the role of physician and the combined statistical/emotional format. This message was rated as the most effective way to deliver HIV/AIDS prevention messages.

  10. Machine learning methods for credibility assessment of interviewees based on posturographic data.

    Science.gov (United States)

    Saripalle, Sashi K; Vemulapalli, Spandana; King, Gregory W; Burgoon, Judee K; Derakhshani, Reza

    2015-01-01

    This paper discusses the advantages of using posturographic signals from force plates for non-invasive credibility assessment. The contributions of our work are two fold: first, the proposed method is highly efficient and non invasive. Second, feasibility for creating an autonomous credibility assessment system using machine-learning algorithms is studied. This study employs an interview paradigm that includes subjects responding with truthful and deceptive intent while their center of pressure (COP) signal is being recorded. Classification models utilizing sets of COP features for deceptive responses are derived and best accuracy of 93.5% for test interval is reported.

  11. Excess Claims and Data Trimming in the Context of Credibility Rating Procedures,

    Science.gov (United States)

    1981-11-01

    Triining in the Context of Credibility Rating Procedures by Hans BShlmann, Alois Gisler, William S. Jewell* 1. Motivation In Ratemaking and in Experience...work on the ETH computer. __.1: " Zen * ’ ’ II / -2- 2. The Basic Model Throughout the paper we work with the most simple model in the credibility...additional structure are summed up by stating that the density -3- f 8 (x) has the following form 1) fe(x) -(1-r)po (x/e) + rape(x) 3. The Basic Problem As

  12. Verification, Validation and Credibility Assessment of a Computational Model of the Advanced Resistive Exercise Device (ARED)

    Science.gov (United States)

    Werner, C. R.; Humphreys, B. T.; Mulugeta, L.

    2014-01-01

    The Advanced Resistive Exercise Device (ARED) is the resistive exercise device used by astronauts on the International Space Station (ISS) to mitigate bone loss and muscle atrophy due to extended exposure to microgravity (micro g). The Digital Astronaut Project (DAP) has developed a multi-body dynamics model of biomechanics models for use in spaceflight exercise physiology research and operations. In an effort to advance model maturity and credibility of the ARED model, the DAP performed verification, validation and credibility (VV and C) assessment of the analyses of the model in accordance to NASA-STD-7009 'Standards for Models and Simulations'.

  13. Lack of Annual Reports Make it Difficult to Analyze Library Strategic Credibility. A Review of: Staines, G. (2009. Towards an assessment of strategic credibility in academic libraries. Library Management, 30(3, 148-162.

    Directory of Open Access Journals (Sweden)

    Kirsty Thomson

    2011-06-01

    Full Text Available Objective – To investigate whether libraries achieve strategic credibility by assessing if strategic planning goals match the achievements described in annual reports.Design – Content analysis of annual reports and strategic plans from a sample of Association of Research Libraries (ARL.Setting – Academic libraries in Canada and the United States of America.Subjects – A random sample of 12 Canadian and 16 American academic libraries. All libraries were members of ARL.Methods – The researcher contacted the directors of 28 ARL libraries and asked for copies of their strategic plans and annual reports. She also visited the websites of libraries to obtain the reports. The contents of the strategic plans and annual reports were analyzed, and trends in the Canadian and American strategic plans were identified.Main Results – This study found that only 39% of ARL libraries produce annual reports, making it difficult to assess if libraries have strategic credibility, as their strategic plans cannot be assessed against annual reports. The strategic plans gathered in this study were analyzed and emerging themes were identified. These included physical library space (renovations, expansions or new buildings; offsite storage; assessment (both of the libraries’ services, and of information literacy training; development activities such as fundraising and marketing; and personnel issues. Cultural differences also were found inthe strategic plans, with American libraries being more focused on trends such as digitization and institutional repositories, andCanadian libraries’ plans being more focused on users’ needs. Trends in annual reports were not reported due to the small number ofannual reports in the sample.Conclusion – This study gives a snapshot ofthe trends in strategic plans of ARL members. It shows that many ARL members do not produce an annual report, and that it istherefore difficult to assess if their strategicplans are

  14. Using Evidence Credibility Decay Model for dependence assessment in human reliability analysis

    International Nuclear Information System (INIS)

    Guo, Xingfeng; Zhou, Yanhui; Qian, Jin; Deng, Yong

    2017-01-01

    Highlights: • A new computational model is proposed for dependence assessment in HRA. • We combined three factors of “CT”, “TR” and “SP” within Dempster–Shafer theory. • The BBA of “SP” is reconstructed by discounting rate based on the ECDM. • Simulation experiments are illustrated to show the efficiency of the proposed method. - Abstract: Dependence assessment among human errors plays an important role in human reliability analysis. When dependence between two sequent tasks exists in human reliability analysis, if the preceding task fails, the failure probability of the following task is higher than success. Typically, three major factors are considered: “Closeness in Time” (CT), “Task Relatedness” (TR) and “Similarity of Performers” (SP). Assume TR is not changed, both SP and CT influence the degree of dependence level and SP is discounted by the time as the result of combine two factors in this paper. In this paper, a new computational model is proposed based on the Dempster–Shafer Evidence Theory (DSET) and Evidence Credibility Decay Model (ECDM) to assess the dependence between tasks in human reliability analysis. First, the influenced factors among human tasks are identified and the basic belief assignments (BBAs) of each factor are constructed based on expert evaluation. Then, the BBA of SP is discounted as the result of combining two factors and reconstructed by using the ECDM, the factors are integrated into a fused BBA. Finally, the dependence level is calculated based on fused BBA. Experimental results demonstrate that the proposed model not only quantitatively describe the fact that the input factors influence the dependence level, but also exactly show how the dependence level regular changes with different situations of input factors.

  15. Combined use of waist and hip circumference to identify abdominally obese HIV-infected patients at increased health risk.

    Directory of Open Access Journals (Sweden)

    Trevor O'Neill

    Full Text Available OBJECTIVES: To determine whether for a given waist circumference (WC, a larger hip circumference (HC was associated with a reduced risk of insulin resistance, type 2 diabetes (T2D, hypertension and cardiovascular disease (CVD in HIV-infected patients. A second objective was to determine whether, for a given WC, the addition of HC improved upon estimates of abdominal adiposity, in particular visceral adipose tissue (VAT, compared to those obtained by WC alone. METHODS: HIV-infected men (N = 1481 and women (N = 841 were recruited between 2005 and 2009. WC and HC were obtained using standard techniques and abdominal adiposity was measured using computed tomography. RESULTS: After control for WC and covariates, HC was negatively associated with risk of insulin resistance (p<0.05 and T2D [Men: OR = 0.91 (95% CI: 0.86-0.96; Women: OR = 0.91 (95% CI: 0.84-0.98]. For a given WC, HC was also negatively associated with a lower risk of hypertension (p<0.05 and CVD [OR = 0.94 (95% CI: 0.88-0.99] in men, but not women. Although HC was negatively associated with VAT in men and women after control for WC (p<0.05, the addition of HC did not substantially improve upon the prediction of VAT compared to WC alone. CONCLUSIONS: The identification of HIV-infected individuals at increased health risk by WC alone is substantially improved by the addition of HC. Estimates of visceral adipose tissue by WC are not substantially improved by the addition of HC and thus variation in visceral adiposity may not be the conduit by which HC identifies increased health risk.

  16. Identifying barriers to mental health system improvements: an examination of community participation in assertive community treatment programs

    Directory of Open Access Journals (Sweden)

    Wakefield Patricia A

    2011-11-01

    Full Text Available Abstract Background Integrating the best available evidence into program standards is essential if system-wide improvements in the delivery of community-based mental health services are to be achieved. Since the beginning of the Assertive Community Treatment (ACT program movement, program standards have included a role for the community. In particular, ACT program standards have sought to ensure that members of the local community are involved in governance and that former clients participate in service delivery as "Peer Support Specialists". This paper reports on the extent to which ACT program standards related to community participation have been implemented and identifies barriers to full compliance. Methods Qualitative and quantitative data were collected through a telephone survey of ACT Program Coordinators in Ontario, Canada, using a census sample of the existing 66 ACT programs. A thematic approach to content analysis was used to analyze respondents' qualitative comments. Quantitative data were analyzed using SPSS 16.0 and included means, frequencies, independent t-tests and Pearson Correlations. Results An 85% response rate was achieved. Of the 33 program standards, the two that received the lowest perceived compliance ratings were the two standards directly concerning community participation. Specifically, the standard to have a functioning Community Advisory Body and the standard requiring the inclusion of a Peer Support Specialist. The three major themes that emerged from the survey data with respect to the barriers to fully implementing the Community Advisory Body were: external issues; standard related issues; and, organizational/structural related issues. The three major themes concerning barriers to implementing the Peer Support Specialist role were: human resource related issues; organizational/structural related issues; and, standard related issues. Conclusions The reasons for low compliance of ACT programs with community

  17. The mental health characteristics of pregnant women with depressive symptoms identified by the Edinburgh Postnatal Depression Scale.

    Science.gov (United States)

    Lydsdottir, Linda B; Howard, Louise M; Olafsdottir, Halldora; Thome, Marga; Tyrfingsson, Petur; Sigurdsson, Jon F

    2014-04-01

    Few studies are available on the effectiveness of screening tools such as the Edinburgh Postnatal Depression Scale (EPDS) in pregnancy or the extent to which such tools may identify women with mental disorders other than depression. We therefore aimed to investigate the mental health characteristics of pregnant women who screen positive on the EPDS. Consecutive women receiving antenatal care in primary care clinics (from November 2006 to July 2011) were invited to complete the EPDS in week 16 of pregnancy. All women who scored above 11 (screen positive) on the EPDS and randomly selected women who scored below 12 (screen negative) were invited to participate in a psychiatric diagnostic interview. 2,411 women completed the EPDS. Two hundred thirty-three women (9.7%) were screened positive in week 16, of whom 153 (66%) agreed to a psychiatric diagnostic interview. Forty-eight women (31.4%) were diagnosed with major depressive disorder according to DSM-IV criteria, 20 (13.1%) with bipolar disorder, 93 (60.8%) with anxiety disorders (including 27 [17.6%] with obsessive-compulsive disorder [OCD]), 8 (5.2%) with dysthymia, 18 (11.8%) with somatoform disorder, 3 (2%) with an eating disorder, and 7 (4.6%) with current substance abuse. Women who screened positive were significantly more likely to have psychosocial risk factors, including being unemployed (χ(2)(1) = 23.37, P ≤.001), lower educational status (χ(2)(1)= 31.68, P ≤ .001), and a history of partner violence (χ(2)(1) = 10.30, P ≤ 001), compared with the women who screened negative. Use of the EPDS early in the second trimester of pregnancy identifies a substantial number of women with potentially serious mental disorders other than depression, including bipolar disorder, OCD, and eating disorders. A comprehensive clinical assessment is therefore necessary following use of the EPDS during pregnancy to ensure that women who screen positive receive appropriate mental health management. © Copyright 2014

  18. Building credibility in public studies: Lessons learned from the Hanford environmental Dose Reconstruction project may apply to all public studies

    International Nuclear Information System (INIS)

    Till, J.E.

    1995-01-01

    This article describes the process by which the author came to recognize the importance of openness to the public in environmental studies, during the Hanford Environmental Dose Reconstruction Project. Using the Dose reconstruction public involvement, the article goes on to describe a general guide to the construction of a new, positive framework for conducting future public studies. The steps include the following: putting the public in the study; building credibility into a public study (1 -search for proof in historical records; 2-define the domain and the exposed population; 3-characterize the material released; 4-identify key materials, pathways and receptors; 5-encouraging public participation; 6 -explaining the meaning of the results) and reconciling scientific and public issues

  19. Building credibility in public studies: Lessons learned from the Hanford environmental Dose Reconstruction project may apply to all public studies

    Energy Technology Data Exchange (ETDEWEB)

    Till, J.E. [Radiological Assessment Corp., Neeses, SC (United States)

    1995-09-01

    This article describes the process by which the author came to recognize the importance of openness to the public in environmental studies, during the Hanford Environmental Dose Reconstruction Project. Using the Dose reconstruction public involvement, the article goes on to describe a general guide to the construction of a new, positive framework for conducting future public studies. The steps include the following: putting the public in the study; building credibility into a public study (1 -search for proof in historical records; 2-define the domain and the exposed population; 3-characterize the material released; 4-identify key materials, pathways and receptors; 5-encouraging public participation; 6 -explaining the meaning of the results) and reconciling scientific and public issues.

  20. Noteworthy practices as identified by the US Department of Energy environmental, safety, and health first 31 Tiger Team assessments

    International Nuclear Information System (INIS)

    1992-05-01

    Noteworthy Practices are exceptional ways of accomplishing a performance objective or some aspect of it. Other DOE facilities are encouraged to adopt these practices when they are applicable to their operation. Noteworthy Practices included in this report have been drawn from the first 31 Tiger Team Assessments at DOE sites. This report includes all noteworthy practices listed in an earlier tabulation (June 1990) which the Secretary of the US Department of Energy distributed for information on July 31, 1990. This earlier tabulation included noteworthy practices from the first thirteen Tiger Team Assessments. A brief key-word title has been assigned to each Noteworthy Practice. This title provides a brief description of each Noteworthy Practice. The reader may peruse these titles in the table of contents to identify Noteworthy Practices that may be applicable to their site, facility, or operations. A flexible-disk copy of this compilation is also available in ASCII format on personal-computer, DOS-formatted disks from the Office of Special Projects in the Office of Environment, Safety, and Health at the Headquarters of the US Department of Energy. The ASCII file may be used in combination with word processing software for more detailed word and text-string searches

  1. Counselor Bilingual Ability, Counselor Ethnicity, Acculturation, and Mexican Americans' Perceived Counselor Credibility

    Science.gov (United States)

    Ramos-Sanchez, Lucila

    2009-01-01

    This study examined the effects of counselor bilingual ability and counselor ethnicity on client-perceived counselor credibility and cultural competence. Participants were assigned to 1 of 4 treatment conditions created by crossing counselor ethnicity with counselor language. No significant differences were found. Regarding rank ordering of the…

  2. Enacting Effective Climate Policy Advice: Institutional Strategies to Foster Saliency, Credibility and Legitimacy

    Science.gov (United States)

    Bauer, Anja; Pregernig, Michael; Reinecke, Sabine

    2016-01-01

    This article asks how scientific advisory institutions (SAIs) in climate policy strive towards effectiveness. Our analysis is grounded on the assumption that effectiveness is not passively experienced but is deliberately enacted by SAIs. We draw on a widely used set of criteria, namely saliency, credibility and legitimacy (SCL). Based on an…

  3. Interviewing to assess credibility in the Swedish asylum procedure: analyzing question style, type and theme

    NARCIS (Netherlands)

    van Veldhuizen, T.S.; Horselenberg, R.; Landström, S.; Granhag, P.A.; van Koppen, P.J.

    2017-01-01

    The aim of the current vignette study is to map the style, type, and themes of questions that are asked when assessing the credibility of asylum seekers' claims. Sixty-five officials from the Swedish Migration Agency (Migrationsverket), were asked to respond to one out of four different vignettes

  4. Civil Society and the Conduct of Free, Fair and Credible Election ...

    African Journals Online (AJOL)

    Civil Society and the Conduct of Free, Fair and Credible Election: Lessons from ... of Non Governmental agencies like civil society to prevent the government of the ... fair so as to rid the continent of its notorious record of post election violence.

  5. Improving speed behaviour : the potential of in-car speed assistance and speed limit credibility.

    NARCIS (Netherlands)

    Nes, C.N. van Houtenbos, M. & Schagen, I.N.L.G. van

    2009-01-01

    Speeding is still a common practice on many roads and it contributes to a significant number of crashes. Two new approaches to solve speeding issues are focused on: intelligent speed assistance systems (ISA) and speed limit credibility. Research has indicated that ISA is promising with respect to

  6. Practicing What We Teach: Credibility and Alignment in the Business Communication Classroom

    Science.gov (United States)

    Ruppert, Bryan; Green, David A.

    2012-01-01

    The authors investigate the importance of instructor communication behaviors in a course on business communication, arguing that alignment between instructor behaviors and the precepts of the discipline has a pronounced effect on perceived instructor credibility in this field. Student evaluations were analyzed qualitatively for their comments on…

  7. Freedom and Responsibility in First Amendment Theory: Defamation Law and Media Credibility.

    Science.gov (United States)

    Hunsaker, David M.

    1979-01-01

    Explores the concepts of freedom and responsibility in the context of First Amendment theory through an examination of the interrelationships between defamation law, access to media, and media credibility. Calls for a reassessment of the importance of defamation law in First Amendment theory. (JMF)

  8. Moderators of Framing Effects on Political Attitudes: Is Source Credibility Worth Investigating?

    Directory of Open Access Journals (Sweden)

    Dana Raluca Buturoiu

    2015-08-01

    Full Text Available This research paper focuses on indirect (mediated media effects. In particular, we discuss which independent variables might intervene in and moderate the impact of framing effects on public attitudes (namely political trust, both in short-term and medium-term contexts. Among these, we focus on source credibility as a possible moderator of framing effects over time. The purpose of this study was to examine if and how source credibility influences individuals’ political trust. The moderator role of source credibility is analysed according to the exposure to different types of frames (repetitive or competitive at different moments (one week or one month. By means of a framing experiment (N=769 on political topics, we argue that media frames could influence political trust: Source credibility has a marginal influence, which suggests that, with stronger stimulus material (video, as opposed to written press articles, the source could play an important role in the willingness of people to trust political figures in general. Thus, we might argue that the media play a significant role not only in offering information about politics and politicians, but also in altering people’s perceptions about them. On the other hand, time seems to matter, since framing effects are more powerful after competitive media exposures. This study proposes new theoretical insights into framing effects, in the sense that classical theories should be revisited in various cultural or political contexts

  9. The Effects of Teacher Self-Disclosure via "Facebook" on Teacher Credibility

    Science.gov (United States)

    Mazer, Joseph P.; Murphy, Richard E.; Simonds, Cheri J.

    2009-01-01

    Research suggests that teachers who personalize their teaching through the use of humor, stories, enthusiasm, and self-disclosure are perceived by their students to be effective in explaining course content. This experimental study examined the effects of computer-mediated teacher self-disclosure on perceptions of teacher credibility. Participants…

  10. Ferrocyanide safety program: Credibility of drying out ferrocyanide tank waste by hot spots

    International Nuclear Information System (INIS)

    Dickinson, D.R.; McLaren, J.M.; Borsheim, G.L.; Crippen, M.D.

    1993-04-01

    The single-shell waste tanks at the Hanford Site that contain significant quantities of ferrocyanide have been considered a possible hazard, since under certain conditions the ferrocyanide in the waste tanks could undergo an exothermic chemical reaction with the nitrates and nitrites that are also present in the tanks. The purpose of this report is to assess the credibility of local dryout of ferrocyanide due to a hotspot. This report considers the following: What amount of decay heat generation within what volume would be necessary to raise the temperature of the liquid in the sludge to its boiling point? What mechanisms could produce a significant local concentration of heat sources? Is it credible that a waste tank heat concentration could be as large as that required to reach the dryout temperatures? This report also provides a recommendation as to whether infrared scanning of the ferrocyanide tanks is needed. From the analyses presented in this report it is evident that formation of dry, and thus chemically reactive, regions in the ferrocyanide sludge by local hotspots is not credible. This conclusion is subject to reevaluation if future analyses of tank core samples show much higher 137 Cs or 90 Sr concentrations than expected. Since hotspots of concern are not credible, infrared scanning to detect such hotspots is not required for safe storage of tank waste

  11. Credibility, Replicability, and Reproducibility in Simulation for Biomedicine and Clinical Applications in Neuroscience

    Science.gov (United States)

    Mulugeta, Lealem; Drach, Andrew; Erdemir, Ahmet; Hunt, C. A.; Horner, Marc; Ku, Joy P.; Myers Jr., Jerry G.; Vadigepalli, Rajanikanth; Lytton, William W.

    2018-01-01

    Modeling and simulation in computational neuroscience is currently a research enterprise to better understand neural systems. It is not yet directly applicable to the problems of patients with brain disease. To be used for clinical applications, there must not only be considerable progress in the field but also a concerted effort to use best practices in order to demonstrate model credibility to regulatory bodies, to clinics and hospitals, to doctors, and to patients. In doing this for neuroscience, we can learn lessons from long-standing practices in other areas of simulation (aircraft, computer chips), from software engineering, and from other biomedical disciplines. In this manuscript, we introduce some basic concepts that will be important in the development of credible clinical neuroscience models: reproducibility and replicability; verification and validation; model configuration; and procedures and processes for credible mechanistic multiscale modeling. We also discuss how garnering strong community involvement can promote model credibility. Finally, in addition to direct usage with patients, we note the potential for simulation usage in the area of Simulation-Based Medical Education, an area which to date has been primarily reliant on physical models (mannequins) and scenario-based simulations rather than on numerical simulations. PMID:29713272

  12. The relationship between clients' depression etiological beliefs and psychotherapy orientation preferences, expectations, and credibility beliefs.

    Science.gov (United States)

    Tompkins, Kelley A; Swift, Joshua K; Rousmaniere, Tony G; Whipple, Jason L

    2017-06-01

    The purpose of this study was to examine the relationship between clients' etiological beliefs for depression and treatment preferences, credibility beliefs, and outcome expectations for five different depression treatments-behavioral activation, cognitive therapy, interpersonal psychotherapy, pharmacotherapy, and psychodynamic psychotherapy. Adult psychotherapy clients (N = 98) were asked to complete an online survey that included the Reasons for Depression Questionnaire, a brief description of each of the five treatment options, and credibility, expectancy, and preference questions for each option. On average, the participating clients rated pharmacotherapy as significantly less credible, having a lower likelihood of success, and being less preferred than the four types of psychotherapy. In general, interpersonal psychotherapy was also rated more negatively than the other types of psychotherapy. However, these findings depended somewhat on whether the participating client was personally experiencing depression. Credibility beliefs, outcome expectations, and preferences for pharmacotherapy were positively associated with biological beliefs for depression; however, the other hypothesized relationships between etiological beliefs and treatment attitudes were not supported. Although the study is limited based on the specific sample and treatment descriptions that were used, the results may still have implications for psychotherapy research, training, and practice. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. Investigating the impact of viral message appeal and message credibility on consumer attitude toward the brand

    Directory of Open Access Journals (Sweden)

    Esmaeilpour Majid

    2016-07-01

    Full Text Available Due to the rapid growth of the Internet and use of e-commerce in the recent years, viral marketing has drawn the attention of manufacturing and service organizations. However, no research has been conducted to examine the impact of message appeal and message source credibility on consumers’ attitude with mediating role of intellectual involvement of consumers and their risk taking level. The aim of this study was to examine the impact of appeal and message source credibility on consumers’ attitude with mediating role of consumers’ intellectual involvement and their risk taking level. The population of this study includes consumers of mobile phones (Samsung, Sony, Nokia, LG and iPhone in the Bushehr city (Iran. As the population of the study is unlimited, 430 questionnaires were distributed using available sampling method, and 391 questionnaires were collected and analyzed. Using structural equation modeling, we analysed the data through smart PLS software. The results show that the appeal and credibility of the message source impact the consumer attitudes toward the brand. We also found that the intellectual involvement of consumers plays the mediating role in the relationship between message appeal and consumer attitudes toward brands. In the relationship between message source credibility and customer attitude towards the brand, the level of risk taking of people has no mediating role.

  14. Twitter Use and Its Effects on Student Perception of Instructor Credibility

    Science.gov (United States)

    DeGroot, Jocelyn M.; Young, Valerie J.; VanSlette, Sarah H.

    2015-01-01

    This study investigates college student perceptions of instructor credibility based on the content of an instructor's Twitterfeed and student beliefs about Twitter as a communication tool. Quantitative and qualitative methods were utilized to explore the effects of three manipulated Twitter feeds (e.g., tweeting social topics, professional topics,…

  15. Credibility, Replicability, and Reproducibility in Simulation for Biomedicine and Clinical Applications in Neuroscience

    Directory of Open Access Journals (Sweden)

    Lealem Mulugeta

    2018-04-01

    Full Text Available Modeling and simulation in computational neuroscience is currently a research enterprise to better understand neural systems. It is not yet directly applicable to the problems of patients with brain disease. To be used for clinical applications, there must not only be considerable progress in the field but also a concerted effort to use best practices in order to demonstrate model credibility to regulatory bodies, to clinics and hospitals, to doctors, and to patients. In doing this for neuroscience, we can learn lessons from long-standing practices in other areas of simulation (aircraft, computer chips, from software engineering, and from other biomedical disciplines. In this manuscript, we introduce some basic concepts that will be important in the development of credible clinical neuroscience models: reproducibility and replicability; verification and validation; model configuration; and procedures and processes for credible mechanistic multiscale modeling. We also discuss how garnering strong community involvement can promote model credibility. Finally, in addition to direct usage with patients, we note the potential for simulation usage in the area of Simulation-Based Medical Education, an area which to date has been primarily reliant on physical models (mannequins and scenario-based simulations rather than on numerical simulations.

  16. Using Initial, Derived, and Terminal Credibility to Help Students Understand How They Are Perceived by Others

    Science.gov (United States)

    Berry, Marcia

    2018-01-01

    Courses: Public Speaking, Interpersonal Communication, Organizational Communication, Introduction to Communication Studies, Business Communication. Objectives: The goal for this activity is not only to provide students with an understanding of their initial, derived, and terminal credibility when relating a personal, edifying story but also to…

  17. Incorrect, fake, and false: Journalists' perceived online source credibility and verification behavior

    NARCIS (Netherlands)

    Vergeer, M.R.M.

    2018-01-01

    This study focuses on the extent journalists verify information provided by online sources, and tests to what extent this verification behavior can be explained by journalists' perceived credibility of online information and other factors, such as journalism education of journalists, work and

  18. Scientific risk communication about controversial issues influences public perceptions of scientists' political orientations and credibility.

    Science.gov (United States)

    Vraga, Emily; Myers, Teresa; Kotcher, John; Beall, Lindsey; Maibach, Ed

    2018-02-01

    Many scientists communicate with the public about risks associated with scientific issues, but such communication may have unintended consequences for how the public views the political orientations and the credibility of the communicating scientist. We explore this possibility using an experiment with a nationally representative sample of Americans in the fall of 2015. We find that risk communication on controversial scientific issues sometimes influences perceptions of the political orientations and credibility of the communicating scientist when the scientist addresses the risks of issues associated with conservative or liberal groups. This relationship is moderated by participant political ideology, with liberals adjusting their perceptions of the scientists' political beliefs more substantially when the scientist addressed the risks of marijuana use when compared with other issues. Conservatives' political perceptions were less impacted by the issue context of the scientific risk communication but indirectly influenced credibility perceptions. Our results support a contextual model of audience interpretation of scientific risk communication. Scientists should be cognizant that audience members may make inferences about the communicating scientist's political orientations and credibility when they engage in risk communication efforts about controversial issues.

  19. Mental health symptoms identify workers at risk of long-term sickness absence due to mental disorders : prospective cohort study with 2-year follow-up

    NARCIS (Netherlands)

    van Hoffen, Marieke F. A.; Joling, Catelijne I.; Heymans, Martijn W.; Twisk, Jos W. R.; Roelen, Corne A. M.

    2015-01-01

    Background: Mental health problems are a leading cause of long-term sickness absence (LTSA). Workers at risk of mental LTSA should preferably be identified before they report sick. The objective of this study was to examine mental health symptoms as predictors of future mental LTSA in non-sicklisted

  20. Formative Assessment Using Social Marketing Principles to Identify Health and Nutrition Perspectives of Native American Women Living within the Chickasaw Nation Boundaries in Oklahoma

    Science.gov (United States)

    Parker, Stephany; Hunter, Toma; Briley, Chiquita; Miracle, Sarah; Hermann, Janice; Van Delinder, Jean; Standridge, Joy

    2011-01-01

    Objective: To identify health product and promotion channels for development of a Chickasaw Nation Supplemental Nutrition Assistance Education Program (SNAP-Ed) social marketing program. Methods: The study was qualitative and used social marketing principles to assess Native American women's views of health and nutrition. Focus groups (n = 8) and…

  1. Identifying essential components of a digital health innovation ecosystem for the Namibian context: findings from a Delphi study

    CSIR Research Space (South Africa)

    Iyawa, GE

    2017-01-01

    Full Text Available The concept of digital health innovation ecosystems is an emerging body of literature which suggests that components of digital health, innovation and digital ecosystems are important in the administration and delivery of healthcare services...

  2. Investigating the impact of viral message appeal and message credibility on consumer attitude toward brand

    Directory of Open Access Journals (Sweden)

    Majid Esmaeilpour

    2016-12-01

    Full Text Available Background - Due to the rapid growth of the Internet and use of e-commerce in recent years, viral marketing has drawn the attention of manufacturing and service organizations. However, no research has been conducted to examine the impact of message appeal and message source credibility on consumers' attitude with mediating role of intellectual involvement of consumers and their risk taking level. Purpose - The aim of this study was to examine the impact of appeal and message source credibility on consumers’ attitude with mediating role of consumers’ intellectual involvement and their risk taking level. Design/methodology/approach – The population of this study includes consumers of mobile phones (Samsung, Sony, Nokia, LG and iPhone in Bushehr city (Iran. As the population of the study is unlimited, 430 questionnaires were distributed using available sampling method, and 391 questionnaires were collected and analyzed. Using structural equation modeling, data were analyzed through smart PLS software. Findings –The results show that the appeal and credibility of the message source have impact on consumer attitudes toward the brand. It was also found that intellectual involvement of consumers plays the mediating role in the relationship between message appeal and consumer attitudes toward brand. In the relationship between message source credibility and customer attitude towards the brand, the level of risk taking of people has no mediating role. Research limitations/implications – Data collection tool was questionnaire in this study, and questionnaire has some disadvantages that can affect the results. Additionally, this study was conducted in Bushehr city (Iran. Therefore, we should be cautious in generalizing the findings. Originality/value – In this study, the effect of message appeal and message source credibility on consumer attitude to brand was examined. The risk taking level of consumer and his involvement level were considered

  3. Global Zero and Deterrence Credibility : A Critical Analysis of Obama`s Nuclear Policy and Extended Nuclear Deterrence Credibility on the Korean Peninsula

    OpenAIRE

    Ganss, Mathias

    2012-01-01

    This thesis is a qualitative case study analysis of the whether the nuclear policies of President Obama has weakened the U.S. extended nuclear deterrence credibility on the Korean Peninsula. To answer this, the thesis employs two strategies: First, two variables are discussed; a nuclear capabilities-variable; and a nuclear policy-variable. The purpose is to assess the impact the New START treaty has on U.S. nuclear capabilities, and to assess the implications of Obama`s nuclear policy, expres...

  4. Omics analysis of human bone to identify genes and molecular networks regulating skeletal remodeling in health and disease.

    Science.gov (United States)

    Reppe, Sjur; Datta, Harish K; Gautvik, Kaare M

    2017-08-01

    The skeleton is a metabolically active organ throughout life where specific bone cell activity and paracrine/endocrine factors regulate its morphogenesis and remodeling. In recent years, an increasing number of reports have used multi-omics technologies to characterize subsets of bone biological molecular networks. The skeleton is affected by primary and secondary disease, lifestyle and many drugs. Therefore, to obtain relevant and reliable data from well characterized patient and control cohorts are vital. Here we provide a brief overview of omics studies performed on human bone, of which our own studies performed on trans-iliacal bone biopsies from postmenopausal women with osteoporosis (OP) and healthy controls are among the first and largest. Most other studies have been performed on smaller groups of patients, undergoing hip replacement for osteoarthritis (OA) or fracture, and without healthy controls. The major findings emerging from the combined studies are: 1. Unstressed and stressed bone show profoundly different gene expression reflecting differences in bone turnover and remodeling and 2. Omics analyses comparing healthy/OP and control/OA cohorts reveal characteristic changes in transcriptomics, epigenomics (DNA methylation), proteomics and metabolomics. These studies, together with genome-wide association studies, in vitro observations and transgenic animal models have identified a number of genes and gene products that act via Wnt and other signaling systems and are highly associated to bone density and fracture. Future challenge is to understand the functional interactions between bone-related molecular networks and their significance in OP and OA pathogenesis, and also how the genomic architecture is affected in health and disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Influence of User Ratings, Expert Ratings and Purposes of Information Use on the Credibility Judgments of College Students

    Science.gov (United States)

    Lim, Sook; Steffel, Nick

    2015-01-01

    Introduction: This study examined whether user ratings, expert ratings and the purpose of the use of a book on a user-generated site influenced the credibility of the book. It also examined whether the effects of user ratings and expert ratings on credibility judgments of the book varied according to the purpose of information use. In addition,…

  6. Truth and Credibility in Sincere Policy Analysis: Alternative Approaches for the Production of Policy-Relevant Knowledge.

    Science.gov (United States)

    Bozeman, Barry; Landsbergen, David

    1989-01-01

    Two competing approaches to policy analysis are distinguished: a credibility approach, and a truth approach. According to the credibility approach, the policy analyst's role is to search for plausible argument rather than truth. Each approach has pragmatic tradeoffs in fulfilling the goal of providing usable knowledge to decision makers. (TJH)

  7. Controversy matters: Impacts of topic and solution controversy on the perceived credibility of a scientist who advocates.

    Directory of Open Access Journals (Sweden)

    Lindsey Beall

    Full Text Available In this article, we focus on the potential influence of a scientist's advocacy position on the public's perceived credibility of scientists as a whole. Further, we examine how the scientist's solution position (information only, non-controversial, and controversial affects the public's perception of the scientist's motivation for sharing information about specific issues (flu, marijuana, climate change, severe weather. Finally, we assess how perceived motivations mediate the relationship between solution position and credibility. Using data from a quota sample of American adults obtained by Qualtrics (n = 2,453, we found that in some conditions advocating for a solution positively predicted credibility, while in one condition, it negatively predicted scientist credibility. We also found that the influence of solution position on perceived credibility was mediated by several motivation perceptions; most notably through perception that the scientist was motivated to: (a serve the public and (b persuade the public. Further results and implications are discussed.

  8. Public Health Insurance in Vietnam towards Universal Coverage: Identifying the challenges, issues, and problems in its design and organizational practices

    OpenAIRE

    Midori Matsushima; Hiroyuki Yamada

    2013-01-01

    Vietnam is attempting to achieve universal health insurance coverage by 2014. Despite great progress, the country faces some challenges, issues and problems. This paper reviewed official documents, existing reports, and related literature to address: (1) grand design for achieving universal health coverage, (2) current insurance coverage, (3) health insurance premium and subsidies by the government, (4) benefit package and payment rule, and (5) organizational practices. From the review, it be...

  9. Credibility issue

    International Nuclear Information System (INIS)

    Hoos, I.R.

    1978-01-01

    One doesn't know whom to believe among the many experts on the disposition of radioactive wastes, and hence he is thrown on naive faith, scientists' and engineers' faith, and fatalistic faith in science and technology. Despite the general faith in disposal in salt beds, geologists have reservations regarding this mode of disposal. The tendency of some experts to shift the disposal problem to someone else is pointed out. Need for public participation remains

  10. Maximum Credible Event Analysis Methods-Tools and Applications in Biosecurity Programs

    International Nuclear Information System (INIS)

    Rao, V.

    2007-01-01

    Maximum Credible Event (MCE) analyses are analogous to worst-case scenarios involving a likely mishap scenario in biotechnology bioprocessing operations, biological products testing laboratories, and biological specimen repository facilities, leading to release of particulate/aerosolized etiologic agents into the environment. The purpose of MCE analyses is to estimate the effectiveness of existing safeguards such as the engineering controls, administrative procedures and the attributes of facility design that, in combination, prevent the probability of release of potentially pathogenic or toxic material from the test facility to external environment. As part of our support to the United States Chemical Biological Defense Program, we have developed a unique set og realistic MCE worst-case scenarios for all laboratory and industrial aspects of a biological product development process. Although MCE analysis is a part of an overall facility biosafety assessment, our approach considered biosecurity related issues such as facility vulnerability, employment procedures and workers background investigations, exercise and drills involving local law enforcement and emergency response community, records and audits process, and facility biosafety and biosecurity oversight and governance issues. our standard operating procedure for tracking biological material transfer agreements and operating procedures for materials transfer, together with an integrated checklist of biosafety/biosecurity facility inspection and evaluation was to ensure compliance with all biosafety and biosecurity guidelines.The results of MCE analysis, described in terms of potential hazard of exposure for workers and immediate environment to etiologic agents from the manufacturing process, is a quasi-quantitative estimate of the nature and extent of adverse impact on the health and immediate environment at the vicinity. Etiologic agent exposure concentrations are estimated based on a Gaussian air depression

  11. eHealth Literacy: Patient Engagement in Identifying Strategies to Encourage Use of Patient Portals Among Older Adults.

    Science.gov (United States)

    Price-Haywood, Eboni G; Harden-Barrios, Jewel; Ulep, Robin; Luo, Qingyang

    2017-12-01

    Innovations in chronic disease management are growing rapidly as advancements in technology broaden the scope of tools. Older adults are less likely to be willing or able to use patient portals or smartphone apps for health-related tasks. The authors conducted a cross-sectional survey of older adults (ages ≥50) with hypertension or diabetes to examine relationships between portal usage, interest in health-tracking tools, and eHealth literacy, and to solicit practical solutions to encourage technology adoption. Among 247 patients surveyed in a large integrated delivery health system between August 2015 and January 2016, eHealth literacy was positively associated with portal usage (OR [95% CI]: 1.3 [1.2-1.5]) and interest in health-tracking tools (1.2 [1.1-1.3]). Portal users compared to nonusers (N = 137 vs.110) had higher rates of interest in using websites/smartphone apps to track blood pressure (55% vs. 36%), weight (53% vs. 35%), exercise (53% vs. 32%), or medication (46% vs 33%, all P marketing initiatives that capture patient stories demonstrating real-life applications of what patients can do with digital technology, how to use it, and why it may be useful. Health systems also must screen for eHealth literacy, provide training, promote proxy users, and institute quality assurance that ensures patients' experiences will not vary across the system.

  12. Mental Health Services, Free Appropriate Public Education, and Students with Disabilities: Legal Considerations in Identifying, Evaluating, and Providing Services

    Science.gov (United States)

    Yell, Mitchell; Smith, Carl; Katsiyannis, Antonis; Losinski, Mickey

    2018-01-01

    In the past few years, the provision of mental health services in public schools has received considerable attention. When students with disabilities are eligible for special education and related services under the Individuals With Disabilities Education Act (IDEA), mental health services are required if such services are needed to provide…

  13. Breaking down "Healthism": Barriers to Health and Fitness as Identified by Immigrant Youth in St. John's, NL, Canada

    Science.gov (United States)

    Shea, Jennifer M.; Beausoleil, Natalie

    2012-01-01

    In this article, we challenge dominant health and fitness discourses which stress individual responsibility in the attainment of these statuses. We examine the results of an empirical study exploring how a group of 15 Canadian immigrant youth, aged 12-17, discursively construct notions of health and fitness. Qualitative data were collected through…

  14. Questioning History, Nationality and Identity in Timberlake Wertenbaker’s Credible Witness

    Directory of Open Access Journals (Sweden)

    Nursen Gömceli

    2014-05-01

    Full Text Available The aim of this paper is to examine the Anglo-American playwright Timberlake Wertenbaker’s approach to the issues of history, nationality and identity in her play Credible Witness (2001, and to discuss the significance of these concepts in our modern world through a close analysis of the play. In Credible Witness, the playwright brings together people from diverse countries, such as Sri Lanka, Algeria, Eritrea, Somalia and Macedonia in a detention centre in London, and via the stories of these asylum seekers, and particularly through the dramatic encounter between Petra, a Macedonian woman with strong nationalistic pride, and her son Alexander, a history teacher forced to seek refuge in Britain for political reasons, Wertenbaker tries to demonstrate “what happens to people when they step outside, or are forced outside, their history, their identity” (Aston 2003, 13.

  15. The Emotional Moves of a Rational Actor: Smiles, Scowls, and Other Credible Messages

    Directory of Open Access Journals (Sweden)

    Lawrence Ian Reed

    2017-03-01

    Full Text Available Many scholars turn to emotions to understand irrational behavior. We do the opposite: we turn to rationality and game theory to understand people’s emotions. We discuss a striking theory of emotions that began with the game theory of credible threats and promises, then was enriched by evolutionary biology and psychology, and now is being tested in psychological experiments. We review some of these experiments which use economic games to set up strategic situations with real payoffs. The experiments test whether a player’s emotional expressions lend credibility to promises, threats, and claims of danger or hardship. The results offer insights into the hidden strategies behind a warm smile, an angry scowl, a look of terror, and eyes of despair.

  16. Disagreement in expectations and the credibility of monetary authorities in the Brazilian inflation targeting regime

    Directory of Open Access Journals (Sweden)

    Luciano Vereda Oliveira

    2016-01-01

    Full Text Available Based on market expectations reported by the Central Bank of Brazil for the SELIC interest rate, the IPCA inflation, the exchange rate (BRL/USD and the growth rate of industrial production for four different forecasting horizons, this work analyzes the term structures of disagreement in expectations regarding the future values of these variables. It also investigates the driving factors of disagreement, paying special attention to the influence of monetary authorities’ credibility. An extensive regression analysis shows that the levels of the term structures of disagreement are negatively related to the output gap (although this result is not very robust; and that the levels of the term structures of disagreement in expectations about the IPCA inflation rate and the SELIC interest rate have a strong negative relationship with central bankers’ credibility; this relationship is positive in the case of the growth rate of industrial production.

  17. Dose assessment around TR-2 reactor due to maximum credible accident

    International Nuclear Information System (INIS)

    Turgut, M. H.; Adalioglu, U.; Aytekin, A.

    2001-01-01

    The revision of safety analysis report of TR-2 research reactor had been initiated in 1995. The whole accident analysis and accepted scenario for maximum credible accident has been revised according to the new safety concepts and the impact to be given to the environment due to this scenario has been assessed. This paper comprises all results of these calculations. The accepted maximum credible accident scenario is the partial blockage of the whole reactor core which resulted in the release of 25% of the core inventory. The DOSER code which uses very conservative modelling of atmospheric distributions were modified for the assessment calculations. Pasquill conditions based on the local weather observations, topography, and building affects were considered. The thyroid and whole body doses for 16 sectors and up to 10 km of distance around CNAEM were obtained. Release models were puff and a prolonged one of two hours of duration. Release fractions for the active isotopes were chosen from literature which were realistic

  18. The 'credibility paradox' in China's science communication: Views from scientific practitioners.

    Science.gov (United States)

    Zhang, Joy Yueyue

    2015-11-01

    In contrast to increasing debates on China's rising status as a global scientific power, issues of China's science communication remain under-explored. Based on 21 in-depth interviews in three cities, this article examines Chinese scientists' accounts of the entangled web of influence which conditions the process of how scientific knowledge achieves (or fails to achieve) its civic authority. A main finding of this study is a 'credibility paradox' as a result of the over-politicisation of science and science communication in China. Respondents report that an absence of visible institutional endorsements renders them more public credibility and better communication outcomes. Thus, instead of exploiting formal channels of science communication, scientists interviewed were more keen to act as 'informal risk communicators' in grassroots and private events. Chinese scientists' perspectives on how to earn public support of their research sheds light on the nature and impact of a 'civic epistemology' in an authoritarian state. © The Author(s) 2015.

  19. Eletronuclear's relationship with the Brazilian media: transparency and credibility

    Energy Technology Data Exchange (ETDEWEB)

    Alvarez, Gloria, E-mail: galvarez@eletronuclear.gov.br [Eletrobras Termonuclear S.A. (ELETRONUCLEAR), Rio de Janeiro, RJ (Brazil)

    2013-07-01

    In a capitalist economy the most valued assets are not money, shares or facilities, but credibility. Lack of money can ruin a company, but often it is reputation that delivers the final blow. It has become challenging to safeguard reputation in a world where Communication is increasingly connected and with such an intense and lightning fast flow of information. This is particularly true for the electricity sector - a commodity so prevalent in everyday modern life, but, whose business dealings, are hardly known by the general public. When it comes to nuclear energy, the challenge of establishing an effective Communication with transparency and credibility touches on even more complex elements. The topic of this paper is the scenario through which the Communication process, along with its characteristics and approaches, unfolds between the nuclear sector and the Brazilian media. (author)

  20. Information Management at a Health Services Research Organization in Toronto, Ontario, Canada: Moving from Identifiable Data to Coded Data

    Directory of Open Access Journals (Sweden)

    Lisa Thurairasu

    2017-04-01

    The processing practices used at the organization comply with Canadian privacy laws such as the Personal Health Information Protection Act (PHIPA as well as organizational policies and Research Ethics Board approvals. The approaches used to conceal individual identities yet allow linkage to various data sources can be modelled by other health agencies, ministries, and non-health related organizations that work with sensitive data but face challenges in maintaining both privacy and research quality. Our organization strives to make processing as efficient as possible and create maximum linkability to the various data sources in house while upholding privacy and confidentiality.

  1. Shifting Roles, Enduring Values: The Credible Journalist in a Digital Age

    OpenAIRE

    Hayes, A.; Singer, J.; Ceppos, J.

    2007-01-01

    When everyone can be a publisher, what distinguishes the journalist? This article considers contemporary challenges to institutional roles in a digital media environment, then focuses on three broad journalistic normative values -- authenticity, accountability and autonomy -- that affect the credibility of both the journalist and the content he or she provides. A set of questions that can help citizens determine the trustworthiness of the information available to them also is provided.

  2. Assessing the Credibility of Climate Science Information: A Roadmap for Educators

    Science.gov (United States)

    Mandia, S. A.

    2017-12-01

    Although there is an overwhelming scientific consensus that humans are driving modern day climate change, a significant portion of Americans are still not convinced. One reason for this gap in understanding results from a large body of misinformation that is easily accessible by students and educators. Here the author presents an effective teaching model to allow students to assess the credibility of organizations and their authors who publish climate science information aimed toward the general public.

  3. Relationship between green marketing strategies and green marketing credibility among Generation Y

    OpenAIRE

    Garcia Sandoval, Michelle Haeberli; Manon Padilla, Alejandro

    2016-01-01

    Since terms like “sustainability” and “consumer consciousness” were introduced, green products began being integrated into consumers’ lifestyles. But due to the greenwashing practices that took place during the 90’s consumers refrain to buy green products because they do not trust the advertising released by marketers. The purpose of this thesis is to explore the relationship between green advertising credibility (dependent variable) and price sensitiveness, and the four proposed green market...

  4. The Concept of Credibility (Validity) in Television and Internet News Discourse: Critical Analysis

    OpenAIRE

    Boris Ružić

    2010-01-01

    This article reverses the traditional notion of media (television, radio or news papers) as a unidirectional agent of communication from producer to receiver to a more appropriate paradigm inwhich information is not embedded with hierarchy. The new media perspective and the appropriation of technology (Internet) have changed the nature of information dissemination. One cannot discuss authenticity or credibility in terms of ”telling the truth or lying”. On the contrary, users today can verify ...

  5. The Bank of Canada's Monetary Policy Framework; Have Recent Changes Enhanced Central Bank Credibility?

    OpenAIRE

    Takatoshi Ito; Brenda Gonzalez-Hermosillo

    1997-01-01

    In recent years the Bank of Canada has made important changes in the way it conducts monetary policy. In particular, the bank has adopted explicit inflation targets and introduced significant changes to its operational framework designed to increase transparency and reduce market uncertainty. This paper examines the key issues associated with the recent changes in the Bank of Canada’s monetary policy framework and analyzes various indicators of central bank credibility.

  6. DIRECT AND INDIRECT EFFECT OF BRAND CREDIBILITY, BRAND COMMITMENT AND LOYALTY INTENTIONS ON BRAND EQUITY

    OpenAIRE

    Veeva Mathew; Sam Thomas; Joseph I Injodey

    2012-01-01

    Brand equity has been and will be an area of interest for marketing managers. All marketing efforts are directed toward the development ofbrand equity. Therefore efforts are taken among the researchers, to understand the concept of brand equity as deep as possible.This paper attempts to understand the interrelationships among key formative indicators of brand equity, using beliefattitude- intention hierarchy of effects. The formative indicators include brand credibility, brand commitment, and...

  7. The Emotional Moves of a Rational Actor: Smiles, Scowls, and Other Credible Messages

    OpenAIRE

    Lawrence Ian Reed; Peter DeScioli

    2017-01-01

    Many scholars turn to emotions to understand irrational behavior. We do the opposite: we turn to rationality and game theory to understand people’s emotions. We discuss a striking theory of emotions that began with the game theory of credible threats and promises, then was enriched by evolutionary biology and psychology, and now is being tested in psychological experiments. We review some of these experiments which use economic games to set up strategic situations with real payoffs. The exper...

  8. MARKETING COMMUNICATION IN ONLINE SOCIAL PROGRAMS: OHANIAN MODEL OF SOURCE CREDIBILITY

    OpenAIRE

    Serban Corina

    2010-01-01

    The development of the Internet as a medium for interaction with customers has resulted in many changes regarding the promotion of organizations. Online marketing is nowadays used not only to sell a product on the market, but also requires ideas and behavioral change. Non-profit organizations active in online communication are based on the quality of their provided information. Crediblity, attractiveness and usefullness are the key elements that provide effective online social programs. This ...

  9. Influence of Source Credibility on Consumer Acceptance of Genetically Modified Foods in China

    Directory of Open Access Journals (Sweden)

    Mingyang Zhang

    2016-09-01

    Full Text Available This paper examines the reasoning mechanism behind the consumer acceptance of genetically modified foods (GMFs in China, and investigates influence of source credibility on consumer acceptance of GMFs. Based on the original Persuasion Model—which was developed by Carl Hovland, an American psychologist and pioneer in the study of communication and its effect on attitudes and beliefs—we conducted a survey using multistage sampling from 1167 urban residents, which were proportionally selected from six cities in three economic regions (south, central, and north in the Jiangsu province through face to face interviews. Mixed-process regression that could correct endogeneity and ordered probit model were used to test the impact of source credibility on consumers’ acceptance of GMFs. Our major finding was that consumer acceptance of GMFs is affected by such factors as information source credibility, general attitudes, gender, and education levels. The reliability of biotechnology research institutes, government offices devoted to management of GM organisms (GMOs, and GMO technological experts have expedited urban consumer acceptance of GM soybean oil. However, public acceptance can also decrease as faith in the environmental organization. We also found that ignorance of the endogeneity of above mentioned source significantly undervalued its effect on consumers’ acceptance. Moreover, the remaining three sources (non-GMO experts, food companies, and anonymous information found on the Internet had almost no effect on consumer acceptance. Surprisingly, the more educated people in our survey were more skeptical towards GMFs. Our results contribute to the behavioral literature on consumer attitudes toward GMFs by developing a reasoning mechanism determining consumer acceptance of GMFs. Particularly, this paper quantitatively studied the influence of different source credibility on consumer acceptance of GMFs by using mixed-process regression to

  10. Identifying sexual orientation health disparities in adolescents: analysis of pooled data from the Youth Risk Behavior Survey, 2005 and 2007.

    Science.gov (United States)

    Mustanski, Brian; Van Wagenen, Aimee; Birkett, Michelle; Eyster, Sandra; Corliss, Heather L

    2014-02-01

    We studied sexual orientation disparities in health outcomes among US adolescents by pooling multiple Youth Risk Behavior Survey (YRBS) data sets from 2005 and 2007 for 14 jurisdictions. Here we describe the methodology for pooling and analyzing these data sets. Sexual orientation-related items assessed sexual orientation identity, gender of sexual contacts, sexual attractions, and harassment regarding sexual orientation. Wording of items varied across jurisdictions, so we created parallel variables and composite sexual minority variables. We used a variety of statistical approaches to address issues with the analysis of pooled data and to meet the aims of individual articles, which focused on a range of health outcomes and behaviors related to cancer, substance use, sexual health, mental health, violence, and injury.

  11. Preserving professional credibility: grounded theory study of medical trainees' requests for clinical support.

    Science.gov (United States)

    Kennedy, Tara J T; Regehr, Glenn; Baker, G Ross; Lingard, Lorelei

    2009-02-09

    To develop a conceptual framework of the influences on medical trainees' decisions regarding requests for clinical support from a supervisor. Phase 1: members of teaching teams in internal and emergency medicine were observed during regular clinical activities (216 hours) and subsequently completed brief interviews. Phase 2: 36 in depth interviews were conducted using videotaped vignettes to probe tacit influences on decisions to request support. Data collection and analysis used grounded theory methods. Three teaching hospitals in an urban setting in Canada. 124 members of teaching teams on general internal medicine wards and in the emergency department, comprising 31 attending physicians, 57 junior and senior residents, 28 medical students, and eight nurses. Purposeful sampling to saturation was conducted. Trainees' decisions about whether or not to seek clinical support were influenced by three issues: the clinical question (clinical importance, scope of practice), supervisor factors (availability, approachability), and trainee factors (skill, desire for independence, evaluation). Trainees perceived that requesting frequent/inappropriate support threatened their credibility and used rhetorical strategies to preserve credibility. These strategies included building a case for the importance of requests, saving requests for opportune moments, making a plan before requesting support, and targeting requests to specific team members. Trainees consider not only clinical implications but also professional credibility when requesting support from clinical supervisors. Exposing the complexity of this process provides the opportunity to make changes to training programmes to promote timely supervision and provides a framework for further exploration of the impact of clinical training on quality of care of patients.

  12. The Concept of Credibility (Validity in Television and Internet News Discourse: Critical Analysis

    Directory of Open Access Journals (Sweden)

    Boris Ružić

    2010-12-01

    Full Text Available This article reverses the traditional notion of media (television, radio or news papers as a unidirectional agent of communication from producer to receiver to a more appropriate paradigm inwhich information is not embedded with hierarchy. The new media perspective and the appropriation of technology (Internet have changed the nature of information dissemination. One cannot discuss authenticity or credibility in terms of ”telling the truth or lying”. On the contrary, users today can verify information by contrasting traditional media, or by autonomous investigation on the Internet. In this manner, the obtained information is rendered semantically ambiguous. With an approach akin to cultural studies, the authority of the speakers becomes important (unlike today in mainstream television media where a speaker is hidden behind his or her program. New media provides a unique perspective in which the user is always the arbiter of informational usefulness. The crisis that is manifested in traditional media by the lack of subjectivity of the reporter becomes diametrically opposite on the Internet. The all-knowing subject vanishes and gives place to an inter-subjective exchange which deletes hierarchy and the ontology of the ”truth”. A mirror perspective becomes the dominant order, by which one becomes inter-subjective par excellence. Within the present and future of new media, credibility will not be reserved for the ideological mass producers of information, but rather the credibility of the users. By becoming media, users begin to bear the burden of subjective analysis and multivocality.

  13. I FEEL CONNECTED: A COMPARATIVE STUDY OF STUDENT ENGAGEMENT AND LECTURERS’ CREDIBILITY

    Directory of Open Access Journals (Sweden)

    Padma Pillai

    2016-12-01

    Full Text Available Communication is essential. Having the ability to communicate thoughts, ideas, and feelings is crucial in all environments. The education industry regards communication as a core business to transfer knowledge. This paper focuses on how two different groups of students at Sunway University, Malaysia, perceived Lecturers’ Credibility (LC in a class that enhances the Students’ Engagement (SE. A group of 50 to 60 students from the Faculty of Arts (FoA and School of Business (SoB completed measures of LC and SE using McCroskey and Teven’s (1999 Source Credibility Questionnaire (SCQ and Students Engagement Survey from Indicators of Positive Development Conference, Child Trends. The variables for LC comprise competence, character and caring (CCC, and the variables for SE consist of cognitive, behaviour and emotion (CBE. The study aims to determine if there are any differences in SE between students from FoA and SoB with their perceived LC. Hopefully, the study sheds some light on the research question: “Are there any differences among Faculty of Arts students and School of Business students in the relationship between lecturers’ credibility and students’ engagement?”

  14. Towards Credible City Branding Practices: How Do Iran’s Largest Cities Face Ecological Modernization?

    Directory of Open Access Journals (Sweden)

    Negar Noori

    2018-04-01

    Full Text Available City branding is not only increasingly practiced in cities in established economies, but also among municipal governments in countries, until quite recently, rather closed off from the outside world. One country with a strong drive to engage in urban (redevelopment in the post-oil era through enhancing its ‘ecological modernization’ is Iran. Megacities in Iran have all begun to venture into making profiles of what they think they are or would like to be. However, some of the adopted city branding strategies lack sophistication. In this article, the authors examine what indicators can be used for evaluating the credibility of city brands and apply these to Iran’s 15 megacities. After offering brief descriptions of the generic features of each of these cities, they map their use of city brand identities and popular city labels related to ecological modernization and analyze the credibility of their city branding practices. Based on their findings, the authors distinguish five types of cities and explain what makes some types more credible in their use of brands than others. Generally speaking, compared to cities in other nations, Iranian cities pay special attention to historical, natural, cultural, and religious aspects.

  15. Determinants of Judgments of Explanatory Power: Credibility, Generality, and Statistical Relevance

    Science.gov (United States)

    Colombo, Matteo; Bucher, Leandra; Sprenger, Jan

    2017-01-01

    Explanation is a central concept in human psychology. Drawing upon philosophical theories of explanation, psychologists have recently begun to examine the relationship between explanation, probability and causality. Our study advances this growing literature at the intersection of psychology and philosophy of science by systematically investigating how judgments of explanatory power are affected by (i) the prior credibility of an explanatory hypothesis, (ii) the causal framing of the hypothesis, (iii) the perceived generalizability of the explanation, and (iv) the relation of statistical relevance between hypothesis and evidence. Collectively, the results of our five experiments support the hypothesis that the prior credibility of a causal explanation plays a central role in explanatory reasoning: first, because of the presence of strong main effects on judgments of explanatory power, and second, because of the gate-keeping role it has for other factors. Highly credible explanations are not susceptible to causal framing effects, but they are sensitive to the effects of normatively relevant factors: the generalizability of an explanation, and its statistical relevance for the evidence. These results advance current literature in the philosophy and psychology of explanation in three ways. First, they yield a more nuanced understanding of the determinants of judgments of explanatory power, and the interaction between these factors. Second, they show the close relationship between prior beliefs and explanatory power. Third, they elucidate the nature of abductive reasoning. PMID:28928679

  16. Mentalizing skills do not differentiate believers from non-believers, but credibility enhancing displays do.

    Directory of Open Access Journals (Sweden)

    David L R Maij

    Full Text Available The ability to mentalize has been marked as an important cognitive mechanism enabling belief in supernatural agents. In five studies we cross-culturally investigated the relationship between mentalizing and belief in supernatural agents with large sample sizes (over 67,000 participants in total and different operationalizations of mentalizing. The relative importance of mentalizing for endorsing supernatural beliefs was directly compared with credibility enhancing displays-the extent to which people observed credible religious acts during their upbringing. We also compared autistic with neurotypical adolescents. The empathy quotient and the autism-spectrum quotient were not predictive of belief in supernatural agents in all countries (i.e., The Netherlands, Switzerland and the United States, although we did observe a curvilinear effect in the United States. We further observed a strong influence of credibility enhancing displays on belief in supernatural agents. These findings highlight the importance of cultural learning for acquiring supernatural beliefs and ask for reconsiderations of the importance of mentalizing.

  17. Consistency between verbal and non-verbal affective cues: a clue to speaker credibility.

    Science.gov (United States)

    Gillis, Randall L; Nilsen, Elizabeth S

    2017-06-01

    Listeners are exposed to inconsistencies in communication; for example, when speakers' words (i.e. verbal) are discrepant with their demonstrated emotions (i.e. non-verbal). Such inconsistencies introduce ambiguity, which may render a speaker to be a less credible source of information. Two experiments examined whether children make credibility discriminations based on the consistency of speakers' affect cues. In Experiment 1, school-age children (7- to 8-year-olds) preferred to solicit information from consistent speakers (e.g. those who provided a negative statement with negative affect), over novel speakers, to a greater extent than they preferred to solicit information from inconsistent speakers (e.g. those who provided a negative statement with positive affect) over novel speakers. Preschoolers (4- to 5-year-olds) did not demonstrate this preference. Experiment 2 showed that school-age children's ratings of speakers were influenced by speakers' affect consistency when the attribute being judged was related to information acquisition (speakers' believability, "weird" speech), but not general characteristics (speakers' friendliness, likeability). Together, findings suggest that school-age children are sensitive to, and use, the congruency of affect cues to determine whether individuals are credible sources of information.

  18. Optimizing and Validating a Brief Assessment for Identifying Children of Service Members at Risk for Psychological Health Problems Following Parent Deployment

    Science.gov (United States)

    2016-07-01

    Journal of Family Therapy, 21, 313-323. Behar, L.B. (1997). The Preschool Behavior Questionnaire. Journal of Abnormal Child Psychology , 5, 265-275... Psychological Health Problems Following Parent Deployment PRINCIPAL INVESTIGATOR: Julie Wargo Aikins, PhD CONTRACTING ORGANIZATION: Wayne State...Validating a Brief Assessment for Identifying Children of Service Members at Risk for Psychological Health Problems Following Parent Deployment 5b. GRANT

  19. Exposing therapists to trauma-focused treatment in psychosis: effects on credibility, expected burden, and harm expectancies

    Directory of Open Access Journals (Sweden)

    David P. G. van den Berg

    2016-09-01

    Full Text Available Background: Despite robust empirical support for the efficacy of trauma-focused treatments, the dissemination proves difficult, especially in relation to patients with comorbid psychosis. Many therapists endorse negative beliefs about the credibility, burden, and harm of such treatment. Objective: This feasibility study explores the impact of specialized training on therapists’ beliefs about trauma-focused treatment within a randomized controlled trial. Method: Therapist-rated (n=16 credibility, expected burden, and harm expectancies of trauma-focused treatment were assessed at baseline, post-theoretical training, post-technical training, post-supervised practical training, and at 2-year follow-up. Credibility and burden beliefs of therapists concerning the treatment of every specific patient in the trial were also assessed. Results: Over time, therapist-rated credibility of trauma-focused treatment showed a significant increase, whereas therapists’ expected burden and harm expectancies decreased significantly. In treating posttraumatic stress disorder (PTSD in patients with psychotic disorders (n=79, pre-treatment symptom severity was not associated with therapist-rated credibility or expected burden of that specific treatment. Treatment outcome had no influence on patient-specific credibility or burden expectancies of therapists. Conclusions: These findings support the notion that specialized training, including practical training with supervision, has long-term positive effects on therapists’ credibility, burden, and harm beliefs concerning trauma-focused treatment.

  20. Identifying determinants of socioeconomic inequality in health service utilization among patients with chronic non-communicable diseases in China.

    Science.gov (United States)

    Xie, Xin; Wu, Qunhong; Hao, Yanhua; Yin, Hui; Fu, Wenqi; Ning, Ning; Xu, Ling; Liu, Chaojie; Li, Ye; Kang, Zheng; He, Changzhi; Liu, Guoxiang

    2014-01-01

    People with chronic non-communicable diseases (NCD) are particularly vulnerable to socioeconomic inequality due to their long-term expensive health needs. This study aimed to assess socioeconomic-related inequality in health service utilization among NCD patients in China and to analyze factors associated with this disparity. Data were taken from the 2008 Chinese National Health Survey, in which a multiple stage stratified random sampling method was employed to survey 56,456 households. We analyzed the distribution of actual use, need-expected use, and need-standardized usage of outpatient services (over a two-week period) and inpatient services (over one-year) across different income groups in 27,233 adult respondents who reported as having a NCD. We used a concentration index to measure inequality in the distribution of health services, which was expressed as HI (Horizontal Inequity Index) for need-standardized use of services. A non-linear probit regression model was employed to detect inequality across socio-economic groups. Pro-rich inequity in health services among NCD patients was more substantial than the average population. A higher degree of pro-rich inequity (HI = 0.253) was found in inpatient services compared to outpatient services (HI = 0.089). Despite a greater need for health services amongst those of lower socio-economic status, their actual use is much less than their more affluent counterparts. Health service underuse by the poor and overuse by the affluent are evident. Household income disparity was the greatest inequality factor in NCD service use for both outpatients (71.3%) and inpatients (108%), more so than health insurance policies. Some medical insurance schemes, such as the MIUE, actually made a pro-rich contribution to health service inequality (16.1% for outpatient and 12.1% for inpatient). Inequality in health services amongst NCD patients in China remains largely determined by patient financial capability. The current

  1. Identifying determinants of socioeconomic inequality in health service utilization among patients with chronic non-communicable diseases in China.

    Directory of Open Access Journals (Sweden)

    Xin Xie

    Full Text Available BACKGROUND: People with chronic non-communicable diseases (NCD are particularly vulnerable to socioeconomic inequality due to their long-term expensive health needs. This study aimed to assess socioeconomic-related inequality in health service utilization among NCD patients in China and to analyze factors associated with this disparity. METHODS: Data were taken from the 2008 Chinese National Health Survey, in which a multiple stage stratified random sampling method was employed to survey 56,456 households. We analyzed the distribution of actual use, need-expected use, and need-standardized usage of outpatient services (over a two-week period and inpatient services (over one-year across different income groups in 27,233 adult respondents who reported as having a NCD. We used a concentration index to measure inequality in the distribution of health services, which was expressed as HI (Horizontal Inequity Index for need-standardized use of services. A non-linear probit regression model was employed to detect inequality across socio-economic groups. RESULTS: Pro-rich inequity in health services among NCD patients was more substantial than the average population. A higher degree of pro-rich inequity (HI = 0.253 was found in inpatient services compared to outpatient services (HI = 0.089. Despite a greater need for health services amongst those of lower socio-economic status, their actual use is much less than their more affluent counterparts. Health service underuse by the poor and overuse by the affluent are evident. Household income disparity was the greatest inequality factor in NCD service use for both outpatients (71.3% and inpatients (108%, more so than health insurance policies. Some medical insurance schemes, such as the MIUE, actually made a pro-rich contribution to health service inequality (16.1% for outpatient and 12.1% for inpatient. CONCLUSIONS: Inequality in health services amongst NCD patients in China remains largely

  2. Evaluation of Quality and Readability of Health Information Websites Identified through India’s Major Search Engines

    Directory of Open Access Journals (Sweden)

    S. Raj

    2016-01-01

    Full Text Available Background. The available health information on websites should be reliable and accurate in order to make informed decisions by community. This study was done to assess the quality and readability of health information websites on World Wide Web in India. Methods. This cross-sectional study was carried out in June 2014. The key words “Health” and “Information” were used on search engines “Google” and “Yahoo.” Out of 50 websites (25 from each search engines, after exclusion, 32 websites were evaluated. LIDA tool was used to assess the quality whereas the readability was assessed using Flesch Reading Ease Score (FRES, Flesch-Kincaid Grade Level (FKGL, and SMOG. Results. Forty percent of websites (n=13 were sponsored by government. Health On the Net Code of Conduct (HONcode certification was present on 50% (n=16 of websites. The mean LIDA score (74.31 was average. Only 3 websites scored high on LIDA score. Only five had readability scores at recommended sixth-grade level. Conclusion. Most health information websites had average quality especially in terms of usability and reliability and were written at high readability levels. Efforts are needed to develop the health information websites which can help general population in informed decision making.

  3. Identifying preferred format and source of exercise information in persons with multiple sclerosis that can be delivered by health-care providers.

    Science.gov (United States)

    Learmonth, Yvonne C; Adamson, Brynn C; Balto, Julia M; Chiu, Chung-Yi; Molina-Guzman, Isabel M; Finlayson, Marcia; Riskin, Barry J; Motl, Robert W

    2017-10-01

    There is increasing recognition of the benefits of exercise in individuals with multiple sclerosis (MS), yet the MS population does not engage in sufficient amounts of exercise to accrue health benefits. There has been little qualitative inquiry to establish the preferred format and source for receiving exercise information from health-care providers among persons with MS. We sought to identify the desired and preferred format and source of exercise information for persons with MS that can be delivered through health-care providers. Participants were adults with MS who had mild or moderate disability and participated in a range of exercise levels. All participants lived in the Midwest of the United States. Fifty semi-structured interviews were conducted and analysed using thematic analysis. Two themes emerged, (i) approach for receiving exercise promotion and (ii) ideal person for promoting exercise. Persons with MS want to receive exercise information through in-person consultations with health-care providers, print media and electronic media. Persons with MS want to receive exercise promotion from health-care providers with expertise in MS (ie neurologists) and with expertise in exercise (eg physical therapists). These data support the importance of understanding how to provide exercise information to persons with MS and identifying that health-care providers including neurologists and physical therapists should be involved in exercise promotion. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  4. Health-Related Quality of Life of Adolescent and Young Adult Survivors of Central Nervous System Tumors: Identifying Domains From a Survivor Perspective.

    Science.gov (United States)

    Kuhlthau, Karen; Luff, Donna; Delahaye, Jennifer; Wong, Alicia; Yock, Torunn; Huang, Mary; Park, Elyse R

    2015-01-01

    This article uses qualitative methods to describe the domains of health-related quality of life (HRQoL) that adolescent and young adult (AYA) survivors of central nervous system (CNS) tumors identify as important. Survivors clearly attributed aspects of their current HRQoL to their disease or its treatment. We identified 7 key domains of AYA CNS tumor survivorship: physical health, social well-being, mental health, cognitive functioning, health behaviors, sexual and reproductive health, and support systems. Although most aspects of HRQoL that survivors discussed represented new challenges, there were several areas where survivors pointed out positive outcomes. There is a need for a HRQoL tool designed for this population of survivors, given their unique treatment and survivorship experience. Aspects of HRQoL related to cognition, sexual and reproductive health, health behaviors, and support systems are not typically included in generic HRQoL tools but should be assessed for this population. Developing HRQoL measurement instruments that capture the most significant aspects of HRQoL will improve the ability to track HRQoL in AYA CNS tumor survivors and in the long-term management of common sequelae from CNS tumors and their treatments. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

  5. Using information communication technology to identify deficits in rural health care: a mixed-methods evaluation from Guatemala.

    Science.gov (United States)

    Wahedi, Katharina; Flores, Walter; Beiersmann, Claudia; Bozorgmehr, Kayvan; Jahn, Albrecht

    2018-01-01

    In August 2014, the Centre for the Studies of Equity and Governance in Health Systems (CEGSS) in Guatemala launched an online platform, which facilitates complaints about health services via text messages. The aim is to collect, systemise and forward such complaints to relevant institutions, and to create a data pool on perceived deficits of health care in rural Guatemala. To evaluate if the online platform is an accepted, user-friendly and efficient medium to engage citizens in the reporting of health care deficiencies in Guatemala. The general study design of this research was a mixed-method approach including a quantitative analysis of complaints received and a qualitative exploration of the attitude of community leaders towards the platform. User statistics showed that a total of N = 228 messages were sent to the platform in the period August 2014-March 2015. The majority of complaints (n = 162, 71%) fell under the 'lack of drugs, equipment or supplies' category. The community leaders welcomed the platform, describing it as modern and progressive. Despite feedback mechanisms and methods to respond to complaints not yet being fully developed, many users showed a high intrinsic motivation to use the new tool. Others, however, were restrained by fear of personal consequences and distrust of the state's judicial system. Access to mobile phones, reception, and phone credit or battery life did not pose major obstacles, but the producing and sending of correctly formatted messages was observed to be difficult. The online platform paired with SMS technology appears to be a viable approach to collect citizens' complaints in health care and connect citizens with relevant institutions. Further studies should be conducted to quantify follow-up activities and the impact on local health care provision.

  6. Strategies to identify future shortages due to interruptions in the health care procurement supply chain and their impact on health services: a method from the English National Health Service.

    Science.gov (United States)

    Grose, Jane; Richardson, Janet

    2014-01-01

    The uninterrupted supply of essential items for patient care is crucial for organizations that deliver health care. Many products central to health care are derived from natural resources such as oil and cotton, supplies of which are vulnerable to climate change and increasing global demand. The purpose of this study was to identify which items would have the greatest effect on service delivery and patient outcomes should they no longer be available. Using a consensus development approach, all items bought by one hospital, over one year, were subjected to a filtering process. Criteria were developed to identify at-risk products and assess them against specific risks and opportunities. Seventy-two items were identified for assessment against a range of potential impacts on service delivery and patient outcomes, from no impact to significant impact. Clinical and non-clinical participants rated the items. In the category of significant impact, consensus was achieved for 20 items out of 72. There were differences of opinion between clinical and non-clinical participants in terms of significant impact in relation to 18 items, suggesting that priority over purchasing decisions may create areas of conflict. Reducing reliance on critically scarce resources and reducing demand were seen as the most important criteria in developing sustainable procurement. The method was successful in identifying items vulnerable to supply chain interruption and should be repeated in other areas to test its ability to adapt to local priorities, and to assess how it functions in a variety of public and private settings.

  7. Animal Health Challenges and Veterinary Aspects of Organic Livestock Farming Identified Through a 3 Year EU Network Project

    DEFF Research Database (Denmark)

    Vaarst, Mette; Padel, Susanne; Younie, David

    2008-01-01

    From 2003-2006, an EU network project ‘Sustaining Animal Health and Food Safety in Organic Farming‘ (SAFO), was carried out with 26 partners from 20 EU-countries and 4 related partners from 4 candidate or new member states. The focus was the integration of animal health and welfare issues...... in organic farming with food safety aspects. Four very consistent conclusions became apparent: 1) The climatic, physical and socio-economic conditions vary considerably throughout Europe, leading to different livestock farming systems. This limits the possibility for technology transfer between regions...

  8. Contributing factors to the use of health-related websites.

    Science.gov (United States)

    Hong, Traci

    2006-03-01

    This study explicates the influence of audience factors on website credibility and the subsequent effect that credibility has on the intention to revisit a site. It does so in an experimental setting in which participants were given two health-related search tasks. Reliance on the web for health-related information positively influenced website credibility in both searches. Knowledge was a significant predictor for the search task that required more cognitive ability. Of the credibility dimensions, trust/expertise and depth were significant predictors of intention to revisit a site in both searches. Fairness and goodwill were nonsignificant predictors in both searches.

  9. Big data in health care: using analytics to identify and manage high-risk and high-cost patients.

    Science.gov (United States)

    Bates, David W; Saria, Suchi; Ohno-Machado, Lucila; Shah, Anand; Escobar, Gabriel

    2014-07-01

    The US health care system is rapidly adopting electronic health records, which will dramatically increase the quantity of clinical data that are available electronically. Simultaneously, rapid progress has been made in clinical analytics--techniques for analyzing large quantities of data and gleaning new insights from that analysis--which is part of what is known as big data. As a result, there are unprecedented opportunities to use big data to reduce the costs of health care in the United States. We present six use cases--that is, key examples--where some of the clearest opportunities exist to reduce costs through the use of big data: high-cost patients, readmissions, triage, decompensation (when a patient's condition worsens), adverse events, and treatment optimization for diseases affecting multiple organ systems. We discuss the types of insights that are likely to emerge from clinical analytics, the types of data needed to obtain such insights, and the infrastructure--analytics, algorithms, registries, assessment scores, monitoring devices, and so forth--that organizations will need to perform the necessary analyses and to implement changes that will improve care while reducing costs. Our findings have policy implications for regulatory oversight, ways to address privacy concerns, and the support of research on analytics. Project HOPE—The People-to-People Health Foundation, Inc.

  10. Formative research to identify perceptions of e-cigarettes in college students: Implications for future health communication campaigns

    Science.gov (United States)

    Case, Kathleen; Crook, Brittani; Lazard, Allison; Mackert, Michael

    2016-01-01

    Objective This formative study examined perceptions of e-cigarettes in college students with the goal of informing future health communication campaigns. Differences between e-cigarette users and nonusers were also examined. Participants: Thirty undergraduate students were recruited from a large southwestern public university (15 users, 15 nonusers). Methods Structured interviews were conducted and transcripts were coded for themes. Results Although users had more favorable attitudes toward e-cigarettes, both users and nonusers believed that e-cigarettes produce water vapor and reported that e-cigarettes were less harmful than conventional cigarettes. Potential health consequences and addiction concerns were the most common perceived threats for both users and nonusers. Both nonusers and users cited social stigma as a perceived disadvantage of e-cigarette use. Conclusions Ultimately, themes with particular relevance to future health communication campaigns included negative perceptions of e-cigarette users and social stigma, as well as harm perceptions and potential health consequences associated with e-cigarette use. PMID:26979833

  11. Design for success: Identifying a process for transitioning to an intensive online course delivery model in health professions education.

    Science.gov (United States)

    McDonald, Paige L; Harwood, Kenneth J; Butler, Joan T; Schlumpf, Karen S; Eschmann, Carson W; Drago, Daniela

    2018-12-01

    Intensive courses (ICs), or accelerated courses, are gaining popularity in medical and health professions education, particularly as programs adopt e-learning models to negotiate challenges of flexibility, space, cost, and time. In 2014, the Department of Clinical Research and Leadership (CRL) at the George Washington University School of Medicine and Health Sciences began the process of transitioning two online 15-week graduate programs to an IC model. Within a year, a third program also transitioned to this model. A literature review yielded little guidance on the process of transitioning from 15-week, traditional models of delivery to IC models, particularly in online learning environments. Correspondingly, this paper describes the process by which CRL transitioned three online graduate programs to an IC model and details best practices for course design and facilitation resulting from our iterative redesign process. Finally, we present lessons-learned for the benefit of other medical and health professions' programs contemplating similar transitions. CRL: Department of Clinical Research and Leadership; HSCI: Health Sciences; IC: Intensive course; PD: Program director; QM: Quality Matters.

  12. Formative Research to Identify Perceptions of E-Cigarettes in College Students: Implications for Future Health Communication Campaigns

    Science.gov (United States)

    Case, Kathleen; Crook, Brittani; Lazard, Allison; Mackert, Michael

    2016-01-01

    Objective: This formative study examined perceptions of e-cigarettes in college students with the goal of informing future health communication campaigns. Differences between e-cigarette users and nonusers were also examined. Participants: Thirty undergraduate students were recruited from a large southwestern public university (15 users, 15…

  13. Human health and the water environment: using the DPSEEA framework to identify the driving forces of disease.

    Science.gov (United States)

    Gentry-Shields, Jennifer; Bartram, Jamie

    2014-01-15

    There is a growing awareness of global forces that threaten human health via the water environment. A better understanding of the dynamic between human health and the water environment would enable prediction of the significant driving forces and effective strategies for coping with or preventing them. This report details the use of the Driving Force-Pressure-State-Exposure-Effect-Action (DPSEEA) framework to explore the linkage between water-related diseases and their significant driving forces. The DPSEEA frameworks indicate that a select group of driving forces, including population growth, agriculture, infrastructure (dams and irrigation), and climate change, is at the root cause of key global disease burdens. Construction of the DPSEEA frameworks also allows for the evaluation of public health interventions. Sanitation was found to be a widely applicable and effective intervention, targeting the driver/pressure linkage of most of the water-related diseases examined. Ultimately, the DPSEEA frameworks offer a platform for constituents in both the health and environmental fields to collaborate and commit to a common goal targeting the same driving forces. © 2013.

  14. LGBT Identity, Untreated Depression, and Unmet Need for Mental Health Services by Sexual Minority Women and Trans-Identified People.

    Science.gov (United States)

    Steele, Leah S; Daley, Andrea; Curling, Deone; Gibson, Margaret F; Green, Datejie C; Williams, Charmaine C; Ross, Lori E

    2017-02-01

    Previous studies have found that transgender, lesbian, and bisexual people report poorer mental health relative to heterosexuals. However, available research provides little information about mental health service access among the highest need groups within these communities: bisexual women and transgender people. This study compared past year unmet need for mental health care and untreated depression between four groups: heterosexual cisgender (i.e., not transgender) women, cisgender lesbians, cisgender bisexual women, and transgender people. This was a cross-sectional Internet survey. We used targeted sampling to recruit 704 sexual and gender minority people and heterosexual cisgendered adult women across Ontario, Canada. To ensure adequate representation of vulnerable groups, we oversampled racialized and low socioeconomic status (SES) women. Trans participants were 2.4 times (95% confidence intervals [CI] = 1.6-3.8, p mental healthcare as cisgender heterosexual women. Trans participants were also 1.6 times (95% CI = 1.0-27, p = 0.04) more likely to report untreated depression. These differences were not seen after adjustment for social context factors such as discrimination and social support. We conclude that there are higher rates of unmet need and untreated depression in trans and bisexual participants that are partly explained by differences in social factors, including experiences of discrimination, lower levels of social support, and systemic exclusion from healthcare. Our findings suggest that the mental health system in Ontario is not currently meeting the needs of many sexual and gender minority people.

  15. Laboratory Characterization of Noroviruses Identified in Specimens from Military Health System Beneficiaries During an Outbreak in Germany, 2016-2017

    Science.gov (United States)

    2017-07-01

    workplaces, restaurants , grocery stores, and day care facilities could have been fre- quented by both military personnel and the local German...guidance and aid in prevention of disease transmission as well as mitigate possible operational impacts. Author affiliations: Armed Forces Health...Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway

  16. The use of nominal group technique in identifying community health priorities in Moshi rural district, northern Tanzania

    DEFF Research Database (Denmark)

    Makundi, E A; Manongi, R; Mushi, A K

    2005-01-01

    in the list implying that priorities should not only be focused on diseases, but should also include health services and social cultural issues. Indeed, methods which are easily understood and applied thus able to give results close to those provided by the burden of disease approaches should be adopted....... The patients/caregivers, women's group representatives, youth leaders, religious leaders and community leaders/elders constituted the principal subjects. Emphasis was on providing qualitative data, which are of vital consideration in multi-disciplinary oriented studies, and not on quantitative information from....... It is the provision of ownership of the derived health priorities to partners including the community that enhances research utilization of the end results. In addition to disease-based methods, the Nominal Group Technique is being proposed as an important research tool for involving the non-experts in priority...

  17. Can optimism, pessimism, hope, treatment credibility and treatment expectancy be distinguished in patients undergoing Total Hip and Total Knee Arthroplasty?

    NARCIS (Netherlands)

    Haanstra, T.M.; Tilbury, C.; Kamper, S.J.; Tordoir, R.L.; Vliet Vlieland, T.P.M.; Nelissen, R.G.H.H.; Cuijpers, P.; de Vet, H.C.W.; Dekker, J.; Knol, D.L.; Ostelo, R.W.J.G.

    2015-01-01

    Objectives: The constructs optimism, pessimism, hope, treatment credibility and treatment expectancy are associated with outcomes of medical treatment. While these constructs are grounded in different theoretical models, they nonetheless show some conceptual overlap. The purpose of this study was to

  18. Gene expression profiling to identify potentially relevant disease outcomes and support human health risk assessment for carbon black nanoparticle exposure.

    Science.gov (United States)

    Bourdon, Julie A; Williams, Andrew; Kuo, Byron; Moffat, Ivy; White, Paul A; Halappanavar, Sabina; Vogel, Ulla; Wallin, Håkan; Yauk, Carole L

    2013-01-07

    New approaches are urgently needed to evaluate potential hazards posed by exposure to nanomaterials. Gene expression profiling provides information on potential modes of action and human relevance, and tools have recently become available for pathway-based quantitative risk assessment. The objective of this study was to use toxicogenomics in the context of human health risk assessment. We explore the utility of toxicogenomics in risk assessment, using published gene expression data from C57BL/6 mice exposed to 18, 54 and 162 μg Printex 90 carbon black nanoparticles (CBNP). Analysis of CBNP-perturbed pathways, networks and transcription factors revealed concomitant changes in predicted phenotypes (e.g., pulmonary inflammation and genotoxicity), that correlated with dose and time. Benchmark doses (BMDs) for apical endpoints were comparable to minimum BMDs for relevant pathway-specific expression changes. Comparison to inflammatory lung disease models (i.e., allergic airway inflammation, bacterial infection and tissue injury and fibrosis) and human disease profiles revealed that induced gene expression changes in Printex 90 exposed mice were similar to those typical for pulmonary injury and fibrosis. Very similar fibrotic pathways were perturbed in CBNP-exposed mice and human fibrosis disease models. Our synthesis demonstrates how toxicogenomic profiles may be used in human health risk assessment of nanoparticles and constitutes an important step forward in the ultimate recognition of toxicogenomic endpoints in human health risk. As our knowledge of molecular pathways, dose-response characteristics and relevance to human disease continues to grow, we anticipate that toxicogenomics will become increasingly useful in assessing chemical toxicities and in human health risk assessment. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

  19. The Age of Emotionality? – How emotions influence consumers’ perception of credibility and trust in CSR communication

    OpenAIRE

    Reupsch, Anika

    2017-01-01

    Companies around the world are using different strategies for their corporate social responsibility (CSR) communication, but finding an appropriate strategy to enhance trust and credibility on the consumer side remains challenging. The constitutive aspect of emotions in CSR communication has long been overlooked. Therefore, this study investigates the influence emotions in CSR communication have on the credibility and trust consumers have in a firm’s CSR. Quantitative research with group divi...

  20. Factors that optimise the credibility of advertisements whilst promoting feelings of emotional well-being and satisfaction

    OpenAIRE

    Duck, Nicholas

    2017-01-01

    The aim of this thesis is to demonstrate that advertisements that challenge the security of consumers can undermine the impact and lasting influence of these messages. Conversely, advertisements could be used to evoke feelings of security and enhance emotional well-being whilst optimising the credibility and impact of messages. Specifically, research demonstrates that advertisements might elicit different motivational styles, referred to as an individual’s regulatory focus. The credibility of...