WorldWideScience

Sample records for profitable online patient

  1. Analisis Teknikal Untuk Mendapatkan Profit Dalam Forex Trading Online

    OpenAIRE

    Liyanto, .; Alwiyah, .

    2012-01-01

    Technical Analysis To Obtain Profit From Online Forex Trading. The purpose of the research is to find profitable consistency in predicting price movement, especially on pairs GBPUSD and EURUSD using candlestick, moving average convergence divergence (MACD) and stochastic oscillator as parts of technical analysis before taking an action whether to buy or to sell forex. The profit is calculated for every given buy-sell signal after considering transaction cost in the amount of spread. The desig...

  2. Patient experience and hospital profitability: Is there a link?

    Science.gov (United States)

    Richter, Jason P; Muhlestein, David B

    Patient experience has had a direct financial impact on hospitals since value-based purchasing was instituted by the Centers for Medicare & Medicaid Services in 2013 as a method to reward or punish hospitals based on performance on various measures, including patient experience. Although other industries have shown an indirect impact of customer experience on overall profitability, that link has not been well established in the health care industry. Return-to-provider rate and perceptions of health quality have been associated with profitability in the health care industry. Our aims were to assess whether, independent of a direct financial impact, a more positive patient experience is associated with increased profitability and whether a more negative patient experience is associated with decreased profitability. We used a sample of 19,792 observations from 3767 hospitals over the 6-year period 2007-2012. The data were sourced from Centers for Medicare & Medicaid Services and Hospital Consumer Assessment of Healthcare Providers and Systems. Using generalized estimating equations to account for repeated measures, we fit four separate models for three dependent variables: net patient revenue, net income, and operating margin. Each model included one of the following independent variables of interest: percentage of patients who definitely recommend the hospital, percentage of patients who definitely would not recommend the hospital, percentage of patients who rated the hospital 9 or 10, and percentage of patients who rated the hospital 6 or lower. We identified that a positive patient experience is associated with increased profitability and a negative patient experience is even more strongly associated with decreased profitability. Management should have greater justification for incurring costs associated with bolstering patient experience programs. Improvements in training, technology, and staffing can be justified as a way to improve not only quality but now

  3. Characteristics of Part-Time Online Instructors: A Comparison of For-Profit to Nonprofit Faith-Based Institutions

    Science.gov (United States)

    Starcher, Keith O.

    2017-01-01

    As the for-profit business model and a reliance on adjunct faculty continues to grow among faith-based institutions, little research exists on the differences in the characteristics of part-time online faculty in for-profit versus nonprofit environments that could provide guidance to administrators. This study utilized a descriptive,…

  4. Simulating the conflict between reputation and profitability for online rating portals

    OpenAIRE

    Galitsky, Boris A.; Levene, Mark

    2004-01-01

    We simulate the process of possible interactions between a set of competitive services and a set of portals that provide online rating for these services. We argue that to have a profitable business, these portals are forced to have subscribed services that are rated by the portals. To satisfy the subscribing services, we make the assumption that the portals improve the rating of a given service by one unit per transaction that involves payment. In this study we follow the 'what-if' methodolo...

  5. Readability assessment of online ophthalmic patient information.

    Science.gov (United States)

    Edmunds, Matthew R; Barry, Robert J; Denniston, Alastair K

    2013-12-01

    Patients increasingly use the Internet to access information related to their disease, but poor health literacy is known to impact negatively on medical outcomes. Multiple agencies have recommended that patient-oriented literature be written at a fourth- to sixth-grade (9-12 years of age) reading level to assist understanding. The readability of online patient-oriented materials related to ophthalmic diagnoses is not yet known. To assess the readability of online literature specifically for a range of ophthalmic conditions. Body text of the top 10 patient-oriented websites for 16 different ophthalmic diagnoses, covering the full range of ophthalmic subspecialties, was analyzed for readability, source (United Kingdom vs non-United Kingdom, not for profit vs commercial), and appropriateness for sight-impaired readers. Four validated readability formulas were used: Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Fog Index (GFOG). Data were compared with the Mann-Whitney test (for 2 groups) and Kruskal-Wallis test (for more than 2 groups) and correlation was assessed by the Spearman r. None of the 160 webpages had readability scores within published guidelines, with 83% assessed as being of "difficult" readability. Not-for-profit webpages were of significantly greater length than commercial webpages (P = .02) and UK-based webpages had slightly superior readability scores compared with those of non-UK webpages (P = .004 to P visually impaired readers. To our knowledge, this is the first study to assess readability of patient-focused webpages specifically for a range of ophthalmic diagnoses. In keeping with previous studies in other medical conditions, we determined that readability scores were inferior to those recommended, irrespective of the measure used. Although readability is only one aspect of how well a patient-oriented webpage may be comprehended, we recommend the use of readability scoring

  6. The Acceptability of Online and For-Profit Nursing Degrees: A Study of Hiring Gatekeeper Perceptions

    Science.gov (United States)

    Kinneer, James W.

    2014-01-01

    A national survey of health care recruiters was used to compare their attitudes toward four different RN-to-BSN degree options based on the method of instruction (classroom, online) and the type of college (traditional, forprofit). The analysis was based on the data received from 116 respondents who completed the questionnaire. The study findings…

  7. Finding the community in sustainable online community engagement: Not-for-profit organisation websites, service-learning and research

    Directory of Open Access Journals (Sweden)

    Alice Dodd

    2017-06-01

    Full Text Available This article explores the use of action research (2008–2014 based on a case study of the Sustainable Online Community Engagement (SOCE Project, a service-learning project in which University of South Australia students build websites for not-for-profit (NFP organisations, to demonstrate that effective teaching, public service and research are interdependent. A significant problem experienced in the SOCE project was that, despite some training and ongoing assistance, the community organisations reported that they found it difficult to make effective use of their websites. One of the proposed solutions was to develop an online community of the participating organisations that would be self-supporting, member-driven and collaborative, and enable the organisations to share information about web-based technology. The research reported here explored the usefulness of developing such an online community for the organisations involved and sought alternative ways to assist the organisations to maintain an effective and sustainable web presence. The research used a three-phase ethnographic action research approach. The first phase was a content analysis and review of the editing records of 135 organisational websites hosted by the SOCE project. The second phase was an online survey sent to 145 community organisation members responsible for the management of these websites, resulting in 48 responses. The third phase consisted of semi-structured, in-depth interviews with 18 of the website managers from 12 of these organisations. The research revealed the extent to which organisations were unable to manage their websites and found that the proposed solution of an online community would not be useful. More importantly, it suggested other useful strategies which have been implemented. In Furco’s (2010 model of the engaged campus, public engagement can be used to advance the public service, teaching and research components of higher education’s tripartite

  8. BUILDING PATIENT LOYALTY USING ONLINE TOOLS

    OpenAIRE

    Vladoi Anca Daniela; Popa Adela Laura

    2010-01-01

    The aim of the paper is to present the online tools used by private healthcare organizations in order to generate patient loyalty. The research emphases a comparative analyze between the Romanian and other European countries private healthcare organizations referring to online tools used by these organizations on their websites to generate patient loyalty.

  9. BUILDING PATIENT LOYALTY USING ONLINE TOOLS

    Directory of Open Access Journals (Sweden)

    Vladoi Anca Daniela

    2010-07-01

    Full Text Available The aim of the paper is to present the online tools used by private healthcare organizations in order to generate patient loyalty. The research emphases a comparative analyze between the Romanian and other European countries private healthcare organizations referring to online tools used by these organizations on their websites to generate patient loyalty.

  10. Profit or patients' health benefit? Exploring the heterogeneity in physician altruism.

    Science.gov (United States)

    Godager, Geir; Wiesen, Daniel

    2013-12-01

    This paper investigates physician altruism toward patients' health benefit using behavioral data from Hennig-Schmidt et al.'s (2011) laboratory experiment. In the experiment, medical students in the role of physicians decide on the provision of medical services. The experimental setup allows us to identify the influence of profits and patients' health benefit on the choice of medical treatment. We estimate physician altruism, the weight individuals attach to patients' health benefit, by fitting mixed logit and multinomial logit regression models to the experimental data. Estimation results provide evidence for physician altruism. We find, however, substantial variation in the degree of physician altruism. We also discuss some implications of our results for the design of physician payment schemes in the light of the theoretical literature. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Compliance or patient empowerment in online communities

    DEFF Research Database (Denmark)

    Wentzer, Helle; Bygholm, Ann

    2010-01-01

    New technologies enable a different organization of the public’s admission to health care services. The article discusses whether online support groups in patient treatment are to be understood in the light of patient empowerment or within the tradition of compliance. The back-ground material...... of opening up health care to the critical voice of the public, the quantitative and qualitative studies surprisingly point to a synthesis of the otherwise opposite positions of empowerment and compliance in patient care. Thereby the critical potential of online communities in health care services seems...... of the discussion is complementary data from quantitative research on characteristics of patient support groups, and from two qualitative, in depth studies of the impact of patient networks for lung patients and for women with fertility problems. We conclude that in spite of the potential of online communities...

  12. The impact of age and gender on resource utilization and profitability in ED patients seen and released.

    Science.gov (United States)

    Henneman, Philip L; Nathanson, Brian H; Ribeiro, Kara; Balasubramanian, Hari

    2014-10-01

    To determine how age and gender impact resource utilization and profitability in patients seen and released from an Emergency Department (ED). Billing data for patients seen and released from an Emergency Department (ED) with >100,000 annual visits between 2003 and 2009 were collected. Resource utilization was measured by length of stay (placement in ED bed to leaving the bed) and direct clinical costs (e.g., ED nursing salary and benefits, pharmacy and supply costs, etc.) estimated using relative value unit cost accounting. The primary outcome of profitability was defined as contribution margin per hour. A patient's contribution margin by insurance type (excluding self-pay) was determined by subtracting direct clinical costs from facility contractual revenue. Results are expressed as medians and US dollars. In 523 882 outpatient ED encounters, as patients' aged, length of stay and direct clinical cost increased while the contribution margin and contribution margin by hour decreased. Women of childbearing age (15-44) had higher median length of stay (2.1 hours), direct clinical cost ($149), and contribution margin per hour ($103/hour) than men of same age (1.7, $131, $85/hour, respectively). Resource utilization and profitability by gender were similar in children and adults over 45. Resource utilization increased and profitability decreased with increasing age in patients seen and released from an ED. The care of women of childbearing age resulted in higher resource utilization and higher profitability than men of the same age. No differences in resource utilization or profitability by gender were observed in children and adults over 45. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. The Impact of Social Engagement on Customer Profitability - Insights from a Direct Banking Institution’s Online Customer Network

    OpenAIRE

    Felgenhauer, Annette; Klier, Julia; Klier, Mathias; Lindner, Georg

    2017-01-01

    The digital transformation leads to an enormous change in the customer-firm relationship. Recently launched firm-sponsored online customer networks enable customers to actively interact with the company and other customers in form of social engagement activities like asking and answering questions or receiving feedback. Despite the increasing importance of online customer networks, existing literature still lacks an in-depth understanding of the impact of social engagement on customer profita...

  14. Self-reported differences in empowerment between lurkers and posters in online patient support groups.

    Science.gov (United States)

    van Uden-Kraan, Cornelia F; Drossaert, Constance H C; Taal, Erik; Seydel, Erwin R; van de Laar, Mart A F J

    2008-06-30

    Patients who visit online support groups benefit in various ways. Results of our earlier study indicated that participation in online support groups had a profound effect on the participants' feelings of "being empowered." However, most studies of online patient support groups have focused on the members of these groups who actively contribute by sending postings (posters). Thus far, little is known about the impact for "lurkers" (ie, those who do not actively participate by sending postings). In the present study, we explored if lurkers in online patient support groups profit to the same extent as posters do. We searched the Internet with the search engine Google to identify all Dutch online support groups for patients with breast cancer, fibromyalgia, and arthritis. Invitations to complete an online survey were sent out by the owners of 19 groups. In the online questionnaire, we asked questions about demographic and health characteristics, use of and satisfaction with the online support group, empowering processes, and empowering outcomes. The online questionnaire was completed by 528 individuals, of which 109 (21%) identified themselves as lurkers. Lurkers (mean age 47 years) were slightly older than active participants (mean age 43 years, P = .002), had a shorter disease history (time since diagnosis 3.7 years vs 5.4 years, P = .001), and reported lower mental well-being (SF 12 subscore 37.7 vs 40.5, P = .004). No significant differences were found in other demographic variables. Posters indicated visiting the online support groups significantly more often for social reasons, such as curiosity about how other members were doing, to enjoy themselves, as a part of their daily routine (all P posters did not differ in their information-related reasons for visiting the online support group. Lurkers were significantly less satisfied with the online support group compared to posters (P posters. However, lurkers did not differ significantly from posters with regard to

  15. Online Patient Ratings of Hand Surgeons.

    Science.gov (United States)

    Trehan, Samir K; DeFrancesco, Christopher J; Nguyen, Joseph T; Charalel, Resmi A; Daluiski, Aaron

    2016-01-01

    To evaluate factors associated with positive online patient ratings and written comments regarding hand surgeons. We randomly selected 250 hand surgeons from the American Society for Surgery of the Hand member directory. Surgeon demographic and rating data were collected from 3 physician review Web sites (www.HealthGrades.com, www.Vitals.com, and www.RateMDs.com). Written comments were categorized as being related to professional competence, communication, cost, overall recommendation, staff, and office practice. Online presence was defined by 5 criteria: professional Web site, Facebook page, Twitter page, and personal profiles on www.Healthgrades.com and/or www.Vitals.com. A total of 245 hand surgeons (98%) had at least one rating among the 3 Web sites. Mean number of ratings for each surgeon was 13.4, 8.3, and 1.9, respectively, and mean overall ratings were 4.0 out of 5, 3.3 out of 4, and 3.8 out of 5 stars on www.HealthGrades.com, www.Vitals.com, and www.RateMDs.com, respectively. Positive overall ratings were associated with a higher number of ratings, Castle Connolly status, and increased online presence. No consistent correlations were observed among online ratings and surgeon age, sex, years in practice, practice type (ie, private practice vs academics), and/or geographic region. Finally, positive written comments were more often related to factors dependent on perceived surgeon competence, whereas negative comments were related to factors independent of perceived competence. Physician review Web sites featured prominently on Google, and 98% of hand surgeons were rated online. This study characterized hand surgeon online patient ratings as well as identified factors associated with positive ratings and comments. In addition, these findings highlight how patients assess care quality. Understanding hand surgeon online ratings and identifying factors associated with positive ratings are important for both patients and surgeons because of the recent growth in

  16. Length of stay for patients undergoing invasive electrode monitoring with stereoelectroencephalography and subdural grids correlates positively with increased institutional profitability.

    Science.gov (United States)

    Chan, Alvin Y; Kharrat, Sohayla; Lundeen, Kelly; Mnatsakanyan, Lilit; Sazgar, Mona; Sen-Gupta, Indranil; Lin, Jack J; Hsu, Frank P K; Vadera, Sumeet

    2017-06-01

    Lowering the length of stay (LOS) is thought to potentially decrease hospital costs and is a metric commonly used to manage capacity. Patients with epilepsy undergoing intracranial electrode monitoring may have longer LOS because the time to seizure is difficult to predict or control. This study investigates the effect of economic implications of increased LOS in patients undergoing invasive electrode monitoring for epilepsy. We retrospectively collected and analyzed patient data for 76 patients who underwent invasive monitoring with either subdural grid (SDG) implantation or stereoelectroencephalography (SEEG) over 2 years at our institution. Data points collected included invasive electrode type, LOS, profit margin, contribution margins, insurance type, and complication rates. LOS correlated positively with both profit and contribution margins, meaning that as LOS increased, both the profit and contribution margins rose, and there was a low rate of complications in this patient group. This relationship was seen across a variety of insurance providers. These data suggest that LOS may not be the best metric to assess invasive monitoring patients (i.e., SEEG or SDG), and increased LOS does not necessarily equate with lower or negative institutional financial gain. Further research into LOS should focus on specific specialties, as each may differ in terms of financial implications. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  17. Tailoring Earth Observation To Ranchers For Improved Land Management And Profitability: The VegMachine Online Project

    Science.gov (United States)

    Scarth, P.; Trevithick, B.; Beutel, T.

    2016-12-01

    VegMachine Online is a freely available browser application that allows ranchers across Australia to view and interact with satellite derived ground cover state and change maps on their property and extract this information in a graphical format using interactive tools. It supports the delivery and communication of a massive earth observation data set in an accessible, producer friendly way . Around 250,000 Landsat TM, ETM and OLI images were acquired across Australia, converted to terrain corrected surface reflectance and masked for cloud, cloud shadow, terrain shadow and water. More than 2500 field sites across the Australian rangelands were used to derive endmembers used in a constrained unmixing approach to estimate the per-pixel proportion of bare, green and non-green vegetation for all images. A seasonal metoid compositing method was used to produce national fractional cover virtual mosaics for each three month period since 1988. The time series of green fraction is used to estimate the persistent green due to tree and shrub canopies, and this estimate is used to correct the fractional cover to ground cover for our mixed tree-grass rangeland systems. Finally, deciles are produced for key metrics every season to track a pixels relativity to the entire time series. These data are delivered through time series enabled web mapping services and customised web processing services that enable the full time series over any spatial extent to be interrogated in seconds via a RESTful interface. These services interface with a front end browser application that provides product visualization for any date in the time series, tools to draw or import polygon boundaries, plot time series ground cover comparisons, look at the effect of historical rainfall and tools to run the revised universal soil loss equation in web time to assess the effect of proposed changes in cover retention. VegMachine Online is already being used by ranchers monitoring paddock condition

  18. Profit U

    Science.gov (United States)

    Weinstein, Margery

    2012-01-01

    Preparing employees for the immediate work in front of them is a challenge. While most companies are still mastering effectively training their own workforce, some, such as "Training" magazine Top 10 Hall of Famer The Ritz-Carlton Hotel Company, have set up for-profit academies open to the public. When Ritz-Carlton won the national Malcolm…

  19. Online Social Networks - Opportunities for Empowering Cancer Patients.

    Science.gov (United States)

    Mohammadzadeh, Zeinab; Davoodi, Somayeh; Ghazisaeidi, Marjan

    2016-01-01

    Online social network technologies have become important to health and apply in most health care areas. Particularly in cancer care, because it is a disease which involves many social aspects, online social networks can be very useful. Use of online social networks provides a suitable platform for cancer patients and families to present and share information about their medical conditions, address their educational needs, support decision making, and help to coping with their disease and improve their own outcomes. Like any other new technologies, online social networks, along with many benefits, have some negative effects such as violation of privacy and publication of incorrect information. However, if these effects are managed properly, they can empower patients to manage cancer through changing behavioral patterns and enhancing the quality of cancer patients lives This paper explains some application of online social networks in the cancer patient care process. It also covers advantages and disadvantages of related technologies.

  20. Net profits.

    Science.gov (United States)

    Menduno, M

    1999-03-01

    As Web traffic surges, health care has become a speed zone all its own. Sixth in Internet content, health sites draw two-thirds of all online users at least once. That's set off a race among the developers of specialized hubs aiming to organize it all--and cash in. "It's a land grab," says one player. "All of a sudden everyone woke up and said, 'We gotta do this.'"

  1. Online peer support for patients with somatic diseases

    NARCIS (Netherlands)

    Kraan, C.F.

    2008-01-01

    With the availability of the Internet, so rose the opportunity to share concerns and experiences with peers online. In this thesis the meaning of online support groups for patients with rheumatoid arthritis, fibromyalgia and breast cancer was examined from different perspectives. To this aim, six

  2. Online information seeking by patients with bipolar disorder

    DEFF Research Database (Denmark)

    Conell, Jörn; Bauer, Rita; Glenn, Tasha

    2016-01-01

    -based, anonymous survey, translated into 12 languages, was completed by 1222 patients in 17 countries as a convenience sample between March 2014 and January 2016. All patients had a diagnosis of bipolar disorder from a psychiatrist. Data were analyzed using descriptive statistics and generalized estimating...... equations to account for correlated data. RESULTS: 976 (81 % of 1212 valid responses) of the patients used the Internet, and of these 750 (77 %) looked for information on bipolar disorder. When looking online for information, 89 % used a computer rather than a smartphone, and 79 % started with a general...... or participated in online support groups. Most patients (62 %) searched a couple times a year. Online information seeking helped about 2/3 to cope (41 % of the entire sample). About 2/3 did not discuss Internet findings with their doctor. CONCLUSION: Online information seeking helps many patients to cope although...

  3. Understanding patient e-loyalty toward online health care services.

    Science.gov (United States)

    Martínez-Caro, Eva; Cegarra-Navarro, Juan Gabriel; Solano-Lorente, Marcelina

    2013-01-01

    Public health institutions are making a great effort to develop patient-targeted online services in an attempt to enhance their effectiveness and reduce expenses. However, if patients do not use those services regularly, public health institutions will have wasted their limited resources. Hence, patients' electronic loyalty (e-loyalty) is essential for the success of online health care services. In this research, an extended Technology Acceptance Model was developed to test e-loyalty intent toward online health care services offered by public health institutions. Data from a survey of 256 users of online health care services provided by the public sanitary system of a region in Spain were analyzed. The research model was tested by using the structural equation modeling approach. The results obtained suggest that the core constructs of the Technology Acceptance Model (perceived usefulness, ease of use, and attitude) significantly affected users' behavioral intentions (i.e., e-loyalty intent), with perceived usefulness being the most decisive antecedent of affective variables (i.e., attitude and satisfaction). This study also reveals a general support for patient satisfaction as a determinant of e-loyalty intent in online health care services. Policy makers should focus on striving to get the highest positive attitude in users by enhancing easiness of use and, mainly, perceived usefulness. Because through satisfaction of patients, public hospitals will enlarge their patient e-loyalty intent, health care providers must always work at obtaining satisfied users and to encourage them to continue using the online services.

  4. Patients' online access to their electronic health records and linked online services: a systematic interpretative review.

    Science.gov (United States)

    de Lusignan, Simon; Mold, Freda; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Gronlund, Toto Anne; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Barker, Fiona; Ellis, Beverley; Koczan, Phil; Arvanitis, Theodoros N; McCarthy, Mary; Jones, Simon; Rafi, Imran

    2014-09-08

    To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Primary care. A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of access to a wider group of patients. A1 SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO

  5. Online information seeking by patients with bipolar disorder

    DEFF Research Database (Denmark)

    Conell, Jörn; Bauer, Rita; Glenn, Tasha

    2016-01-01

    -based, anonymous survey, translated into 12 languages, was completed by 1222 patients in 17 countries as a convenience sample between March 2014 and January 2016. All patients had a diagnosis of bipolar disorder from a psychiatrist. Data were analyzed using descriptive statistics and generalized estimating...... alternative information sources remain important. Most patients do not discuss Internet findings with their doctor, and concern remains about the quality of online information especially related to prescription drugs. Patients may not rate search skills accurately, and may not understand limitations of online...

  6. Personnel Policy and Profit

    DEFF Research Database (Denmark)

    Bingley, Paul; Westergård-Nielsen, Niels Chr.

    2004-01-01

    personnel structure variation. It is found that personnel policy is strongly related to economic performance. At the margin, more hires are associated with lower profit, and more separations with higher profit. For the average firm, one new job, all else equal, is associated with ?2680 (2000 prices) lower...... annual profit. Higher wage level and lower wage growth is associated with higher profit. A workforce that has less tenure, all else equal, is more profitable....

  7. Readability of Patient-oriented Online Dermatology Resources.

    Science.gov (United States)

    Tulbert, Brittain H; Snyder, Clint W; Brodell, Robert T

    2011-03-01

    Supplemental educational reading material is of no value to patients if it is not read and comprehended. Using standardized research tools, online patient education materials were comparatively assessed for readability and length in words to identify the strengths and weaknesses of widely utilized sources. Three sources of patient-education material on the internet (WebMD.com, Wikipedia.org, and MedicineOnline.com) were compared with materials produced by the American Academy of Dermatology for readability utilizing Flesch-Kincaid Grade Level and Flesch Reading Ease Scale. Automated word counts were used to determine the length of each educational piece. The information presented in American Academy of Dermatology electronic pamphlets on the internet is significantly harder to comprehend than MedicineOnline.com, but easier than Wikipedia.org. The latter site proved significantly harder to comprehend than all other sources. The American Academy of Dermatology electronic pamphlets and MedicineOnline.com materials were the most concise, averaging 1,200 words or less, although this was not a statistically significant difference in length compared to other online patient-education resources. No single source of online patient-education material demonstrates optimal features with regard to each of these parameters. Only 15 topic areas in the four most commonly accessed sources of patient information were analyzed in this study. No single source of commonly used internet patient-education material demonstrates optimal features with regard to readability, length, and presence of photographic illustrations. These educational materials should target a length of 1,200 words, be illustrated with clinical images, and readability should correspond with the national average reading level.

  8. Online Patient Education for Chronic Disease Management: Consumer Perspectives.

    Science.gov (United States)

    Win, Khin Than; Hassan, Naffisah Mohd; Oinas-Kukkonen, Harri; Probst, Yasmine

    2016-04-01

    Patient education plays an important role in chronic disease management. The aim of this study is to identify patients' preferences in regard to the design features of effective online patient education (OPE) and the benefits. A review of the existing literature was conducted in order to identify the benefits of OPE and its essential design features. These design features were empirically tested by conducting survey with patients and caregivers. Reliability analysis, construct validity and regression analysis were performed for data analysis. The results identified patient-tailored information, interactivity, content credibility, clear presentation of content, use of multimedia and interpretability as the essential design features of online patient education websites for chronic disease management.

  9. The influence of episodic mood disorders on length of stay among patients admitted to private and non-profit hospitals with alcohol dependence syndrome

    OpenAIRE

    Justin B. Dickerson

    2011-01-01

    Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hos...

  10. IVF patients show three types of online behaviour.

    NARCIS (Netherlands)

    Tuil, W.S.; Verhaak, C.M.; Robbe, P.F.; Kremer, J.A.M.

    2008-01-01

    BACKGROUND: The internet introduces new ways to deal with stress. However, it is unclear how its resources are used in everyday life. Using a web-based personal health record (PHR), we observed the patient's online behaviour and linked this to distress, theories on dealing with stress and

  11. Patients' Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice.

    Science.gov (United States)

    Mold, Freda; de Lusignan, Simon

    2015-12-04

    Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.

  12. Online Nutrition Algorithm For Hemodialysis Patients Improves Dietitian-Patient Interactions

    Directory of Open Access Journals (Sweden)

    Rosa Hand

    2012-06-01

    These surveys show that dietitians felt that an online nutrition algorithm may improve dietitian-patient interactions and understanding of patient conditions which may be helpful in medically complex cases.

  13. Readability assessment of online urology patient education materials.

    Science.gov (United States)

    Colaco, Marc; Svider, Peter F; Agarwal, Nitin; Eloy, Jean Anderson; Jackson, Imani M

    2013-03-01

    The National Institutes of Health, American Medical Association, and United States Department of Health and Human Services recommend that patient education materials be written at a fourth to sixth grade reading level to facilitate comprehension. We examined and compared the readability and difficulty of online patient education materials from the American Urological Association and academic urology departments in the Northeastern United States. We assessed the online patient education materials for difficulty level with 10 commonly used readability assessment tools, including the Flesch Reading Ease Score, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, Gunning Frequency of Gobbledygook, New Dale-Chall Test, Coleman-Liau index, New Fog Count, Raygor Readability Estimate, FORCAST test and Fry score. Most patient education materials on the websites of these programs were written at or above the eleventh grade reading level. Urological online patient education materials are written above the recommended reading level. They may need to be simplified to facilitate better patient understanding of urological topics. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  14. Social networking in online support groups for health: how online social networking benefits patients.

    Science.gov (United States)

    Chung, Jae Eun

    2014-01-01

    An increasing number of online support groups (OSGs) have embraced the features of social networking. So far, little is known about how patients use and benefit from these features. By implementing the uses-and-gratifications framework, the author conducted an online survey with current users of OSGs to examine associations among motivation, use of specific features of OSG, and support outcomes. Findings suggest that OSG users make selective use of varied features depending on their needs, and that perceptions of receiving emotional and informational support are associated more with the use of some features than others. For example, those with strong motivation for social interaction use diverse features of OSG and make one-to-one connections with other users by friending. In contrast, those with strong motivation for information seeking limit their use primarily to discussion boards. Results also show that online social networking features, such as friending and sharing of personal stories on blogs, are helpful in satisfying the need for emotional support. The present study sheds light on online social networking features in the context of health-related OSGs and provides practical lessons on how to improve the capacity of OSGs to serve the needs of their users.

  15. Analysis of online patient education materials in pediatric ophthalmology.

    Science.gov (United States)

    John, Ann M; John, Elizabeth S; Hansberry, David R; Thomas, Prashant J; Guo, Suqin

    2015-10-01

    Patients increasingly consult online resources for healthcare information. The American Medical Association (AMA) and National Institutes of Health (NIH) recommend that online education resources be written between a 3rd- and 7th-grade level. This study assesses whether online health information abides by these guidelines. Ten pediatric ophthalmology conditions were entered into a commonly used search engine, Google.com, and analyzed using 10 validated readability scales. Scientific articles and articles written on patient forums were excluded. The 10 conditions--amblyopia, cataract, conjunctivitis, corneal abrasion, nystagmus, retinoblastoma, retinopathy of prematurity, strabismus, stye, and glaucoma--were also searched and analyzed separately from widely used websites, including Wikipedia and WebMD, as well as those of professional societies, including the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) and the American Optometric Association (AOA). The majority of articles were written above recommended guidelines. All scales showed that the 100 articles were written at a mean grade-level of 11.75 ± 2.72. Only 12% of articles were written below a 9th-grade level and only 3% met recommended criteria. The articles accrued separately from Wikipedia, WebMD, AAPOS, and AOA also had average grade levels above the recommended guidelines. The readability of online patient education material exceeds NIH and AMA guidelines. This disparity can adversely affect caregiver comprehension of such resources and contribute to poor decision making. Pediatric ophthalmology online articles are generally written at a level too high for average caregiver comprehension. Revision of articles can increase satisfaction, improve outcomes, and facilitate the patient-ophthalmologist relationship. Published by Elsevier Inc.

  16. The association of willingness-to-pay and patient attributes: a cost-volume-profit analysis of cardiac catheter unit services in Ramallah Hospital, Palestine.

    Science.gov (United States)

    Jabr, Samer F K; Younis, Mustafa Mike Z; Forgione, Dana A

    2009-01-01

    The purpose of this study is to examine the association of willingness-to-pay and patient attributes in relation to the multi-service cost-volume-profit structure of a cardiac catheter unit in Ramallah Hospital. This article contributes to the literature by providing primary evidence on patient willingness-to-pay, by identifying the specific break-even parameters of three hospital cardiac catheter unit service types (diagnosis, balloon, and pacemaker), and by demonstrating the cross-subsidization of patient income groups that is inherent in the existing hospital rate structure. Our results provide information useful for (1) evidence-based policy making with respect to hospital rate setting and cross-subsidies of patient income groups; (2) the advancement of hospital management, by demonstrating the estimated variable and fixed cost parameters and the impact of patient revenue mix on the profitability of cardiac catheter unit services; and (3) the advancement of theory, by documenting the relationship of patient demand and the cost of supply in a multi-patient-group, multi-service hospital setting.

  17. Introducing students to patient safety through an online interprofessional course.

    Science.gov (United States)

    Blue, Amy V; Charles, Laurine; Howell, David; Koutalos, Yiannis; Mitcham, Maralynne; Nappi, Jean; Zoller, James

    2010-01-01

    Interprofessional education (IPE) is increasingly called upon to improve health care systems and patient safety. Our institution is engaged in a campus-wide IPE initiative. As a component of this initiative, a required online interprofessional patient-safety-focused course for a large group (300) of first-year medical, dental, and nursing students was developed and implemented. We describe our efforts with developing the course, including the use of constructivist and adult learning theories and IPE competencies to structure students' learning in a meaningful fashion. The course was conducted online to address obstacles of academic calendars and provide flexibility for faculty participation. Students worked in small groups online with a faculty facilitator. Thematic modules were created with associated objectives, online learning materials, and assignments. Students posted completed assignments online and responded to group members' assignments for purposes of group discussion. Students worked in interprofessional groups on a project requiring them to complete a root cause analysis and develop recommendations based on a fictional sentinel event case. Through project work, students applied concepts learned in the course related to improving patient safety and demonstrated interprofessional collaboration skills. Projects were presented during a final in-class session. Student course evaluation results suggest that learning objectives and content goals were achieved. Faculty course evaluation results indicate that the course was perceived to be a worthwhile learning experience for students. We offer the following recommendations to others interested in developing an in-depth interprofessional learning experience for a large group of learners: 1) consider a hybrid format (inclusion of some face-to-face sessions), 2) address IPE and broader curricular needs, 3) create interactive opportunities for shared learning and working together, 4) provide support to faculty

  18. Assessment of online patient materials for breast reconstruction.

    Science.gov (United States)

    Vargas, Christina R; Kantak, Neelesh A; Chuang, Danielle J; Koolen, Pieter G; Lee, Bernard T

    2015-11-01

    Limited health literacy affects nearly half of American adults and adversely affects patient participation, satisfaction, health care costs, and overall outcomes. As patients increasingly search the Internet for health information, accessibility of online material is critical. Previous studies examining this topic have focused on the readability of these materials. This study evaluates online breast reconstruction resources with regard to reading level, however, adds new metrics to assess degree of complexity, and suitability for the intended audience. The 10 most popular patient Web sites for "breast reconstruction" were identified using the largest Internet search engine. The content of each site was assessed for readability using the simple measure of gobbledygook analysis, complexity using the PMOSE/iKIRSCH formula, and suitability using the suitability assessment of materials instrument. Resulting scores were analyzed overall and by Web site. Readability analysis revealed an overall average grade level of 13.4 (range 10.7-15.8). All sites exceeded the recommended sixth grade level. Complexity evaluation revealed a mean PMOSE/iKIRSCH score of 6.3, consistent with "low" complexity and requiring an 8th-12th grade education; individual sites ranged from "very low" to "high" complexity. Suitability assessment overall produced a mean 41.2% score, interpreted as "adequate" for the intended patient audience. Five of the 10 sites were found to be "not suitable" when examined individually; the remaining five were "adequate." Available online patient material for breast reconstruction is often too difficult for many patients to understand based on readability, complexity, and suitability metrics. Comprehensive assessment is needed to design appropriate patient material and minimize disparities related to limited health literacy. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Online Learning of Safe Patient Transfers in Occupational Therapy Education

    Directory of Open Access Journals (Sweden)

    Cynthia L. Hayden D. H. Ed., OTR/L, CHT

    2013-02-01

    Full Text Available Online higher education is steadily increasing. For programs in allied health to be offered effectively in an elearning format, clinical psychomotor skills need to be addressed. The aim of this research was to design, implement, and evaluate an online safe patient transfers module for occupational therapy assistant (OTAstudents. The efficacy of teaching safe patient transfers in an e-learning environment was appraised using both quantitative and qualitative analysis. The applied research project was completed at a Tennessee community college. A convenience sample of eighteen students participated in the pilot study. Twenty-five studentsparticipated in the subsequent study. The instructional design of the course was based on Mager’s CriterionReferenced Instruction model. Streaming video was used as the delivery method for course material. A pretest/posttest evaluated the students’ cognitive knowledge of safe patient transfers. A behavioral transferscompetency checklist was used to rate videotapes of students’ performance of assisted stand pivot and dependent sliding board transfers. Research findings indicated students were able to learn this psychomotor clinical skill online with beginning proficiency. A paired t-test showed marked improvement of cognitive knowledge. A student learning survey revealed the majority of students preferred at least one hands-on classroom session where instructor feedback and interaction with classmates confirmed safe and effectiveclinical technique.

  20. Service provision, pricing, and patient satisfaction in online health communities.

    Science.gov (United States)

    Wu, Hong; Lu, Naiji

    2018-02-01

    Background The emergence of online health communities (OHCs) broadens and diversifies channels for patient-doctor interaction. In recent times, patient satisfaction has gained new attention within the context of OHCs where unique patterns are provided: a variety of services with unique attributes are available in OHCs for patients and doctors have the options of providing and pricing for different services. OHCs are given high hopes on improving medical efficiency and patient satisfaction. Knowing how these patterns in OHCs affect patient satisfaction is crucial for the development of OHCs and medical practices. An empirical research is conducted to examine the effects of provision and pricing of online services on patient satisfaction by analyzing data from 2309 doctors in a Chinese OHC. The results from this study provided empirical support, suggesting that service quantity positively influenced patient satisfaction. A non-linear correlation between service price and satisfaction was explored and results suggested an inverted U-shaped relationship. At the low price level, service price led to an increase in patient satisfaction, whereas the high price level (over 330 CNY/US$49) could have just the opposite effect. Importantly, we found that price difference between a doctor's different services significantly decreased patient satisfaction. A mediating effect was tested in post-hoc analyses, and results revealed that the impact of price difference on patient satisfaction was partially mediated by flexibility of service selection, and the mediating effect accounted for 28.6% of the total effect. Our results indicate that patient satisfaction can be improved by effectively providing and pricing services in OHCs. Specifically, doctors can offer different type services and charge within a reasonable range. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Empowerment of patients in online discussions about medicine use.

    Science.gov (United States)

    van Berkel, Jasper J; Lambooij, Mattijs S; Hegger, Ingrid

    2015-04-08

    Patient empowerment is crucial in the successful self-management of people with chronic diseases. In this study, we investigated whether discussions about medicine use taking place on online message boards contribute to patient empowerment and could subsequently result in the more effective use of medicines. We discuss the extent to which patient empowerment processes occur in discussions on online message boards, focusing on patients with three disorders with different characteristics: diabetes, Amyotrophic Lateral Sclerosis (ALS) and Attention Deficit / Hyperactivity Disorder (ADHD). Because information is an important factor in both patient empowerment and self-management, we also evaluate the quality of the information being exchanged. We used a deductive thematic analysis method based on pre-existing categories. We gathered and analysed 5532 posts related to the conditions ADHD, ALS and diabetes from seven message boards (three for ADHD, three for diabetes, and one for ALS). We coded the posts for empowerment processes and the quality of the information exchanged. We identified patient empowerment processes in posts related to all three disorders. There is some variation in the frequency of these processes, but they show a similar order in the results: patients used the online message boards to exchange information, share personal experiences and for empathy or support. The type of information shared in these processes could contribute to the patient's self-efficacy when it comes to medicine use. The exchanged information was either correct or largely harmless. We also observed a tendency whereby participants correct previously posted incorrect information, and refer people to a healthcare professional following a request for medical advice, e.g. concerning the choice of medicines or dosage. Our findings show that patient empowerment processes occur in posts related to all three disorders. The type of information shared in these processes can contribute to the

  2. SPECIFICITY OF COMMUNICATION DOCTOR – PATIENT, ONLINE, THROUGH SOCIAL NETWORKS

    Directory of Open Access Journals (Sweden)

    Florin-Alexandru LUCA

    2014-12-01

    Full Text Available A survey in 2013 of Division Market Research Group Rentrop Straton Romanian-German - "state services and private clinics. Comparative Analysis ", highlights the fact that into urban population in Romania, the internet is the most popular source of information on health services. According to the survey, 81.9% of respondents use the Internet to find out about the best doctors available to them. Preferences of respondents to the online environment as the main source of information translates into ease of access and the possibility of interaction, but also trust recommendations based on personal experiences, recommendations can be found through discussion forums, mostly or comments left on pages on social networking sites. In the present study we try to emphasize the specificity of communication physician - patient online through social networks.

  3. Online Patient Ratings: Why They Matter and What They Mean.

    Science.gov (United States)

    Trehan, Samir K; Daluiski, Aaron

    2016-02-01

    The increasing focus on patient satisfaction and consumer-driven health care, combined with the recent rise in online social media, have resulted in the growing trend of patients rating physicians on publicly accessible Web sites. The number and use of such Web sites continue to grow despite potential concerns about the validity of these ratings and negative physician perception. These Web sites can influence patient decision making regarding physician selection. In this article, we review the literature regarding the use of such Web sites by patients, the validity of these ratings, potential implications for hand surgical practice, and methods to minimize or challenge inaccurate reviews. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  4. DataProfit

    DEFF Research Database (Denmark)

    2016-01-01

    DataProfit er et værktøj til at kortlægge og analysere din virksomheds evne til datadreven forretningsudvikling.......DataProfit er et værktøj til at kortlægge og analysere din virksomheds evne til datadreven forretningsudvikling....

  5. Profit vs. Purpose

    DEFF Research Database (Denmark)

    Strand, Robert

    2017-01-01

    Money helps us meet our basic needs, but what about our need for meaning? Businesses will profit — not just financially — by finding their souls.......Money helps us meet our basic needs, but what about our need for meaning? Businesses will profit — not just financially — by finding their souls....

  6. Profit maximization mitigates competition

    DEFF Research Database (Denmark)

    Dierker, Egbert; Grodal, Birgit

    1996-01-01

    competition than utility maximization. Since profit maximization tends to raise prices, it may be regarded as beneficial for the owners as a whole. Moreover, if profit maximization is a good proxy for utility maximization, then there is no need for a general equilibrium analysis that takes the distribution...

  7. Self-reported differences in empowerment between lurkers and posters in online patient support groups

    NARCIS (Netherlands)

    Kraan, C.F.; Drossaert, Constance H.C.; Taal, Erik; Seydel, E.R.; van de Laar, Mart A F J

    2008-01-01

    Background: Patients who visit online support groups benefit in various ways. Results of our earlier study indicated that participation in online support groups had a profound effect on the participants’ feelings of “being empowered.” However, most studies of online patient support groups have

  8. Self-reported differences in empowerment between lurkers and posters in online patient support groups.

    NARCIS (Netherlands)

    van Uden-Kraan, Cornelia F.; Drossaert, Constance H C; Taal, Erik; Seydel, Erwin R.; van de Laar, M.A.

    2008-01-01

    BACKGROUND: Patients who visit online support groups benefit in various ways. Results of our earlier study indicated that participation in online support groups had a profound effect on the participants' feelings of "being empowered." However, most studies of online patient support groups have

  9. Active patient participation in the development of an online intervention.

    Science.gov (United States)

    van Bruinessen, Inge Renske; van Weel-Baumgarten, Evelyn M; Snippe, Harm Wouter; Gouw, Hans; Zijlstra, Josée M; van Dulmen, Sandra

    2014-11-06

    An important and challenging part of living with cancer relates to the repeated visits to the hospital. Since how patients cope between these post-diagnostic visits depends partly on the information and support received from their physician during the visits, it is important to make the most of them. Recent findings reinforce the importance of training not only the health care professionals in communication skills, but providing patients with support in communication as well. Delivering such supportive interventions online can have potential benefits in terms of accessibility, cost-effectiveness, and ability to tailor information to personal needs. However, problems with attrition (dropout, non-usage) during the test phase and poor uptake after implementation are frequently reported. The marginal level of engagement of the patient as end user seems to play a role in this. Therefore, recent research suggests integrating theory-based development methods with methods that promote involvement of the patient at an early stage. This paper describes a participatory protocol, used to let patients guide a theory-informed development process. The objective of this project was to apply a bottom-up inspired procedure to develop a patient-centered intervention with corresponding evaluation and implementation plan. The applied development protocol was based on the intervention mapping framework, combined with patient participatory methods that were inspired by the participation ladder and user-centred design methods. The applied protocol led to a self-directed online communication intervention aimed at helping patients gain control during their communications with health care professionals. It also led to an evaluation plan and an implementation plan. The protocol enabled the continuous involvement of patient research partners and the partial involvement of patient service users, which led to valuable insights and improvements. The applied protocol realized patient participation

  10. Most American Academy of Orthopaedic Surgeons' online patient education material exceeds average patient reading level.

    Science.gov (United States)

    Eltorai, Adam E M; Sharma, Pranav; Wang, Jing; Daniels, Alan H

    2015-04-01

    Advancing health literacy has the potential to improve patient outcomes. The American Academy of Orthopaedic Surgeons' (AAOS) online patient education materials serve as a tool to improve health literacy for orthopaedic patients; however, it is unknown whether the materials currently meet the National Institutes of Health/American Medical Association's recommended sixth grade readability guidelines for health information or the mean US adult reading level of eighth grade. The purposes of this study were (1) to evaluate the mean grade level readability of online AAOS patient education materials; and (2) to determine what proportion of the online materials exceeded recommended (sixth grade) and mean US (eighth grade) reading level. Reading grade levels for 99.6% (260 of 261) of the online patient education entries from the AAOS were analyzed using the Flesch-Kincaid formula built into Microsoft Word software. Mean grade level readability of the AAOS patient education materials was 9.2 (SD ± 1.6). Two hundred fifty-one of the 260 articles (97%) had a readability score above the sixth grade level. The readability of the AAOS articles exceeded the sixth grade level by an average of 3.2 grade levels. Of the 260 articles, 210 (81%) had a readability score above the eighth grade level, which is the average reading level of US adults. Most of the online patient education materials from the AAOS had readability levels that are far too advanced for many patients to comprehend. Efforts to adjust the readability of online education materials to the needs of the audience may improve the health literacy of orthopaedic patients. Patient education materials can be made more comprehensible through use of simpler terms, shorter sentences, and the addition of pictures. More broadly, all health websites, not just those of the AAOS, should aspire to be comprehensible to the typical reader.

  11. Online survey of cancer patients on complementary and alternative medicine.

    Science.gov (United States)

    Huebner, Jutta; Prott, Franz J; Micke, Oliver; Muecke, Ralf; Senf, Bianca; Dennert, Gabriele; Muenstedt, Karsten

    2014-01-01

    Complementary and alternative medicine (CAM) is often used by cancer patients, yet, communication with the oncologist is poor. The objective of our study was to gather information on patients' usage of CAM, source of information, and aims, in order to derive strategies to improve the communication between physicians and patients on this topic. An online survey was conducted by linking a standardized questionnaire to the largest internet portal for cancer patients in Germany. The questionnaire addresses CAM usage, disclosure to physicians, source of information, objectives for using CAM, and perceived reasons for cancer. Of 170 participants, 77% were currently using CAM. Disclosure to a physician was rather high with 63% having informed their oncologist. Asked whether the oncologist took time to discuss CAM, 74% answered 'no'. Most frequently used are biologically based therapies, relaxation techniques, prayer, and meditation. Most patients want to reduce side effects, boost their immune system, and get active. Almost half the participants had positive experiences with some type of CAM before they fell ill. Understanding patients' concepts of the etiology of cancer and accepting their goals for using CAM may help oncologists communicate with their patients and guide them to a safe use of CAM. © 2014 S. Karger GmbH, Freiburg.

  12. What Predicts Patients' Willingness to Undergo Online Treatment and Pay for Online Treatment? Results from a Web-Based Survey to Investigate the Changing Patient-Physician Relationship.

    Science.gov (United States)

    Roettl, Johanna; Bidmon, Sonja; Terlutter, Ralf

    2016-02-04

    Substantial research has focused on patients' health information-seeking behavior on the Internet, but little is known about the variables that may predict patients' willingness to undergo online treatment and willingness to pay additionally for online treatment. This study analyzed sociodemographic variables, psychosocial variables, and variables of Internet usage to predict willingness to undergo online treatment and willingness to pay additionally for online treatment offered by the general practitioner (GP). An online survey of 1006 randomly selected German patients was conducted. The sample was drawn from an e-panel maintained by GfK HealthCare. Missing values were imputed; 958 usable questionnaires were analyzed. Variables with multi-item measurement were factor analyzed. Willingness to undergo online treatment and willingness to pay additionally for online treatment offered by the GP were predicted using 2 multiple regression models. Exploratory factor analyses revealed that the disposition of patients' personality to engage in information-searching behavior on the Internet was unidimensional. Exploratory factor analysis with the variables measuring the motives for Internet usage led to 2 separate factors: perceived usefulness (PU) of the Internet for health-related information searching and social motives for information searching on the Internet. Sociodemographic variables did not serve as significant predictors for willingness to undergo online treatment offered by the GP, whereas PU (B=.092, P=.08), willingness to communicate with the GP more often in the future (B=.495, Ponline communication with the GP (B=.198, Ponline treatment, but it was predicted by health-related information-seeking personality (B=.127, P=.07), PU (B=-.098, P=.09), willingness to undergo online treatment (B=.391, Ponline communication with the GP (B=.192, P=.001), highest education level (B=.178, Ponline more often in the future (B=.076, P=.03). Age, gender, and trust in the GP

  13. NHS England Patient Online - Patient Access to their Medical Record in General Practice

    Directory of Open Access Journals (Sweden)

    Jana Dale

    2015-10-01

    Patient Online can be promoted quickly and successfully when the clear evidence demonstrates it reduces workload. Its implementation will then result in the improved patient care and changes in behaviour necessary for the NHS National Information Board “Personalised Health and Care 2020” Implementation.

  14. Proton therapy for prostate cancer online: patient education or marketing?

    Science.gov (United States)

    Sadowski, Daniel J; Ellimoottil, Chandy S; Tejwani, Ajay; Gorbonos, Alex

    2013-12-01

    Proton therapy (PT) for prostate cancer is an expensive treatment with limited evidence of benefit over conventional radiotherapy. We sought to study whether online information on PT for prostate cancer was balanced and whether the website source influenced the content presented. We applied a systematic search process to identify 270 weblinks associated with PT for prostate cancer, categorized the websites by source, and filtered the results to 50 websites using predetermined criteria. We then used a customized version of the DISCERN instrument, a validated tool for assessing the quality of consumer health information, to evaluate the remaining websites for balance of content and description of risks, benefits and uncertainty. Depending on the search engine and key word used, proton center websites (PCWs) made up 10%-47% of the first 30 encountered links. In comparison, websites from academic and nonacademic medical centers without ownership stake in proton centers appeared much less frequently as a search result (0%-3%). PCWs scored lower on DISCERN questions compared to other sources for being balanced/unbiased (p online information regarding PT for prostate cancer may represent marketing by proton centers rather than comprehensive and unbiased patient education. An awareness of these results will also better prepare clinicians to address the potential biases of patients with prostate cancer who search the Internet for health information.

  15. Patients' online access to their electronic health records and linked online services: a systematic review in primary care.

    Science.gov (United States)

    Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley

    2015-03-01

    Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King's Fund, Nuffield Health, PsycINFO, OpenGrey (1999-2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of record access and use by specific ethnic and socioeconomic groups

  16. For-Profit Colleges

    National Research Council Canada - National Science Library

    David Deming; Claudia Goldin; Lawrence Katz

    2013-01-01

    For-profit, or proprietary, colleges are the fastest-growing postsecondary schools in the nation, enrolling a disproportionately high share of disadvantaged and minority students and those ill-prepared for college...

  17. Combining Purpose With Profits

    DEFF Research Database (Denmark)

    Julian Birkinshaw, Julian; Foss, Nicolai Juul; Lindenberg, Siegwart

    2014-01-01

    A sense of purpose that transcends making money can motivate employees. But to sustain both a sense of purpose and a solid level of profitability over time, companies need to pay attention to several fundamental organizing principles.......A sense of purpose that transcends making money can motivate employees. But to sustain both a sense of purpose and a solid level of profitability over time, companies need to pay attention to several fundamental organizing principles....

  18. Determinants of Bank Profitability

    OpenAIRE

    Mukesh Chaudhry; Arjun Chatrath; Ravindra Kamath

    1995-01-01

    This study investigates the determinants of profitability of U.S. commercial banks in the 1970s and 1980s. It is established that banks, depending on their size, may need to exercise greater control over a defined set of variables in order to maximize profits and/or minimize costs. Further, the study provides some indirect evidence of economies of scale/scope in certain aspects of the banksÕ loan and investment portfolios.

  19. Measuring Bank Profit Efficiency

    OpenAIRE

    Fitzpatrick, Trevor; McQuinn, Kieran

    2005-01-01

    This paper proposes that a variant of the Battese and Coelli (1995) inefficiency model can be applied as a consistent and unifying framework in exploring the determinants of credit institutions’ profit inefficiency scores. To date, work concerned with the potential determinants of credit institutions' profit inefficiency levels has addressed the issue in either a single-step or multi-step process. In the former, inefficiency scores are conditioned by region and bank-specific indicators, while...

  20. Factors affecting patients' online health information-seeking behaviours: The role of the Patient Health Engagement (PHE) Model.

    Science.gov (United States)

    Graffigna, Guendalina; Barello, Serena; Bonanomi, Andrea; Riva, Giuseppe

    2017-10-01

    To identify the variables affecting patients' online health information-seeking behaviours by examining the relationships between patient participation in their healthcare and online health information-seeking behaviours. A cross-sectional survey of Italian chronic patients (N=352) was conducted on patient's online health information-seeking behaviours and patient participation-related variables. Structural equation modeling analysis was conducted to test the hypothesis. This study showed how the healthcare professionals' ability to support chronic patients' autonomy affect patients' participation in their healthcare and patient's online health information-seeking behaviours. However, results do not confirm that the frequency of patients' online health-information seeking behavior has an impact on their adherence to medical prescriptions. Assuming a psychosocial perspective, we have discussed how patients' engagement - conceived as the level of their emotional elaboration of the health condition - affects the patients' ability to search for and manage online health information. To improve the effectiveness of patients' online health information-seeking behaviours and to enhance the effectiveness of technological interventions in this field, healthcare providers should target assessing and improving patient engagement and patient empowerment in their healthcare. It is important that health professionals acknowledge patients' online health information-seeking behaviours that they discuss the information offered by patients and guide them to reliable and accurate web sources. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. General Practitioners' Concerns About Online Patient Feedback: Findings From a Descriptive Exploratory Qualitative Study in England.

    Science.gov (United States)

    Patel, Salma; Cain, Rebecca; Neailey, Kevin; Hooberman, Lucy

    2015-12-08

    The growth in the volume of online patient feedback, including online patient ratings and comments, suggests that patients are embracing the opportunity to review online their experience of receiving health care. Very little is known about health care professionals' attitudes toward online patient feedback and whether health care professionals are comfortable with the public nature of the feedback. The aim of the overall study was to explore and describe general practitioners' attitudes toward online patient feedback. This paper reports on the findings of one of the aims of the study, which was to explore and understand the concerns that general practitioners (GPs) in England have about online patient feedback. This could then be used to improve online patient feedback platforms and help to increase usage of online patient feedback by GPs and, by extension, their patients. A descriptive qualitative approach using face-to-face semistructured interviews was used in this study. A topic guide was developed following a literature review and discussions with key stakeholders. GPs (N=20) were recruited from Cambridgeshire, London, and Northwest England through probability and snowball sampling. Interviews were transcribed verbatim and analyzed in NVivo using the framework method, a form of thematic analysis. Most participants in this study had concerns about online patient feedback. They questioned the validity of online patient feedback because of data and user biases and lack of representativeness, the usability of online patient feedback due to the feedback being anonymous, the transparency of online patient feedback because of the risk of false allegations and breaching confidentiality, and the resulting impact of all those factors on them, their professional practice, and their relationship with their patients. The majority of GPs interviewed had reservations and concerns about online patient feedback and questioned its validity and usefulness among other things

  2. The development of online learning designs for patients with type 2 diabetes.

    Science.gov (United States)

    Mason, Glenn

    2012-01-01

    A case study in the development of online educational material for a patient with type 2 diabetes (T2DM) is presented in this paper. Analysis of an interview of a patient with T2DM was conducted and analysed using Interpretive Phenomenological Analysis. Emerging themes were identified and used as the basis for the development of online educational material and the online platform for hosting this material is discussed. The method presented in this paper for the development of online learning environments for one patient with T2DM is considered to be one way of developing authentic and patient-centred educational resources.

  3. Quality of Online Resources for Pancreatic Cancer Patients.

    Science.gov (United States)

    De Groot, Lauren; Harris, Ilene; Regehr, Glenn; Tekian, Ara; Ingledew, Paris-Ann

    2017-10-18

    The Internet is increasingly a source of information for pancreatic cancer patients. This disease is usually diagnosed at an advanced stage; therefore, timely access to high-quality information is critical. Our purpose is to systematically evaluate the information available to pancreatic cancer patients on the internet. An internet search using the term "pancreatic cancer" was performed, with the meta-search engines "Dogpile", "Yippy" and "Google". The top 100 websites returned by the search engines were evaluated using a validated structured rating tool. Inter-rater reliability was evaluated using kappa statistics and results were analyzed using descriptive statistics. Amongst the 100 websites evaluated, etiology/risk factors and symptoms were the most accurately covered (70 and 67% of websites). Prevention, treatment and prognosis were the least accurate sections (55, 55 and 43% of websites). Prevention and prognosis were also the least likely to be covered with 63 and 51 websites covering these, respectively. Only 40% of websites identified an author. Twenty-two percent of websites were at a university reading level. The majority of online information is accurate but incomplete. Websites may lack information on prognosis. Many websites are outdated and lacked author information, and readability levels are inappropriate. This knowledge can inform the dialogue between healthcare providers and patients.

  4. How do online sports gambling disorder patients compare with land-based patients?

    Science.gov (United States)

    Estévez, Ana; Rodríguez, Raquel; Díaz, Noelia; Granero, Roser; Mestre-Bach, Gemma; Steward, Trevor; Fernández-Aranda, Fernando; Aymamí, Neus; Gómez-Peña, Mónica; Pino-Gutiérrez, Amparo Del; Baño, Marta; Moragas, Laura; Mallorquí-Bagué, Núria; López-González, Hibai; Jauregui, Paula; Onaindia, Jaione; Martín-Romera, Virginia; Menchón, José M; Jiménez-Murcia, Susana

    2017-12-01

    Background and aims Recent technological developments have brought about notable changes in the way people gamble. The widespread use of mobile Internet devices and gambling websites has led to a significant leap in the number of people who recreationally gamble. However, for some, gambling can turn into a psychiatric disorder resembling substance addiction. At present, there is a shortage of studies examining differences between adults with gambling disorder (GD) who exclusively make sports bets online, GD patients that are non-sports Internet gamblers, and offline gamblers. Therefore, this study was undertaken to determine the differences between these three groups, considering sociodemographic, personality, and clinical characteristics. Methods The sample consisted of 2,743 treatment-seeking male patients from the Pathological Gambling Unit at a university hospital. All patients met DSM-5 criteria for GD. Results We found that gamblers who exclusively engaged in non-sports Internet gambling activities were younger than offline gamblers and online sports gamblers. Non-sports Internet gamblers were also more likely to have greater levels of debt compared with offline gamblers. In terms of personality characteristics, our sample displayed low levels of self-directedness and cooperativeness and high levels of novelty seeking. In addition, online sports gamblers obtained higher scores in persistence than non-sports Internet gamblers and offline gamblers. Discussion and conclusion Although differences if terms of gambling severity were not identified between groups, GD patients who exclusively bet online appear to possess distinct personality characteristics and higher debt levels compared with offline gamblers.

  5. Financialization and financial profit

    Directory of Open Access Journals (Sweden)

    Arturo Guillén

    2014-09-01

    Full Text Available This article starts from the critical review of the concept of financial capital. I consider it is necessary not to confuse this category with of financialization, which has acquired a certificate of naturalization from the rise of neoliberalism. Although financial monopoly-financial capital is the hegemonic segment of the bourgeoisie in the major capitalist countries, their dominance does not imply, a fortiori, financialization of economic activity, since it depends of the conditions of the process reproduction of capital. The emergence of joint stock companies modified the formation of the average rate of profit. The "promoter profit" becomes one of the main forms of income of monopoly-financial capital. It is postulated that financial profit is a kind of "extraordinary surplus-value" which is appropriated by monopoly-financial capital by means of the monopolistic control it exerts on the issue and circulation of fictitious capital.

  6. Alternative Pathways to Legitimacy: Promotional Practices in the Ontario For-Profit College Sector

    Science.gov (United States)

    Pizarro Milian, Roger; Quirke, Linda

    2017-01-01

    This study empirically examines how for-profit career colleges in Ontario, Canada market themselves to prospective students. It uses a mixed-methods approach to review the content of 489 online promotional profiles representing 375 unique for-profit colleges. It finds that for-profit colleges adopt several distinct marketing strategies, including…

  7. Social support and responsiveness in online patient communities: impact on service quality perceptions.

    Science.gov (United States)

    Nambisan, Priya; Gustafson, David H; Hawkins, Robert; Pingree, Suzanne

    2016-02-01

    Hospitals frequently evaluate their service quality based on the care and services provided to patients by their clinical and non-clinical staff.(1,2) However, such evaluations do not take into consideration the many interactions that patients have in online patient communities with the health-care organization (HCO) as well as with peer patients. Patients' interactions in these online communities could impact their perceptions regarding the HCO's service quality. The objective of this pilot study was to evaluate the impact of social support and responsiveness that patients experience in an HCO's online community on patients' perceptions regarding the HCO's service quality. The study data are collected from CHESS, a health-care programme (Comprehensive Health Enhancement Support System) run by the Centre for Health Enhancement System Studies at the University of Wisconsin-Madison. Findings show that the social support and the responsiveness received from peer patients in the online patient communities will impact patients' perceptions regarding the service quality of the HCO even when the organizational members themselves do not participate in the online discussions. The results indicate that interactions in such HCO-provided online patient communities should not be ignored as they could translate into patients' perceptions regarding HCOs' service quality. Ways to improve responsiveness and social support in an HCO's online patient community are discussed. © 2014 John Wiley & Sons Ltd.

  8. For-profit colleges.

    Science.gov (United States)

    Deming, David; Goldin, Claudia; Katz, Lawrence

    2013-01-01

    For-profit, or proprietary, colleges are the fastest-growing postsecondary schools in the nation, enrolling a disproportionately high share of disadvantaged and minority students and those ill-prepared for college. Because these schools, many of them big national chains, derive most of their revenue from taxpayer-funded student financial aid, they are of interest to policy makers not only for the role they play in the higher education spectrum but also for the value they provide their students. In this article, David Deming, Claudia Goldin, and Lawrence Katz look at the students who attend for-profits, the reasons they choose these schools, and student outcomes on a number of broad measures and draw several conclusions. First, the authors write, the evidence shows that public community colleges may provide an equal or better education at lower cost than for-profits. But budget pressures mean that community colleges and other nonselective public institutions may not be able to meet the demand for higher education. Some students unable to get into desired courses and programs at public institutions may face only two alternatives: attendance at a for-profit or no postsecondary education at all. Second, for-profits appear to be at their best with well-defined programs of short duration that prepare students for a specific occupation. But for-profit completion rates, default rates, and labor market outcomes for students seeking associate's or higher degrees compare unfavorably with those of public postsecondary institutions. In principle, taxpayer investment in student aid should be accompanied by scrutiny concerning whether students complete their course of study and subsequently earn enough to justify the investment and pay back their student loans. Designing appropriate regulations to help students navigate the market for higher education has proven to be a challenge because of the great variation in student goals and types of programs. Ensuring that potential

  9. What Do Ovarian Cancer Patients Expect From Treatment?: Perspectives From an Online Patient Community.

    Science.gov (United States)

    Simacek, Kristina; Raja, Priya; Chiauzzi, Emil; Eek, Daniel; Halling, Katarina

    Advances in ovarian cancer treatment have improved outcomes. However, the gap between patients' hopes and expectations and their actual outcomes remains an understudied aspect of treatment decision making. This gap has been noted to be a predictor of poorer health-related quality of life. Incorporating patient hopes and expectations for treatment into clinical care may improve patient experiences. The aim of this study is to describe the hopes and expectations of ovarian cancer patients at diagnosis and throughout treatment transitions. This study sampled from an online community of patients with ovarian cancer. Thirty members completed an online qualitative survey about their diagnostic and treatment journey, including hopes and expectations around treatment. Initially, ovarian cancer patients hoped for a complete cure or removal of cancer. As they progressed through treatment, hopes and expectations centered on issues related to living with ovarian cancer. A subset of patients emphasized a lack of information about treatment side effects. The shift in expectations from survival to living with ovarian cancer may demonstrate an enhanced understanding of ovarian cancer prognosis as patients learn more about their condition. Patients underscored that a more involved discussion of side effect profiles with clinicians would enhance their treatment decision making and expectation setting process. Expectation setting may be improved by contextualizing treatment in terms of the transitions ovarian cancer patients experience. Providing relevant information that aligns with patient needs, desires, and concerns at critical transitions may improve clinical care and decision making.

  10. Are patients comprehending? A critical assessment of online patient educational materials.

    Science.gov (United States)

    Bui, Thanh-Lan; Silva-Hirschberg, Catalina; Torres, Josefina; Armstrong, April W

    2017-09-22

    The primary aim of this study was to evaluate the readability, understandability, suitability and actionability of online psoriasis patient educational materials. A secondary aim was to identify areas for improvement. We conducted an evaluation study to assess online psoriasis patient educational materials from the American Academy of Dermatology and National Psoriasis Foundation available in July 2017. We used two validated assessment tools specific to online healthcare materials. Outcomes were expressed as percentages, where higher percentages corresponded to higher quality materials. Overall, the educational materials had a mean understandability score (72.7%) that was understandable; a suitability score (58.8%) that was adequate; a reading grade level (10.5) that was not readable; and an actionability score (54.7%) that was not actionable. Areas of improvement include reading grade level, visual aids, word choice, specific steps for actions and cultural appropriateness. Online psoriasis patient educational materials are understandable and suitable, but they are written above the American Medical Association and National Institutes of Health's recommended 6th-8th grade reading level and are not actionable. Materials can benefit from decreasing reading grade level, including more visual elements, incorporating more actionable items and being culturally inclusive.

  11. Medical Schools for Profit?

    African Journals Online (AJOL)

    and that funding is only spent on that will deliver more or better medical education. So staffing and other resources will be kept to the minimum required to deliver a high‑quality service. Secondly as in other walks of life, the profit motive should be a driver of innovation, and this should also be the case in medical education.

  12. From People to Profits.

    Science.gov (United States)

    Barber, L.; Hayday, S.; Bevan, S.

    An empirical test of the service-profit chain in a large United Kingdom retail business explored how employee attitudes and behavior can improve customer retention and, consequently, company sales performance. Data were collected from 65,000 employees and 25,000 customers from almost 100 stores. The business collected customer satisfaction for…

  13. Emotional coping differences among breast cancer patients from an online support group: A longitudinal study

    NARCIS (Netherlands)

    Batenburg, A.E.; Das, H.H.J.

    2014-01-01

    Background: Previous research on the effects of online peer support on psychological well-being of patients with cancer showed mixed findings. There is a need for longitudinal studies explaining if and when online peer-led support groups are beneficial. How patients cope with emotions that come

  14. Quality Assessment of Diabetes Online Patient Education Materials from Academic Institutions

    Science.gov (United States)

    Dorcely, Brenda; Agarwal, Nitin; Raghuwanshi, Maya

    2015-01-01

    Objective: The purpose of this study was to assess and compare the readability of type 2 diabetes online patient education materials from academic institutions in the northeast USA and the American Diabetes Association. Many US residents utilise the Internet to obtain health information. Studies have shown that online patient education materials…

  15. Adherence to an online exercise program for copd patients in the home environment- a pilot study

    NARCIS (Netherlands)

    Kun, L.; van Weering, Marit; Vollenbroek-Hutten, Miriam Marie Rosé; Hermens, Hermanus J.

    2016-01-01

    The objective of this study was to determine the adherence to an online exercise program for patients with moderate to very severe COPD in their home environment. The intervention consisted of three modules: module 1 online exercising; module 2 telemonitoring and module 3 telecommunication. Patients

  16. Effect of patient's age on the profitability of inpatient cardiac catheterization: a contribution margin analysis of frequently performed procedures over a 5-year period.

    Science.gov (United States)

    Plehn, Gunnar; Butz, Thomas; Maagh, Petra; Meissner, Axel

    2017-01-18

    Due to a continuing age shift in the German society hospital providers are concerned about the additional costs associated with the treatment of elderly patients. It is not clear if cardiac catheterization in aged patients leads to higher resource utilization and if DRG-revenues do compensate for this factor. Procedure-related and administrative data of all patients who underwent cardiac catheterization at a tertiary heart center between 2007 and 2011 were collected and analyzed. Then a profitability analysis was performed by comparing the case related variable costs with the Diagnosis-related group (DRG) per case revenues. A particular emphasis was placed on a comparative analysis of identical clusters of procedures. The most frequently performed catheterization procedure (n = 1800) was associated with significantly higher material expenditure in very old patients (178 ± 48 €) than in old (171 ± 28; p = 0.001) and young patients (172 ± 39; p = 0.046). Furthermore, radiation time and the length of hospital stay were increased in very old patients (3.5 ± 3.8 min and 6.2 ± 4.8 days) compared to old (2.7 ± 2.8 min and 4.6 ± 3.8 days; p < 0.001) and young patients (2.5 ± 2.5 min and 4.5 ± 3.9 days; p < 0.001). Due to higher DRG revenues very old patients achieved higher absolute contribution margins (2065 ± 1033 €) than old (1804 ± 1902 €; p < 0.001) and young patients (1771 ± 902 €; p < 0.001). However, the contribution margins per day were significantly smaller (440 ± 226 €) than those in old (488 ± 234 €; p = 0.001) and young patients (484 ± 206 €; p = 0.001). Catheterization of very old patients is related to lower contribution margins per day despite higher material and time expenditures. Since efforts to reduce the length of hospital stay of these patients are limited, this may result in a competitive disadvantage of hospitals which

  17. Hypodense liver lesions in patients with hepatic steatosis: do we profit from dual-energy computed tomography?

    Energy Technology Data Exchange (ETDEWEB)

    Nattenmueller, Johanna; Hosch, Waldemar; Nguyen, Tri-Thien; Skornitzke, Stephan; Joeres, Andreas; Grenacher, Lars; Kauczor, Hans-Ulrich; Sommer, Christof M.; Stiller, Wolfram [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology (DIR), Heidelberg (Germany)

    2015-12-15

    To evaluate dual-energy CT (DECT) imaging of hypodense liver lesions in patients with hepatic steatosis, having a high incidence in the general population and among cancer patients receiving chemotherapy. One hundred and five patients with hepatic steatosis (liver parenchyma <40 HU) underwent contrast-enhanced DECT with reconstruction of pure iodine (PI), optimum contrast (OC), 80 kV{sub p}, and 120 kV{sub p}-equivalent data sets. Image noise (IN), lesion to liver signal to noise (SNR) and contrast to noise (CNR) ratios were quantitatively analysed; image quality was rated on a 5-point scale (1, excellent; 2, good; 3, fair; 4, poor; 5, non-diagnostic) by two independent reviewers. In 21 patients with hypodense liver lesions, IN was lowest in PI followed by 120 kV{sub p}-equivalent and OC, and highest in 80 kV{sub p}. SNR was highest in PI (1.30), followed by 120 kV{sub p}-equivalent (0.72) and 80 kV{sub p} (0.63), and lowest in OC (0.55). CNR was highest in 120 kV{sub p}-equivalent (4.95), followed by OC (4.55) and 80 kV{sub p} (4.14), and lowest in PI (3.63). The 120 kV{sub p}-equivalent series exhibited best overall qualitative image score (1.88), followed by OC (1.98), 80 kV{sub p} (3.00) and PI (3.67). In our study, the 120 kV{sub p}-equivalent series was best suited for visualization of hypodense lesions within steatotic liver parenchyma, while using DECT currently seems to offer no additional diagnostic advantage. (orig.)

  18. Narratives of empowerment and compliance:Studies of communication in online patient support groups

    OpenAIRE

    Wentzer, Helle; Bygholm, Ann

    2013-01-01

    Purpose: New technologies enable new forms of patient participation in health care. Thearticle discusses whether communication in online patient support groups is a source ofindividual as well as collective empowerment or to be understood within the tradition ofcompliance. The discussion is based on a qualitative analysis of patient communicationin two online groups on the Danish portal sundhed.dk, one for lung patients and one forwomen with fertility problems.Methods: The object of study is ...

  19. Correlations among Social Anxiety, Self-Esteem, Impulsivity, and Game Genre in Patients with Problematic Online Game Playing

    OpenAIRE

    Park, Jeong Ha; Han, Doug Hyun; Kim, Bung-Nyun; Cheong, Jae Hoon; Lee, Young-Sik

    2016-01-01

    Objective Recent studies of online game addiction have suggested that social interaction and impulsivity are critical factors for the etiology and progress of online game addiction. We hypothesized that the genre of the online game is associated with impulsivity and sociality in individuals with online game addictions. Methods In total, 212 patients with problematic online game playing were divided into four groups by game genre: 1) massive multiplayer online role playing game (MMORPG), 2) re...

  20. Issues in online forum administration among multi-ethnic cancer patients.

    Science.gov (United States)

    Guevara, Enrique; Lim, Hyun Ju; Tsai, Hsiu Min

    2006-01-01

    This presentation is about practical issues and challenges in conducting online forums among multi-ethnic groups of cancer patients including Whites, Asian, and Hispanics in the U.S. The issues were identified while administrating three ethnic-specific online forums for White, Asian, and Hispanic cancer patients in the U.S. The issues included authenticity issues, language difficulties, inactive participation of ethnic minority cancer patients, culturally different attitudes towards emails and email greeting cards, and Internet access issues. Despite these issues, the findings suggest that online forums are excellent research methods to reach multi-ethnic cancer patients across the nation.

  1. Profit and place

    Directory of Open Access Journals (Sweden)

    Ian Bentley

    1997-01-01

    Full Text Available The article deals with the physical and symbolic effects the built environment has on human activities in a capitalist economy. The built environment is integrated in the capitalist economy on three levels: as the focus of a profit-oriented manufacturing industry, as the setting for all sorts of other enterprises and as the built context of the whole economy. The built environment is understood as a commodity. The capitalist system contains inbuilt tensions which have important design implications: the first tension arises because the system, if left to itself, lacks any overall planning functions, the second tension stems from the ability of the system to generate profit and the third arises from the character of labour, which distinguishes it from other commodities used in the production process. In conclusion methods of designing built environments, which perpetuate social order, are discussed.

  2. Determinants of Tunisian Bank Profitability

    OpenAIRE

    Raoudha Bejaoui; Houssam Bouzgarrou

    2014-01-01

    The aim of this study is to examine the persistence of profit and the effect of bank-specific determinants of Tunisian bank profitability. To account for profit persistence, we apply a dynamic panel model, using Generalized Methods of Moments (GMM) system for 16 Tunisian commercial banks, divided into 11 deposit banks and 5 development banks during the period 1999-2010. The estimates show that the evidence for profit persistence is positive and significant for both deposit and development ban...

  3. The influence of episodic mood disorders on length of stay among patients admitted to private and non-profit hospitals with alcohol dependence syndrome

    Directory of Open Access Journals (Sweden)

    Justin B. Dickerson

    2011-02-01

    Full Text Available Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358. Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders (b=0.31, P=0.001, referral to a hospital by a physician (b=0.35, P=0.014, and increasing age (b= 0.01, P=0.001 were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14-1.62. Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.

  4. Illustrations enhance older colorectal cancer patients' website satisfaction and recall of online cancer information

    NARCIS (Netherlands)

    Bol, N.; Smets, E. M A; Eddes, E. H.; de Haes, J. C J M; Loos, E. F.|info:eu-repo/dai/nl/078758475; van Weert, J. C M

    2015-01-01

    This study aims to investigate the effects of illustrations in online cancer information on older cancer patients' website satisfaction (i.e. satisfaction with the attractiveness, comprehensibility and emotional support from the website) and recall of information. In an online experiment, 174

  5. Improving Self-Care of Patients with Chronic Disease using Online Personal Health Record

    Directory of Open Access Journals (Sweden)

    Amol Wagholikar

    2012-09-01

    Full Text Available Background Effective management of chronic diseases such as prostate cancer is important. Research suggests a tendency to use self-care treatment options such as over-the-counter (OTC complementary medications among prostate cancer patients. The current trend in patient-driven recording of health data in an online Personal Health Record (PHR presents an opportunity to develop new data-driven approaches for improving prostate cancer patient care. However, the ability of current online solutions to share patients’ data for better decision support is limited. An informatics approach may improve online sharing of self-care interventions among these patients. It can also provide better evidence to support decisions made during their self-managed care.Aims To identify requirements for an online system and describe a new case-based reasoning (CBR method for improving self-care of advanced prostate cancer patients in an online PHR environment. Method A non-identifying online survey was conducted to understand self-care patterns among prostate cancer patients and to identify requirements for an online information system. The pilot study was carried out between August 2010 and December 2010. A case-base of 52 patients was developed. Results The data analysis showed self-care patterns among the prostate cancer patients. Selenium (55% was the common complementary supplement used by the patients. Paracetamol (about 45% was the commonly used OTC by the patients. Conclusion The results of this study specified requirements for an online case-based reasoning information system. The outcomes of this study are being incorporated in design of the proposed Artificial Intelligence (AI driven patient journey browser system. A basic version of the proposed system is currently being considered for implementation.

  6. METKA - Forest energy profitably

    Energy Technology Data Exchange (ETDEWEB)

    Kymaelaeinen, M. (FMA Kanta-Hame, Hameenlinna (Finland)); Rieppo, K. (TTS Research, Hameenlinna (Finland)), e-mail: matti.kymalainen@mhy.fi, e-mail: kaarlo.rieppo@tts.fi

    2010-07-01

    The harvesting and profitability of forest energy in Finland is practically entirely dependent on state subsidies. Currently, there is a lot to improve in forest energy knowledge and competence. METKA - Forest energy profitably project (2008-2011) aims at increasing the cost efficiency of the forest energy chain and the volume of the supply chain in Haeme region. The project ia coordinated by Forest Management Association Kanta-Haeme (Kanta-Haemeen Metsanhoitoyhdistys ry). Project partners include FMA Paeijaet-Haeme, TTS Research and the Finnish Forest Research Institute's (METLA) Joensuu unit. METKA -project belongs to the Rural Development Programme for Mainland Finland 2007-2013 and is being funded partly by the European Agricultural Fund for Rural Development (EAFRD). The final project objective is to develop a new operational forest energy model for FMA Kanta-Haeme and FMA Paeijaet-Haeme. In order to create the operational model, the project has been divided into several sub-tasks, in which TTS Research and Metla are responsible for the research. TTS Research conducts studies that focus on forest energy harvesting and processing. The studies investigate especially small-diameter energy wood harvesting. Majority of the studies investigate the use of time, and they form the basis for cost and profit analyses. Metla is responsible or areas of research that contribute to the development of a forest energy storage's moisture estimation algorithm and a forest energy harvesting yield calculation program. Upon completion, the calculation program and the estimation algorithm are integrated to the logistics control system developed by FMA Kanta-Haeme and FMA Paeijaet-Haeme and taken into use as aids in forestry planning. During 2008 and 2009, several practical tests have been performed. Tests will be executed in autumn 2010 as well. The analysis of the results is likely to be completed in 2010, and the results is likely to be completed in 2010, and the results

  7. Does outsourcing affect hospital profitability?

    Science.gov (United States)

    Danvers, Kreag; Nikolov, Pavel

    2010-01-01

    Organizations outsource non-core service functions to achieve cost reductions and strategic benefits, both of which can impact profitability performance. This article examines relations between managerial outsourcing decisions and profitability for a multi-state sample of non-profit hospitals, across 16 states and four regions of the United States. Overall regression results indicate that outsourcing does not necessarily improve hospital profitability. In addition, we identify no profitability impact from outsourcing for urban hospitals, but somewhat positive effects for teaching hospitals. Our regional analysis suggests that hospitals located in the Midwest maintain positive profitability effects with outsourcing, but those located in the South realize negative effects. These findings have implications for cost reduction efforts and the financial viability of non-profit hospitals.

  8. The Service-profit Chain

    DEFF Research Database (Denmark)

    Grønholdt, Lars; Martensen, Anne

    2016-01-01

    This paper examines the links between employee attitudes, customer loyalty and company profitability. From a conceptual point of view, this employee-customer-profit chain, also known as the service-profit chain, is well founded and generally accepted. But for many companies, it seems difficult...... to demonstrate such links, and several issues must be addressed to uncover the links. To investigate these links empirically, a hotel chain provided data matching employee and customer measures with measures of profitability. We have successfully employed a modeling approach, and the paper reports empirical...... evidence of the employee-customer-profit chain. As it is possible to estimate the links, we have demonstrated their effect on company profitability. The research findings provide a better understanding of the service-profit chain and may help practitioners in improving company financial performance....

  9. Patient seeking behaviors and online personas: social media's role in cosmetic dermatology.

    Science.gov (United States)

    Ross, Nicholas A; Todd, Quintin; Saedi, Nazanin

    2015-02-01

    Social media sites, composed of providers, patients, and their social circles, facilitate health and healthcare delivery. To examine patients' perspective on social media as an information source, communication tool, and referral service through an anonymous survey. In addition, influences on patient Internet personas, an actively constructed online identity, around the time of cosmetic procedures are examined. Patients completed an anonymous institutional review board-approved survey during their initial cosmetic visit. Patients are highly active on social media using it as a multipurpose tool for physician referral services, support groups, and disease education. Patients gathered dermatology information from multiple sources, including friends, family, social media pages, and other online sources, often sharing their own experiences through social media platforms. Patients indicated a desire for provider educational materials on interactive media pages. Most preferred material written by a physician, but some indicated a preference for both physician and lay material. Online images highlighting dissatisfying skin features were influential to select patients, prompting manipulation of online personas and evaluation for aesthetic procedures. Although the study examines cosmetic patient perspectives, data highlight valuable trends for all dermatologists. Social media can improve patient education, collaboration, recruitment, and online professional image, leading to healthier patient-centered care.

  10. An online patient completed Aberdeen Varicose Vein Questionnaire can help to guide primary care referrals.

    Science.gov (United States)

    Ward, A; Abisi, S; Braithwaite, B D

    2013-02-01

    To determine the feasibility and reliability of an online patient completed Aberdeen Varicose Vein Questionnaire (AVVQ) as a tool to guide specialist referral. This was a prospective qualitative and quantitative study. One hundred and six patients completed an online questionnaire. Some 43 (40%) completed the AVVQ questionnaire at home and 63 (60%) did it immediately before their appointment. Venous Clinical Severity Score (VCSS) and CEAP grades were assigned by a consultant vascular surgeon. In 11 patients, the questionnaire was repeated at the time of surgery to assess reproducibility and bias. The AVVQ correlated with the specialist's VCSS scores (Spearman coefficient 0.795; p online AVVQ was positive. An online questionnaire is acceptable to patients, correlates with clinical findings and using a threshold value could be used by healthcare Commissioners to guide varicose vein referrals. Copyright © 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  11. Alternative quality measures and profitability of hospital inpatient services offered.

    Science.gov (United States)

    Self, Donald R; Hegji, Charles E; Self, Robin M

    2010-01-01

    In this analysis, we study the relationship between hospital quality and hospital profits for a sample of 88 Alabama (USA) hospitals. Quality is measured by three groups of procedures performed on newly admitted patients as suggested by the Center for Medicare and Medicaid Services and the Health Quality Alliance (HQA) as well as a weighted quality measure. Profit is measured for eight hospital services. Profits from cardiac care were most responsive to the quality measures studied. Moreover, profits from six of the inpatient services increased as the weighted quality measure increased. Finally, in two cases quality increased with the relative number of employees a hospital utilized.

  12. Online information seeking by patients with bipolar disorder: results from an international multisite survey.

    Science.gov (United States)

    Conell, Jörn; Bauer, Rita; Glenn, Tasha; Alda, Martin; Ardau, Raffaella; Baune, Bernhard T; Berk, Michael; Bersudsky, Yuly; Bilderbeck, Amy; Bocchetta, Alberto; Bossini, Letizia; Paredes Castro, Angela Marianne; Cheung, Eric Yat Wo; Chillotti, Caterina; Choppin, Sabine; Del Zompo, Maria; Dias, Rodrigo; Dodd, Seetal; Duffy, Anne; Etain, Bruno; Fagiolini, Andrea; Garnham, Julie; Geddes, John; Gildebro, Jonas; Gonzalez-Pinto, Ana; Goodwin, Guy M; Grof, Paul; Harima, Hirohiko; Hassel, Stefanie; Henry, Chantal; Hidalgo-Mazzei, Diego; Kapur, Vaisnvy; Kunigiri, Girish; Lafer, Beny; Lam, Chun; Larsen, Erik Roj; Lewitzka, Ute; Licht, Rasmus; Lund, Anne Hvenegaard; Misiak, Blazej; Piotrowski, Patryk; Monteith, Scott; Munoz, Rodrigo; Nakanotani, Takako; Nielsen, René E; O'Donovan, Claire; Okamura, Yasushi; Osher, Yamima; Reif, Andreas; Ritter, Philipp; Rybakowski, Janusz K; Sagduyu, Kemal; Sawchuk, Brett; Schwartz, Elon; Scippa, Ângela Miranda; Slaney, Claire; Sulaiman, Ahmad Hatim; Suominen, Kirsi; Suwalska, Aleksandra; Tam, Peter; Tatebayashi, Yoshitaka; Tondo, Leonardo; Vieta, Eduard; Vinberg, Maj; Viswanath, Biju; Volkert, Julia; Zetin, Mark; Zorrilla, Iñaki; Whybrow, Peter C; Bauer, Michael

    2016-12-01

    Information seeking is an important coping mechanism for dealing with chronic illness. Despite a growing number of mental health websites, there is little understanding of how patients with bipolar disorder use the Internet to seek information. A 39 question, paper-based, anonymous survey, translated into 12 languages, was completed by 1222 patients in 17 countries as a convenience sample between March 2014 and January 2016. All patients had a diagnosis of bipolar disorder from a psychiatrist. Data were analyzed using descriptive statistics and generalized estimating equations to account for correlated data. 976 (81 % of 1212 valid responses) of the patients used the Internet, and of these 750 (77 %) looked for information on bipolar disorder. When looking online for information, 89 % used a computer rather than a smartphone, and 79 % started with a general search engine. The primary reasons for searching were drug side effects (51 %), to learn anonymously (43 %), and for help coping (39 %). About 1/3 rated their search skills as expert, and 2/3 as basic or intermediate. 59 % preferred a website on mental illness and 33 % preferred Wikipedia. Only 20 % read or participated in online support groups. Most patients (62 %) searched a couple times a year. Online information seeking helped about 2/3 to cope (41 % of the entire sample). About 2/3 did not discuss Internet findings with their doctor. Online information seeking helps many patients to cope although alternative information sources remain important. Most patients do not discuss Internet findings with their doctor, and concern remains about the quality of online information especially related to prescription drugs. Patients may not rate search skills accurately, and may not understand limitations of online privacy. More patient education about online information searching is needed and physicians should recommend a few high quality websites.

  13. THE ANALYSIS OF PROFITABILITY INDICATORS

    Directory of Open Access Journals (Sweden)

    SUCIU GHEORGHE

    2013-08-01

    Full Text Available The analysis of profitability indicators is an activity that should preoccupy all companies. Profitabilitydoes not mean only obtaining profit. A company is competitive if the ownership equity grows (the shareholders’money, the company has a profit that is comparable to that of other companies from the same area of activity,has a positive cash flow and the employees are satisfied with their salaries. Multiple indicators are used tomeasure performance: profit, commercial, economic, financial, investment rate of return, breakeven point,economic value added, net operating result.

  14. A More Detailed Understanding Of Factors Associated With Hospital Profitability.

    Science.gov (United States)

    Bai, Ge; Anderson, Gerard F

    2016-05-01

    To identify the characteristics of the most profitable US hospitals, we examined the profitability of acute care hospitals in fiscal year 2013, measured as net income from patient care services per adjusted discharge. Based on Medicare Cost Reports and Final Rule Data, the median hospital lost $82 for each such discharge. Forty-five percent of hospitals were profitable, with 2.5 percent earning more than $2,475 per adjusted discharge. The ten most profitable hospitals, seven of which were nonprofit, each earned more than $163 million in total profits from patient care services. Hospitals with for-profit status, higher markups, system affiliation, or regional power, as well as those located in states with price regulation, tended to be more profitable than other hospitals. Hospitals that treated a higher proportion of Medicare patients, had higher expenditures per adjusted discharge, were located in counties with a high proportion of uninsured patients, or were located in states with a dominant insurer or greater health maintenance organization (HMO) penetration had lower profitability than hospitals that did not have these characteristics. These findings can inform policy reforms, while providing a baseline against which to measure the impact of any subsequent reforms. Project HOPE—The People-to-People Health Foundation, Inc.

  15. The Meaning of Patient Empowerment in the Digital Age: The Role of Online Patient-Communities.

    Science.gov (United States)

    Lamas, Eugenia; Salinas, Rodrigo; Coquedano, Carla; Simon, Marie-Pierre; Bousquet, Cedric; Ferrer, Marcela; Zorrilla, Sergio

    2017-01-01

    Traditionally, patient empowerment has been used as a strategy for health promotion. The rise of online communities of patients represents a good example of how patient empowerment occurs, independently of the intervention of existing healthcare providers and insurers, allowing thus a more accurate definition of meaning of this concept. We describe two situations related with the development of health-related social networks: (1) The emergence of a new biomedical research model in which patients lead research, shifting the equilibrium of power from the professionals to research subjects themselves, and (2) The emergence of Lay Crowd-Sourced Expertise in these communities, arising from the daily exchange among patients affected by chronic conditions and their relatives, giving place to a new era of bottom-up data generation, previously unknown in biomedical sciences. We enrich these descriptions by analyzing interviews to key actors of these "on line" communities": Michael Chekroun, founder of "Carenity, France", and Paul Wicks Vice President at "PatientsLikeMe, USA".

  16. Access to Radiology Reports via an Online Patient Portal: Experiences of Referring Physicians and Patients.

    Science.gov (United States)

    Henshaw, Dan; Okawa, Grant; Ching, Karen; Garrido, Terhilda; Qian, Heather; Tsai, Joanne

    2015-06-01

    Few organizations have reported providing radiology reports to patients via an electronic health record patient portal. The authors describe the process of manual release of reports made by referring physicians, and patients' and referring physicians' experiences during the first year that release through the portal was available. A survey of 508 patients assessed perceived accessibility and importance of portal-released radiology reports, and communications with referring physicians before and after the release. A survey of 48 referring physicians and a group interview assessed the utility of releasing reports, preferences regarding automatic release, and workload impact. Data were analyzed using descriptive statistics and qualitative methods. A total of 74% (377) of patients found reports easy to access, and 88% (446) reported that the ability to do so was important. In all, 49% (250) of patients were contacted by their referring physician before report release, and 25% (156) contacted their physician for more information after viewing a report. Of the referring physicians, 88% (42) found that releasing reports to patients was useful. Auto-release of x-ray reports, with a 1-week delay, was preferred by 58% (28), but they were more reluctant to auto-release CT and MRI reports. A total of 86% (41) of referring physicians reported that follow-up emails, telephone calls, and office visits were unchanged or had decreased. Referring-physician release of radiology reports via the online portal is important to patients, useful to referring physicians, and does not affect referring-physician workloads. A delay between reporting results to referring physicians and releasing them to patients allows time for needed physician-patient communication. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. What Predicts Patients’ Willingness to Undergo Online Treatment and Pay for Online Treatment? Results from a Web-Based Survey to Investigate the Changing Patient-Physician Relationship

    Science.gov (United States)

    Bidmon, Sonja; Terlutter, Ralf

    2016-01-01

    Background Substantial research has focused on patients’ health information–seeking behavior on the Internet, but little is known about the variables that may predict patients’ willingness to undergo online treatment and willingness to pay additionally for online treatment. Objective This study analyzed sociodemographic variables, psychosocial variables, and variables of Internet usage to predict willingness to undergo online treatment and willingness to pay additionally for online treatment offered by the general practitioner (GP). Methods An online survey of 1006 randomly selected German patients was conducted. The sample was drawn from an e-panel maintained by GfK HealthCare. Missing values were imputed; 958 usable questionnaires were analyzed. Variables with multi-item measurement were factor analyzed. Willingness to undergo online treatment and willingness to pay additionally for online treatment offered by the GP were predicted using 2 multiple regression models. Results Exploratory factor analyses revealed that the disposition of patients’ personality to engage in information-searching behavior on the Internet was unidimensional. Exploratory factor analysis with the variables measuring the motives for Internet usage led to 2 separate factors: perceived usefulness (PU) of the Internet for health-related information searching and social motives for information searching on the Internet. Sociodemographic variables did not serve as significant predictors for willingness to undergo online treatment offered by the GP, whereas PU (B=.092, P=.08), willingness to communicate with the GP more often in the future (B=.495, Ponline communication with the GP (B=.198, Ponline treatment, but it was predicted by health-related information–seeking personality (B=.127, P=.07), PU (B=–.098, P=.09), willingness to undergo online treatment (B=.391, Ponline communication with the GP (B=.192, P=.001), highest education level (B=.178, Ponline more often in the future (B

  18. The effect of computer-mediated social support in online communities on patient empowerment and doctor-patient communication.

    Science.gov (United States)

    Oh, Hyun Jung; Lee, Byoungkwan

    2012-01-01

    In the context of diabetes, this study tested a mechanism through which Korean diabetes patients' exchange of computer-mediated social support (CMSS) in diabetes online communities influences their sense of empowerment and intention to actively communicate with the doctor. Analysis of data from 464 Korean diabetes patients indicates significant relationships among diabetes patients' online community activities, perceived CMSS, sense of empowerment, and their intention to actively communicate with the doctor. Diabetes patients who have engaged more in online community activities perceived greater social support from other members of the community. Perceived CMSS significantly predicted their intention to actively communicate with the doctor through sense of empowerment. Sense of empowerment was a valid underlying mechanism that explains how patients' perceived CMSS influences their intention to actively communicate with the doctor. The implications for health communication research and practice are discussed.

  19. Patient perspectives on online health information and communication with doctors: a qualitative study of patients 50 years old and over.

    Science.gov (United States)

    Silver, Michelle Pannor

    2015-01-13

    As health care systems around the world shift toward models that emphasize self-care management, there is increasing pressure for patients to obtain health information online. It is critical that patients are able to identify potential problems with using the Internet to diagnose and treat a health issue and that they feel comfortable communicating with their doctor about the health information they acquire from the Internet. Our aim was to examine patient-identified (1) problems with using the Internet to identify and treat a health issue, (2) barriers to communication with a doctor about online health information seeking, and (3) facilitators of communication with a doctor about patient searches for health information on the Internet. For this qualitative exploratory study, semistructured interviews were conducted with a sample of 56 adults age 50 years old and over. General concerns regarding use of the Internet to diagnose and treat a health issue were examined separately for participants based on whether they had ever discussed health information obtained through the Internet with a doctor. Discussions about barriers to and facilitators of communication about patient searches for health information on the Internet with a doctor were analyzed using thematic analysis. Six higher-level general concerns emerged: (1) limitations in own ability, (2) credibility/limitations of online information, (3) anxiety, (4) time consumption, (5) conflict, and (6) non-physical harm. The most prevalent concern raised by participants who communicated with a doctor about their online health information seeking related to the credibility or limitations in online information. Participants who had never communicated with a doctor about their online health information seeking most commonly reported concerns about non-physical harm. Four barriers to communication emerged: (1) concerns about embarrassment, (2) concerns that the doctor doesn't want to hear about it, (3) belief that there

  20. Patient Perspectives on Online Health Information and Communication With Doctors: A Qualitative Study of Patients 50 Years Old and Over

    Science.gov (United States)

    2015-01-01

    Background As health care systems around the world shift toward models that emphasize self-care management, there is increasing pressure for patients to obtain health information online. It is critical that patients are able to identify potential problems with using the Internet to diagnose and treat a health issue and that they feel comfortable communicating with their doctor about the health information they acquire from the Internet. Objective Our aim was to examine patient-identified (1) problems with using the Internet to identify and treat a health issue, (2) barriers to communication with a doctor about online health information seeking, and (3) facilitators of communication with a doctor about patient searches for health information on the Internet. Methods For this qualitative exploratory study, semistructured interviews were conducted with a sample of 56 adults age 50 years old and over. General concerns regarding use of the Internet to diagnose and treat a health issue were examined separately for participants based on whether they had ever discussed health information obtained through the Internet with a doctor. Discussions about barriers to and facilitators of communication about patient searches for health information on the Internet with a doctor were analyzed using thematic analysis. Results Six higher-level general concerns emerged: (1) limitations in own ability, (2) credibility/limitations of online information, (3) anxiety, (4) time consumption, (5) conflict, and (6) non-physical harm. The most prevalent concern raised by participants who communicated with a doctor about their online health information seeking related to the credibility or limitations in online information. Participants who had never communicated with a doctor about their online health information seeking most commonly reported concerns about non-physical harm. Four barriers to communication emerged: (1) concerns about embarrassment, (2) concerns that the doctor doesn’t want

  1. Profitability analysis of sustainable swine production in Abia State ...

    African Journals Online (AJOL)

    Profitability analysis of sustainable swine production in Abia State, Nigeria. NC Ehirim, SUO Onyeagocha, CA Emenyonu, SC Onyemauwa, OG Ugochukwu. Abstract. No Abstract. Animal Production Research Advances Vol. 4 (1) 2008: pp. 63-72. http://dx.doi.org/10.4314/apra.v4i1.36430 · AJOL African Journals Online.

  2. JAAD online. Over-the-counter scar products for postsurgical patients: disparities between online advertised benefits and evidence regarding efficacy.

    Science.gov (United States)

    Morganroth, Pamela; Wilmot, Alissa Cowden; Miller, Christopher

    2009-12-01

    Surgical patients frequently read about over-the-counter (OTC) scar products online and ask physicians for advice about product use. We summarized the characteristics of the 20 best-selling scar products on the Web site drugstore.com and reviewed the medical literature for data supporting the efficacy of OTC scar products used on fresh postsurgical wounds. Products had an average price of $16.25 (range $9.49-$59.99) and an average of 9.2 ingredients (range 1-29). Silicone, vitamin E, and onion extract were common ingredients. Although weak evidence indicates that silicone gel dressings may improve postsurgical scar appearance, published evidence does not support postoperative use of most scar products. However, many products have multiple ingredients, and few clinical trials assess the ingredient combinations of specific products. The practical information about OTC scar products and published efficacy data found in this review may help physicians to counsel patients about postsurgical product use and counter unrealistic expectations gained from online advertisements.

  3. DataProfit

    DEFF Research Database (Denmark)

    Ritter, Thomas; Lund Pedersen, Carsten; Eibe Sørensen, Hans

    Mange erhvervsledere har store forventninger til at bruge data til at tjene penge i deres virksomheder. Dog viser det sig, at det ikke er så ligetil – mange forventninger bliver simpelthen ikke indfriet. Derfor har vi igennem de seneste to år kortlagt de kompetencer, som er nødvendige for at real......Mange erhvervsledere har store forventninger til at bruge data til at tjene penge i deres virksomheder. Dog viser det sig, at det ikke er så ligetil – mange forventninger bliver simpelthen ikke indfriet. Derfor har vi igennem de seneste to år kortlagt de kompetencer, som er nødvendige...... sammen for at udnytte mulighederne for datadreven profitabel vækst. Denne guide giver en anvendelsesorienteret gennemgang af de ni kompetencer i vores kort, som vi kalder for DataProfit. I guiden beskrives hver kompetence – og du inviteres til at analysere din virksomhed. Til sidst sætter vi hele...

  4. The use of nationwide on-line prescription records improves the drug history in hospitalized patients

    DEFF Research Database (Denmark)

    Glintborg, Bente; Poulsen, Henrik E; Dalhoff, Kim P

    2008-01-01

    records through a real-time online electronic database What this study adds: Omission errors are frequent among hospitalized patients despite structured drug interviews and home visits. Pharmacy records may be used to minimize patients' recall bias and improve the medication lists.......What is already known about this subject: Structured medication interviews improve the medication history upon hospitalization. Pharmacy records are valid lists of the prescribed medications available to individual patients. In Denmark, treating doctors now have access to their patients' pharmacy...

  5. Clinical trials from the patient perspective: survey in an online patient community.

    Science.gov (United States)

    DasMahapatra, Pronabesh; Raja, Priya; Gilbert, Jeremy; Wicks, Paul

    2017-02-27

    Developing new medicines relies on the successful conduct of clinical trials. As trial protocols become more arduous, it becomes harder to recruit and retain patient volunteers, although recent efforts such as OMERACT and I-SPY2 show that partnering with patients can be beneficial. We sought to describe drivers and barriers to trial participation, as well as condition-specific trial preferences. An online survey was fielded via the patient-powered research network PatientsLikeMe to 1,621 members living with nine selected chronic health conditions. Questions included demographics, trial experience, reasons for non-participation, questions relating to aspects of trial design, and an adaptation of the Net Promoter Score (NPS) for trial satisfaction. Mean age of respondents was 55 years; most patients were white (93%), female (67%), and living in the United States (72%). Primary conditions were MS (21%), Parkinson's (20%), fibromyalgia (15%), ALS (10%), type 2 diabetes (10%), rheumatoid arthritis (RA, 8%), epilepsy (8%), major depressive disorder (MDD, 5%) and systemic lupus erythematosus (SLE, 3%). Most patients had not discussed a trial with their physician and only 21% had ever enrolled, with rates highest in ALS (36%), Parkinson's disease (36%) and MS (20%) and lowest among SLE (9%), MDD (11%) and Fibromyalgia (11%). Common reasons for non-participation were eligibility criteria, inconvenience of travel and concerns about side effects. NPS suggested that many patients were unsatisfied; patients with lupus, epilepsy, RA, and fibromyalgia reported negative scores, i.e. they would dissuade other patients like them from taking part in trials. The most important considerations in trial participation were the opportunity to improve one's own health and that of others, the reputation of the institution, and having medical bills covered in case of injury. Least important were remuneration and possibility of receiving a placebo. ALS patients were more willing to tolerate

  6. Determinants of engagement in face-to-face and online patient support groups

    NARCIS (Netherlands)

    Kraan, C.F.; Drossaert, Constance H.C.; Taal, Erik; Smit, Willem M.; Bernelot Moens, Hein J.; van de Laar, Mart A F J

    2011-01-01

    Background: Although peer-to-peer contact might empower patients in various ways, studies show that only a few patients actually engage in support groups. Objective: The objective of our study was to explore factors that facilitate or impede engagement in face-to-face and online peer support, using

  7. Cultural Competence Clinic: An Online, Interactive, Simulation for Working Effectively with Arab American Muslim Patients

    Science.gov (United States)

    Smith, Brian Daniel; Silk, Kami

    2011-01-01

    Objective: This pilot study investigates the impact of an online, interactive simulation involving an Arab American Muslim patient on the knowledge, skills, and attitudes of 2nd-year medical students regarding culturally competent healthcare, both in general and specific to Arab American Muslim patients. Method: Participants (N = 199), were…

  8. Characteristics of Patients Who Report Confusion After Reading Their Primary Care Clinic Notes Online.

    Science.gov (United States)

    Root, Joseph; Oster, Natalia V; Jackson, Sara L; Mejilla, Roanne; Walker, Jan; Elmore, Joann G

    2016-01-01

    Patient access to online electronic medical records (EMRs) is increasing and may offer benefits to patients. However, the inherent complexity of medicine may cause confusion. We elucidate characteristics and health behaviors of patients who report confusion after reading their doctors' notes online. We analyzed data from 4,528 patients in Boston, MA, central Pennsylvania, and Seattle, WA, who were granted online access to their primary care doctors' clinic notes and who viewed at least one note during the 1-year intervention. Three percent of patients reported confusion after reading their visit notes. These patients were more likely to be at least 70 years of age (p reading visit notes (relative risk [RR] 4.83; confidence interval [CI] 3.17, 7.36) compared to patients who were not confused. In adjusted analyses, they were less likely to report feeling more in control of their health (RR 0.42; CI 0.25, 0.71), remembering their care plan (RR 0.26; CI 0.17, 0.42), and understanding their medical conditions (RR 0.32; CI 0.19, 0.54) as a result of reading their doctors' notes compared to patients who were not confused. Patients who were confused by reading their doctors' notes were less likely to report benefits in health behaviors. Understanding this small subset of patients is a critical step in reducing gaps in provider-patient communication and in efforts to tailor educational approaches for patients.

  9. Do clinicians use online evidence to support patient care? A study of 55,000 clinicians.

    Science.gov (United States)

    Westbrook, Johanna I; Gosling, A Sophie; Coiera, Enrico

    2004-01-01

    To determine clinicians' (doctors', nurses', and allied health professionals') "actual" and "reported" use of a point-of-care online information retrieval system; and to make an assessment of the extent to which use is related to direct patient care by testing two hypotheses: hypothesis 1: clinicians use online evidence primarily to support clinical decisions relating to direct patient care; and hypothesis 2: clinicians use online evidence predominantly for research and continuing education. Web-log analysis of the Clinical Information Access Program (CIAP), an online, 24-hour, point-of-care information retrieval system available to 55,000 clinicians in public hospitals in New South Wales, Australia. A statewide mail survey of 5,511 clinicians. Rates of online evidence searching per 100 clinicians for the state and for the 81 individual hospitals studied; reported use of CIAP by clinicians through a self-administered questionnaire; and correlations between evidence searches and patient admissions. Monthly rates of 48.5 "search sessions" per 100 clinicians and 231.6 text hits to single-source databases per 100 clinicians (n = 619,545); 63% of clinicians reported that they were aware of CIAP and 75% of those had used it. Eighty-eight percent of users reported CIAP had the potential to improve patient care and 41% reported direct experience of this. Clinicians' use of CIAP on each day of the week was highly positively correlated with patient admissions (r = 0.99, p true for all ten randomly selected hospitals. Clinicians' online evidence use increases with patient admissions, supporting the hypothesis that clinicians' use of evidence is related to direct patient care. Patterns of evidence use and clinicians' self-reports also support this hypothesis.

  10. The Contribution of Online Peer-to-Peer Communication Among Patients With Adrenal Disease to Patient-Centered Care

    NARCIS (Netherlands)

    Kauw, D.; Repping-Wuts, H.; Noordzij, A.; Stikkelbroeck, N.; Hermus, A.R.; Faber, M.J.

    2015-01-01

    BACKGROUND: Addison's disease and Cushing's syndrome are rare. The Dutch Adrenal Society offers an online forum for Dutch adrenal patients to meet and communicate. However, little is known about the added value such a forum has for the delivery of patient-centered care. OBJECTIVE: Our aim was to

  11. No change in physician dictation patterns when visit notes are made available online for patients.

    Science.gov (United States)

    Kind, Elizabeth A; Fowles, Jinnet B; Craft, Cheryl E; Kind, Allan C; Richter, Sara A

    2011-05-01

    To determine whether physicians document office visits differently when they know their patients have easy, online access to visit notes. We conducted a natural experiment with a pre-post design and a nonrandomized control group. The setting was a multispecialty group practice in Minnesota. We reviewed a total of 400 visit notes: 100 each for patients seen in a rheumatology department (intervention group) and a pulmonary medicine department (control group) from July 1 to August 30, 2005, before online access to notes, and 100 each for patients seen in these 2 departments 1 year later, from July 1 to August 30, 2006, when only rheumatology patients had online access to visit notes. We measured changes in visit note content related to 9 hypotheses for increased patient understanding and 5 for decreased frank or judgmental language. Changes occurred for 2 of the 9 hypotheses related to patient understanding, both in an unpredicted direction. The proportion of acronyms or abbreviations increased more in the notes of rheumatologists than of pulmonologists (0.6% vs 0.1%; P=.01), whereas the proportion of anatomy understood decreased more in the notes of rheumatologists than of pulmonologists (-5.9% vs -0.8%; P=.02). One change (of 5 possible) occurred related to the use of frank or judgmental terms. Mentions of mental health status decreased in rheumatology notes and increased in pulmonology notes (-8% vs 7%; P=.02). Dictation patterns appear relatively stable over time with or without online patient access to visit notes.

  12. Patients and professionals have different views on online patient information about cleft lip and palate (CL/P).

    Science.gov (United States)

    van den Bosch, S; Koudstaal, M; Versnel, S; Maal, T; Xi, T; Nelen, W; Bergé, S; Faber, M

    2016-06-01

    Parents of children with a cleft lip and/or palate (CL/P) and patients with CL/P actively search for online information about CL/P. The quality of this information has not been sufficiently evaluated. The aim of this study was to define quality criteria for online information about CL/P and assess the quality of frequently accessed websites. Patients, parents, and professionals were equally involved in all stages of this study. A literature review was performed to obtain known quality criteria for online information. These criteria were prioritized by patients, parents, and professionals. The most important criteria were used to rate the quality of four websites on CL/P. Forty-two quality items were extracted from the literature. Patients, parents, and professionals agreed on the importance of 16 of these items. New groups of patients, parents, and professionals assessed four websites on CL/P. Although the groups were like-minded in their overall assessment of the quality of the websites, distinct differences emerged between the groups in relation to certain items. This study shows the importance of patient participation in healthcare research, as well as a feasible approach to do so. Involving patients in composing online health information will set different priorities, which is necessary in establishing high quality information. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. Communication at an online infertility expert forum: provider responses to patients' emotional and informational cues.

    Science.gov (United States)

    Aarts, J W M; van Oers, A M; Faber, M J; Cohlen, B J; Nelen, W L D M; Kremer, J A M; van Dulmen, A M

    2015-01-01

    Online patient-provider communication has become increasingly popular in fertility care. However, it is not known to what extent patients express cues or concerns and how providers respond. In this study, we investigated cues and responses that occur in online patient-provider communication at an infertility-specific expert forum. We extracted 106 threads from the multidisciplinary expert forum of two Dutch IVF clinics. We performed the following analyses: (1) thematic analysis of patients' questions; and (2) rating patients' emotional and informational cues and subsequent professionals' responses using an adaptation of the validated Medical Interview Aural Rating Scale. Frequencies of themes, frequencies of cues and responses, and sequences (what cue is followed by what response) were extracted. Sixty-five infertile patients and 19 providers participated. The most common themes included medication and lifestyle. Patients gave more informational than emotional cues (106 versus 64). Responses to informational cues were mostly adequate (61%). The most common response to emotional cues was empathic acknowledgment (72%). Results indicate that an online expert forum could have a positive effect on patient outcomes, which should guide future research. Offering infertile patients an expert forum to communicate with providers can be a promising supplement to usual care in both providing information and addressing patients' concerns.

  14. Identifying barriers to patient acceptance of active surveillance: content analysis of online patient communications.

    Science.gov (United States)

    Mishra, Mark V; Bennett, Michele; Vincent, Armon; Lee, Olivia T; Lallas, Costas D; Trabulsi, Edouard J; Gomella, Leonard G; Dicker, Adam P; Showalter, Timothy N

    2013-01-01

    Qualitative research aimed at identifying patient acceptance of active surveillance (AS) has been identified as a public health research priority. The primary objective of this study was to determine if analysis of a large-sample of anonymous internet conversations (ICs) could be utilized to identify unmet public needs regarding AS. English-language ICs regarding prostate cancer (PC) treatment with AS from 2002-12 were identified using a novel internet search methodology. Web spiders were developed to mine, aggregate, and analyze content from the world-wide-web for ICs centered on AS. Collection of ICs was not restricted to any specific geographic region of origin. NLP was used to evaluate content and perform a sentiment analysis. Conversations were scored as positive, negative, or neutral. A sentiment index (SI) was subsequently calculated according to the following formula to compare temporal trends in public sentiment towards AS: [(# Positive IC/#Total IC)-(#Negative IC/#Total IC) x 100]. A total of 464 ICs were identified. Sentiment increased from -13 to +2 over the study period. The increase sentiment has been driven by increased patient emphasis on quality-of-life factors and endorsement of AS by national medical organizations. Unmet needs identified in these ICs include: a gap between quantitative data regarding long-term outcomes with AS vs. conventional treatments, desire for treatment information from an unbiased specialist, and absence of public role models managed with AS. This study demonstrates the potential utility of online patient communications to provide insight into patient preferences and decision-making. Based on our findings, we recommend that multidisciplinary clinics consider including an unbiased specialist to present treatment options and that future decision tools for AS include quantitative data regarding outcomes after AS.

  15. Profit Patterns Across American Agriculture

    OpenAIRE

    Blank, Steven C.; Erickson, Kenneth W.; Moss, Charles B.

    2005-01-01

    To remain viable, agriculture in each location must offer returns that are competitive with those from alternative investments and sufficient to cover producers' financial obligations. Economic theory says that rates of return converge over time as resources flow into more-profitable industries and out of less-profitable industries, causing factor price changes. Both traditional growth and trade theories say factor markets will adjust to equalize commodity returns over time. This study examin...

  16. Active patient participation in the development of an online intervention.

    NARCIS (Netherlands)

    Bruinessen, I.R. van; Weel-Baumgarten, E.M. van; Snippe, H.W.; Gouw, H.; Zijlstra, J.M.; Dulmen, S. van

    2014-01-01

    Background: An important and challenging part of living with cancer relates to the repeated visits to the hospital. Since how patients cope between these post-diagnostic visits depends partly on the information and support received from their physician during the visits, it is important to make the

  17. Active patient participation in the development of an online intervention

    NARCIS (Netherlands)

    Bruinessen, I.R. van; Weel-Baumgarten, E.M. van; Snippe, H.W.; Gouw, H.; Zijlstra, J.M.; Dulmen, S. van

    2014-01-01

    BACKGROUND: An important and challenging part of living with cancer relates to the repeated visits to the hospital. Since how patients cope between these post-diagnostic visits depends partly on the information and support received from their physician during the visits, it is important to make the

  18. Patients covertly recording clinical encounters: threat or opportunity? A qualitative analysis of online texts

    NARCIS (Netherlands)

    Tsulukidze, M.; Grande, S.W.; Thompson, R.; Rudd, K.; Elwyn, G.

    2015-01-01

    BACKGROUND: The phenomenon of patients covertly recording clinical encounters has generated controversial media reports. This study aims to examine the phenomenon and analyze the underlying issues. METHODS AND FINDINGS: We conducted a qualitative analysis of online posts, articles, blogs, and forums

  19. An online self-care education program to support patients after total laryngectomy : feasibility and satisfaction

    NARCIS (Netherlands)

    Cnossen, Ingrid C; van Uden-Kraan, Cornelia F; Eerenstein, Simone E J; Jansen, Femke; Witte, Birgit I; Lacko, Martin; Hardillo, José A; Honings, Jimmie; Halmos, Gyorgy B; Goedhart-Schwandt, Noortje L Q; de Bree, Remco; Leemans, C René; Leeuw, Irma M Verdonck-de

    The purpose of this study was to investigate the feasibility of an online self-care education program supporting early rehabilitation of patients after total laryngectomy (TLPs) and factors associated with satisfaction. Health care professionals (HCPs) were invited to participate and to recruit

  20. Online information on complementary and alternative medicine for cancer patients: evidence-based recommendations.

    Science.gov (United States)

    Huebner, Jutta; Senf, Bianca; Micke, Oliver; Muecke, Ralph; Stoll, Christoph; Prott, Franz J; Muenstedt, Karsten; Dennert, Gabriele

    2013-01-01

    Many cancer patients use complementary and alternative medicine (CAM). Most websites offering online information on CAM are not helpful for them. We extracted decisive elements for online information on CAM by analyzing the literature on the information needs of cancer patients and on counseling cancer patients on CAM. Key issues for online information on CAM are the qualification of the authors, transparency and accountability of the information, description of the aims, a scientific approach, description of treatment alternatives, support for the patient-physician relationship, individualized information, a summary of the information, disclosure of funding, and the privacy policy. The communicative challenge will be to convey information without destroying hope and motivation. We suggest that CAM topics should be integrated into broader information provided on cancer (etiology, conventional treatment). By also providing information for physicians, such a website could promote shared decision-making. Online information will gain the status of independent expert knowledge if provided by a well-known scientific organization as, e.g., a national cancer society. Copyright © 2013 S. Karger AG, Basel.

  1. Priorities, satisfaction and treatment goals in psychosis patients: an online consumer's survey

    NARCIS (Netherlands)

    Sterk, B.; Winter van Rossum, I.; Muis, M.; de Haan, L.

    2013-01-01

    An insight into preferences, satisfaction and treatment goals of patients is important for reaching treatment alliance and may increase the success of initiated treatment. Participants from the Netherlands,with at least one psychotic episode, were asked to fill in an online questionnaire.

  2. Older Patients' Recall of Online Cancer Information: Do Ability and Motivation Matter More than Chronological Age?

    NARCIS (Netherlands)

    Bol, Nadine; Smets, Ellen M. A.; Burgers, Jacobus A.; Samii, Suzy M.; de Haes, Hanneke C. J. M.; van Weert, Julia C. M.

    2017-01-01

    This study proposes and tests a model to provide a more comprehensive understanding of the contribution of chronological age versus age-related ability and motivation factors in explaining recall of online cancer information among older patients (n = 197). Results revealed that recall is not a

  3. An online readability analysis of pathology-related patient education articles: an opportunity for pathologists to educate patients.

    Science.gov (United States)

    Prabhu, Arpan V; Kim, Christopher; Crihalmeanu, Tudor; Hansberry, David R; Agarwal, Nitin; DeFrances, Marie C; Trejo Bittar, Humberto E

    2017-07-01

    Information for patients regarding their clinical conditions and treatment options is widely available online. The American Medical Association and National Institutes of Health recommend that online patient-oriented materials be written at no higher than a seventh-grade reading level to ensure full comprehension by the average American. This study sought to determine whether online patient-oriented materials explaining common pathology procedures are written at appropriate reading levels. Ten pathology procedures that patients would likely research were queried into Google search, and plain text from the first 10 Web sites containing patient education materials for each procedure was analyzed using 10 validated readability scales. We determined mean reading levels of materials grouped by readability scale, procedure, and Web site domain, the overall average reading level of all resources, and popular Web site domains. One hundred Web sites were accessed; one was omitted for short length (pathology-related patient education materials exceeded those recommended by national health literacy guidelines. These patient education materials should be revised to help patients fully understand them. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Radiation Oncology and Online Patient Education Materials: Deviating From NIH and AMA Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Prabhu, Arpan V. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Hansberry, David R. [Department of Radiology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania (United States); Agarwal, Nitin [Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Clump, David A. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Heron, Dwight E., E-mail: herond2@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Department of Otolaryngology, Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States)

    2016-11-01

    Purpose: Physicians encourage patients to be informed about their health care options, but much of the online health care–related resources can be beneficial only if patients are capable of comprehending it. This study's aim was to assess the readability level of online patient education resources for radiation oncology to conclude whether they meet the general public's health literacy needs as determined by the guidelines of the United States National Institutes of Health (NIH) and the American Medical Association (AMA). Methods: Radiation oncology–related internet-based patient education materials were downloaded from 5 major professional websites (American Society for Radiation Oncology, American Association of Physicists in Medicine, American Brachytherapy Society, (RadiologyInfo.org), and Radiation Therapy Oncology Group). Additional patient education documents were downloaded by searching for key radiation oncology phrases using Google. A total of 135 articles were downloaded and assessed for their readability level using 10 quantitative readability scales that are widely accepted in the medical literature. Results: When all 10 assessment tools for readability were taken into account, the 135 online patient education articles were written at an average grade level of 13.7 ± 2.0. One hundred nine of the 135 articles (80.7%) required a high school graduate's comprehension level (12th-grade level or higher). Only 1 of the 135 articles (0.74%) met the AMA and NIH recommendations for patient education resources to be written between the third-grade and seventh-grade levels. Conclusion: Radiation oncology websites have patient education material written at an educational level above the NIH and AMA recommendations; as a result, average American patients may not be able to fully understand them. Rewriting radiation oncology patient education resources would likely contribute to the patients' understanding of their health and treatment

  5. Radiation Oncology and Online Patient Education Materials: Deviating From NIH and AMA Recommendations.

    Science.gov (United States)

    Prabhu, Arpan V; Hansberry, David R; Agarwal, Nitin; Clump, David A; Heron, Dwight E

    2016-11-01

    Physicians encourage patients to be informed about their health care options, but much of the online health care-related resources can be beneficial only if patients are capable of comprehending it. This study's aim was to assess the readability level of online patient education resources for radiation oncology to conclude whether they meet the general public's health literacy needs as determined by the guidelines of the United States National Institutes of Health (NIH) and the American Medical Association (AMA). Radiation oncology-related internet-based patient education materials were downloaded from 5 major professional websites (American Society for Radiation Oncology, American Association of Physicists in Medicine, American Brachytherapy Society, RadiologyInfo.org, and Radiation Therapy Oncology Group). Additional patient education documents were downloaded by searching for key radiation oncology phrases using Google. A total of 135 articles were downloaded and assessed for their readability level using 10 quantitative readability scales that are widely accepted in the medical literature. When all 10 assessment tools for readability were taken into account, the 135 online patient education articles were written at an average grade level of 13.7 ± 2.0. One hundred nine of the 135 articles (80.7%) required a high school graduate's comprehension level (12th-grade level or higher). Only 1 of the 135 articles (0.74%) met the AMA and NIH recommendations for patient education resources to be written between the third-grade and seventh-grade levels. Radiation oncology websites have patient education material written at an educational level above the NIH and AMA recommendations; as a result, average American patients may not be able to fully understand them. Rewriting radiation oncology patient education resources would likely contribute to the patients' understanding of their health and treatment options, making each physician-patient interaction more productive

  6. Patients' expectations and online presence of Oral and Maxillofacial Surgery in the United Kingdom.

    Science.gov (United States)

    Abu-Serriah, M; Bharmal, R Valiji; Gallagher, J; Ameerally, P J

    2014-02-01

    In patient-centred medical practice, consideration of the patients' expectations is vital to the planning and delivery of service. Modern medicine must use the continuing advances in information technology to disseminate knowledge and raise awareness among patients and the public. People increasingly use the Internet to search for information on health, and the online presence of an organisation or a profession is known to bring a wide range of benefits. We aimed to find out what patients expect from the website of an Oral and Maxillofacial Surgery (OMFS) unit and to assess the online presence of OMFS units in the United Kingdom. Results from 100 self-administered questionnaires showed that there were 18 common domains that patients would like to see on OMFS websites. When ranked according to the number of times they were mentioned, a map of the department was mentioned most and the complaints policy least. Of the 156 OMFS units in the UK, only 51% have websites and of these, 80% are in London. There were none in Wales and Northern Ireland. Only half of the websites contained information that related to patients' expectations. Strategies to improve the content of websites for OMFS units and to improve their online presence are urgently needed. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Online patient safety education programme for junior doctors: is it worthwhile?

    Science.gov (United States)

    McCarthy, S E; O'Boyle, C A; O'Shaughnessy, A; Walsh, G

    2016-02-01

    Increasing demand exists for blended approaches to the development of professionalism. Trainees of the Royal College of Physicians of Ireland participated in an online patient safety programme. Study aims were: (1) to determine whether the programme improved junior doctors' knowledge, attitudes and skills relating to error reporting, open communication and care for the second victim and (2) to establish whether the methodology facilitated participants' learning. 208 junior doctors who completed the programme completed a pre-online questionnaire. Measures were "patient safety knowledge and attitudes", "medical safety climate" and "experience of learning". Sixty-two completed the post-questionnaire, representing a 30 % matched response rate. Participating in the programme resulted in immediate (p attitudes towards error reporting (p doctors routinely report medical errors and 42 % disagreed that doctors routinely share information about medical errors and what caused them. Participants rated interactive features as the most positive elements of the programme. An online training programme on medical error improved self-rated knowledge, attitudes and skills in junior doctors and was deemed an effective learning tool. Perceptions of work issues such as a poor culture of error reporting among doctors may prevent improved attitudes being realised in practice. Online patient safety education has a role in practice-based initiatives aimed at developing professionalism and improving safety.

  8. Talking about your health to strangers: understanding the use of online social networks by patients

    Science.gov (United States)

    Colineau, Nathalie; Paris, Cécile

    2010-04-01

    The internet has become a participatory place where everyone can contribute and interact with others. In health in particular, social media have changed traditional patient-physician relationships. Patients are organising themselves in groups, sharing observations and helping each other, although there is still little evidence of the effectiveness of these online communities on people's health. To understand why and how people use health-related sites, we studied these sites and identified three dimensions characterising most of them: informational/supportive; general/focused; and new relationships/existing ones. We conducted an online survey about the use of health-related social networking (SN) sites and learnt that, consistent with previous research, most patients were seeking information about their medical condition online, while, at the same time, still interacting with health professionals to talk about sensitive information and complex issues. We also found that, while people's natural social network played an important role for emotional support, sometimes, people chose to not involve their family, but instead interact with peers online because of their perceived support and ability to understand someone's experience, and also to maintain a comfortable emotional distance. Finally, our results show that people using general SN sites do not necessarily use health-related sites and vice versa.

  9. Metaboli-Net: online groupware system providing counseling guidance for patients with metabolic syndrome.

    Science.gov (United States)

    Kuwata, Shigeki; Taniguchi, Shin-ichi; Kato, Atsuko; Inoue, Kazuoki; Yamamoto, Naoya; Ohkura, Tsuyoshi; Teramoto, Kei; Shigemasa, Chiaki; Kondoh, Hiroshi

    2010-01-01

    This study presented a newly developed online groupware system, Metaboli-Net, to yield counseling guidance on diet and exercise to patients with metabolic syndrome. A distinctive feature adopted in the system to maintain the retention rate of patients was the social network service (SNS) that enables the patients to share their dietary and relevant health information with other participants in the same group on the network. A pilot study was conducted to prove the effectiveness of the system in improving the patient's lifestyle and dietary health awareness. SNS also contributed to the participant's adherence to intervention programs.

  10. Emotional coping differences among breast cancer patients from an online support group: a cross-sectional study.

    Science.gov (United States)

    Batenburg, Anika; Das, Enny

    2014-02-05

    Due to mixed findings in research on the effect of online peer-to-peer support on psychological well-being, there is a need for studies explaining why and when online support communities are beneficial for cancer patients. Previous studies have typically not taken into account individual coping differences, despite the fact that patients have different strategies to cope with cancer-related emotions. In the current study, it was predicted that the effects of online support group participation would partly depend on patients' ability to cope with thoughts and emotions regarding the illness. For this study, 184 Dutch breast cancer patients filled out a questionnaire assessing activity within a peer-led online support community, coping with emotions and thoughts regarding the illness (cognitive avoidance, emotional processing, and expression) and psychological well-being (depression, breast cancer-related concerns, and emotional well-being). Of these, 163 patients were visiting an online peer-led support community. Results showed interactions of the intensity of support group participation and coping style on psychological well-being. Specifically, we found an interaction of online activity and emotional expression on depression (beta=-.17, P=.030), a marginally significant interaction of online activity and emotional expression on emotional well-being (beta=.14, P=.089), and an interaction of online activity and cognitive avoidance on breast cancer-related concerns (beta=.15, P=.027). For patients who actively dealt with their emotions and thoughts, active online support group participation was positively related to psychological well-being. For patients high on avoidance of illness-related thoughts or low on emotional expression, active participation was negatively related to measures of well-being. The current study revealed the role of individual differences in coping in online support group participation. Results suggest that breast cancer patients' ability to

  11. Hard Internet Truths: 34,748 Online Reviews Reveal What Patients Really Want from Doctors.

    Science.gov (United States)

    King, Ron Harman; Stanley, Jonathan; Baum, Neil

    2016-01-01

    For all of us living in the Internet age, it's hard to underestimate the power of online reviews. Before booking a reservation at a new hotel or restaurant, who doesn't consult websites such as TripAdvisor and Open Table? Who would gamble $100 on a dinner out or $200 on a hotel stay before first seeing what other diners and patrons had to say about their experiences? Patients who are looking for a healthcare provider are no different than those customers looking for a restaurant or a hotel; they want opinions from others who have previously availed themselves of that restaurant or hotel. This article addresses the importance of online reputation management and offers ideas and suggestions for healthcare providers to control and protect their online reputations.

  12. Including the online feedback site, Patient Opinion, in the nursing curriculum: Exploratory study.

    Science.gov (United States)

    Jones, Ray; Young, Kim; Munro, James; Miller, Heather; Brelsford, Stephanie; Aronsson, Jennie; Goodman, Benny; Peters, Jane

    2017-10-01

    Globally, universities aim to involve people who use health services to enrich the nursing curriculum for students, but there can be barriers to this involvement. Many also want students to contribute to local communities. Online communication can help connect students to service users to achieve these aims. The online British patient feedback site, Patient Opinion, gathers comments from service users about services and encourages service responses to the comments. To explore the feasibility and acceptability of five ways of including Patient Opinion in the undergraduate nursing curriculum. Five case studies using mixed data collection methods. British University with nursing students across two campuses, accustomed to using webinars, video presentations and social media. Students from different years participated in the five approaches of making use of Patient Opinion in the curriculum; 18 students took part in an online forum to discuss Patient Opinion in the curriculum. We trialled timetabled webinars, video-linked lectures, optional enhanced access for self-study, optional audit of service user comments for two local hospitals, and optional Twitter and Tweetchat. Students discussed the aims and approaches in an online forum. Of the five approaches trialled, webinars seemed effective in ensuring that all nursing students engaged with the topic. Video-linked lectures provided an alternative when timetabling did not allow webinars, but were less interactive. The three optional approaches (Tweetchats, audit exercise, self-directed study) provided opportunities for some students to enhance their learning but students needed guidance. Sending a summary of student reviews of patients' feedback to local hospitals illustrated how students might be agents of change in local health services. Experience from these case studies suggests that webinars followed by use of Patient Opinion preparing for placements may be a sustainable way of embedding feedback sites in the

  13. Narratives of empowerment and compliance: studies of communication in online patient support groups.

    Science.gov (United States)

    Wentzer, Helle S; Bygholm, Ann

    2013-12-01

    New technologies enable new forms of patient participation in health care. The article discusses whether communication in online patient support groups is a source of individual as well as collective empowerment or to be understood within the tradition of compliance. The discussion is based on a qualitative analysis of patient communication in two online groups on the Danish portal sundhed.dk, one for lung patients and one for women with fertility problems. The object of study is the total sum of postings during a specific period of time - a total of 4301 posts are included. The textmaterial was analyzed according to the textual paradigm of Paul Ricoeur, and the three steps of critical interpretation. Thus, the analysis moves from describing communicative characteristics of the site to a thorough semantic analysis of its narrative structure of construing meaning, interaction and collective identity, and finally as a source of collective action. The meta-narratives of the two groups confirm online patient support groups for individual empowerment, for collective group identity, but not for collective empowerment. The collective identities of patienthood on the two sites are created by the users (patients) through specific styles of communication and interaction, referred to as 'multi-logical narratives'. In spite of the potential of online communities of opening up health care to the critical voice of the public, the analysis points to a synthesis of the otherwise opposite positions of empowerment and compliance in patient care. On a collective level, the site is empowering the individual users to comply with 'doctor's recommendations' as a group. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Online self-management interventions for chronically ill patients: cognitive impairment and technology issues.

    Science.gov (United States)

    Archer, Norm; Keshavjee, Karim; Demers, Catherine; Lee, Ryan

    2014-04-01

    As the fraction of the population with chronic diseases continues to grow, methods and/or technologies must be found to help the chronically ill to take more responsibility to self-manage their illnesses. Internet based and/or mobile support for disease self-management interventions have often proved effective, but patients with chronic illnesses may have co-occurring cognitive impairment, making it more difficult for them to cope with technologies. Many older patients are also not familiar with technologies or they may have cognitive disabilities or dementia that reduce their ability to self-manage their healthcare. On-line solutions to the needs of chronically ill patients must be investigated and acted upon with care in an integrated manner, since resources invested in these solutions will be lost if patients do not adopt and continue to use them successfully. To review the capabilities of online and mobile support for self-management of chronic illnesses, and the impacts that age and disease-related issues have on these interventions, including cognitive impairment and lack of access or familiarity with Internet or mobile technologies. This study includes a review of the co-occurrence of cognitive impairment with chronic diseases, and discusses how cognitive impairment, dyadic caregiver patient support, patient efficacy with technology, and smart home technologies can impact the effectiveness and sustainability of online support for disease self-management. Disease self-management interventions (SMIs) using online patient centered support can often enable patients to manage their own chronic illnesses. However, our findings show that cognitive impairment often co-occurs in patients with chronic disease. This, along with age-related increases in multiple chronic illnesses and lack of technology efficacy, can be obstacles to Internet and mobile support for chronic disease self-management. Patients with chronic diseases may have greater than expected difficulties

  15. How Patients Contribute to an Online Psychoeducation Forum for Bipolar Disorder: A Virtual Participant Observation Study.

    Science.gov (United States)

    Poole, Ria; Smith, Daniel; Simpson, Sharon

    2015-01-01

    In a recent exploratory randomized controlled trial, an online psychoeducation intervention for bipolar disorder has been found to be feasible and acceptable to patients and may positively impact on their self-management behaviors and quality of life. The objective of the study was to investigate how these patients contribute to an online forum for bipolar disorder and the issues relevant for them. Participants in the intervention arm of the Bipolar Interactive PsychoEDucation ("BIPED") trial were invited to contribute to the Beating Bipolar forum alongside receiving interactive online psychoeducation modules. Within this virtual participant observation study, forum posts were analyzed using thematic analysis, incorporating aspects of discourse analysis. The key themes which arose from the forum posts included: medication, employment, stigma, social support, coping strategies, insight and acceptance, the life chart, and negative experiences of health care. Participants frequently provided personal narratives relating to their history of bipolar disorder, life experiences, and backgrounds, which often contained emotive language and humor. They regularly sought and offered advice, and expressed encouragement and empathy. The forum would have benefitted from more users to offer a greater support network with more diverse views and experiences. Online forums are inexpensive to provide and may offer peer support and the opportunity for patients to share their experiences and explore issues related to their illness anonymously. Future research should focus on how to enhance patient engagement with online health care forums. ISRCTN81375447; http://www.isrctn.com/ISRCTN81375447 (Archived by WebCite at http://www.webcitation.org/6YzWtHUqu).

  16. Online Monitoring System for Patients with Coronary Heart Disease Using ST Elevation Signal Identification

    Directory of Open Access Journals (Sweden)

    Ratna Adil

    2009-12-01

    Full Text Available The coronary heart disease is one of desease leading to the sudden death. This is the reason why online monitoring system is urgently needed to monitor the patients with coronary heart disease. This paper proposse the system with an algorithm which is developed from signal identification of ST elevation. The medical record in this system is measured by a new wireless ECG development and followed Zigbee standard. If the system detects the possibility of disturbance in cardiac function, then soon, an alarm signal is send to the server at the hospital, in order that an intensive first aid can be given immediately. Based on the testing results, the level of success of an online monitoring system is possible to reach 100% if the patient does not make any moving around. It is expected that the application of this system will reduce the sudden death for patients at hospital with coronary heart disease.

  17. An Online Health Community for Aneurysmal Subarachnoid Hemorrhage Patients: A Pilot Study

    Science.gov (United States)

    van Nuenen-Platvoet, Willemijn; van den Abbeele, Leonie; Petersen, Harriette; Draskovic, Irena; de Vries, Joost; Westert, Gert; Grotenhuis, J Andre; Bartels, Ronald

    2014-01-01

    Background Aneurysmal subarachnoid hemorrhage (aSAH) is a condition affecting relatively young patients and has high rates of morbidity and mortality. Online health communities have emerged to fill the void for patient advocacy and information, allowing individuals with shared experiences and chronic disorders to connect. Objective We have developed an online health community for aSAH patients, and this pilot study was conducted to evaluate it from a patient’s perspective. Methods We implemented an online, members-only, health community (MijnSAB, translation: MySAH) in addition to the usual aSAH care at Radboudumc, Nijmegen, the Netherlands. A questionnaire that was sent to consecutive aSAH patients was used to evaluate the usability and utility of MySAH. Answers were provided using a 5-point Likert scale. There was also one open-ended question asking about what was missing from the MySAH tool. Results In total, 66 consecutive patients with aneurysmal subarachnoid hemorrhage were informed about the online health community. Of 64 potential MySAH users, 26 patients gained access to MySAH, 20 of whom were willing to participate in the evaluation. Those who used the community were younger (P=.03) and in a better condition at discharge (P=.03). The patients were positive about MySAH’s contribution to the quality of their care, but not to their quality of life. Most patients (18/20, 90%) reported that they would recommend the community to others in their position. Open suggestions on how to improve the tool included more frequent blogs, including by a rehabilitation specialist. Conclusions This pilot study showed that the online health community, MySAH, has a beneficial effect on the aftercare of patients suffering from aSAH because it gives easy access to relevant information provided by peers or caregivers. Due to the variable clinical outcomes after aSAH, the tool will mainly be useful for a select group of patients (with a better clinical outcome). PMID:25405364

  18. Electronic Payments Profitability Extent Model

    Directory of Open Access Journals (Sweden)

    Rudolf Vohnout

    2016-12-01

    Full Text Available Cashless payments are recent phenomena, which even increased with the introduction of contactless means like NFC, PayPass or payWave. Such new methods speed-up the entire payment process and in comparison to cash transactions are much simpler and faster. But on the other hand the key question for merchant is if it is worth to have such device, which accept these new payment means or not to have the terminal at all. What is the amount of cash flow, which delimits the cash holdings to be still profitable? This paper tries to give answers to such question by presenting general profitability model, which will address defining the cash threshold amount. The aim is to show that cash holdings could be profitable up to certain amount, but after the threshold is met, cashless payment methods are fairly superior despite their additional costs.

  19. Patient Access to Online Radiology Reports: Frequency and Sociodemographic Characteristics Associated with Use.

    Science.gov (United States)

    Miles, Randy C; Hippe, Daniel S; Elmore, Joann G; Wang, Carolyn L; Payne, Thomas H; Lee, Christoph I

    2016-09-01

    Our objective was to evaluate the frequency with which patients viewed their online radiology reports in relation to clinical and laboratory notes and identify sociodemographic factors associated with report viewing. We conducted a cross-sectional study of 129,419 patients who had online patient portal access in our large health system in 2014. We determined whether patients viewed their radiology reports, laboratory reports, and clinical notes. We also collected patient sociodemographic information including gender, age, primary spoken language, race/ethnicity, and insurance status. We performed multivariate analyses to determine significant associations between viewing of radiology reports and viewing of other types of clinical reports and patient characteristics. Of 61,131 patients with at least one radiology report available, 31,308 (51.2%) viewed them. Patients who also viewed laboratory reports or clinical notes were significantly more likely to view their radiology reports (P characteristics of traditionally underserved patient populations. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  20. Patterns in Patient Access and Utilization of Online Medical Records: Analysis of MyChart.

    Science.gov (United States)

    Redelmeier, Donald A; Kraus, Nicole C

    2018-02-06

    Electronic patient portals provide a new method for sharing personal medical information with individual patients. Our aim was to review utilization patterns of the largest online patient portal in Canada's largest city. We conducted a 4-year time-trend analysis of aggregated anonymous utilization data of the MyChart patient portal at Sunnybrook Health Sciences Centre in Ontario, Canada, from January 1, 2012, through December 31, 2015. Prespecified analyses examined trends related to day (weekend vs weekday), season (July vs January), year (2012 vs 2015), and an extreme adverse weather event (ice storm of December 20-26, 2013). Primary endpoints included three measures of patient portal activity: registrations, logins, and pageviews. We identified 32,325 patients who registered for a MyChart account during the study interval. Time-trend analysis showed no sign of attenuating registrations over time. Logins were frequent, averaged 734 total per day, and showed an increasing trend over time. Pageviews mirrored logins, averaged about 3029 total per day, and equated to about 5 pageviews during the average login. The most popular pageviews were clinical notes, followed by laboratory results and medical imaging reports. All measures of patient activity were lower on weekends compared to weekdays (Pmalware attack, or software failure occurred during the study. Online patient portals can provide a popular and reliable system for distributing personal medical information to active patients and may merit consideration for hospitals.

  1. Bupropion in the treatment of problematic online game play in patients with major depressive disorder

    Science.gov (United States)

    Han, Doug Hyun; Renshaw, Perry F

    2015-01-01

    As one of the problematic behaviors in patients with major depressive disorder (MDD), excessive online game play (EOP) has been reported in a number of recent studies. Bupropion has been evaluated as a potential treatment for MDD and substance dependence. We hypothesized that bupropion treatment would reduce the severity of EOP as well as depressive symptoms. Fifty male subjects with comorbid EOP and MDD were randomly assigned to bupropion + education for internet use (EDU) or placebo + EDU groups. The current study consisted in a 12-week, prospective, randomized, double-blind clinical trial, including an eight-week active treatment phase and a four-week post treatment follow-up period. During the active treatment period, Young Internet Addiction Scale (YIAS) scores and the mean time of online game playing in the bupropion group were greatly reduced compared with those of the placebo group. The Beck Depression Inventory (BDI) scores in the bupropion group were also greatly reduced compared with those of the placebo group. During the four-week post-treatment follow-up period, bupropion-associated reductions in online game play persisted, while depressive symptoms recurred. Conclusively, bupropion may improve depressive mood as well as reduce the severity of EOP in patients with comorbid MDD and online game addiction. PMID:21447539

  2. Bupropion in the treatment of problematic online game play in patients with major depressive disorder.

    Science.gov (United States)

    Han, Doug Hyun; Renshaw, Perry F

    2012-05-01

    As one of the problematic behaviors in patients with major depressive disorder (MDD), excessive online game play (EOP) has been reported in a number of recent studies. Bupropion has been evaluated as a potential treatment for MDD and substance dependence. We hypothesized that bupropion treatment would reduce the severity of EOP as well as depressive symptoms. Fifty male subjects with comorbid EOP and MDD were randomly assigned to bupropion + education for internet use (EDU) or placebo + EDU groups. The current study consisted in a 12-week, prospective, randomized, double-blind clinical trial, including an eight-week active treatment phase and a four-week post treatment follow-up period. During the active treatment period, Young Internet Addiction Scale (YIAS) scores and the mean time of online game playing in the bupropion group were greatly reduced compared with those of the placebo group. The Beck Depression Inventory (BDI) scores in the bupropion group were also greatly reduced compared with those of the placebo group. During the four-week post-treatment follow-up period, bupropion-associated reductions in online game play persisted, while depressive symptoms recurred. Conclusively, bupropion may improve depressive mood as well as reduce the severity of EOP in patients with comorbid MDD and online game addiction.

  3. Advantages and limitations of online communities of patients for research on health products.

    Science.gov (United States)

    Ravoire, Sophie; Lang, Marie; Perrin, Elena

    2017-02-01

    The way patients and their caregivers share information on various online platforms about health topics and their own experiential knowledge presents new potential environments for research, particularly as concerns health products. The information provided individually and voluntarily by patients who are members of these online communities is a new resource for identifying and understanding precisely how health products are used, assessing their effectiveness, quantifying potential adverse effects in real-life situations, detecting subtle signs that are significant for experts in pharmacovigilance and addiction studies, and developing new assessment tools to help form new working hypotheses. How patients freely express their experiences and feelings and the reality of what they share also opens the way for societal research into health products, a field that is still under-explored. Well-established regulations govern research into health products, which uses resources and methodologies that have changed little over the years. However, the development of online communities of patients presents new possibilities in this field. The challenge we face today is defining their place among traditional research techniques. This place cannot be accepted by all stakeholders unless we first establish a firm understanding of the advantages, limitations, and constraints of these communities. The round table on this topic endeavoured to: explore these issues and develop a better understanding of the phenomenon and the different varieties of online communities and networks for patients; identify possible advantages, special features, and methodological, regulatory, and ethical limitations that researchers currently face; and finally, to put forward the first recommendations in this growing field of research. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  4. Information retrieval and terminology extraction in online resources for patients with diabetes.

    Science.gov (United States)

    Seljan, Sanja; Baretić, Maja; Kucis, Vlasta

    2014-06-01

    Terminology use, as a mean for information retrieval or document indexing, plays an important role in health literacy. Specific types of users, i.e. patients with diabetes need access to various online resources (on foreign and/or native language) searching for information on self-education of basic diabetic knowledge, on self-care activities regarding importance of dietetic food, medications, physical exercises and on self-management of insulin pumps. Automatic extraction of corpus-based terminology from online texts, manuals or professional papers, can help in building terminology lists or list of "browsing phrases" useful in information retrieval or in document indexing. Specific terminology lists represent an intermediate step between free text search and controlled vocabulary, between user's demands and existing online resources in native and foreign language. The research aiming to detect the role of terminology in online resources, is conducted on English and Croatian manuals and Croatian online texts, and divided into three interrelated parts: i) comparison of professional and popular terminology use ii) evaluation of automatic statistically-based terminology extraction on English and Croatian texts iii) comparison and evaluation of extracted terminology performed on English manual using statistical and hybrid approaches. Extracted terminology candidates are evaluated by comparison with three types of reference lists: list created by professional medical person, list of highly professional vocabulary contained in MeSH and list created by non-medical persons, made as intersection of 15 lists. Results report on use of popular and professional terminology in online diabetes resources, on evaluation of automatically extracted terminology candidates in English and Croatian texts and on comparison of statistical and hybrid extraction methods in English text. Evaluation of automatic and semi-automatic terminology extraction methods is performed by recall

  5. Non-profits discover the benefits of using software through the Internet.

    Science.gov (United States)

    2001-04-01

    Many non-profits are looking at ways that they can leverage the Internet to assist in fund raising. Some organizations are using the Internet as a form of e-commerce to accept online gifts, while others are using the immediacy of the Internet for online auctions.

  6. Bundling and pricing for information brokerage: customer satisfaction as a means to profit optimization

    NARCIS (Netherlands)

    D.J.A. Somefun (Koye); J.A. La Poutré (Han)

    2003-01-01

    textabstractTraditionally, the study of on-line dynamic pricing and bundling strategies for information goods is motivated by the value-extracting or profit-generating potential of these strategies. In this paper we discuss the relatively overlooked potential of these strategies to on-line learn

  7. Towards generic online multicriteria decision support in patient-centred health care

    DEFF Research Database (Denmark)

    Dowie, Jack; Kaltoft, Mette Kjer; Salkeld, Glenn

    2015-01-01

    OBJECTIVE: To introduce a new online generic decision support system based on multicriteria decision analysis (MCDA), implemented in practical and user-friendly software (Annalisa©). BACKGROUND: All parties in health care lack a simple and generic way to picture and process the decisions to be made...... in pursuit of improved decision making and more informed choice within an overall philosophy of person- and patient-centred care. METHODS: The MCDA-based system generates patient-specific clinical guidance in the form of an opinion as to the merits of the alternative options in a decision, which are all......-off practicality (including resource constraints) with normative rigour and empirical complexity, in both their development and delivery, is emphasized. CONCLUSION: The MCDA-/Annalisa-based decision support system represents a prescriptive addition to the portfolio of decision-aiding tools available online...

  8. Towards generic online multicriteria decision support in patient-centred health care

    DEFF Research Database (Denmark)

    Dowie, Jack; Kaltoft, Mette Kjer; Salkeld, Glenn

    2015-01-01

    OBJECTIVE: To introduce a new online generic decision support system based on multicriteria decision analysis (MCDA), implemented in practical and user-friendly software (Annalisa©). BACKGROUND: All parties in health care lack a simple and generic way to picture and process the decisions to be made...... scored and ranked. The scores for each option combine, in a simple expected value calculation, the best estimates available now for the performance of those options on patient-determined criteria, with the individual patient's preferences, expressed as importance weightings for those criteria. The survey......-off practicality (including resource constraints) with normative rigour and empirical complexity, in both their development and delivery, is emphasized. CONCLUSION: The MCDA-/Annalisa-based decision support system represents a prescriptive addition to the portfolio of decision-aiding tools available online...

  9. The world of e-patients: A content analysis of online social networks focusing on diseases.

    Science.gov (United States)

    Orizio, Grazia; Schulz, Peter; Gasparotti, Cinzia; Caimi, Luigi; Gelatti, Umberto

    2010-12-01

    as the participatory Web developed to create virtual worlds and communities, health institutions and activists discovered Web 2.0 tools, in particular the creation of health-related online social networks. To analyze the existing online social networks dedicated to health issues, we performed an active search on the Internet for such Web sites and analyzed their features according to the content analysis method. the study was performed in September and October 2009. We analyzed a sample of health social networks for patients, selected using four common search engines. A codebook was elaborated to investigate four areas: general information; technical characteristics and utilities; characteristics of the Web site and contents, both general and related to the online community. the search led to a sample of 41 social networks. Twenty-three Web sites (56.1%) were dedicated to several diseases, the others to one only. Although the majority of the sample (87.8%) provided a way to contact the Web site, only five (12.2%) showed the name of the author or operating organization. Eight Web sites (19.5%) indicated one or more sponsors, and nine (22.0%) named one or more partners. It was often hard to tell whether an institution mentioned was a sponsor or a partner. Five Web sites (12.2%) enabled users to buy health-related products online. Twelve Web sites (29.3%) offered users the chance to search for doctors, and 12 (29.3%) gave therapeutic information. Two Web sites (4.9%) published aggregate statistical data about the patients registered with the social network. the data reveal the high heterogeneity of health-related social networks and raise interesting considerations on such controversial topics as the quality of online health information, research perspectives, interactivity, and empowerment. In particular, our findings are relevant to criticism regarding the openness and transparency of these Web sites, the use of personal data, and privacy issues.

  10. From the closest observers of patient care: a thematic analysis of online narrative reviews of hospitals.

    Science.gov (United States)

    Bardach, Naomi S; Lyndon, Audrey; Asteria-Peñaloza, Renée; Goldman, L Elizabeth; Lin, Grace A; Dudley, R Adams

    2016-11-01

    Patient-centred care has become a priority in many countries. It is unknown whether current tools capture aspects of care patients and their surrogates consider important. We investigated whether online narrative reviews from patients and surrogates reflect domains in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and we described additional potential domains. We used thematic analysis to assess online narrative reviews for reference to HCAHPS domains and salient non-HCAHPS domains and compared results by reviewer type (patient vs surrogate). We identified hospitals for review from the American Hospital Association database using a stratified random sampling approach. This approach ensured inclusion of reviews of a diverse set of hospitals. We searched online in February 2013 for narrative reviews from any source for each hospital. We included up to two narrative reviews for each hospital. Outpatient or emergency department reviews, reviews from self-identified hospital employees, or reviews of <10 words. 50.0% (n=122) of reviews (N=244) were from patients and 38.1% (n=93) from friends or family members. Only 57.0% (n=139) of reviews mentioned any HCAHPS domain. Additional salient domains were: Financing, including unexpected out-of-pocket costs and difficult interactions with billing departments; system-centred care; and perceptions of safety. These domains were mentioned in 51.2% (n=125) of reviews. Friends and family members commented on perceptions of safety more frequently than patients. A substantial proportion of consumer reviews do not mention HCAHPS domains. Surrogates appear to observe care differently than patients, particularly around safety. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Performance of an online translation tool when applied to patient educational material.

    Science.gov (United States)

    Khanna, Raman R; Karliner, Leah S; Eck, Matthias; Vittinghoff, Eric; Koenig, Christopher J; Fang, Margaret C

    2011-11-01

    Language barriers may prevent clinicians from tailoring patient educational material to the needs of individuals with limited English proficiency. Online translation tools could fill this gap, but their accuracy is unknown. We evaluated the accuracy of an online translation tool for patient educational material. We selected 45 sentences from a pamphlet available in both English and Spanish, and translated it into Spanish using GoogleTranslate™ (GT). Three bilingual Spanish speakers then performed a blinded evaluation on these 45 sentences, comparing GT-translated sentences to those translated professionally, along four domains: fluency (grammatical correctness), adequacy (information preservation), meaning (connotation maintenance), and severity (perceived dangerousness of an error if present). In addition, evaluators indicated whether they had a preference for either the GT-translated or professionally translated sentences. The GT-translated sentences had significantly lower fluency scores compared to the professional translation (3.4 vs. 4.7, P error (39% vs. 22%, P = 0.05), but not statistically more likely to have a severe error (4% vs. 2%, P = 0.61). Evaluators preferred the professional translation for complex sentences, but not for simple ones. When applied to patient educational material, GT performed comparably to professional human translation in terms of preserving information and meaning, though it was slightly worse in preserving grammar. In situations where professional human translations are unavailable or impractical, online translation may someday fill an important niche. Copyright © 2011 Society of Hospital Medicine.

  12. Online working alliance predicts treatment outcome for posttraumatic stress symptoms in Arab war-traumatized patients.

    Science.gov (United States)

    Wagner, Birgit; Brand, Janine; Schulz, Wassima; Knaevelsrud, Christine

    2012-07-01

    Previous studies have shown that Internet-based interventions for posttraumatic stress disorder are feasible. However, little is known about how therapeutic process factors impact online interventions in war and conflict regions. This study aims to assess the quality of the working alliance at midtreatment and posttreatment and its relationship with therapy outcome in an Internet-based cognitive-behavioral intervention for Arabic-speaking traumatized patients. A trial was conducted from January 2009 to August 2011 with patients recruited specifically in Iraq. Fifty-five participants with posttraumatic stress symptoms completed the Working Alliance Inventory (WAI) after at least session 4. Participants' mean age was 27.7 years (SD = 6.9); 78% of participants were females. Participants received two weekly 45-min Internet-based cognitive-behavioral interventions over a 5-week period. The main outcome measures were the Posttraumatic Diagnostic Scale (PDS) and the WAI. High ratings of the therapeutic alliance were obtained early in treatment, and results remained stable from sessions 4 to 10, indicating that it was possible to establish a positive and stable online therapeutic relationship. The working alliance at both assessment points predicted treatment outcome for posttraumatic stress symptoms. Despite the instability of the settings and patients' ongoing exposure to human right violations through war and dictatorships, it was possible to establish a stable online therapeutic relationship. © 2012 Wiley Periodicals, Inc.

  13. Online and smartphone based cognitive behavioral therapy for bariatric surgery patients: Initial pilot study.

    Science.gov (United States)

    Zhang, Melvyn W B; Ho, Roger C M; Cassin, Stephanie E; Hawa, Raed; Sockalingam, Sanjeev

    2015-01-01

    The respective rates of obesity in Canada and the United states are estimated to be 24.1% and 34.1%. Due to the increased incidence of obesity, Bariatric surgery has been recognized as one of the treatment options. Despite the success of Bariatric surgery, studies have proposed that it has neglected the contributions of other factors, such as psychological factors in the causation as well as the maintenance of obesity amongst individuals. Cognitive behavioral therapy (CBT) is largely a psychosocial intervention that has been shown to be efficacious, as studies have demonstrated that even brief CBT interventions could help in the reduction of binge eating and maintenance of weight loss. Previously identified problems with regards to the integration and the provision of such interventions include that of geographical barriers. In order to overcome the geographical barriers, telephone-based CBT has been conceptualized. Over the past decade, there has been massive advancement and development in Internet, Web-based and smartphone technologies, but there is still a paucity of applications in this area. Our current research objective is to determine if bariatric surgery patients will be receptive towards an online and smartphone based CBT intervention. The Bariatric Surgery Online CBT portal and Smartphone companion application was developed between July 2013 and December 2013. A low-cost methodology of developing the online portal was adopted. In terms of development, 4 core development phases were adopted. These included that of: a) Formulation of users' requirements, b) System design and development, c) System evaluation and d) System deployment and pilot application. The bariatric surgery workgroup from the Toronto Western Hospital helped with the recruitment of the subjects from the outpatient specialist service. Links to the web-portal was provided to each of the participants recruited. Since the inception of the online portal to date, in terms of usage rates, there

  14. Emotional coping differences among breast cancer patients from an online support group: A cross-sectional study

    NARCIS (Netherlands)

    Batenburg, A.E.; Das, H.H.J.

    2014-01-01

    Background: Due to mixed findings in research on the effect of online peer-to-peer support on psychological well-being, there is a need for studies explaining why and when online support communities are beneficial for cancer patients. Objective: Previous studies have typically not taken into account

  15. Emotional coping differences among breast cancer patients from an online support group: a cross-sectional study

    NARCIS (Netherlands)

    Batenburg, A.E.; Das, E.

    2014-01-01

    Background: Due to mixed findings in research on the effect of online peer-to-peer support on psychological well-being, there is a need for studies explaining why and when online support communities are beneficial for cancer patients. Objective: Previous studies have typically not taken into account

  16. Association Between Patient Value Systems and Physician and Practice Attributes Available Online.

    Science.gov (United States)

    Welshhans, Jamie L; Harmon, Jeffrey J; Papel, Ira; Gentile, Richard; Mangat, Devinder; Byrne, Patrick; Collar, Ryan M

    2017-08-31

    The relative value of facial plastic surgeon personal and practice attributes is relevant to the broader health care system because of increasing out-of-pocket expenses to patients. To determine the relative value of specific facial plastic surgeon personal and practice attributes available online from the perspective of patients. This study consisted of an electronic survey sent to patients by email using choice-based conjoint analysis; surveys were sent between December 2015 and March 2016. Participants had agreed to join email registries to be sent email surveys and promotions at 3 private facial plastic and reconstructive surgery practices. The following surgeon personal and practice attributes and levels were compared: (1) outcome transparency (above average, average, not available); (2) surgical training affiliations (US News and World Reports rankings); (3) online rating site scores (2 [poor], 3, or 4 [excellent] stars); and (4) price ($1×, $2×, and $3× [× = $1500; average cost was set at $2×]). The relative importance of outcome transparency, surgical training affiliations, online rating scores, and price to prospective patients. Overall, 291 patients participated for a completion rate of 68%. Outcome transparency was the most valued attribute (attribute utility range = 141; attribute importance = 35.2%). Price was the least valued attribute (attribute utility range = 58.59; attribute importance = 15.1%). Assuming top-tier affiliations and 4-star ratings, share of market (SOM) was 75.5% for surgeons with above-average outcome transparency priced at $3× compared with those surgeons with no outcomes available priced at $1×. Holding price constant at $2×, surgeons with middle-tier affiliations and 2-star online ratings but above average outcomes achieved 48.4% SOM when compared with those surgeons with top-tier affiliations and 4-star online ratings without available outcomes. Facial plastic surgery patients most value surgeons who

  17. Improving the readability of online foot and ankle patient education materials.

    Science.gov (United States)

    Sheppard, Evan D; Hyde, Zane; Florence, Mason N; McGwin, Gerald; Kirchner, John S; Ponce, Brent A

    2014-12-01

    Previous studies have shown the need for improving the readability of many patient education materials to increase patient comprehension. This study's purpose was to determine the readability of foot and ankle patient education materials and to determine the extent readability can be improved. We hypothesized that the reading levels would be above the recommended guidelines and that decreasing the sentence length would also decrease the reading level of these patient educational materials. Patient education materials from online public sources were collected. The readability of these articles was assessed by a readability software program. The detailed instructions provided by the National Institutes of Health (NIH) were then used as a guideline for performing edits to help improve the readability of selected articles. The most quantitative guideline, lowering all sentences to less than 15 words, was chosen to show the effect of following the NIH recommendations. The reading levels of the sampled articles were above the sixth to seventh grade recommendations of the NIH. The MedlinePlus website, which is a part of the NIH website, had the lowest reading level (8.1). The articles edited had an average reduction of 1.41 grade levels, with the lowest reduction in the Medline articles of 0.65. Providing detailed instructions to the authors writing these patient education articles and implementing editing techniques based on previous recommendations could lead to an improvement in the readability of patient education materials. This study provides authors of patient education materials with simple editing techniques that will allow for the improvement in the readability of online patient educational materials. The improvement in readability will provide patients with more comprehendible education materials that can strengthen patient awareness of medical problems and treatments. © The Author(s) 2014.

  18. Profitability analysis of KINGLONG nearly 5 years

    Science.gov (United States)

    Zhang, Mei; Wen, Jinghua

    2017-08-01

    Profitability analysis for measuring business performance and forecast its prospects play an important role. In this paper, the research instance King Long Motor in understanding the basic theory on the basis of financial management, to take a combination of theory and data analysis methods, combined with a measure of profitability related indicators of King Long Motor company’s profitability do a specific analysis to identify factors constraining the profitability of Kinglong company exists and the motivation to improve profitability, which made recommendations to improve the profitability of Kinglong car company to promote the company’s future can be better and faster development.)

  19. Trends of online ratings of otolaryngologists: what do your patients really think of you?

    Science.gov (United States)

    Sobin, Lindsay; Goyal, Parul

    2014-07-01

    The otolaryngologist's online reputation is of increasing importance. Physician rating websites are becoming increasingly prevalent, and patients are using them to evaluate their current and future physicians. To evaluate patterns in online ratings of otolaryngologists. From May 1, 2013, through June 1, 2013, lists of academic program faculty members in the Northeastern United States were compiled, and academic allopathic otolaryngologists from the Eastern Section of the Triological Society were identified. Each faculty member's name was searched using the Google search engine to link to profiles on the Healthgrades.com and Vitals.com websites. State, program, academic position, years in practice, subspecialty, ratings, and reviews were recorded. Ratings were compared using analysis of variance. A total of 281 faculty members from 25 programs were identified. A total of 266 otolaryngologists (94.7%) had a profile on Healthgrades, and 247 (87.9%) had a profile on Vitals. Of those with profiles, 186 (69.9%) and 202 (81.8%) had patient reviews on Healthgrades and Vitals, respectively. The mean score was 4.4 of 5.0 on Healthgrades and 3.4 of 4.0 on Vitals. On Vitals, 179 profiles (63.7%) had comments associated with them. Overall, 49 comments (27.3%) were determined to be negative, and 138 otolaryngologists (49.1%) had at least 1 negative comment. Academic position and subspecialty affected reviews on Healthgrades. State and years in practice did not influence reviews. Most patients use online resources for information on health care professionals. Physician perceptions of these sites tend to be negative. Awareness of the content and rating patterns may help physicians better manage their online reputation.

  20. Impact of the frequency of online verifications on the patient set-up accuracy and set-up margins

    Directory of Open Access Journals (Sweden)

    Mohamed Adel

    2011-08-01

    Full Text Available Abstract Purpose The purpose of the study was to evaluate the patient set-up error of different anatomical sites, to estimate the effect of different frequencies of online verifications on the patient set-up accuracy, and to calculate margins to accommodate for the patient set-up error (ICRU set-up margin, SM. Methods and materials Alignment data of 148 patients treated with inversed planned intensity modulated radiotherapy (IMRT or three-dimensional conformal radiotherapy (3D-CRT of the head and neck (n = 31, chest (n = 72, abdomen (n = 15, and pelvis (n = 30 were evaluated. The patient set-up accuracy was assessed using orthogonal megavoltage electronic portal images of 2328 fractions of 173 planning target volumes (PTV. In 25 patients, two PTVs were analyzed where the PTVs were located in different anatomical sites and treated in two different radiotherapy courses. The patient set-up error and the corresponding SM were retrospectively determined assuming no online verification, online verification once a week and online verification every other day. Results The SM could be effectively reduced with increasing frequency of online verifications. However, a significant frequency of relevant set-up errors remained even after online verification every other day. For example, residual set-up errors larger than 5 mm were observed on average in 18% to 27% of all fractions of patients treated in the chest, abdomen and pelvis, and in 10% of fractions of patients treated in the head and neck after online verification every other day. Conclusion In patients where high set-up accuracy is desired, daily online verification is highly recommended.

  1. Disparities between online assisted reproduction patient education for same-sex and heterosexual couples.

    Science.gov (United States)

    Jin, Helen; Dasgupta, Shoumita

    2016-10-01

    Does the prevalence of online education in fertility center websites differ for lesbian, gay, bisexual, transgender (LGBT) couples compared to online education for heterosexual couples? This review of fertility center websites showed that the majority of websites with patient education for heterosexual couples do not have similar materials for LGBT couples. In order to have biologically related children, LGBT individuals or couples utilize assisted reproductive technologies (ART). Fertility clinic websites provide online education to familiarize patients with the different ART procedures; however, no studies have examined the prevalence of educational information for LGBT couples compared to information for heterosexual couples utilizing ART. This website review evaluated Centers for Disease Control and Prevention (CDC)-reported fertility center websites. Websites were reviewed in 2014 using the latest 2011 CDC report, and reviewed again in 2015 with the latest 2013 CDC report. Patient education information was coded using categories determined after a sample review, and differences were analyzed with χ(2) tests, with P-values calculated with Fisher's exact test. In 2014, 31.1% (121) of 389 websites with information for heterosexual couples also contained information for LGBT couples. In 2015, the number of fertility centers with information for LGBT couples increased by 52.9% to 185 (P online information on fertility center websites may not directly reflect the quality of care LGBT individuals or couples receive in the clinic, and the effect of this absence of online information on the clinical experiences of LGBT patients is unknown. These findings add to the growing body of work showing disparities in the treatment of LGBT persons compared to the overall population. To overcome these discrepancies, healthcare providers should adapt their practice to include this growing and underserved patient population. Funding was provided by the Medical Student Summer

  2. A Decomposition of Hospital Profitability

    Directory of Open Access Journals (Sweden)

    Jason Turner

    2015-06-01

    Full Text Available Objectives: This paper evaluates the drivers of profitability for a large sample of U.S. hospitals. Following a methodology frequently used by financial analysts, we use a DuPont analysis as a framework to evaluate the quality of earnings. By decomposing returns on equity (ROE into profit margin, total asset turnover, and capital structure, the DuPont analysis reveals what drives overall profitability. Methods: Profit margin, the efficiency with which services are rendered (total asset turnover, and capital structure is calculated for 3,255 U.S. hospitals between 2007 and 2012 using data from the Centers for Medicare & Medicaid Services’ Healthcare Cost Report Information System (CMS Form 2552. The sample is then stratified by ownership, size, system affiliation, teaching status, critical access designation, and urban or non-urban location. Those hospital characteristics and interaction terms are then regressed (OLS against the ROE and the respective DuPont components. Sensitivity to regression methodology is also investigated using a seemingly unrelated regression. Results: When the sample is stratified by hospital characteristics, the results indicate investor-owned hospitals have higher profit margins, higher efficiency, and are substantially more leveraged. Hospitals in systems are found to have higher ROE, margins, and efficiency but are associated with less leverage. In addition, a number of important and significant interactions between teaching status, ownership, location, critical access designation, and inclusion in a system are documented. Many of the significant relationships, most notably not-for-profit ownership, lose significance or are predominately associated with one interaction effect when interaction terms are introduced as explanatory variables. Results are not sensitive to the alternative methodology. Conclusion: The results of the DuPont analysis suggest that although there appears to be convergence in the behavior of

  3. A Decomposition of Hospital Profitability

    Science.gov (United States)

    Broom, Kevin; Elliott, Michael; Lee, Jen-Fu

    2015-01-01

    Objectives: This paper evaluates the drivers of profitability for a large sample of U.S. hospitals. Following a methodology frequently used by financial analysts, we use a DuPont analysis as a framework to evaluate the quality of earnings. By decomposing returns on equity (ROE) into profit margin, total asset turnover, and capital structure, the DuPont analysis reveals what drives overall profitability. Methods: Profit margin, the efficiency with which services are rendered (total asset turnover), and capital structure is calculated for 3,255 U.S. hospitals between 2007 and 2012 using data from the Centers for Medicare & Medicaid Services’ Healthcare Cost Report Information System (CMS Form 2552). The sample is then stratified by ownership, size, system affiliation, teaching status, critical access designation, and urban or non-urban location. Those hospital characteristics and interaction terms are then regressed (OLS) against the ROE and the respective DuPont components. Sensitivity to regression methodology is also investigated using a seemingly unrelated regression. Results: When the sample is stratified by hospital characteristics, the results indicate investor-owned hospitals have higher profit margins, higher efficiency, and are substantially more leveraged. Hospitals in systems are found to have higher ROE, margins, and efficiency but are associated with less leverage. In addition, a number of important and significant interactions between teaching status, ownership, location, critical access designation, and inclusion in a system are documented. Many of the significant relationships, most notably not-for-profit ownership, lose significance or are predominately associated with one interaction effect when interaction terms are introduced as explanatory variables. Results are not sensitive to the alternative methodology. Conclusion: The results of the DuPont analysis suggest that although there appears to be convergence in the behavior of NFP and IO

  4. The replacement of 'paper' cases by interactive online virtual patients in problem-based learning.

    Science.gov (United States)

    Poulton, Terry; Conradi, Emily; Kavia, Sheetal; Round, Jonathan; Hilton, Sean

    2009-08-01

    St George's University of London (SGUL) has a Problem-Based Learning (PBL) curriculum for its undergraduate medicine course, using traditional paper-based patient cases. To counter the limitation that paper cases are linear and do not allow students to explore the consequences of decisions, interactive online virtual patients (VPs) were developed which allowed students to consider options as the cases unfold, and allow students to explore the consequences of their actions. A PBL module was converted to VPs, and delivered to 72 students in 10 tutorial groups, with 5 groups each week receiving VPs with options and consequences, and 5 groups receiving online VPs but without options. A comprehensive evaluation was carried out, using questionnaires, and interviews.Both tutors and students believed that the ability to explore options and consequences created a more engaging experience and encouraged students to explore their learning. They regretted the loss of paper and neither group could see any value in putting cases online without the options. SGUL is now adapting its transitional year between the early campus years and the clinical attachment years. This will include the integration of all technology-based resources with face-to-face learning and create a more adaptive, personalised, competency-based style of learning.

  5. Screen Shots: When Patients and Families Publish Negative Health Care Narratives Online.

    Science.gov (United States)

    Eijkholt, Marleen; Jankowski, Jane; Fisher, Marilyn

    2017-01-01

    Social media sites and their relationship to health care is a subject of intense debate. Common discussions regarding social media address patient privacy, or e-professionalism. This case study explores the tensions that arise for health care providers when negative patient statements surface in social media and blog forums. Recognizing that patients and families often find relief in sharing personal illness narratives, we contemplate if, and how, individual health care professionals and institutions should address complaints aired in public, unmoderated media. Our discussion begins by presenting a case of a family blogging on the Internet to share grievances (to deidentify the case, we have changed some details). Next, we offer an exploration of the impact on health care delivery when professionals become aware of specific criticisms published online. Strategies for managing electronic criticisms are then proposed. We conclude by proposing a novel E-THICS approach to address negative patient expressions via electronic word of mouth (eWOM). Our examination of this evolving issue focuses on maintaining satisfactory relationships between health care providers and patients/families when dealing with health care narratives published in open online media.

  6. Adequacy of Online Patient Information Resources on Gout and Potentially Curative Urate-Lowering Treatment.

    Science.gov (United States)

    Jimenez-Liñan, L M; Edwards, L; Abhishek, A; Doherty, Michael

    2017-05-01

    To assess the content and readability of online patient information resources against the current understanding of gout. An online survey was undertaken using Google UK, USA, Australia, and Canada. Information was assessed for content and accuracy on 19 key points regarding core content for gout patient information resources. Readability was assessed using the Flesch-Kincaid Reading Ease score. Fifteen randomly selected websites were reviewed by a blinded second observer. A total of 85 websites were selected. More than 50% of the websites provided no information or had inaccuracies regarding the pathogenesis of gout. Most websites contained information on dietary and lifestyle modifications for treating gout and did not emphasize urate-lowering therapy (ULT) and its potential for cure. Over 75% of the websites had no/inaccurate information on the role of ULT or prophylaxis for preventing gout attacks on starting ULT. The majority of websites were difficult to read, with information in 68% of the websites rated at least fairly difficult. Only a few web-based patient information resources provide accurate and easy-to-read information on gout. This study will help physicians direct patients to currently reliable resources, but there is a need to improve many web-based patient information resources, which at present act as barriers to care. © 2016, American College of Rheumatology.

  7. Online correlation of spontaneous arterial and intracranial pressure fluctuations in patients with diffuse severe head injury.

    Science.gov (United States)

    Reinert, Michael; Andres, Robert H; Fuhrer, Martin; Müller, Alexander; Schaller, Benoit; Widmer, HansRuedi

    2007-07-01

    Determination of relevant clinical monitoring parameters for helping guide the intensive care therapy in patients with severe head injury, is one of the most demanding issues in neurotrauma research. New insights into cerebral autoregulation and metabolism have revealed that a rigid cerebral perfusion pressure (CPP) regimen might not be suitable for all severe head injured patients. We thus developed an online analysis technique to monitor the correlation (AI rho) between the spontaneous fluctuations of the mean arterial blood pressure (MABP) and the intracranial pressure (ICP). In addition, brain tissue oxygen (PtiO2) and metabolic microdialysate measures including glucose and lactate were registered. We found that in patients with good outcome, the AI rho values were significantly lower as compared with patients with poor outcome. Accordingly, microdialysate glucose and lactate were significantly higher in the good outcome group. We conclude that online determination of AI rho offers a valuable additional and technically easily performable tool for guidance of therapy in patients with severe head injury.

  8. Online virtual-patient cases versus traditional problem-based learning in advanced pharmacy practice experiences.

    Science.gov (United States)

    Al-Dahir, Sara; Bryant, Kendrea; Kennedy, Kathleen B; Robinson, Donna S

    2014-05-15

    To evaluate the efficacy of faculty-led problem-based learning (PBL) vs online simulated-patient case in fourth-year (P4) pharmacy students. Fourth-year pharmacy students were randomly assigned to participate in either online branched-case learning using a virtual simulation platform or a small-group discussion. Preexperience and postexperience student assessments and a survey instrument were completed. While there were no significant differences in the preexperience test scores between the groups, there was a significant increase in scores in both the virtual-patient group and the PBL group between the preexperience and postexperience tests. The PBL group had higher postexperience test scores (74.8±11.7) than did the virtual-patient group (66.5±13.6) (p=0.001). The PBL method demonstrated significantly greater improvement in postexperience test scores than did the virtual-patient method. Both were successful learning methods, suggesting that a diverse approach to simulated patient cases may reach more student learning styles.

  9. How reliable is online diffusion of medical information targeting patients and families?

    Science.gov (United States)

    Xavier-Elsas, Pedro; Bastos, Sandra Epifânio; Gaspar-Elsas, Maria Ignez C

    2015-11-20

    To determine whether online diffusion of the "Ten Warning Signs of Primary Immunodeficiency Diseases (PID)'' adheres to accepted scientific standards. We analyzed how reproducible is online diffusion of a unique instrument, the "Ten Warning Signs of PID", created by the Jeffrey Modell Foundation (JMF), by Google-assisted searches among highly visited sites from professional, academic and scientific organizations; governmental agencies; and patient support/advocacy organizations. We examined the diffusion, consistency of use and adequate referencing of this instrument. Where applicable, variant versions of the instrument were examined for changes in factual content that would have practical impact on physicians or on patients and their families. Among the first 100 sites identified by Google search, 85 faithfully reproduced the JMF model, and correctly referenced to its source. By contrast, the other 15 also referenced the JMF source but presented one or more changes in content relative to their purported model and therefore represent uncontrolled variants, of unknown origin. Discrepancies identified in the latter included changes in factual content of the original JMF list (C), as well as removal (R) and introduction (I) of novel signs (Table 2), all made without reference to any scientific publications that might account for the drastic changes in factual content. Factual changes include changes in the number of infectious episodes considered necessary to raise suspicion of PID, as well as the inclusion of various medical conditions not mentioned in the original. Together, these changes will affect the way physicians use the instrument to consult or to inform patients, and the way patients and families think about the need for specialist consultation in view of a possible PID diagnosis. The retrieved adaptations and variants, which significantly depart from the original instrument, raise concerns about standards for scientific information provided online to

  10. Online participation: a content analysis of differences in utilization of two online cancer communities by men and women, patients and family members.

    Science.gov (United States)

    Ginossar, Tamar

    2008-01-01

    The Internet provides a new modality for health communication by facilitating the creation of virtual communities. These communities have the potential to influence health behavior beyond traditional FTF support groups. This study utilized content analysis of 1,424 e-mail messages posted to 2 online cancer communities to examine uses of these groups. Findings revealed (a) similarities in the content of communication in the 2 virtual communities, (b) gender differences in participation, and (c) differences in utilization of these online groups between patients and family members. These results are discussed in light of the diverse uses of online cancer communities that they reveal, the role of family members in support seeking and provision, and gender communication styles in health computer-mediated communication.

  11. Support patient search on pathology reports with interactive online learning based data extraction.

    Science.gov (United States)

    Zheng, Shuai; Lu, James J; Appin, Christina; Brat, Daniel; Wang, Fusheng

    2015-01-01

    Structural reporting enables semantic understanding and prompt retrieval of clinical findings about patients. While synoptic pathology reporting provides templates for data entries, information in pathology reports remains primarily in narrative free text form. Extracting data of interest from narrative pathology reports could significantly improve the representation of the information and enable complex structured queries. However, manual extraction is tedious and error-prone, and automated tools are often constructed with a fixed training dataset and not easily adaptable. Our goal is to extract data from pathology reports to support advanced patient search with a highly adaptable semi-automated data extraction system, which can adjust and self-improve by learning from a user's interaction with minimal human effort. We have developed an online machine learning based information extraction system called IDEAL-X. With its graphical user interface, the system's data extraction engine automatically annotates values for users to review upon loading each report text. The system analyzes users' corrections regarding these annotations with online machine learning, and incrementally enhances and refines the learning model as reports are processed. The system also takes advantage of customized controlled vocabularies, which can be adaptively refined during the online learning process to further assist the data extraction. As the accuracy of automatic annotation improves overtime, the effort of human annotation is gradually reduced. After all reports are processed, a built-in query engine can be applied to conveniently define queries based on extracted structured data. We have evaluated the system with a dataset of anatomic pathology reports from 50 patients. Extracted data elements include demographical data, diagnosis, genetic marker, and procedure. The system achieves F-1 scores of around 95% for the majority of tests. Extracting data from pathology reports could enable

  12. PatientVOICE: Development of a Preparatory, Pre-Chemotherapy Online Communication Tool for Older Patients With Cancer.

    Science.gov (United States)

    van Dulmen, Sandra; Driesenaar, Jeanine A; van Weert, Julia Cm; van Osch, Mara; Noordman, Janneke

    2017-05-10

    Good communication around cancer treatment is essential in helping patients cope with their disease and related care, especially when this information is tailored to one's needs. Despite its importance, communication is often complex, in particular in older patients (aged 65 years or older). In addition to the age-related deterioration in information and memory processing older patients experience, communication is also complicated by their required yet often unmet role of being an active, participatory patient. Older patients rarely express their informational needs and their contributions to consultations are often limited. Therefore, older patients with cancer need to be prepared to participate more actively in their care and treatment. The objective of this paper was to report the development of PatientVOICE, an online, preparatory tool with audio facility aimed to enhance the participation of older patients during educational nursing encounters preceding chemotherapy and to improve their information recall. PatientVOICE was developed by applying the following 6 steps of the intervention mapping framework that involved both patients and nurses: (1) needs assessment, (2) specifying determinants and change objectives, (3) reviewing and selecting theoretical methods and practical strategies, (4) developing intervention components, (5) designing adoption and implementation, and (6) making an evaluation plan. A careful execution of these consecutive steps resulted in the ready-to-use preparatory website. PatientVOICE provides pre-visit information about chemotherapy (ie, medical information, side effects, and recommendations of dealing with side effects), information about the educational nursing visit preceding chemotherapy (ie, aim, structure, and recommendations for preparation), techniques to improve patients' communication skills using a question prompt sheet (QPS) and video-modeling examples showing "best practices", and the opportunity to upload and listen

  13. Patients' Use and Evaluation of an Online System to Annotate Radiology Reports with Lay Language Definitions.

    Science.gov (United States)

    Cook, Tessa S; Oh, Seong Cheol; Kahn, Charles E

    2017-09-01

    The increasing availability of personal health portals has made it easier for patients to obtain their imaging results online. However, the radiology report typically is designed to communicate findings and recommendations to the referring clinician, and may contain many terms unfamiliar to lay readers. We sought to evaluate a web-based interface that presented reports of knee MRI (magnetic resonance imaging) examinations with annotations that included patient-oriented definitions, anatomic illustrations, and hyperlinks to additional information. During a 7-month observational trial, a statement added to all knee MRI reports invited patients to view their annotated report online. We tracked the number of patients who opened their reports, the terms they hovered over to view definitions, and the time hovering over each term. Patients who accessed their annotated reports were invited to complete a survey. Of 1138 knee MRI examinations during the trial period, 185 patients (16.3%) opened their report in the viewing portal. Of those, 141 (76%) hovered over at least one term to view its definition, and 121 patients (65%) viewed a mean of 27.5 terms per examination and spent an average of 3.5 minutes viewing those terms. Of the 22 patients who completed the survey, 77% agreed that the definitions helped them understand the report and 91% stated that the illustrations were helpful. A system that provided definitions and illustrations of the medical and technical terms in radiology reports has potential to improve patients' understanding of their reports and their diagnoses. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  14. Information-seeking Behavior and Information Needs in Patients With Amyotrophic Lateral Sclerosis: Analyzing an Online Patient Community.

    Science.gov (United States)

    Oh, Juyeon; Kim, Jung A

    2017-07-01

    A few studies have examined the specific informational needs of the population with amyotrophic lateral sclerosis. The aims of this study were to describe the information-seeking behavior and information needs of patients with amyotrophic lateral sclerosis and their families in Korea by analyzing messages from an online patient community. A total of 1047 messages from the question and answer forum of the "Lou Gehrig's Disease Network" (http://cafe.daum.net/alsfree) from January 2010 to September 2015 were collected. The word frequency, main questions, and asker of the messages were analyzed and coded. Terms such as "hospital," "mother," "father," "gastrostomy," and "ALS" were most frequently identified. The most commonly mentioned main topic was about disease-specific information, while the most frequent subcategory was symptoms or management of symptoms. Other prominent categories concerned information about treatment, rehabilitation, and the medical system. The people who wrote the questions were mostly the son/daughter of patients with amyotrophic lateral sclerosis. Patients with amyotrophic lateral sclerosis and their family members commonly obtained information by posting their inquiries online and have a variety of questions regarding amyotrophic lateral sclerosis in this study. The findings of this study can be used as a base of information for developing educational programs and resources for patients with amyotrophic lateral sclerosis and their families.

  15. An ethical justification of profit maximization

    DEFF Research Database (Denmark)

    Koch, Carsten Allan

    2010-01-01

    behaviour. It is argued that some form of consequential ethics must be applied, and that both profit seeking and profit maximization can be defended from a rule-consequential point of view. It is noted, however, that the result does not apply unconditionally, but requires that certain form of profit (and...

  16. 40 CFR 35.936-4 - Profits.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Profits. 35.936-4 Section 35.936-4... ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.936-4 Profits. Only fair and reasonable profits may be earned by contractors in subagreements under EPA grants. See § 35.937-7 for...

  17. Patients covertly recording clinical encounters: threat or opportunity? A qualitative analysis of online texts.

    Directory of Open Access Journals (Sweden)

    Maka Tsulukidze

    Full Text Available The phenomenon of patients covertly recording clinical encounters has generated controversial media reports. This study aims to examine the phenomenon and analyze the underlying issues.We conducted a qualitative analysis of online posts, articles, blogs, and forums (texts discussing patients covertly recording clinical encounters. Using Google and Google Blog search engines, we identified and analyzed 62 eligible texts published in multiple countries between 2006 and 2013. Thematic analysis revealed four key themes: 1 a new behavior that elicits strong reactions, both positive and negative, 2 an erosion of trust, 3 shifting patient-clinician roles and relationships, and 4 the existence of confused and conflicting responses. When patients covertly record clinical encounters - a behavior made possible by various digital recording technologies - strong reactions are evoked among a range of stakeholders. The behavior represents one consequence of an erosion of trust between patients and clinicians, and when discovered, leads to further deterioration of trust. Confused and conflicting responses to the phenomenon by patients and clinicians highlight the need for policy guidance.This study describes strong reactions, both positive and negative, to the phenomenon of patients covertly recording clinical encounters. The availability of smartphones capable of digital recording, and shifting attitudes to patient-clinician relationships, seems to have led to this behavior, mostly viewed as a threat by clinicians but as a welcome and helpful innovation by some patients, possibly indicating a perception of subordination and a lack of empowerment. Further examination of this tension and its implications is needed.

  18. Patients covertly recording clinical encounters: threat or opportunity? A qualitative analysis of online texts.

    Science.gov (United States)

    Tsulukidze, Maka; Grande, Stuart W; Thompson, Rachel; Rudd, Kenneth; Elwyn, Glyn

    2015-01-01

    The phenomenon of patients covertly recording clinical encounters has generated controversial media reports. This study aims to examine the phenomenon and analyze the underlying issues. We conducted a qualitative analysis of online posts, articles, blogs, and forums (texts) discussing patients covertly recording clinical encounters. Using Google and Google Blog search engines, we identified and analyzed 62 eligible texts published in multiple countries between 2006 and 2013. Thematic analysis revealed four key themes: 1) a new behavior that elicits strong reactions, both positive and negative, 2) an erosion of trust, 3) shifting patient-clinician roles and relationships, and 4) the existence of confused and conflicting responses. When patients covertly record clinical encounters - a behavior made possible by various digital recording technologies - strong reactions are evoked among a range of stakeholders. The behavior represents one consequence of an erosion of trust between patients and clinicians, and when discovered, leads to further deterioration of trust. Confused and conflicting responses to the phenomenon by patients and clinicians highlight the need for policy guidance. This study describes strong reactions, both positive and negative, to the phenomenon of patients covertly recording clinical encounters. The availability of smartphones capable of digital recording, and shifting attitudes to patient-clinician relationships, seems to have led to this behavior, mostly viewed as a threat by clinicians but as a welcome and helpful innovation by some patients, possibly indicating a perception of subordination and a lack of empowerment. Further examination of this tension and its implications is needed.

  19. Trauma center finances and length of stay: identifying a profitability inflection point.

    Science.gov (United States)

    Fakhry, Samir M; Couillard, Debbie; Liddy, Casey T; Adams, David; Norcross, E Douglass

    2010-05-01

    Trauma centers frequently report unfavorable financial results for the care of injured patients. Many variables contribute to these results. The objective of this study was to determine the relationship of adult trauma patient hospital length of stay (LOS) to trauma center profitability. The trauma registry of a Level I trauma center was queried for patients older than 18 years for the period July 1, 2003 to June 30, 2008. Hospital financial records were matched to patient trauma registry data. There were 7,990 patients who met selection criteria: 71% were men, mean age was 40 years, mean Injury Severity Score was 12 +/-10, 84.2% of injuries were blunt, and mean LOS was 6.23 days. In the 5 years of the study, total charges were $329,315,191, total costs were $137,680,039, and overall profit was $7,644,894. Total costs rose each year and percent collections fell. The bulk of the profit was realized from patients with LOS profitability as LOS increased. A notable "inflection point" at 11 days defined the cohort of profitable patients. Trauma patient LOS correlates closely with profitability. In this center, the vast majority of profit was realized from patients with LOS profitability and reflects the current reimbursement environment, which rewards shorter LOS over severity and quality. Copyright 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  20. An Online Tailored Self-Management Program for Patients With Rheumatoid Arthritis: A Developmental Study.

    Science.gov (United States)

    Zuidema, Rixt M; van Gaal, Betsie Gi; van Dulmen, Sandra; Repping-Wuts, Han; Schoonhoven, Lisette

    2015-12-25

    Every day rheumatoid arthritis (RA) patients make many decisions about managing their disease. An online, computer-tailored, self-management program can support this decision making, but development of such a program requires the active participation of patients. To develop an online, computer-tailored, self-management program integrated with the nursing care, as nurses have an important role in supporting self-management behavior. The intervention mapping framework was used to develop the program. Development was a multistep process: (1) needs assessment; (2) developing program and change objectives in a matrix; (3) selecting theory-based intervention methods and practical application strategies; (4) producing program components; (5) planning and adoption, implementation, and sustainability; and (6) planning for evaluation. After conducting the needs assessment (step 1), nine health-related problems were identified: (1) balancing rest and activity, (2) setting boundaries, (3) asking for help and support, (4) use of medicines, (5) communicating with health professionals, (6) use of assistive devices, (7) performing physical exercises, (8) coping with worries, and (9) coping with RA. After defining performance and change objectives (step 2), we identified a number of methods which could be used to achieve them (step 3), such as provision of general information about health-related behavior, self-monitoring of behavior, persuasive communication, modeling, and self-persuasion and tailoring. We described and operationalized these methods in texts, videos, exercises, and a medication intake schedule. The resulting program (step 4) consisted of an introduction module and nine modules dealing with health-related problems. The content of these modules is tailored to the user's self-efficacy, and patients can use the online program as often as they want, working through a module or modules at their own speed. After implementation (step 5), the program will be evaluated in a

  1. Determinants of Market Share of For-Profit Hospitals: An Empirical Examination

    Directory of Open Access Journals (Sweden)

    Seungchul Lee

    2017-10-01

    Full Text Available This study estimates the effects of a prospective payment system on the growth of for-profit hospitals. The empirical results show that the proportion of patient care paid for by Medicare managed care has a positive, statistically significant relationship with the market share of for-profit hospitals. Medicare managed care reimburses health care providers prospectively, and a larger portion of prospective reimbursements is received by for-profit hospitals, whose market share consequently increases. In addition, the proportion of patients with Medi-Cal and third party managed care has a positive, statistically significant relationship with the market share of for-profit hospitals.

  2. Young patients', parents', and survivors' communication preferences in paediatric oncology: Results of online focus groups

    Directory of Open Access Journals (Sweden)

    Kamps Willem A

    2007-11-01

    Full Text Available Abstract Background Guidelines in paediatric oncology encourage health care providers to share relevant information with young patients and parents to enable their active participation in decision making. It is not clear to what extent this mirrors patients' and parents' preferences. This study investigated communication preferences of childhood cancer patients, parents, and survivors of childhood cancer. Methods Communication preferences were examined by means of online focus groups. Seven patients (aged 8–17, 11 parents, and 18 survivors (aged 8–17 at diagnosis participated. Recruitment took place by consecutive inclusion in two Dutch university oncological wards. Questions concerned preferences regarding interpersonal relationships, information exchange and participation in decision making. Results Participants expressed detailed and multi-faceted views regarding their needs and preferences in communication in paediatric oncology. They agreed on the importance of several interpersonal and informational aspects of communication, such as honesty, support, and the need to be fully informed. Participants generally preferred a collaborative role in medical decision making. Differences in views were found regarding the desirability of the patient's presence during consultations. Patients differed in their satisfaction with their parents' role as managers of the communication. Conclusion Young patients' preferences mainly concur with current guidelines of providing them with medical information and enabling their participation in medical decision making. Still, some variation in preferences was found, which faces health care providers with the task of balancing between the sometimes conflicting preferences of young cancer patients and their parents.

  3. Legal, Practical, and Ethical Considerations for Making Online Patient Portals Accessible for All.

    Science.gov (United States)

    Lyles, Courtney R; Fruchterman, Jim; Youdelman, Mara; Schillinger, Dean

    2017-10-01

    Largely driven by the financial incentives of the HITECH Act's Meaningful Use program as part of federal US health care reform, access to portal Web sites has rapidly expanded, allowing many patients to view their medical record information online. Despite this expansion, there is little attention paid to the accessibility of portals for more vulnerable patient populations-especially patients with limited health literacy or limited English proficiency, and individuals with disabilities. We argue that there are potential legal mandates for improving portal accessibility (e.g., the Civil Rights and the Rehabilitation Acts), as well as ethical considerations to prevent the exacerbation of existing health and health care disparities. To address these legal, practical, and ethical considerations, we present standards and broad recommendations that could greatly improve the reach and impact of portal Web sites.

  4. Virtual patients in massive open online courses--design implications and integration strategies.

    Science.gov (United States)

    Stathakarou, Natalia; Zary, Nabil; Kononowicz, Andrzej A

    2014-01-01

    Massive Open Online Courses (MOOCs) are raising extensive attention across disciplines, while it becomes evident that rethinking of learning designs that work well in these environments is needed. In the field of medical education, where the technology of MOOCs is not widely adopted yet, we wish to investigate the potential offered by virtual patients for the purpose of clinical reasoning skills training. In this paper we describe three use case scenarios employing virtual patients' features in MOOCs: (1) collective evaluation of decision making in the context of uncertainty; (2) collective repurposing of cases and division of discussion into subgroups focusing on local variances in healthcare; (3) division of content in short cases for flexible selection and adaptive learning with virtual patients. We also present technical requirements for implementing the use case scenarios and future work plans.

  5. Quality of online information to support patient decision-making in breast cancer surgery.

    Science.gov (United States)

    Bruce, Jordan G; Tucholka, Jennifer L; Steffens, Nicole M; Neuman, Heather B

    2015-11-01

    Breast cancer patients commonly use the internet as an information resource. Our objective was to evaluate the quality of online information available to support patients facing a decision for breast surgery. Breast cancer surgery-related queries were performed (Google and Bing), and reviewed for content pertinent to breast cancer surgery. The DISCERN instrument was used to evaluate websites' structural components that influence publication reliability and ability of information to support treatment decision-making. Scores of 4/5 were considered "good." 45 unique websites were identified. Websites satisfied a median 5/9 content questions. Commonly omitted topics included: having a choice between breast conservation and mastectomy (67%) and potential for 2nd surgery to obtain negative margins after breast conservation (60%). Websites had a median DISCERN score of 2.9 (range 2.0-4.5). Websites achieved higher scores on structural criteria (median 3.6 [2.1-4.7]), with 24% rated as "good." Scores on supporting decision-making questions were lower (2.6 [1.3-4.4]), with only 7% scoring "good." Although numerous breast cancer-related websites exist, most do a poor job providing women with essential information necessary to actively participate in decision-making for breast cancer surgery. Providing easily- accessible, high-quality online information has the potential to significantly improve patients' experiences with decision-making. © 2015 Wiley Periodicals, Inc.

  6. Measuring Customer Profitability in Complex Environments

    DEFF Research Database (Denmark)

    Holm, Morten; Kumar, V.; Rohde, Carsten

    2012-01-01

    that the degree of sophistication deployed when implementing customer profitability measurement models is determined by the type of complexity encountered in firms’ customer environments. This gives rise to a contingency framework for customer profitability measurement model selection and five research......Customer profitability measurement is an important element in customer relationship management and a lever for enhanced marketing accountability. Two distinct measurement approaches have emerged in the marketing literature: Customer Lifetime Value (CLV) and Customer Profitability Analysis (CPA...... propositions. Additionally, the framework provides design and implementation guidance for managers seeking to implement customer profitability measurement models for resource allocation purposes....

  7. Patients, care partners, and shared access to the patient portal: online practices at an integrated health system.

    Science.gov (United States)

    Wolff, Jennifer L; Berger, Andrea; Clarke, Deserae; Green, Jamie A; Stametz, Rebecca; Yule, Christina; Darer, Jonathan D

    2016-11-01

    To describe the characteristics and online practices of patients and "care partners" who share explicit access to a patient portal account at a large integrated health system that implemented shared access functionality in 2003. Survey of 323 patients and 389 care partners at Geisinger Health System with linked information regarding access and use of patient portal functionality. Few (0.4%) registered adult patient portal users shared access to their account. Patients varied in age (range: 18-102); more than half had a high school education or less (53.6%). Patient motivations for sharing access included: to help manage care (41.9%), for emergency reasons (29.7%), lack of technology experience (18.4%), or care partner request (10.0%). Care partners were parents (39.8%), adult children (27.9%), spouses (26.2%), and other relatives (6.1%). Patients were more likely than care partners to have inadequate health literacy (54.8% versus 8.8%, P care (53.0% versus 88.1%; P Care partners were more likely than patients to perform health management activities electronically (95.5% versus 48.4%; P access the patient portal (89.2% versus 30.3%; P Care partners used their own credentials (89.1%) and patient credentials (23.3%) to access the patient portal. Shared access is an underused strategy that may bridge patients' health literacy deficits and lack of technology experience and that helps but does not fully resolve concerns regarding patient and care partner identity credentials. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. A critical review of the readability of online patient education resources from RadiologyInfo.Org.

    Science.gov (United States)

    Hansberry, David R; John, Ann; John, Elizabeth; Agarwal, Nitin; Gonzales, Sharon F; Baker, Stephen R

    2014-03-01

    Health consumers and their families rely on the Internet as a source of authoritative information regarding the procedures used to reach a diagnosis, effect treatment, and influence prognosis. In radiology, online materials can be a means by which to offer patients comprehensible explanations of the capabilities, the risks and rewards, and the techniques under our purview. Consequently, estimations of health literacy should take into account the reading level of the average American when composing and transmitting such information to the lay public without the mediation of a referring physician. In December 2012, patient education reports from the files of RadiologyInfo.org, a jointly sponsored website of the American College of Radiology and the Radiological Society of North America, were downloaded to assess their textual sophistication. All 138 patient education articles including the glossary were analyzed for their respective level of "readability" using the following 10 evaluative scales: Flesch Reading Ease, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook Grading, Coleman-Liau Index, Gunning Fog Index, New Dale-Chall scale, FORCAST, Fry graph, Raygor Readability Estimate, and New Fog Count. The 138 online patient education articles were written, on average, between the 10th and 14th grade levels, which exceeds both the American Medical Association and the National Institutes of Health recommendations that patient education resources be comprehensible to those who read no higher than the seventh grade level. Patients may accrue a greater benefit from written articles available on RadiologyInfo.org if the texts were revised to be in compliance with the National Institutes of Health and American Medical Association grade level recommendations. This could lead to a broadened appreciation of the capabilities of radiology's role in general and enhanced understanding of imaging techniques and their application to clinical practice.

  9. Use of sentiment analysis for capturing patient experience from free-text comments posted online.

    Science.gov (United States)

    Greaves, Felix; Ramirez-Cano, Daniel; Millett, Christopher; Darzi, Ara; Donaldson, Liam

    2013-11-01

    There are large amounts of unstructured, free-text information about quality of health care available on the Internet in blogs, social networks, and on physician rating websites that are not captured in a systematic way. New analytical techniques, such as sentiment analysis, may allow us to understand and use this information more effectively to improve the quality of health care. We attempted to use machine learning to understand patients' unstructured comments about their care. We used sentiment analysis techniques to categorize online free-text comments by patients as either positive or negative descriptions of their health care. We tried to automatically predict whether a patient would recommend a hospital, whether the hospital was clean, and whether they were treated with dignity from their free-text description, compared to the patient's own quantitative rating of their care. We applied machine learning techniques to all 6412 online comments about hospitals on the English National Health Service website in 2010 using Weka data-mining software. We also compared the results obtained from sentiment analysis with the paper-based national inpatient survey results at the hospital level using Spearman rank correlation for all 161 acute adult hospital trusts in England. There was 81%, 84%, and 89% agreement between quantitative ratings of care and those derived from free-text comments using sentiment analysis for cleanliness, being treated with dignity, and overall recommendation of hospital respectively (kappa scores: .40-.74, P<.001 for all). We observed mild to moderate associations between our machine learning predictions and responses to the large patient survey for the three categories examined (Spearman rho 0.37-0.51, P<.001 for all). The prediction accuracy that we have achieved using this machine learning process suggests that we are able to predict, from free-text, a reasonably accurate assessment of patients' opinion about different performance aspects of

  10. Evaluating the complexity of online patient education materials about brain aneurysms published by major academic institutions.

    Science.gov (United States)

    Gupta, Raghav; Adeeb, Nimer; Griessenauer, Christoph J; Moore, Justin M; Patel, Apar S; Kim, Christopher; Thomas, Ajith J; Ogilvy, Christopher S

    2017-08-01

    OBJECTIVE Health care education resources are increasingly available on the Internet. A majority of people reference these resources at one point or another. A threshold literacy level is needed to comprehend the information presented within these materials. A key component of health literacy is the readability of educational resources. The National Institutes of Health (NIH) and the American Medical Association have recommended that patient education materials be written between a 4th- and a 6th-grade education level. The authors assessed the readability of online patient education materials about brain aneurysms that have been published by several academic institutions across the US. METHODS Online patient education materials about brain aneurysms were downloaded from the websites of 20 academic institutions. The materials were assessed via 8 readability scales using Readability Studio software (Oleander Software Solutions), and then were statistically analyzed. RESULTS None of the patient education materials were written at or below the NIH's recommended 6th-grade reading level. The average educational level required to comprehend the texts across all institutions, as assessed by 7 of the readability scales, was 12.4 ± 2.5 (mean ± SD). The Flesch Reading Ease Scale classified the materials as "difficult" to understand, correlating with a college-level education or higher. An ANOVA test found that there were no significant differences in readability among the materials from the institutions (p = 0.215). CONCLUSIONS Brain aneurysms affect 3.2% of adults 50 years or older across the world and can cause significant patient anxiety and uncertainty. Current patient education materials are not written at or below the NIH's recommended 4th- to 6th-grade education level.

  11. A comparative study of the risk profile of hemodialysis patients in a for profit network and in two regional registries of the Italian Society of Nephrology.

    Science.gov (United States)

    Postorino, Maurizio; Amato, Claudia; Mancini, Elena; Carioni, Paola; D'Arrigo, Graziella; Di Benedetto, Attilio; Cerino, Fabrizio; Marino, Carmela; Vilasi, Antonio; Tripepi, Giovanni; Stuard, Stefano; Capasso, Giovanbattista; Santoro, Antonio; Zoccali, Carmine

    2017-02-16

    In 2013, the Italian Society of Nephrology joined forces with Nephrocare-Italy to create a clinical research cohort of patients on file in the data-rich clinical management system (EUCLID) of this organization for the performance of observational studies in the hemodialysis (HD) population. To see whether patients in EUCLID are representative of the HD population in Italy, we set out to compare the whole EUCLID population with patients included in the regional HD registries in Emilia-Romagna (Northern Italy) and in Calabria (Southern Italy), the sole regions in Italy which have systematically collected an enlarged clinical data set allowing comparison with the data-rich EUCLID system. An analysis of prevalent and incident patients in 2010 and 2011 showed that EUCLID patients had a lower prevalence of coronary heart disease, peripheral vascular disease, heart failure, valvular heart disease, liver disease, peptic ulcer and other comorbidities and risk factors and a higher fractional urea clearance (Kt/V) than those in the Emilia Romagna and Calabria registries. Accordingly, survival analysis showed a lower mortality risk in the EUCLID 2010 and 2011 cohorts than in the combined two regional registries in the corresponding years: for 2010, hazard ratio (HR) EUCLID vs. Regional registries: 0.80 [95% confidence interval: 0.71-0.90]; for 2011, HR: 0.76 [0.65-0.90]. However, this difference was nullified by statistical adjustment for the difference in comorbidities and risk factors, indicating that the longer survival in the EUCLID database was attributable to the lower risk profile of patients included in that database. This preliminary analysis sets the stage for future observational studies and indicates that appropriate adjustment for difference in comorbidities and risk factors is needed to generalize to the Italian HD population analyses based on the data-rich EUCLID database.

  12. The impact of profitability of hospital admissions on mortality.

    Science.gov (United States)

    Lindrooth, Richard C; Konetzka, R Tamara; Navathe, Amol S; Zhu, Jingsan; Chen, Wei; Volpp, Kevin

    2013-04-01

    Fiscal constraints faced by Medicare are leading to policies designed to reduce expenditures. Evidence of the effect of reduced reimbursement on the mortality of Medicare patients discharged from all major hospital service lines is limited. We modeled risk-adjusted 30-day mortality of patients discharged from 21 hospital service lines as a function of service line profitability, service line time trends, and hospital service line and year-fixed effects. We simulated the effect of alternative revenue-neutral reimbursement policies on mortality. Our sample included all Medicare discharges from PPS-eligible hospitals (1997, 2001, and 2005). The results reveal a statistically significant inverse relationship between changes in profitability and mortality. A $0.19 average reduction in profit per $1.00 of costs led to a 0.010-0.020 percentage-point increase in mortality rates (p profitable. Policy simulations that target service line inequities in payment generosity result in lower mortality rates, roughly 700-13,000 fewer deaths nationally. The policy simulations raise questions about the trade-offs implicit in universal reductions in reimbursement. The effect of reduced payment generosity on mortality could be mitigated by targeting highly profitable services only for lower reimbursement. © Health Research and Educational Trust.

  13. Uncompensated care provided by for-profit, not-for-profit, and government owned hospitals

    Directory of Open Access Journals (Sweden)

    Vaughan-Sarrazin Mary S

    2010-04-01

    Full Text Available Abstract Background There is growing concern certain not-for-profit hospitals are not providing enough uncompensated care to justify their tax exempt status. Our objective was to compare the amount of uncompensated care provided by not-for-profit (NFP, for-profit (FP and government owned hospitals. Methods We used 2005 state inpatient data (SID for 10 states to identify patients hospitalized for three common conditions: acute myocardial infarction (AMI, coronary artery bypass grafting (CABG, or childbirth. Uncompensated care was measured as the proportion of each hospital's total admissions for each condition that were classified as being uninsured. Hospitals were categorized as NFP, FP, or government owned based upon data obtained from the American Hospital Association. We used bivariate methods to compare the proportion of uninsured patients admitted to NFP, FP and government hospitals for each diagnosis. We then used generalized linear mixed models to compare the percentage of uninsured in each category of hospital after adjusting for the socioeconomic status of the markets each hospital served. Results Our cohort consisted of 188,117 patients (1,054 hospitals hospitalized for AMI, 82,261 patients (245 hospitals for CABG, and 1,091,220 patients for childbirth (793 hospitals. The percentage of admissions classified as uninsured was lower in NFP hospitals than in FP or government hospitals for AMI (4.6% NFP; 6.0% FP; 9.5% government; P Conclusions For the three conditions studied NFP and FP hospitals appear to provide a similar amount of uncompensated care while government hospitals provide significantly more. Concerns about the amount of uncompensated care provided by NFP hospitals appear warranted.

  14. Development of an Online Sleep Diary for Physician and Patient Use

    Directory of Open Access Journals (Sweden)

    Jacqueline Blake

    2010-06-01

    Full Text Available This paper describes the development of an electronic sleep diary and outlines its advantages over the traditional paper based approach still used by many sleep centres throughout the world. A sleep diary is a record of sleep details filled in by a patient normally over a period of two weeks. This information is then used by a physician as a diagnostic tool for identify sleep disorders in the patient. The development method used was convergent interviews with sleep specialists in order to establish initial requirements. This was followed by a rapid prototyping approach in order to produce the final specification. This paper concludes that an online sleep diary is a low cost, viable alternative offering benefits to both patients and physicians. The benefits to patients include the ability to perform functional analysis of their own sleep habits (referred to as sleep hygiene and to determine factors affecting their sleep patterns. This knowledge leads to greater patient understanding of their circumstances and can lead to a potential increase in patient, physician collaboration. The physician gains access to timely accessible patient information as well as to an evidence database that will allow for greater analysis of sleep disorders throughout the general public over time.

  15. Readability of online patient education materials from the AAOS web site.

    Science.gov (United States)

    Sabharwal, Sanjeev; Badarudeen, Sameer; Unes Kunju, Shebna

    2008-05-01

    One of the goals of the American Academy of Orthopaedic Surgeons (AAOS) is to disseminate patient education materials that suit the readability skills of the patient population. According to standard guidelines from healthcare organizations, the readability of patient education materials should be no higher than the sixth-grade level. We hypothesized the readability level of patient education materials available on the AAOS Web site would be higher than the recommended grade level, regardless when the material was available online. Readability scores of all articles from the AAOS Internet-based patient information Web site, "Your Orthopaedic Connection," were determined using the Flesch-Kincaid grade formula. The mean Flesch-Kincaid grade level of the 426 unique articles was 10.43. Only 10 (2%) of the articles had the recommended readability level of sixth grade or lower. The readability of the articles did not change with time. Our findings suggest the majority of the patient education materials available on the AAOS Web site had readability scores that may be too difficult for comprehension by a substantial portion of the patient population.

  16. Student Views Regarding Online Freshmen Physics Courses

    Science.gov (United States)

    Ramlo, Susan

    2017-01-01

    Background: Nationally, many public universities have started to move into the online course and program market that was previously associated with for-profit institutions of higher education. Public university administrators state that students seek the flexibility of online courses. But do students want to take courses online, especially…

  17. Assessing the Accuracy and Readability of Online Health Information for Patients With Pancreatic Cancer.

    Science.gov (United States)

    Storino, Alessandra; Castillo-Angeles, Manuel; Watkins, Ammara A; Vargas, Christina; Mancias, Joseph D; Bullock, Andrea; Demirjian, Aram; Moser, A James; Kent, Tara S

    2016-09-01

    The degree to which patients are empowered by written educational materials depends on the text's readability level and the accuracy of the information provided. The association of a website's affiliation or focus on treatment modality with its readability and accuracy has yet to be thoroughly elucidated. To compare the readability and accuracy of patient-oriented online resources for pancreatic cancer by treatment modality and website affiliation. An online search of 50 websites discussing 5 pancreatic cancer treatment modalities (alternative therapy, chemotherapy, clinical trials, radiation therapy, and surgery) was conducted. The website's affiliation was identified. Readability was measured by 9 standardized tests, and accuracy was assessed by an expert panel. Nine standardized tests were used to compute the median readability level of each website. The median readability scores were compared among treatment modality and affiliation categories. Accuracy was determined by an expert panel consisting of 2 medical specialists and 2 surgical specialists. The 4 raters independently evaluated all websites belonging to the 5 treatment modalities (a score of 1 indicates that nonprofit organizations (median readability level, 12.9 [IQR, 11.2-15.0]) were easier to read than media (median readability level, 16.0 [IQR, 13.4-17.0]) (P < .001) and academic (median readability level, 14.8 [IQR, 12.9-17.0]) (P < .001) websites. Privately owned websites (median readability level, 14.0 [IQR, 12.1-16.1]) were easier to read than media websites (P = .001). Among treatment modalities, alternative therapy websites exhibited the lowest accuracy scores (median accuracy score, 2 [IQR, 1-4]) (P < .001). Nonprofit (median accuracy score, 4 [IQR, 4-5]), government (median accuracy score, 5 [IQR, 4-5]), and academic (median accuracy score, 4 [IQR, 3.5-5]) websites were more accurate than privately owned (median accuracy score, 3.5 [IQR, 1.5-4]) and media (median accuracy

  18. Metal-on-Metal Total Hip Arthroplasty: Quality of Online Patient Information.

    Science.gov (United States)

    Crozier-Shaw, Geoff; Queally, Joseph M; Quinlan, John F

    2017-03-01

    Metal-on-metal total hip arthroplasty (THA) has generated much attention in the media because of early failure of certain implant systems. This study assessed the quality, accuracy, and readability of online information on metal-on-metal THA. The search terms "metal-on-metal hip replacement" and "metal hip replacement" were entered into the 3 most popular search engines. Information quality was assessed with the DISCERN score and a specific metal-on-metal THA content score. Accuracy of information was assessed with a customized score. Readability of the websites was assessed with the Flesch-Kincaid grade level score. A total of 61 unique websites were assessed. For 56% of websites, the target audience was patients. Media or medicolegal sources accounted for 44% of websites. As assessed by DISCERN (range, 16-80) and metal-on-metal THA (range, 0-25) scores, quality of the websites was moderate at best (47.1 and 9.6, respectively). Accuracy (range, 0-8) of the information presented also was moderate, with a mean score of 6.6. Media and medicolegal websites had the lowest scores for both quality and accuracy, despite making up the greatest proportion of sites assessed. Only 1 website (2%) had a Flesch-Kincaid grade level at or less than the recommended level of 8th grade. This study found that online information on metal-on-metal THA was of poor quality, often was inaccurate, and was presented at an inappropriately high reading level, particularly for media and medicolegal websites. Health care providers should counsel patients on the quality of information available and recommend appropriate online resources. [Orthopedics. 2017; 40(2):e262-e268.]. Copyright 2016, SLACK Incorporated.

  19. Correlations among Social Anxiety, Self-Esteem, Impulsivity, and Game Genre in Patients with Problematic Online Game Playing.

    Science.gov (United States)

    Park, Jeong Ha; Han, Doug Hyun; Kim, Bung-Nyun; Cheong, Jae Hoon; Lee, Young-Sik

    2016-05-01

    Recent studies of online game addiction have suggested that social interaction and impulsivity are critical factors for the etiology and progress of online game addiction. We hypothesized that the genre of the online game is associated with impulsivity and sociality in individuals with online game addictions. In total, 212 patients with problematic online game playing were divided into four groups by game genre: 1) massive multiplayer online role playing game (MMORPG), 2) real-time strategy (RTS), 3) first-person shooter (FPS), and 4) other. Their symptoms and characteristics were assessed using 8 scales and 2 tests to estimate self-esteem, impulsiveness, comorbidity, social interaction status, and cognitive function. The mean social anxiety score was highest in the MMORPG group and lowest in the FPS group. The mean self-esteem score was highest in the RTS group. Social anxiety score was positively correlated with Internet addiction score in the MMORPG group, and the self-esteem score was positively correlated with Internet addiction score in the RTS group. The genre of online game was not associated with impulsivity, but social anxiety status varied significantly with game genre, and differences in social anxiety were especially pronounced in patients playing the MMORPG (highest social anxiety) and FPS (lowest social anxiety) game genres. In addition, self-esteem was highest in the RTS game genre.

  20. Correlations among Social Anxiety, Self-Esteem, Impulsivity, and Game Genre in Patients with Problematic Online Game Playing

    Science.gov (United States)

    Park, Jeong Ha; Han, Doug Hyun; Kim, Bung-Nyun; Cheong, Jae Hoon

    2016-01-01

    Objective Recent studies of online game addiction have suggested that social interaction and impulsivity are critical factors for the etiology and progress of online game addiction. We hypothesized that the genre of the online game is associated with impulsivity and sociality in individuals with online game addictions. Methods In total, 212 patients with problematic online game playing were divided into four groups by game genre: 1) massive multiplayer online role playing game (MMORPG), 2) real-time strategy (RTS), 3) first-person shooter (FPS), and 4) other. Their symptoms and characteristics were assessed using 8 scales and 2 tests to estimate self-esteem, impulsiveness, comorbidity, social interaction status, and cognitive function. Results The mean social anxiety score was highest in the MMORPG group and lowest in the FPS group. The mean self-esteem score was highest in the RTS group. Social anxiety score was positively correlated with Internet addiction score in the MMORPG group, and the self-esteem score was positively correlated with Internet addiction score in the RTS group. Conclusion The genre of online game was not associated with impulsivity, but social anxiety status varied significantly with game genre, and differences in social anxiety were especially pronounced in patients playing the MMORPG (highest social anxiety) and FPS (lowest social anxiety) game genres. In addition, self-esteem was highest in the RTS game genre. PMID:27247595

  1. An Investigation of the Information Sought by Caregivers of Alzheimer's Patients on Online Peer Support Groups.

    Science.gov (United States)

    Scharett, Emma; Madathil, Kapil Chalil; Lopes, Snehal; Rogers, Hunter; Agnisarman, Sruthy; Narasimha, Shraddhaa; Ashok, Aparna; Dye, Cheryl

    2017-10-01

    Caregivers of Alzheimer's patients find respite in online communities for solutions and emotional support. This study aims to understand the characteristics of information caregivers of Alzheimer's patients are searching for and the kind of support they receive through Internet-based peer support communities. Using a Web crawler written in Python Web programming language, we retrieved publicly available 2,500 random posts and their respective solutions from April 2012 to October 2016 on the solutions category of the Caregiver's Forum on ALZConnected.org . A content analysis was conducted on these randomly selected posts and 4,219 responses to those posts based on a classification system were derived from initial analyses of 750 posts and related responses. The results showed most posts (26%) related to queries about Alzheimer's symptoms, and the highest percentage of responses (45.56%) pertained to caregiver well-being. The LIWC analyses generated an average tone rating of 27.27 for the posts, implying a negative tone and 65.17 for their responses, implying a slightly positive tone. The ALZConnected.org Web site has the potential of being an emotionally supportive tool for caregivers; however, a more user-friendly interface is required to accommodate the needs of most caregivers and their technological skills. Solutions offered on the peer support groups are often subjective opinions of other caregivers and should not be considered professional or comprehensive; further research on educating caregivers using online forums is necessary.

  2. Assessing the quality of online information for patients with carotid disease.

    Science.gov (United States)

    Keogh, C J; McHugh, S M; Clarke Moloney, M; Hannigan, A; Healy, D A; Burke, P E; Kavanagh, E G; Grace, P A; Walsh, S R

    2014-01-01

    Controversy exists relating to carotid endarterectomy (CEA) versus carotid artery stenting (CAS). We aimed to assess the quality of online patient information relating to both. The Google search engine was searched for "carotid endarterectomy" and "carotid stenting". The first 50 webpages returned were assessed. The Gunning Fog Index (GFI) and Flesch Reading Ease Score (FRES) were calculated to assess readability. The LIDA tool (Minervation Ltd., Oxford, U.K.) was used to assess accessibility, usability and reliability. 20% (n = 10) of the webpages returned for CEA were from peer reviewed sources with 34% (n = 17) posted by hospitals or health services. Comparatively, for CAS, 40% (n = 20) were peer reviewed with 16% (n = 8) posted by hospitals or health services. GFI and FRES scores indicated webpages for both CEA and CAS had poor general readability. Webpages for CEA were easier to read than those for CAS (mean FRES difference of 6.7 (95% CI 0.51 to 12.93, p = 0.03). Median LIDA scores demonstrated acceptable reliability, accessibility and usability of information for both CEA and CAS webpages. The more readable webpages were not associated with higher LIDA scores for either CEA or CAS webpages. Webpages providing information on carotid disease management must be made more readable. Online information currently available to patients regarding CAS is more difficult to read and comprehend than CEA. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  3. Colorectal cancer screening patient education materials-how effective is online health information?

    Science.gov (United States)

    John, Elizabeth Sheena; John, Ann M; Hansberry, David R; Thomas, Prashant J; Agarwal, Prateek; Deitch, Christopher; Chokhavatia, Sita

    2016-12-01

    Patients screened for colorectal cancer (CRC) frequently turn to the Internet to improve their understanding of tests used for detection, including colonoscopy, flexible sigmoidoscopy, fecal occult blood test (FOBT), and CT colonography. It was of interest to determine the quality and readability levels of online health information. The screening tools were googled, and the top 20 results of each test were analyzed for readability, accessibility, usability, and reliability. The 80 articles excluded scientific literature and blogs. We used ten validated readability scales to measure grade levels, and one-way ANOVA and Tukey's honestly statistical different (HSD) post hoc analyses to determine any statistically significant differences among the four diagnostic tests. The LIDA tool assessed overall quality by measuring accessibility, usability, and reliability. The 80 articles were written at an 11.7 grade level, with CT colonography articles written at significantly higher levels than FOBT articles, F(3, 75) = 3.07, p = 0.033. LIDA showed moderate percentages in accessibility (83.9 %), usability (73.0 %), and reliability (75.9 %). Online health information about CRC screening tools are written at higher levels than the National Institute of Health (NIH) and American Medical Association (AMA) recommended third to seventh grade levels. More patients could benefit from this modality of information if it were written at a level and quality that would better facilitate understanding.

  4. Research on the Rural Express Alliance based on ANP improved profit Allocation

    Science.gov (United States)

    Zhuang, Yufeng; Zhang, Bin

    2018-01-01

    Online shopping platform in rural distribution difficulties, leading to rural online shopping market and logistics market development is slow. At present, China Post and other private courier companies are not possible to do. So we need to build distribution alliances. Reasonable profit allocation mechanism is the key to the stable development of this distribution alliance. So we proposed the Shapley Value Method and the ANP Improved Model to allocate profits. Finally, the rationality of the method is proved by numerical analysis before and after using the corrected Shapley Value.

  5. Negative effects of internet interventions: a qualitative content analysis of patients' experiences with treatments delivered online.

    Science.gov (United States)

    Rozental, Alexander; Boettcher, Johanna; Andersson, Gerhard; Schmidt, Brad; Carlbring, Per

    2015-01-01

    Internet interventions are defined as the delivery of health care-related treatments via an online or a smartphone interface, and have been shown to be a viable alternative to face-to-face treatments. However, not all patients benefit from such treatments, and it is possible that some may experience negative effects. Investigations of face-to-face treatments indicate that deterioration occurs in 5-10% of all patients. The nature and scope of other negative effects of Internet interventions is, however, largely unknown. Hence, the current study explored patients' reported negative experiences while undergoing treatments delivered via the Internet. Data from four large clinical trials (total N = 558) revealed that 9.3% of patients reported some type of negative effects. Qualitative content analysis was used to explore the patients' responses to open-ended questions regarding their negative experiences. Results yielded two broad categories and four subcategories of negative effects: patient-related negative effects (insight and symptom) and treatment-related negative effects (implementation and format). Results emphasize the importance of always considering negative effects in Internet-based interventions, and point to several ways of preventing such experiences, including regular assessment of negative events, increasing the flexibility of treatment schedules and therapist contact, as well as prolonging the treatment duration.

  6. University Business Models and Online Practices: A Third Way

    Science.gov (United States)

    Rubin, Beth

    2013-01-01

    Higher Education is in a state of change, and the existing business models do not meet the needs of stakeholders. This article contrasts the current dominant business models of universities, comparing the traditional non-profit against the for-profit online model, examining the structural features and online teaching practices that underlie each.…

  7. Students' Views about Potentially Offering Physics Courses Online

    Science.gov (United States)

    Ramlo, Susan E.

    2016-01-01

    Nationally, many public universities have started to move into the online course and program market that is most often associated with for-profit institutions of higher education. Administrators in public universities make statements regarding benefits to students' desire for flexibility and profit margins related to online courses. But do…

  8. The role of provider-patient communication and trust in online sources in Internet use for health-related activities.

    Science.gov (United States)

    Hou, Jiran; Shim, Minsun

    2010-01-01

    Provider-patient communication is an important factor influencing patients' satisfaction and health outcomes. This study draws upon the uses and gratification theory to examine how individuals' perception of communication with healthcare providers is associated with their Internet use for health-related activities. Using the data from the 2007 Health Information National Trends Survey (HINTS), we found that as individuals perceived their communication with providers to be less patient-centered, they were more likely to engage in various types of online health activities, such as using websites for healthy lifestyles, searching for healthcare providers, and seeking health information. Trust in online health information was also found to be a significant predictor of online health activities. The results of this study emphasized the important role of provider-patient communication in motivating individuals to turn to the Internet for health purposes.

  9. Towards generic online multicriteria decision support in patient-centred health care.

    Science.gov (United States)

    Dowie, Jack; Kjer Kaltoft, Mette; Salkeld, Glenn; Cunich, Michelle

    2015-10-01

    To introduce a new online generic decision support system based on multicriteria decision analysis (MCDA), implemented in practical and user-friendly software (Annalisa©). All parties in health care lack a simple and generic way to picture and process the decisions to be made in pursuit of improved decision making and more informed choice within an overall philosophy of person- and patient-centred care. The MCDA-based system generates patient-specific clinical guidance in the form of an opinion as to the merits of the alternative options in a decision, which are all scored and ranked. The scores for each option combine, in a simple expected value calculation, the best estimates available now for the performance of those options on patient-determined criteria, with the individual patient's preferences, expressed as importance weightings for those criteria. The survey software within which the Annalisa file is embedded (Elicia©) customizes and personalizes the presentation and inputs. Principles relevant to the development of such decision-specific MCDA-based aids are noted and comparisons with alternative implementations presented. The necessity to trade-off practicality (including resource constraints) with normative rigour and empirical complexity, in both their development and delivery, is emphasized. The MCDA-/Annalisa-based decision support system represents a prescriptive addition to the portfolio of decision-aiding tools available online to individuals and clinicians interested in pursuing shared decision making and informed choice within a commitment to transparency in relation to both the evidence and preference bases of decisions. Some empirical data establishing its usability are provided. © 2013 The Authors. Health Expectations published by John Wiley & Sons Ltd.

  10. Cardiac Resynchronization Therapy Online: What Patients Find when Searching the World Wide Web.

    Science.gov (United States)

    Modi, Minal; Laskar, Nabila; Modi, Bhavik N

    2016-06-01

    To objectively assess the quality of information available on the World Wide Web on cardiac resynchronization therapy (CRT). Patients frequently search the internet regarding their healthcare issues. It has been shown that patients seeking information can help or hinder their healthcare outcomes depending on the quality of information consulted. On the internet, this information can be produced and published by anyone, resulting in the risk of patients accessing inaccurate and misleading information. The search term "Cardiac Resynchronisation Therapy" was entered into the three most popular search engines and the first 50 pages on each were pooled and analyzed, after excluding websites inappropriate for objective review. The "LIDA" instrument (a validated tool for assessing quality of healthcare information websites) was to generate scores on Accessibility, Reliability, and Usability. Readability was assessed using the Flesch Reading Ease Score (FRES). Of the 150 web-links, 41 sites met the eligibility criteria. The sites were assessed using the LIDA instrument and the FRES. A mean total LIDA score for all the websites assessed was 123.5 of a possible 165 (74.8%). The average Accessibility of the sites assessed was 50.1 of 60 (84.3%), on Usability 41.4 of 54 (76.6%), on Reliability 31.5 of 51 (61.7%), and 41.8 on FRES. There was a significant variability among sites and interestingly, there was no correlation between the sites' search engine ranking and their scores. This study has illustrated the variable quality of online material on the topic of CRT. Furthermore, there was also no apparent correlation between highly ranked, popular websites and their quality. Healthcare professionals should be encouraged to guide their patients toward the online material that contains reliable information. © 2016 Wiley Periodicals, Inc.

  11. Assessing Readability and Reliability of Online Patient Information Regarding Vestibular Schwannoma.

    Science.gov (United States)

    Spiers, Harry; Amin, Nikul; Lakhani, Raj; Martin, Andrew J; Patel, Parag M

    2017-12-01

    The aim of this study is to objectively assess the quality and readability of websites related to vestibular schwannomas. Patients are increasingly seeking information on confirmed or suspected diagnoses through the Internet. Clinicians are often concerned regarding the accuracy, quality, and readability of web-based sites. Online information relating to vestibular schwannoma was searched using the three most popular search engines. The terms "acoustic neuroma" and "vestibular schwannoma" were used. The top 50 results from each site were assessed for readability using the Flesch-Kincaid Grade Level, Flesch Reading Ease Score, and the Gunning-Fog Index. Quality of website information was scored using the DISCERN tool. Of 300 search results analyzed, 58 separate appropriate websites were identified. The mean readability score using Flesch-Kincaid Grade Level was 10.27 (95% confidence interval [CI] 9.84-10.70). The mean Flesch Reading Ease Score was 48.75 (95% CI 46.57-50.92). The Gunning-Fog Index was 13.40 (95% CI 12.92-13.89). These scores equate to someone finishing secondary school/first year university student. DISCERN scores were highly variable but consistently demonstrated great variability in quality of information. Online patient information on vestibular schwannoma is highly variable in quality. Although there are a wide range of different websites easily available to patients on their condition and its treatment options, the information is written at a difficult level which may exceed the understanding level of many patients as it is written at a higher than average level of expected reading ability.

  12. Drug resistance in bacteria isolated from patients presenting with wounds at a non-profit Surgical Center in Phnom Penh, Cambodia from 2011-2013.

    Science.gov (United States)

    Hout, Boren; Oum, Chamroeun; Men, Putheavy; Vanny, Vanvathanak; Supaprom, Chonthida; Heang, Vireak; Rachmat, Agus; Prouty, Michael; Newell, Steven; Harrison, Dustin; Noor, Saqib; Gollogly, James; Tho, Ly; Kim, Yong June; Ford, Gavin

    2015-01-01

    Emerging antibiotic resistance amongst clinically significant bacteria is a public health issue of increasing significance worldwide, but it is relatively uncharacterized in Cambodia. In this study we performed standard bacterial cultures on samples from wounds at a Non-Governmental-Organization (NGO) Hospital in Phnom Penh, Cambodia. Testing was performed to elucidate pathogenic bacteria causing wound infections and the antibiotic resistance profiles of bacterial isolates. All testing was performed at the Naval Medical Research Unit, No.2 (NAMRU-2) main laboratory in Phnom Penh, Cambodia. Between 2011-2013, a total of 251 specimens were collected from patients at the NGO hospital and analyzed for bacterial infection by standard bacterial cultures techniques. Specimens were all from wounds and anonymous. No specific clinical information accompanied the submitted specimens. Antibiotic susceptibility testing, and phenotypic testing for extended-spectrum beta-lactamase (ESBL) were performed and reported based on CLSI guidelines. Further genetic testing for CTX-M, TEM and SHV ESBLs was accomplished using PCR. One-hundred and seventy-six specimens were positive following bacterial culture (70 %). Staphlycoccus aureus was the most frequently isolated bacteria. Antibiotic drug resistance testing revealed that 52.5 % of Staphlycoccus aureus isolates were oxacillin resistant. For Escherichia coli isolates, 63.9 % were ciprofloxacin and levofloxacin resistant and 96 % were ESBL producers. Resistance to meropenem and imipenem was observed in one of three Acinetobacter spp isolates. This study is the first of its kind detailing the antibiotic resistance profiles of pathogenic bacteria causing wound infections at a single surgical hospital in Cambodia. The reported findings of this study demonstrate significant antibiotic resistance in bacteria from injured patients and should serve to guide treatment modalities in Cambodia.

  13. Socioeconomic deprivation and age are barriers to the online collection of patient reported outcome measures in orthopaedic patients.

    Science.gov (United States)

    Jenkins, P J; Sng, S; Brooksbank, K; Brooksbank, A J

    2016-01-01

    Introduction Questionnaires are used commonly to assess functional outcome and satisfaction in surgical patients. Although these have in the past been administered through written forms, there is increasing interest in the use of new technology to improve the efficiency of collection. The aim of this study was to assess the availability of internet access for a group of orthopaedic patients and the acceptability of online survey completion. Methods A total of 497 patients attending orthopaedic outpatient clinics were surveyed to assess access to the internet and their preferred means for completing follow-up questionnaires. Results Overall, 358 patients (72%) reported having internet access. Lack of access was associated with socioeconomic deprivation and older age. Multivariable regression confirmed increased age and greater deprivation to be independently associated with lack of internet access. Out of the total group, 198 (40%) indicated a preference for assessment of outcomes via email and the internet. Conclusions Internet access was not universal among the patients in our orthopaedic clinic. Reliance on internet collection of PROMs may introduce bias by not including results from patients in older age groups and those from the more deprived socioeconomic groups.

  14. Marketing's profit impact : Quantifying online and offline funnel progression

    NARCIS (Netherlands)

    Wiesel, T.; Pauwels, K.; Arts, J.

    2011-01-01

    I nofec, a small- to medium-sized enterprise in the business-to-business sector, desired a more analytic approach to allocate marketing resources across communication activities and channels. We developed a conceptual framework and econometric model to empirically investigate (1) the marketing

  15. The association between patient activation and accessing online health information: results from a national survey of US adults.

    Science.gov (United States)

    Smith, Samuel G; Pandit, Anjali; Rush, Steven R; Wolf, Michael S; Simon, Carol

    2015-12-01

    There are increasing opportunities for the public to access online health information, but attitudinal barriers to use are less well-known. Patient activation is associated with key health outcomes, but its relationship with using online health information is not known. We examined the relationship between patient activation and the likelihood of accessing a range of different types of online health information in a nationally representative US sample. Cross-sectional nationally representative survey. Data were from an online (n = 2700) and random digit dial telephone survey (n = 700) of US adults (total n = 3400). Respondent characteristics and the Patient Activation Measure. Self-reported access of five types of online health information in the past 12 months (online medical records, cost estimation tools, quality comparison tools, health information about a specific condition, preventive health information). Approximately, one-fifth of the sample had accessed their medical record (21.6%), treatment cost estimation tools (17.3%) and hospital and physician quality comparison tools (21.8%). Nearly half of the sample had accessed information about medical conditions or treatments (48.3%) or preventive health and well-being (45.9%). In multivariable analyses adjusted for participant characteristics, respondents with greater patient activation were more likely to have accessed all types of health information other than cost estimation tools. Activated people are more likely to make use of online heath information. Increasing patient activation could improve the public's ability to participate in health care and personal health self-management by encouraging health information seeking. © 2014 John Wiley & Sons Ltd.

  16. 'Quality signposting': the role of online information prescription in providing patient information.

    Science.gov (United States)

    Brewster, Liz; Sen, Barbara

    2011-03-01

      Information prescriptions (IPs) are part of a Department of Health (DH) initiative to improve patient care. IPs aim to meet health information needs by providing personalised, high quality patient information about conditions and treatment.   This paper identifies current online IP provision and evaluates a sample of IP websites against the original DH aims of IP provision; British Medical Association usability criteria; and information seeking vignettes.   Five UK and one international IP website were randomly selected as a sample. Two checklists designed to appraise the websites were used to review each IP provider. Two patient information seeking vignettes were developed to enable the websites to be assessed from a patient-centred perspective.   Information prescriptions currently vary in content, accessibility and quality. National IP websites score more highly than local IP websites, which are often weak on content for specific conditions and poorly designed but strong on signposting to local services.   Guidelines for IP provision need to be improved to ensure higher quality, more easily accessible information is available. A synthesis of expertise included in national and local websites would improve usability for patients. IP websites should conform to standards of web design and accessibility. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

  17. Designing Messaging to Engage Patients in an Online Suicide Prevention Intervention: Survey Results From Patients With Current Suicidal Ideation

    Science.gov (United States)

    Lungu, Anita; Richards, Julie; Simon, Gregory E; Clingan, Sarah; Siler, Jaeden; Snyder, Lorilei; Ludman, Evette

    2014-01-01

    Background Computerized, Internet-delivered interventions can be efficacious; however, uptake and maintaining sustained client engagement are still big challenges. We see the development of effective engagement strategies as the next frontier in online health interventions, an area where much creative research has begun. We also argue that for engagement strategies to accomplish their purpose with novel targeted populations, they need to be tailored to such populations (ie, content is designed with the target population in mind). User-centered design frameworks provide a theoretical foundation for increasing user engagement and uptake by including users in development. However, deciding how to implement this approach to enage users in mental health intervention development is challenging. Objective The aim of this study was to get user input and feedback on acceptability of messaging content intended to engage suicidal individuals. Methods In March 2013, clinic intake staff distributed flyers announcing the study, “Your Feedback Counts” to potential participants (individuals waiting to be seen for a mental health appointment) together with the Patient Health Questionnaire. The flyer explained that a score of two or three (“more than half the days” or “nearly every day” respectively) on the suicide ideation question made them eligible to provide feedback on components of a suicide prevention intervention under development. The patient could access an anonymous online survey by following a link. After providing consent online, participants completed the anonymous survey. Results Thirty-four individuals provided data on past demographic information. Participants reported that they would be most drawn to an intervention where they knew that they were cared about, that was personalized, that others like them had found it helpful, and that included examples with real people. Participants preferred email invitations with subject lines expressing concern and

  18. Designing messaging to engage patients in an online suicide prevention intervention: survey results from patients with current suicidal ideation.

    Science.gov (United States)

    Whiteside, Ursula; Lungu, Anita; Richards, Julie; Simon, Gregory E; Clingan, Sarah; Siler, Jaeden; Snyder, Lorilei; Ludman, Evette

    2014-02-07

    Computerized, Internet-delivered interventions can be efficacious; however, uptake and maintaining sustained client engagement are still big challenges. We see the development of effective engagement strategies as the next frontier in online health interventions, an area where much creative research has begun. We also argue that for engagement strategies to accomplish their purpose with novel targeted populations, they need to be tailored to such populations (ie, content is designed with the target population in mind). User-centered design frameworks provide a theoretical foundation for increasing user engagement and uptake by including users in development. However, deciding how to implement this approach to engage users in mental health intervention development is challenging. The aim of this study was to get user input and feedback on acceptability of messaging content intended to engage suicidal individuals. In March 2013, clinic intake staff distributed flyers announcing the study, "Your Feedback Counts" to potential participants (individuals waiting to be seen for a mental health appointment) together with the Patient Health Questionnaire. The flyer explained that a score of two or three ("more than half the days" or "nearly every day" respectively) on the suicide ideation question made them eligible to provide feedback on components of a suicide prevention intervention under development. The patient could access an anonymous online survey by following a link. After providing consent online, participants completed the anonymous survey. Thirty-four individuals provided data on past demographic information. Participants reported that they would be most drawn to an intervention where they knew that they were cared about, that was personalized, that others like them had found it helpful, and that included examples with real people. Participants preferred email invitations with subject lines expressing concern and availability of extra resources. Participants also

  19. Social uses of personal health information within PatientsLikeMe, an online patient community: what can happen when patients have access to one another's data.

    Science.gov (United States)

    Frost, Jeana H; Massagli, Michael P

    2008-05-27

    This project investigates the ways in which patients respond to the shared use of what is often considered private information: personal health data. There is a growing demand for patient access to personal health records. The predominant model for this record is a repository of all clinically relevant health information kept securely and viewed privately by patients and their health care providers. While this type of record does seem to have beneficial effects for the patient-physician relationship, the complexity and novelty of these data coupled with the lack of research in this area means the utility of personal health information for the primary stakeholders-the patients-is not well documented or understood. PatientsLikeMe is an online community built to support information exchange between patients. The site provides customized disease-specific outcome and visualization tools to help patients understand and share information about their condition. We begin this paper by describing the components and design of the online community. We then identify and analyze how users of this platform reference personal health information within patient-to-patient dialogues. Patients diagnosed with amyotrophic lateral sclerosis (ALS) post data on their current treatments, symptoms, and outcomes. These data are displayed graphically within personal health profiles and are reflected in composite community-level symptom and treatment reports. Users review and discuss these data within the Forum, private messaging, and comments posted on each other's profiles. We analyzed member communications that referenced individual-level personal health data to determine how patient peers use personal health information within patient-to-patient exchanges. Qualitative analysis of a sample of 123 comments (about 2% of the total) posted within the community revealed a variety of commenting and questioning behaviors by patient members. Members referenced data to locate others with particular

  20. Impact of robotic operative efficiency on profitability.

    Science.gov (United States)

    Geller, Elizabeth J; Matthews, Catherine A

    2013-07-01

    We sought to determine the impact of robotic operative efficiency on profitability and assess the impact of secondary variables. Financial data were collected for all robotic cases performed for fiscal years 2010 (FY10) and 2011 (FY11) at University of North Carolina at Chapel Hill, and included 9 surgical subspecialties. Profitability was defined as a positive operating income. From July 2009 through June 2011, 1295 robotic cases were performed. Robotic surgery was profitable in both fiscal years, with an operating income of $386,735 in FY10 and $822,996 in FY11. In FY10, urogynecology and pediatric surgery were the only nonprofitable subspecialties. In FY11, all subspecialties were profitable. Profitability was associated with case time, payor mix, and procedure type (all P profitability regardless of surgical specialty. Copyright © 2013 Mosby, Inc. All rights reserved.

  1. Analyzing profit efficiency of banks in India with undesirable output – Nerlovian profit indicator approach

    Directory of Open Access Journals (Sweden)

    A.R. Jayaraman

    2014-12-01

    Full Text Available The objective of this paper is to provide a holistic approach to measure the profit efficiency of banks, factoring desirable/undesirable outputs, using Nerlovian profit indicator approach. The profit inefficiency of banks has been decomposed into technical and allocation inefficiency using directional distance function. Results reveal that profit inefficiency of banks is primarily due to allocative inefficiency and the impact of technical inefficiency on profit inefficiency is minimal compared to allocative inefficiency, which indicates that banks need to focus on optimal utilization of input–output mix to enhance profit efficiency.

  2. The importance of working capital management for hospital profitability: evidence from bond-issuing, not-for-profit U.S. hospitals.

    Science.gov (United States)

    Rauscher, Simone; Wheeler, John R C

    2012-01-01

    Increased financial pressures on hospitals have elevated the importance of working capital management, that is, the management of current assets and current liabilities, for hospitals' profitability. Efficient working capital management allows hospitals to reduce their holdings of current assets, such as inventory and accounts receivable, which earn no interest income and require financing with short-term debt. The resulting cash inflows can be reinvested in interest-bearing financial instruments or used to reduce short-term borrowing, thus improving the profitability of the organization. This study examines the relationship between hospitals' profitability and their performance at managing two components of working capital: accounts receivable, measured in terms of hospitals' average collection periods, and accounts payable, measured in terms of hospitals' average payment periods. Panel data derived from audited financial statements for 1,397 bond-issuing, not-for-profit U.S. hospitals for 2000-2007 were analyzed using hospital-level fixed-effects regression analysis. The results show a negative relationship between hospitals' average collection period and profitability. That is, hospitals that collected on their patient revenue faster reported higher profit margins than did hospitals that have larger balances of accounts receivable outstanding. We also found a negative relationship between hospitals' average payment period and their profitability. Hospital managers did not appear to delay paying their vendors. Rather, the findings indicated that more profitable hospitals paid their suppliers faster, possibly to avoid high effective interest rates on outstanding accounts payable, whereas less profitable hospitals waited longer to pay their bills. The findings of this study suggest that working capital management indeed matters for hospitals' profitability. Efforts aimed at reducing large balances in both accounts receivable and accounts payable may frequently be

  3. Profitable tail-end production

    Energy Technology Data Exchange (ETDEWEB)

    Pinchbeck, R.H.

    1997-12-31

    This presentation discusses the origins of the present challenge faced in making mature oil fields profitable in the North Sea. It briefly examines the origins of these challenges, which are rooted in the industrial psychology of the North Sea. It develops a methodological formula for the successful re-engineering of inefficiently-run assets, focusing in particular on the personnel management aspects. It identifies some key areas to seek sustainable cost reductions and recognises the importance of renewing the context for investment in tail-end fields. Finally, it speculates about the way in which the learnings developed in the experiences of the last few years will influence the future of the North Sea. 2 refs.

  4. Profitable use of bio fuels

    Energy Technology Data Exchange (ETDEWEB)

    Ekelund, Mats [Strateco Develoment AB, Vega (Sweden)], e-mail: mats.e@strateco.se

    2012-11-01

    Traditionally, the transportation industry has been opposed to any new legislation and when rather stringent emission legislation occurred, they objected just as they did when new fuels came on the agenda. On very short notice, Taxi Stockholm lost 20 % of their business when the County decided to award all public transportation contracts to a competitor. It was time to change plans instead of complaining and to take advantage of new opportunities - 'The first mover advantage'. Making the use of bio fuels into a profitable business takes a change of a standard 'business model' to do and there is still much room others to do the same. With a new CEO, an active marketing department and active individuals among the Board of Directors, Taxi Stockholm massaged a strategy where more business and private customers would be attracted by justifying the green leaf on every cab. All initiatives were publically announced and Taxi Stockholm broke new ice by putting a ban on spike tires - a decision which the vice Mayor made part of her ruling for the whole city. The Ban on gasoline and diesel cars were announced and such a statement attracted business from a loyalty point of view and from companies that had a 'Green Transport Policy' to live up to. Taxi Stockholm has seen growth and profitability grow since and credit the green policy on bio fuels such as bio gas and ethanol for most of it. Preem, Stockholm Transit, Volvo and other market driven operators have all seen markets grow from green initiatives.

  5. The Persistence of Shocks to Profitability

    OpenAIRE

    Anita M McGahan; Porter, Michael E.

    1999-01-01

    In this study, we use data for 1981 through 1994 on a large sample of U.S. companies to examine the persistence of incremental industry, corporate-parent, and business-specific effects on profitability. Our results indicate that the incremental effects of industry on profitability persist longer than the incremental effects of the corporate parent and of the specific business. Changes in industry structure have a more persistent impact on profitability than do changes in firm structure. © 199...

  6. The Choice of For-Profit College

    OpenAIRE

    Chung, Anna

    2008-01-01

    In this paper I investigate whether students self-select into the US for-profit colleges or whether the choice of for-profit sector is accidental or due to the reasons external to the students (geographic exposure to for-profit providers, tuition pricing, or random circumstances). The main student-level data samples come from the National Education Longitudinal Study of 1988 (NELS:88) and the associated Postsecondary Education Transcript Study (PETS:2000). I estimate a multinomial logit of co...

  7. Farm profitability and Labour Use Efficiency

    OpenAIRE

    Amarender A, Reddy

    2013-01-01

    Appropriate choice of cropping systems to local agro-ecology increases profitability and employment. The increased labour shortage and reduced profitability are growing concerns to the farmers. Keeping this, the paper written with the following objectives: i) To assess the profitability among different cropping systems in the semi-arid tropics; ii) To assess the labour use pattern among different cropping systems and farm size; iii) To determine the resource use efficiency of the different cr...

  8. Differential regional gray matter volumes in patients with on-line game addiction and professional gamers

    Science.gov (United States)

    Han, Doug Hyun; Lyoo, In Kyoon; Renshaw, Perry F.

    2015-01-01

    Patients with on-line game addiction (POGA) and professional video game players play video games for extended periods of time, but experience very different consequences for their on-line game play. Brain regions consisting of anterior cingulate, thalamus and occpito-temporal areas may increase the likelihood of becoming a pro-gamer or POGA. Twenty POGA, seventeen pro-gamers, and eighteen healthy comparison subjects (HC) were recruited. All magnetic resonance imaging (MRI) was performed on a 1.5 Tesla Espree MRI scanner (SIEMENS, Erlangen, Germany). Voxel-wise comparisons of gray matter volume were performed between the groups using the two-sample t-test with statistical parametric mapping (SPM5). Compared to HC, the POGA group showed increased impulsiveness and perseverative errors, and volume in left thalamus gray matter, but decreased gray matter volume in both inferior temporal gyri, right middle occipital gyrus, and left inferior occipital gyrus, compared with HC. Pro-gamers showed increased gray matter volume in left cingulate gyrus, but decreased gray matter volume in left middle occipital gyrus and right inferior temporal gyrus compared with HC. Additionally, the pro-gamer group showed increased gray matter volume in left cingulate gyrus and decreased left thalamus gray matter volume compared with the POGA group. The current study suggests that increased gray matter volumes of the left cingulate gyrus in pro-gamers and of the left thalamus in POGA may contribute to the different clinical characteristics of pro-gamers and POGA. PMID:22277302

  9. Online Social Support for Patients with Multiple Sclerosis: A Thematic Analysis of Messages Posted to a Virtual Support Community

    Directory of Open Access Journals (Sweden)

    Masoumeh Abbasi Shavazi

    2016-07-01

    Full Text Available Background: Currently with the emergence of the Internet, patients have an opportunity to exchange social support online. However, little attention has been devoted to different dimensions of online social support exchanged in virtual support communities for patients with multiple sclerosis (MS. Methods: To provide a rich insight, the aim of this qualitative study was to explore and categorize different dimensions of online social support in messages exchanged in a virtual support community for patients with MS. A total of 548 posted messages created during one year period were selected using purposive sampling to consider the maximum variation sampling. Prior-research-driven thematic analysis was then conducted. In this regard, we used the Cutruna and Suhr’s coding system. The messages that could not be categorized with the used coding system were thematically analyzed to explore new additional social support themes. Results: The results showed that various forms of social support including informational, emotional, network, esteem and tangible support were exchanged. Moreover, new additional social support themes including sharing personal experiences, sharing coping strategies and spiritual support emerged in this virtual support community. Conclusion: The wide range of online social support exchanged in the virtual support community can be regarded as a supplementary source of social support for patients with MS. Future researches can examine online social support more comprehensively considering additional social support themes emerging in the present study.

  10. Emissions trading and profit-neutral grandfathering

    Energy Technology Data Exchange (ETDEWEB)

    Hepburn, Cameron; Ritz, Robert; Quah, John (Oxford Univ., Smith School of Enterprise and the Environment, Oxford (United Kingdom))

    2008-07-01

    This paper examines the amount of grandfathering needed for an emissions trading scheme (ETS) to have a neutral impact on firm profits. We provide a simple formula to calculate profit-neutral grandfathering in an asymmetric Cournot model with a general demand function. Using this formula, we obtain estimates of profit-neutral grandfathering for the electricity, cement, newsprint and steel industries. Under the current EU ETS, firms obtain close to full grandfathering. We find no evidence that any industry as a whole could be worse off with full grandfathering. We also show that the common presumption that a higher rate of cost pass-through lowers profit-neutral grandfathering is unreliable

  11. 'What else can I do?': Insights from atrial fibrillation patient communication online.

    Science.gov (United States)

    Redman, Kirsten; Thorne, Sally; Lauck, Sandra B; Taverner, Tarnia

    2017-03-01

    Many patients with atrial fibrillation experience uncertainty and psychological distress. Internet support groups for atrial fibrillation have yet to be studied. To determine the content and dialogue on an online message board for atrial fibrillation with the purpose of elucidating information and support needs from patient perspectives. Interpretative description methodology was undertaken to explore conversation from a publicly available website for atrial fibrillation over a 3-month period. Individuals interacted with the message board to make sense of their atrial fibrillation events by sharing experiences with medications, complementary and alternative medicine, trigger avoidance and ablation. The opinions of lay experts on the message board, anecdotal stories and hyperlinked Internet data were all highly valued sources of information in the messages. Using the learning gained from the board, individuals proceeded with strategies to treat their atrial fibrillation, often in a trial and error fashion. Throughout the process, individuals came back to the board, to update on their progress and gain assistance from others. The studied atrial fibrillation population had unmet needs for education regarding non-pharmacological approaches to treat atrial fibrillation. In the absence of opportunity to discuss these needs with healthcare professionals, patients may be vulnerable to unproved approaches advocated by Internet peers. Further research is suggested to examine the prevalence of complementary and alternative medicine use in the atrial fibrillation population and to understand better how social media can be utilised to support atrial fibrillation patients.

  12. Uterine Artery Embolization: An Analysis of Online Patient Information Quality and Readability with Historical Comparison.

    Science.gov (United States)

    Murray, Timothy E; Mansoor, Tayyaub; Bowden, Dermot J; O'Neill, Damien C; Lee, Michael J

    2018-01-10

    Investigators aimed to assess online information describing uterine artery embolization (UAE) to examine the quality and readability of websites patients are accessing. A list of applicable, commonly used searchable terms was generated, including "Uterine Artery Embolization," "Fibroid Embolization," "Uterine Fibroid Embolization," and "Uterine Artery Embolisation." Each possible term was assessed across the five most-used English language search engines to determine the most commonly used term. The most common term was then investigated across each search engine, with the first 25 pages returned by each engine included for analysis. Duplicate pages, nontext content such as video or audio, and pages behind paywalls were excluded. Pages were analyzed for quality and readability using validated tools including DISCERN score, JAMA Benchmark Criteria, HONcode Certification, Flesch Reading Ease Score, Flesch-Kincaid Grade Level, and Gunning-Fog Index. Secondary features such as age, rank, author, and publisher were recorded. The most common applicable term was "Uterine Artery Embolization" (492,900 results). Mean DISCERN quality of information provided by UAE websites is "fair"; however, it has declined since comparative 2012 studies. Adherence to JAMA Benchmark Criteria has reduced to 6.7%. UAE website readability remains more difficult than the World Health Organization-recommended 7-8th grade reading levels. HONcode-certified websites (35.6%) demonstrated significantly higher quality than noncertified websites. Quality of online UAE information remains "fair." Adherence to JAMA benchmark criteria is poor. Readability is above recommended 7-8th grade levels. HONcode certification was predictive of higher website quality, a useful guide to patients requesting additional information. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  13. Health outcomes in patients using no-prescription online pharmacies to purchase prescription drugs.

    Science.gov (United States)

    Cicero, Theodore J; Ellis, Matthew Stephen

    2012-12-06

    Many prescription drugs are freely available for purchase on the Internet without a legitimate prescription from a physician. This study focused on the motivations for using no-prescription online pharmacies (NPOPs) to purchase prescription drugs rather than using the traditional doctor-patient-pharmacy model. We also studied whether users of NPOP-purchased drugs had poorer health outcomes than those who obtain the same drug through legitimate health care channels. We selected tramadol as a representative drug to address our objective because it is widely prescribed as an unscheduled opioid analgesic and can easily be purchased from NPOPs. Using search engine marketing (SEM), we placed advertisements on search result pages stemming from the keyword "tramadol" and related terms and phrases. Participants, who either used the traditional doctor-patient-pharmacy model to obtain tramadol (traditional users, n = 349) or purchased it on the Web without a prescription from their local doctor (ie, nontraditional users, n = 96), were then asked to complete an online survey. Respondents in both groups were primarily white, female, and in their mid-forties (nontraditional users) to upper forties (traditional users). Nearly all nontraditional users indicated that their tramadol use was motivated by a need to treat pain (95%, 91/96) that they perceived was not managed appropriately through legitimate health care channels. A majority of nontraditional users (55%, 41/75) indicated they used NPOPs because they did not have access to sufficient doses of tramadol to relieve pain. In addition, 29% (22/75) of nontraditional users indicated that the NPOPs were a far cheaper alternative than seeing a physician, paying for an office visit, and filling a prescription at a local pharmacy, which is often at noninsured rates for those who lack medical insurance (37%, 35/96, of NPOP users). The remainder of participants (16%, 12/96) cited other motivations (eg, anonymity) for using NPOPs. In

  14. Assessing the standards of online oral hygiene instructions for patients with fixed orthodontic appliances.

    Science.gov (United States)

    Verhoef, Willem A; Livas, Christos; Delli, Konstantina; Ren, Yijin

    2015-05-01

    The authors conducted this study to assess the quality of the information available on the Web about oral hygiene for patients with fixed orthodontic appliances. The authors entered the search terms "cleaning braces," "brushing braces," and "oral hygiene and braces" into Google, Yahoo, and Bing search engines. They analyzed Web sites satisfying the inclusion criteria from the first 20 hits of each search for accessibility, usability, and reliability by using the LIDA instrument; for readability by using the Flesch Reading Ease (FRE) score; and for the completeness of oral hygiene instructions. Sixty-two Web sites met the inclusion criteria. The mean total LIDA score of 71.2 indicated the moderate quality of the design of the reviewed Web sites. The mean (standard deviation [SD]) values of LIDA scores for accessibility, usability, and reliability were 85.9 (7.0), 63.4 (16.1), and 48.0 (10.4), respectively. The mean (SD) FRE Score of 68.6 (9.7) applied to standard reading skills. The completeness of information (mean [SD] = 67.1 [27.8]) presented the highest variability. Overall, the authors found that the standards of online oral hygiene materials for orthodontic patients with fixed appliances exhibited modest scores. Readability appeared to be appropriate for young adolescents, whereas the comprehensiveness of the displayed information was highly variable. Further improvement of the infrastructure of electronic health information (that is, e-health) in orthodontics is necessary to meet patients' needs. Given the moderate quality of oral hygiene instruction available on the Web for patients with fixed appliances, orthodontic patients and caregivers should be cautious when browsing the Internet for relevant information. Dental professionals should refer patients to valid Web-based educational materials. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  15. Online discourse on fibromyalgia: text-mining to identify clinical distinction and patient concerns.

    Science.gov (United States)

    Park, Jungsik; Ryu, Young Uk

    2014-10-07

    The purpose of this study was to evaluate the possibility of using text-mining to identify clinical distinctions and patient concerns in online memoires posted by patients with fibromyalgia (FM). A total of 399 memoirs were collected from an FM group website. The unstructured data of memoirs associated with FM were collected through a crawling process and converted into structured data with a concordance, parts of speech tagging, and word frequency. We also conducted a lexical analysis and phrase pattern identification. After examining the data, a set of FM-related keywords were obtained and phrase net relationships were set through a web-based visualization tool. The clinical distinction of FM was verified. Pain is the biggest issue to the FM patients. The pains were affecting body parts including 'muscles,' 'leg,' 'neck,' 'back,' 'joints,' and 'shoulders' with accompanying symptoms such as 'spasms,' 'stiffness,' and 'aching,' and were described as 'sever,' 'chronic,' and 'constant.' This study also demonstrated that it was possible to understand the interests and concerns of FM patients through text-mining. FM patients wanted to escape from the pain and symptoms, so they were interested in medical treatment and help. Also, they seemed to have interest in their work and occupation, and hope to continue to live life through the relationships with the people around them. This research shows the potential for extracting keywords to confirm the clinical distinction of a certain disease, and text-mining can help objectively understand the concerns of patients by generalizing their large number of subjective illness experiences. However, it is believed that there are limitations to the processes and methods for organizing and classifying large amounts of text, so these limits have to be considered when analyzing the results. The development of research methodology to overcome these limitations is greatly needed.

  16. Development and Validation of an Online Program for Promoting Self-Management among Korean Patients with Chronic Hepatitis B

    Directory of Open Access Journals (Sweden)

    Jinhyang Yang

    2013-01-01

    Full Text Available The hepatitis B virus is second only to tobacco as a known human carcinogen. However, chronic hepatitis B usually does not produce symptoms and people feel healthy even in the early stages of live cancer. Therefore, chronically infected people should perceive it as a serious health problem and move on to appropriate health behaviour. The purpose of this paper is to develop and validate an online program for promoting self-management among Korean patients with chronic hepatitis B. The online program was developed using a prototyping approach and system developing life cycle method, evaluated by users for their satisfaction with the website and experts for the quality of the site. To evaluate the application of the online program, knowledge and self-management compliance of the subjects were measured and compared before and after the application of the online program. There were statistically significant increases in knowledge and self-management compliance in the user group. An online program with high accessibility and applicability including information, motivation, and behavior skill factors can promote self-management of the patient with chronic hepatitis B. Findings from this study allow Korean patients with chronic hepatitis B to engage in proactive and effective health management in the community or clinical practice.

  17. Development and Validation of an Online Program for Promoting Self-Management among Korean Patients with Chronic Hepatitis B.

    Science.gov (United States)

    Yang, Jinhyang

    2013-01-01

    The hepatitis B virus is second only to tobacco as a known human carcinogen. However, chronic hepatitis B usually does not produce symptoms and people feel healthy even in the early stages of live cancer. Therefore, chronically infected people should perceive it as a serious health problem and move on to appropriate health behaviour. The purpose of this paper is to develop and validate an online program for promoting self-management among Korean patients with chronic hepatitis B. The online program was developed using a prototyping approach and system developing life cycle method, evaluated by users for their satisfaction with the website and experts for the quality of the site. To evaluate the application of the online program, knowledge and self-management compliance of the subjects were measured and compared before and after the application of the online program. There were statistically significant increases in knowledge and self-management compliance in the user group. An online program with high accessibility and applicability including information, motivation, and behavior skill factors can promote self-management of the patient with chronic hepatitis B. Findings from this study allow Korean patients with chronic hepatitis B to engage in proactive and effective health management in the community or clinical practice.

  18. Quality of care in nursing homes: an analysis of relationships among profit, quality, and ownership.

    Science.gov (United States)

    O'Neill, Ciaran; Harrington, Charlene; Kitchener, Martin; Saliba, Debra

    2003-12-01

    Recent work has highlighted a negative correlation between proprietary status and nursing home quality of care. This relationship might be explained by the context in which proprietary homes operate. However, another possible explanation is that some proprietary homes take excessive profit to the detriment of care quality. To examine the relationship between profit levels and quality in proprietary and nonproprietary nursing homes (NHs), accounting for resident and market characteristics. Data on 1098 free-standing NHs were taken from the California Office of Statewide Health Planning and Development, the On-line Survey Certification and Reporting System, and California licensing and statistical reports for 1998 and 1999. Tobit multivariate techniques were used to examine the relationship between deficiency citations and a range of explanatory variables, including profit. Proprietary homes in California had significantly lower quality of care than nonproprietary homes. A stratified analysis revealed that, controlling for resident, facility, and market characteristics, profits located within the highest 14% of the proprietary sector's profit distribution were associated with significantly more total deficiencies and serious deficiencies. This relationship was not found in nonproprietary facilities. Other factors related to deficiencies included the ethnic mix of residents and facility size. Within the context in which proprietary homes operate, profit above a given threshold is associated with a higher number of deficiencies. Given this and the role of the proprietary sector in NH care, careful monitoring of profit levels in this sector appears warranted.

  19. Web portals in primary care: an evaluation of patient readiness and willingness to pay for online services.

    Science.gov (United States)

    Adler, Kenneth G

    2006-10-26

    Online Web communication between physician and patient has been proposed by leading primary care organizations as a way to enhance physician-patient communication, but lack of payment for this service has acted as a significant barrier to implementation. This study evaluates current patient readiness and willingness to pay for online services in a fairly typical urban family medicine practice. All patients that visited the author for medical care during a one-month period in the spring of 2006 were anonymously surveyed with a one-page survey instrument that inquired about demographics, willingness to pay a small annual fee for online services, the greatest fee they were willing to pay, and their most desired service. A total of 346 patients out of 2380 active patients in the study practice (14.5%) were surveyed. The valid survey response rate was 95.1% (329/346.) Three quarters, or 75.4%, of patients had Internet access. The group with the highest access were 18- to 29-year-olds (97%), and the group with the least access were those 70 years and up (56%) (P online services: viewing of parts of their medical record, messaging with their physician, medication refills, appointment requests, and billing inquiries. Willingness to pay did not vary significantly by age (P = .06). Of all respondents, regardless of Internet access, 47.1% (n = 155) were willing to pay US $10 or more per year, with the median amount being US $20. Of those with Internet access (n = 248), 60.1% (n = 149) were willing to pay US $10 or more per year, and 31% were willing to pay US $50 or more per year. The three most important services to patients with Internet access (n = 248), in order of importance, were emailing with their physician (34%), Internet viewing of their medical record (22%), and medication refills (11%) (P online services with their primary care physician's office. If 47.1% of a practice of 2500 patients each paid US $10 per year for online services, the annual revenue generated

  20. Bundling and pricing for information brokerage: customer satisfaction as a means to profit optimization

    OpenAIRE

    Somefun, Koye; La Poutré, Han

    2003-01-01

    textabstractTraditionally, the study of on-line dynamic pricing and bundling strategies for information goods is motivated by the value-extracting or profit-generating potential of these strategies. In this paper we discuss the relatively overlooked potential of these strategies to on-line learn more about customers' preferences. Based on this enhanced customer knowledge an information broker can-- by tailoring the brokerage services more to the demand of the various customer groups-- persuad...

  1. Health Social Networks as Online Life Support Groups for Patients With Cardiovascular Diseases

    Energy Technology Data Exchange (ETDEWEB)

    Medina, Edhelmira Lima, E-mail: edhyly@ic.uff.br; Loques, Orlando Filho [Instituto de Computação - Universidade Federal Fluminense, Niterói, RJ (Brazil); Mesquita, Cláudio Tinoco [Hospital Universitário Antônio Pedro - Universidade Federal Fluminense, Niterói, RJ (Brazil)

    2013-08-15

    The number of patients who use the internet in search for information that might improve their health conditions has increased. Among them, those looking for virtual environments to share experiences, doubts, opinions, and emotions, and to foster relationships aimed at giving and getting support stand out. Therefore, there is an increasing need to assess how those environments can affect the patients' health. This study was aimed at identifying scientific studies on the proliferation and impact of virtual communities, known as health social networks or online support groups, directed to cardiovascular diseases, which might be useful to patients with certain conditions, providing them with information and emotional support. A systematic review of the literature was conducted with articles published from 2007 to 2012, related to cardiovascular diseases and collected from the following databases: PubMed; Association for Computing Machinery(ACM); and Institute of Electrical and Electronics Engineers (IEEE). Four articles meeting the inclusion criteria were selected. The results were interesting and relevant from the health viewpoint, identifying therapeutic benefits, such as provision of emotional support, greater compliance to treatment, and information sharing on diseases and on life experiences.

  2. Online communication in a rehabilitation setting: Experiences of patients with chronic conditions using a web portal in Denmark

    DEFF Research Database (Denmark)

    Cerdan de Las Heras, Jose Manuel; Catalan-Matamoros, Daniel; Warny, Sarah

    2017-01-01

    Abstract Objective To gain insight into the experiences of patients with long-term conditions enrolled in an online rehabilitation programme using a web portal. Methods Danish outpatients were recruited from a rehabilitation department and were granted access to a web portal which included...... an online rehabilitation programme with key information, clinical advice, and self-management activities. After two weeks, patients were invited to participate in focus groups. A topic guide was used to explore this new online rehabilitation programme in relation to participants’ experiences. Results...... Fourteen participants, ranging from 42 to 72 years old, were allocated into three focus groups. Participants mainly reported negative experiences by the following four themes: ‘patients’ experiences’, ‘technical aspects’, ‘areas for improvement’, and ‘digitalization added value’. Conclusion Participants...

  3. Uncompensated care provided by for-profit, not-for-profit, and government owned hospitals.

    Science.gov (United States)

    Cram, Peter; Bayman, Levent; Popescu, Ioana; Vaughan-Sarrazin, Mary S; Cai, Xueya; Rosenthal, Gary E

    2010-04-07

    There is growing concern certain not-for-profit hospitals are not providing enough uncompensated care to justify their tax exempt status. Our objective was to compare the amount of uncompensated care provided by not-for-profit (NFP), for-profit (FP) and government owned hospitals. We used 2005 state inpatient data (SID) for 10 states to identify patients hospitalized for three common conditions: acute myocardial infarction (AMI), coronary artery bypass grafting (CABG), or childbirth. Uncompensated care was measured as the proportion of each hospital's total admissions for each condition that were classified as being uninsured. Hospitals were categorized as NFP, FP, or government owned based upon data obtained from the American Hospital Association. We used bivariate methods to compare the proportion of uninsured patients admitted to NFP, FP and government hospitals for each diagnosis. We then used generalized linear mixed models to compare the percentage of uninsured in each category of hospital after adjusting for the socioeconomic status of the markets each hospital served. Our cohort consisted of 188,117 patients (1,054 hospitals) hospitalized for AMI, 82,261 patients (245 hospitals) for CABG, and 1,091,220 patients for childbirth (793 hospitals). The percentage of admissions classified as uninsured was lower in NFP hospitals than in FP or government hospitals for AMI (4.6% NFP; 6.0% FP; 9.5% government; P NFP; 3.3% FP; 7.0% government; P NFP; 4.2% FP; 11.8% government; P NFP and FP hospitals (4.4% vs. 4.3%; P = 0.71), and higher for government hospitals (6.0%; P NFP vs. government). Likewise, results demonstrated similar proportions of uninsured patients in NFP and FP hospitals and higher levels of uninsured in government hospitals for both CABG and childbirth. For the three conditions studied NFP and FP hospitals appear to provide a similar amount of uncompensated care while government hospitals provide significantly more. Concerns about the amount of

  4. Education for Profit, Education for Freedom

    Science.gov (United States)

    Nussbaum, Martha C.

    2009-01-01

    Education is often discussed in low-level utilitarian terms: how can educators produce technically trained people who can hold onto "their" share of the global market? With the rush to profitability, values precious for the future of democracy are in danger of getting lost. The profit motive suggests to most concerned politicians that science and…

  5. Corporate Social Responsibility and Profit Maximizing Behaviour

    OpenAIRE

    Becchetti, Leonardo; Giallonardo, Luisa; Tessitore, Maria Elisabetta

    2005-01-01

    We examine the behavior of a profit maximizing monopolist in a horizontal differentiation model in which consumers differ in their degree of social responsibility (SR) and consumers SR is dynamically influenced by habit persistence. The model outlines parametric conditions under which (consumer driven) corporate social responsibility is an optimal choice compatible with profit maximizing behavior.

  6. Price Discrimination, Economies of Scale, and Profits.

    Science.gov (United States)

    Park, Donghyun

    2000-01-01

    Demonstrates that it is possible for economies of scale to induce a price-discriminating monopolist to sell in an unprofitable market where the average cost always exceeds the price. States that higher profits in the profitable market caused by economies of scale may exceed losses incurred in the unprofitable market. (CMK)

  7. Cooperation and profit allocation in distribution chains

    NARCIS (Netherlands)

    Guardiola, Luis A.; Meca, Ana; Timmer, Judith B.

    2007-01-01

    We study the coordination of actions and the allocation of profit in supply chains under decentralized control in which a single supplier supplies several retailers with goods for replenishment of stocks. The goal of the supplier and the retailers is to maximize their individual profits. Since the

  8. Risk Management And Organisational Profitability | Ukandu ...

    African Journals Online (AJOL)

    The level of growth and profit maximization in the oil industry has been impaired by a lot of risks. Risk control measures and effective plan are used to reduce the occurrence of such risks. Also, proper risk evaluation techniques are used to evaluate the cost implication of risk on production and the profitability level of such ...

  9. Will farm profits shift in 2013?

    OpenAIRE

    Nathan Kauffman

    2012-01-01

    Despite a severe drought, profits in the U.S. farm sector soared in 2012. Beginning in late June, U.S. crops and pastures wilted under one of the worst droughts in history. Although total farm incomes remained high, the drought exacerbated a widening gulf in profitability between the crop and livestock sectors.

  10. relating customer satisfaction to customer profitability

    African Journals Online (AJOL)

    PROF EKWUEME

    carried out by marketing scholars. This is not likely to advance marketing theory. After all, accounting to profitability lies at the heart of the marketing concept, Kohli & Jaworski (1990:1-18) and Narver and Slater (1990:35). Similarly, according to Buttle (1996) marketing's link to profitability is stressed in the definitions of.

  11. Factors Influencing Patients' Perspectives of Radiology Imaging Centers: Evaluation Using an Online Social Media Ratings Website.

    Science.gov (United States)

    Doshi, Ankur M; Somberg, Molly; Rosenkrantz, Andrew B

    2016-02-01

    The goal of this study was to use patient reviews posted on Yelp.com, an online ratings website, to identify factors most commonly associated with positive versus negative patient perceptions of radiology imaging centers across the United States. A total of 126 outpatient radiology centers from the 46 largest US cities were identified using Yelp.com; 1,009 patient reviews comprising 2,582 individual comments were evaluated. Comments were coded as pertaining to either the radiologist or other service items, and as expressing either a positive or negative opinion. Distribution of comments was compared with center ratings using Fisher's exact test. Overall, 14% of comments were radiologist related; 86% pertained to other aspects of service quality. Radiologist-related negative comments more frequent in low-performing centers (mean rating ≤2 on 1-5 scale) than high-performing centers (rating ≥4) pertained to imaging equipment (25% versus 7%), report content (25% versus 2%), and radiologist professionalism (25% versus 2%) (P negative comments more frequent in low-performing centers pertained to receptionist professionalism (70% versus 21%), billing (65% versus 10%), wait times (60% versus 26%), technologist professionalism (55% versus 12%), scheduling (50% versus 17%), and physical office conditions (50% versus 5%) (P < .020). Positive comments more frequent in high-performing centers included technologist professionalism (98% versus 55%), receptionist professionalism (79% versus 50%), wait times (72% versus 40%), and physical office conditions (64% versus 25%) (P < .020). Patients' perception of radiology imaging centers is largely shaped by aspects of service quality. Schedulers, receptionists, technologists, and billers heavily influence patient satisfaction in radiology. Thus, radiologists must promote a service-oriented culture throughout their practice. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  12. A longitudinal analysis of the impact of hospital service line profitability on the likelihood of readmission.

    Science.gov (United States)

    Navathe, Amol S; Volpp, Kevin G; Konetzka, R Tamara; Press, Matthew J; Zhu, Jingsan; Chen, Wei; Lindrooth, Richard C

    2012-08-01

    Quality of care may be linked to the profitability of admissions in addition to level of reimbursement. Prior policy reforms reduced payments that differentially affected the average profitability of various admission types. The authors estimated a Cox competing risks model, controlling for the simultaneous risk of mortality post discharge, to determine whether the average profitability of hospital service lines to which a patient was admitted was associated with the likelihood of readmission within 30 days. The sample included 12,705,933 Medicare Fee for Service discharges from 2,438 general acute care hospitals during 1997, 2001, and 2005. There was no evidence of an association between changes in average service line profitability and changes in readmission risk, even when controlling for risk of mortality. These findings are reassuring in that the profitability of patients' admissions did not affect readmission rates, and together with other evidence may suggest that readmissions are not an unambiguous quality indicator for in-hospital care.

  13. ROMANIAN INVESTORS PORTFOLIO. ONLINE VERSUS ASSISTED TRADING

    Directory of Open Access Journals (Sweden)

    Ioana Ancuţa IANCU

    2017-05-01

    Full Text Available One of the most important aspects in deciding to trade online, alone, without the help of a broker, is the portfolio profitability. In this study, using the personal experience, survey data and secondary sources, we identify some factors that may influence the gain and the loss of investors which trade online. Our study contradicts other results from literature that claim that the transition from assisted to online trading is a big drawback in terms of portfolio profitability. By analyzing the performance of the portfolio when passing from assisted to online trading, we observe that half of the investors achieved identical profitability. We also observed that the efficiency of the portfolios belonging to the online investors that were assisted in the past by a broker for a short period, is lower compared to the ones assisted (in the past for a longer period.

  14. Online detection of tonic-clonic seizures in pediatric patients using ECG and low-complexity incremental novelty detection.

    Science.gov (United States)

    De Cooman, Thomas; Van de Vel, Anouk; Ceulemans, Berten; Lagae, Lieven; Vanrumste, Bart; Van Huffel, Sabine

    2015-08-01

    Home monitoring of refractory epilepsy patients has become of more interest the last couple of decades. A biomedical signal that can be used for online seizure detection at home is the electrocardiogram. Previous studies have shown that tonic-clonic seizures are most often accompanied with a strong heart rate increase. The main issue however is the strong patient-specific behavior of the ictal heart rate features, which makes it hard to make a patient-independent seizure detection algorithm. A patient-specific algorithm might be a solution, but existing methods require the availability of data of several seizures, which would make them inefficient in case the first seizure only occurs after a couple of days. Therefore an online method is described here that automatically converts from a patient-independent towards a patient-specific algorithm as more patient-specific data become available. This is done by using online feedback from the users to previously given alarms. By using a simplified one-class classifier, no seizure training data needs to be available for a good performance. The method is already able to adapt to the patient-specific characteristics after a couple of hours, and is able to detect 23 of 24 seizures longer than 10s, with an average of 0.38 false alarms per hour. Due to its low-complexity, it can be easily used for wearable seizure detection at home.

  15. Determinants of Iranian bank profitability

    Directory of Open Access Journals (Sweden)

    Hassan Ghodrati

    2014-04-01

    Full Text Available Banks are the most important tool for preparing and supplying money in each country. In recent years, by institution of the new private banks and privatization of the governmental banks, banking competition has become very complex. This paper performs an empirical investigation to study the effects of different factors on return on assets and return on equities on 18 selected Iranian firms over the period 2002-2011. Using different regression models, the study studies the effects of total assets, debt ratio, etc. on return of assets (ROA and return on equities (ROE on selected eighteen Iranian banks as statistical community. The study considers total assets, ownership ratio, deposits to assets ratio, and loans to assets ratio as independent variables, and ROE and ROA as dependent variables. The results indicate that the private banks returns were better than governmental banks and the commercial banks’ returns were better than special banks. There is a reverse relationship between logarithm of total assets and ownership ratio with profitability based on return of assets.

  16. Profiting from innovative user communities

    DEFF Research Database (Denmark)

    Jeppesen, Lars Bo

    Modding - the modification of existing products by consumers - is increasingly exploited by manufacturers to enhance product development and sales. In the computer games industry modding has evolved into a development model in which users act as unpaid `complementors' to manufacturers' product pl......, a manufacturer can incorporate and commercialize the best complements found in the user communities. Keywords: innovation, modding, user communities, software platform, business model. JEL code(s): L21; L23; O31; O32...... platforms. This article explains how manufacturers can profit from their abilities to organize and facilitate a process of innovation by user communities and capture the value of the innovations produced in such communities. When managed strategically, two distinct, but not mutually exclusive business...... models appear from the production of user complements: firstly, a manufacturer can let the (free) user complements `drift' in the user communities, where they increase the value to consumers of owning the given platform and thus can be expected to generate increased platform sales, and secondly...

  17. Profitability Analysis of Soybean Oil Processes

    Directory of Open Access Journals (Sweden)

    Ming-Hsun Cheng

    2017-10-01

    Full Text Available Soybean oil production is the basic process for soybean applications. Cash flow analysis is used to estimate the profitability of a manufacturing venture. Besides capital investments, operating costs, and revenues, the interest rate is the factor to estimate the net present value (NPV, break-even points, and payback time; which are benchmarks for profitability evaluation. The positive NPV and reasonable payback time represent a profitable process, and provide an acceptable projection for real operating. Additionally, the capacity of the process is another critical factor. The extruding-expelling process and hexane extraction are the two typical approaches used in industry. When the capacities of annual oil production are larger than 12 and 173 million kg respectively, these two processes are profitable. The solvent free approach, known as enzyme assisted aqueous extraction process (EAEP, is profitable when the capacity is larger than 17 million kg of annual oil production.

  18. Profitability Analysis of Soybean Oil Processes.

    Science.gov (United States)

    Cheng, Ming-Hsun; Rosentrater, Kurt A

    2017-10-07

    Soybean oil production is the basic process for soybean applications. Cash flow analysis is used to estimate the profitability of a manufacturing venture. Besides capital investments, operating costs, and revenues, the interest rate is the factor to estimate the net present value (NPV), break-even points, and payback time; which are benchmarks for profitability evaluation. The positive NPV and reasonable payback time represent a profitable process, and provide an acceptable projection for real operating. Additionally, the capacity of the process is another critical factor. The extruding-expelling process and hexane extraction are the two typical approaches used in industry. When the capacities of annual oil production are larger than 12 and 173 million kg respectively, these two processes are profitable. The solvent free approach, known as enzyme assisted aqueous extraction process (EAEP), is profitable when the capacity is larger than 17 million kg of annual oil production.

  19. An online self-care education program to support patients after total laryngectomy: feasibility and satisfaction.

    Science.gov (United States)

    Cnossen, Ingrid C; van Uden-Kraan, Cornelia F; Eerenstein, Simone E J; Jansen, Femke; Witte, Birgit I; Lacko, Martin; Hardillo, José A; Honings, Jimmie; Halmos, Gyorgy B; Goedhart-Schwandt, Noortje L Q; de Bree, Remco; Leemans, C René; Verdonck-de Leeuw, Irma M

    2016-03-01

    The purpose of this study was to investigate the feasibility of an online self-care education program supporting early rehabilitation of patients after total laryngectomy (TLPs) and factors associated with satisfaction. Health care professionals (HCPs) were invited to participate and to recruit TLPs. TLPs were informed on the self-care education program "In Tune without Cords" (ITwC) after which they gained access. A study specific survey was used (at baseline T0 and postintervention T1) on TLPs' uptake. Usage, satisfaction (general impression, willingness to use, user-friendliness, satisfaction with self-care advice and strategies, Net Promoter Score (NPS)), sociodemographic, and clinical factors were analyzed. HCPs of 6 out of 9 centers (67% uptake rate) agreed to participate and recruited TLPs. In total, 55 of 75 TLPs returned informed consent and the baseline T0 survey and were provided access to ITwC (73% uptake rate). Thirty-eight of these 55 TLPs used ITwC and completed the T1 survey (69% usage rate). Most (66%) TLPs were satisfied (i.e., score ≥7 (scale 1-10) on 4 survey items) with the self-care education program (mean score 7.2, SD 1.1). NPS was positive (+5). Satisfaction with the self-care education program was significantly associated with (higher) educational level and health literacy skills (P = .004, P = .038, respectively). No significant association was found with gender, age, marital status, employment status, Internet use, Internet literacy, treatment modality, time since total laryngectomy, and quality of life. The online self-care education program ITwC supporting early rehabilitation was feasible in clinical practice. In general, TLPs were satisfied with the program.

  20. Differential regional gray matter volumes in patients with on-line game addiction and professional gamers.

    Science.gov (United States)

    Han, Doug Hyun; Lyoo, In Kyoon; Renshaw, Perry F

    2012-04-01

    Patients with on-line game addiction (POGA) and professional video game players play video games for extended periods of time, but experience very different consequences for their on-line game play. Brain regions consisting of anterior cingulate, thalamus and occpito-temporal areas may increase the likelihood of becoming a pro-gamer or POGA. Twenty POGA, seventeen pro-gamers, and eighteen healthy comparison subjects (HC) were recruited. All magnetic resonance imaging (MRI) was performed on a 1.5 Tesla Espree MRI scanner (SIEMENS, Erlangen, Germany). Voxel-wise comparisons of gray matter volume were performed between the groups using the two-sample t-test with statistical parametric mapping (SPM5). Compared to HC, the POGA group showed increased impulsiveness and perseverative errors, and volume in left thalamus gray matter, but decreased gray matter volume in both inferior temporal gyri, right middle occipital gyrus, and left inferior occipital gyrus, compared with HC. Pro-gamers showed increased gray matter volume in left cingulate gyrus, but decreased gray matter volume in left middle occipital gyrus and right inferior temporal gyrus compared with HC. Additionally, the pro-gamer group showed increased gray matter volume in left cingulate gyrus and decreased left thalamus gray matter volume compared with the POGA group. The current study suggests that increased gray matter volumes of the left cingulate gyrus in pro-gamers and of the left thalamus in POGA may contribute to the different clinical characteristics of pro-gamers and POGA. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Do videos improve website satisfaction and recall of online cancer-related information in older lung cancer patients?

    NARCIS (Netherlands)

    Bol, N.; Smets, E.M.A.; Rutgers, M.M.; Burgers, J.A.; de Haes, H.C.J.M.; Loos, E.F.; van Weert, J.C.M.

    2013-01-01

    Objective This study investigated the effects of personalized audiovisual information in addition to text on website satisfaction and recall of cancer-related online information in older lung cancer patients. Methods An experiment using a 3 (condition: text only vs. text with nonpersonalized video

  2. The Difference in the Online Medical Information Searching Behaviors of Hospital Patients and Their Relatives versus the General Public

    Science.gov (United States)

    Wang, Hung-Yuan; Liang, Jyh-Chong; Tsai, Chin-Chung

    2014-01-01

    The purpose of this study is two-fold: to explore the differences in online medical information searching behaviors, including evaluative standards and search strategies, of the general public (general group) and those of hospital patients and their relatives (hospital group); and to compare the predictive relationship between the evaluative…

  3. Online social network use by health care providers in a high traffic patient care environment.

    Science.gov (United States)

    Black, Erik; Light, Jennifer; Paradise Black, Nicole; Thompson, Lindsay

    2013-05-17

    The majority of workers, regardless of age or occupational status, report engaging in personal Internet use in the workplace. There is little understanding of the impact that personal Internet use may have on patient care in acute clinical settings. The objective of this study was to investigate the volume of one form of personal Internet use-online social networking (Facebook)-generated by workstations in the emergency department (ED) in contrast to measures of clinical volume and severity. The research team analyzed anonymous network utilization records for 68 workstations located in the emergency medicine department within one academic medical center for 15 consecutive days (12/29/2009 to 1/12/2010). This data was compared to ED work index (EDWIN) data derived by the hospital information systems. Health care workers spent an accumulated 4349 minutes (72.5 hours) browsing Facebook, staff cumulatively visited Facebook 9369 times and spent, on average, 12.0 minutes per hour browsing Facebook. There was a statistically significant difference in the time spent on Facebook according to time of day (19.8 minutes per hour versus 4.3 minutes per hour, P<.001). There was a significant, positive correlation between EDWIN scores and time spent on Facebook (r=.266, P<.001). Facebook use constituted a substantive percentage of staff time during the 15-day observation period. Facebook use increased with increased patient volume and severity within the ED.

  4. The Prevalence of Online Health Information Seeking Among Patients in Scotland: A Cross-Sectional Exploratory Study.

    Science.gov (United States)

    Moreland, Julia; French, Tara L; Cumming, Grant P

    2015-07-15

    Online health information seeking is an activity that needs to be explored in Scotland. While there are a growing number of studies that adopt a qualitative approach to this issue and attempt to understand the behaviors associated with online health information seeking, previous studies focusing on quantifying the prevalence and pattern of online health seeking in the United Kingdom have been based on Internet users in general. This exploratory study sought to describe the prevalence of online health information seeking in a rural area of Scotland based on primary data from a patient population. A survey design was employed utilizing self-completed questionnaires, based on the Pew Internet and American Life Project; questionnaires were distributed among adult patients in 10 primary care centers in a rural community in Scotland. A convenience sample of 571 (0.10% of the total population in Grampian, N=581,198) patients completed the questionnaire. A total of 68.4% (379/554) of patients had previously used the Internet to acquire health information. A total of 25.4% (136/536) of patients consulted the Internet for health information regarding their current appointment on the day surveyed; 34.6% (47/136) of these patients were influenced to attend their appointment as a result of that online health information. A total of 43.2% (207/479) of patients stated the health information helped improve their health and 67.1% (290/432) indicated that they had learned something new. A total of 34.0% (146/430) of patients talked to a health professional about the information they had found and 90.0% (376/418) reported that the information was useful. In total, 70.4% (145/206) of patients were concerned about obtaining health information online from reliable sources. A total of 67.1% (139/207) of patients were concerned that a health site may sell their personal information, yet only 6.7% (36/535) checked the privacy policy of the site visited. However, 27.9% (55/197) of patients

  5. New high profitable wind turbines

    Energy Technology Data Exchange (ETDEWEB)

    Frankovic, Bernard [Rijeka Univ., Faculty of Engineering, Rijeka (Croatia); Vrsalovic, Ivan [Rijekaprojekt d.o.o., Rijeka (Croatia)

    2001-11-01

    To generate more quantities of electric energy from wind it is necessary to use a new type of wind turbine built in the regulable mantle's nozzle. This wind turbine type replaces the free air stream from wind by a programmed, i.e. regulated, and partially concentrated stream of air. The nozzle shell is designed as an aerodynamically shaped ring with wings with its lower pressure side pointed towards the centre so that the lift force on each part of the wing is directed radially towards the centre. This induces centrifugal reaction force in the airflow that causes the stream field to expand strongly downstream of the rotor and includes a greater number of streamlines in the active stream in front of the rotor (upstream). Thus the nozzle forces a higher mass flow rate of air through the turbine. The higher mass flow and higher velocity reduction behind the rotor result in a higher energy output from the wind turbine in the nozzle. In this way the wind turbine efficiency is multiplied. New turbines induce more power from weaker and medium winds and their lasting time, because of the relation p = f(v{sup 3}) (i.e. the power corresponds to wind velocity raised to third power). Wind turbine nozzle produces three times more energy than conventional wind turbine. Short economic analysis for conditions of the island of Lastovo indicates that profit gained by new turbines is up to five times higher than by conventional turbines. The new wind turbine nozzle should generate interest and demand on an international market, even for regions with weaker winds. (Author)

  6. Emotional approach coping and the effects of online peer-led support group participation among patients with breast cancer: a longitudinal study

    NARCIS (Netherlands)

    Batenburg, A.E.; Das, E.

    2014-01-01

    Background: Previous research on the effects of online peer support on psychological well-being of patients with cancer showed mixed findings. There is a need for longitudinal studies explaining if and when online peer-led support groups are beneficial. How patients cope with emotions that come

  7. Hospital financial management: what is the link between revenue cycle management, profitability, and not-for-profit hospitals' ability to grow equity?

    Science.gov (United States)

    Singh, Simone Rauscher; Wheeler, John

    2012-01-01

    Effective revenue cycle management--from appointment scheduling and patient registration at the front end of the revenue cycle to billing and cash collections at the back end--plays a crucial role in hospitals' efforts to improve their financial performance. Using data for 1,397 bond-issuing, not-for-profit US hospitals for 2000 to 2007, this study analyzed the relationship between hospitals' performance at managing the revenue cycle and their profitability and ability to build equity capital. Hospital-level fixed effects regression analysis was used to model four different measures of profitability and equity capital as functions of two key financial indicators of revenue cycle management--amount of patient revenue and speed of revenue collection. The results indicated that higher amounts of patient revenue in relation to a hospital's assets were associated with statistically significant increases in operating and total profit margins, free cash flow, and equity capital (p profit margins and larger equity values. For revenue cycle managers, these findings represent good news: Streamlining a hospital's management of the patient revenue cycle can advance the organization's financial viability by improving profitability and enabling equity growth.

  8. An online resource of digital stories about cancer genetics: qualitative study of patient preferences and information needs.

    Science.gov (United States)

    Iredale, Rachel; Mundy, Lisa; Hilgart, Jennifer

    2011-09-30

    The Cancer Genetics Service for Wales (CGSW) was established in 1998 as an all-Wales service for individuals with concerns about their family history of cancer. CGSW offers a range of services such as risk assessment, genetic counseling, and genetic testing. Individuals referred to cancer genetics services often have unmet information and support needs, and they value access to practical and experiential information from other patients and health professionals. As a result of the lifelong nature of genetic conditions, a fundamental challenge is to meet the ongoing needs of these patients by providing easily accessible and reliable information. Our aims were to explore how the long-term information and support needs of CGSW patients could be met and to assess whether an online bank of digital stories about cancer genetics would be acceptable to patients. In 2009, CGSW organized patient panels across Wales. During these events, 169 patients were asked for their feedback about a potential online resource of digital stories from CGSW patients and staff. A total of 75 patients registered to take part in the project and 23 people from across Wales agreed to share their story. All participants took part in a follow-up interview. Patient preferences for an online collection of cancer genetics stories were collected at the patient panels. Key topics to be covered by the stories were identified, and this feedback informed the development of the website to ensure that patients' needs would be met. The 23 patient storytellers were aged between 28 and 75 years, and 19 were female. The digital stories reflect patients' experiences within CGSW and the implications of living with or at risk of cancer. Follow-up interviews with patient storytellers showed that they shared their experiences as a means of helping other patients and to increase understanding of the cancer genetics service. Digital stories were also collected from 12 members of staff working at CGSW. The digital

  9. Evaluating the impact of patients' online access to doctors' visit notes: designing and executing the OpenNotes project

    Directory of Open Access Journals (Sweden)

    Leveille Suzanne G

    2012-04-01

    Full Text Available Abstract Background Providers and policymakers are pursuing strategies to increase patient engagement in health care. Increasingly, online sections of medical records are viewable by patients though seldom are clinicians' visit notes included. We designed a one-year multi-site trial of online patient accessible office visit notes, OpenNotes. We hypothesized that patients and primary care physicians (PCPs would want it to continue and that OpenNotes would not lead to significant disruptions to doctors' practices. Methods/Design Using a mixed methods approach, we designed a quasi-experimental study in 3 diverse healthcare systems in Boston, Pennsylvania, and Seattle. Two sites had existing patient internet portals; the third used an experimental portal. We targeted 3 key areas where we hypothesized the greatest impacts: beliefs and attitudes about OpenNotes, use of the patient internet portals, and patient-doctor communication. PCPs in the 3 sites were invited to participate in the intervention. Patients who were registered portal users of participating PCPs were given access to their PCPs' visit notes for one year. PCPs who declined participation in the intervention and their patients served as the comparison groups for the study. We applied the RE-AIM framework to our design in order to capture as comprehensive a picture as possible of the impact of OpenNotes. We developed pre- and post-intervention surveys for online administration addressing attitudes and experiences based on interviews and focus groups with patients and doctors. In addition, we tracked use of the internet portals before and during the intervention. Results PCP participation varied from 19% to 87% across the 3 sites; a total of 114 PCPs enrolled in the intervention with their 22,000 patients who were registered portal users. Approximately 40% of intervention and non-intervention patients at the 3 sites responded to the online survey, yielding a total of approximately 38

  10. Digital Natives Versus Digital Immigrants: Influence of Online Health Information Seeking on the Doctor-Patient Relationship.

    Science.gov (United States)

    Haluza, Daniela; Naszay, Marlene; Stockinger, Andreas; Jungwirth, David

    2017-11-01

    Ubiquitous Internet access currently revolutionizes the way people acquire information by creating a complex, worldwide information network. The impact of Internet use on the doctor-patient relationship is a moving target that varies across sociodemographic strata and nations. To increase scientific knowledge on the patient-Web-physician triangle in Austria, this study reports findings regarding prevailing online health information-seeking behavior and the respective impact on doctor-patient interactions among a nonprobability convenience sample of Internet users. To investigate digital age group-specific influences, we analyzed whether digital natives and digital immigrants differed in their perspectives. The questionnaire-based online survey collected sociodemographic data and online health information-seeking behavior from a sample of 562 respondents (59% females, mean age 37 ± 15 years, 54% digital natives). Most respondents (79%) referred to the Internet to seek health information, making it the most commonly used source for health information, even more prevalent then the doctor. We found similar predictors for using the Internet as a source for health-related information across digital age groups. Thus, the overall generational gap seems to be small among regular Internet users in Austria. However, study participants expressed a rather skeptical attitude toward electronic exchange of health data between health care professionals and patients, as well as toward reliability of online health information. To improve adoption of electronic doctor-patient communication and patient empowerment, public education and awareness programs are required to promote consumer-centered health care provision and patient empowerment.

  11. Evaluation of the Quality, Accuracy, and Readability of Online Patient Resources for the Management of Articular Cartilage Defects.

    Science.gov (United States)

    Wang, Dean; Jayakar, Rohit G; Leong, Natalie L; Leathers, Michael P; Williams, Riley J; Jones, Kristofer J

    2017-04-01

    Objective Patients commonly use the Internet to obtain their health-related information. The purpose of this study was to investigate the quality, accuracy, and readability of online patient resources for the management of articular cartilage defects. Design Three search terms ("cartilage defect," "cartilage damage," "cartilage injury") were entered into 3 Internet search engines (Google, Bing, Yahoo). The first 25 websites from each search were collected and reviewed. The quality and accuracy of online information were independently evaluated by 3 reviewers using predetermined scoring criteria. The readability was evaluated using the Flesch-Kincaid (FK) grade score. Results Fifty-three unique websites were evaluated. Quality ratings were significantly higher in websites with a FK score >11 compared to those with a score of ≤11 ( P = 0.021). Only 10 websites (19%) differentiated between focal cartilage defects and diffuse osteoarthritis. Of these, 7 (70%) were elicited using the search term "cartilage defect" ( P = 0.038). The average accuracy of the websites was high (11.7 out of maximum 12), and the average FK grade level (13.4) was several grades higher than the recommended level for readable patient education material (eighth grade level). Conclusions The quality and readability of online patient resources for articular cartilage defects favor those with a higher level of education. Additionally, the majority of these websites do not distinguish between focal chondral defects and diffuse osteoarthritis, which can fail to provide appropriate patient education and guidance for available treatment. Clinicians should help guide patients toward high-quality, accurate, and readable online patient education material.

  12. Digital danger: a review of the global public health, patient safety and cybersecurity threats posed by illicit online pharmacies.

    Science.gov (United States)

    Mackey, Tim K; Nayyar, Gaurvika

    2016-06-01

    Amidst the rise of e-commerce, there has been a proliferation of illicit online pharmacies that threaten global patient safety by selling drugs without a prescription directly to the consumer. Despite this clear threat, little is known about the key risk characteristics, central challenges and current legal, regulatory and law enforcement responses. A review was conducted of the English literature with search terms 'online pharmacies', 'Internet pharmacies', 'cyber pharmacies', 'rogue pharmacies', and 'e-pharmacies' using PubMed, JSTOR, and Google Scholar from 1999-2005. Illicit online pharmacies are a rapidly growing public health threat and are characterized by a number of complex and interrelated risk factors. Solutions are varied and are of questionable utility in the face of evolving technology that enables this form of transnational cybercrime. Legal, regulatory and technology solutions must address the entire illicit online pharmacy ecosystem in order to be effective. There is a critical need to build international consensus, conduct additional research and develop technology to combat illicit online pharmacies. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Digital danger: a review of the global public health, patient safety and cybersecurity threats posed by illicit online pharmacies

    Science.gov (United States)

    Mackey, Tim K.; Nayyar, Gaurvika

    2016-01-01

    Background Amidst the rise of e-commerce, there has been a proliferation of illicit online pharmacies that threaten global patient safety by selling drugs without a prescription directly to the consumer. Despite this clear threat, little is known about the key risk characteristics, central challenges and current legal, regulatory and law enforcement responses. Sources of data A review was conducted of the English literature with search terms ‘online pharmacies’, ‘Internet pharmacies’, ‘cyber pharmacies’, ‘rogue pharmacies’, and ‘e-pharmacies’ using PubMed, JSTOR, and Google Scholar from 1999–2005. Areas of agreement Illicit online pharmacies are a rapidly growing public health threat and are characterized by a number of complex and interrelated risk factors. Areas of controversy Solutions are varied and are of questionable utility in the face of evolving technology that enables this form of transnational cybercrime. Growing points Legal, regulatory and technology solutions must address the entire illicit online pharmacy ecosystem in order to be effective. Areas timely for developing research There is a critical need to build international consensus, conduct additional research and develop technology to combat illicit online pharmacies. PMID:27151957

  14. Using the Patient Centered Observation Form: Evaluation of an online training program.

    Science.gov (United States)

    Keen, Misbah; Cawse-Lucas, Jeanne; Carline, Jan; Mauksch, Larry

    2015-06-01

    The Patient Centered Observation Form (PCOF) helps trainees identify and describe specific communication skills and enhance self-awareness about skill use. We studied the effectiveness and ease of use of the Improving Communication Assessment Program (ICAP), an online module that prepares trainees to use the PCOF. Students, residents and medical educators viewed two videos (common and better skill use) of the same interaction and rated each video using the PCOF. Video sequence was randomized. We assessed agreement with experts, ease of use, concepts learned, and areas of confusion. Trainees (211) achieved strong agreement (.83) with experts and were highly satisfied (mean 4.18 out of 5). Viewing the common video first produced higher agreement (.87 vs .79; ES=.4) with experts and greater satisfaction (4.36 vs 4.02, ES .4) than viewing the better video first. Trainees reported diverse areas of learning and minimal confusion. ICAP training to use the PCOF may facilitate teaching and assessment of communication skills and enrich training through peer observation and feedback. We offer several educational strategies. Learning to use the PCOF via the ICAP module may accelerate communication training for medical students, residents, medical educators and practicing clinicians. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. The Process Management in Non - Profit Organisations

    National Research Council Canada - National Science Library

    Dagmara Bubel; Sylwia Legowik-Swiacik; Michal Dziadkiewicz; Anna Wisniewska-Salek

    2016-01-01

      The purpose of this paper is to learn about the implementation of the process management concepts in the non-profit organisations and the possible evaluation of effectiveness raise of the organisations' functioning...

  16. Construct the stable vendor managed inventory partnership through a profit-sharing approach

    Science.gov (United States)

    Li, S.; Yu, Z.; Dong, M.

    2015-01-01

    In real life, the vendor managed inventory (VMI) model is not always a stable supply chain partnership. This paper proposes a cooperative game based profit-sharing method to stabilize the VMI partnership. Specifically, in a B2C setting, we consider a VMI program including a manufacturer and multiple online retailers. The manufacturer provides the finished product at the equal wholesale price to multiple online retailers. The online retailers face the same customer demand information. We offer the model to compute the increased profits generated by information sharing for total possible VMI coalitions. Using the solution concept of Shapley value, the profit-sharing scheme is produced to fairly divide the total increased profits among the VMI members. We find that under a fair allocation scheme, the higher inventory cost of one VMI member increases the surplus of the other members. Furthermore, the manufacturer is glad to increase the size of VMI coalition, whereas, the retailers are delighted to limit the size of the alliance. Finally, the manufacturer can select the appropriate retailer to boost its surplus, which has no effect on the surplus of the other retailers. The numerical examples indicate that the grand coalition is stable under the proposed allocation scheme.

  17. Donations and Differentiation: Three Essays on Non-Profit Strategy

    OpenAIRE

    Wolfolds, Sarah

    2016-01-01

    Given increased competition with for-profit firms, the issue of the comparative advantage of non-profit organizations is renewed. While non-profits may want to differentiate themselves when faced with additional non-profit competition, it is unclear whether they would want to differentiate themselves or converge towards for-profit competitors. This paper addresses this issue by considering the different financing models, human resource systems, and objectives of non-profit organizations, as c...

  18. TRANSPARENCY IN ITALIAN NON PROFIT ORGANIZATIONS

    Directory of Open Access Journals (Sweden)

    Patrizia Gazzola

    2014-07-01

    Full Text Available The aim of the paper is to evaluate the accountability and transparency of Italian non profits organizations. The main goal is to understand if a general accountability or transparency problem, or a systematic publicity deficit, exist in the third sector in Italy. Non profit organizations have an ethical obligation to their stakeholder and to the public to conduct their activities with accountability and transparency. Non profit organizations should regularly and openly convey information to the stakeholder about their vision, mission, objectives, activities, accomplishments, decision-making processes and organizational structure. Information from a non profit organization should be easily accessible to the stakeholder and should create external visibility, public understanding and trust in the organization, conditions necessary to find donors. Non profit organizations work with communities and community donors need to know how their money is used. In the first part the analysis of the definition of transparency and accountability is made and the sustainability report like an important instrument of communication is considered. In the second part an empirical research is presented. The Italian law allows taxpayers to devote 5 per thousand of their income tax to non profit organizations, choosing between charities, social promotion associations, recognized associations, entities dedicated to scientific research and health care, universities, municipal social services and other non profit organizations. The present study present a quantitative research and it’s based on an empirical analysis of non-profit organizations that receive this donation in Italy in the year 2010 and 2011. In the paper we analyze the transparency and the accountability of the top 100 non profit organizations that have received the contribution of 5 per thousand, checking whether they prepare their Sustainability Report or any other kind of report for communicate the use

  19. Haematology patients and the Internet--the use of on-line health information and the impact on the patient-doctor relationship.

    Science.gov (United States)

    Rider, Tom; Malik, Muzaffar; Chevassut, Timothy

    2014-11-01

    Patients access on-line health information (OHI) to better understand their health. We aimed to determine which demographic factors influence OHI use. We also explored how OHI is used and subsequent implications to the patient-doctor relationship. We distributed a self-administered questionnaire to 202 haematology out-patients. 62.3% used the internet and 54.3% used OHI. Higher education, (Pbehaviour during consultations. Haematologists could facilitate patients using OHI by recommending high quality websites and act supportively when patients share OHI. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Online social networking by patients with diabetes: a qualitative evaluation of communication with Facebook.

    Science.gov (United States)

    Greene, Jeremy A; Choudhry, Niteesh K; Kilabuk, Elaine; Shrank, William H

    2011-03-01

    Several disease-specific information exchanges now exist on Facebook and other online social networking sites. These new sources of knowledge, support, and engagement have become important for patients living with chronic disease, yet the quality and content of the information provided in these digital arenas are poorly understood. To qualitatively evaluate the content of communication in Facebook communities dedicated to diabetes. We identified the 15 largest Facebook groups focused on diabetes management. For each group, we downloaded the 15 most recent "wall posts" and the 15 most recent discussion topics from the 10 largest groups. Four hundred eighty unique users were identified in a series of 690 comments from wall posts and discussion topics. Posts were abstracted and aggregated into a database. Two investigators evaluated the posts, developed a thematic coding scheme, and applied codes to the data. Patients with diabetes, family members, and their friends use Facebook to share personal clinical information, to request disease-specific guidance and feedback, and to receive emotional support. Approximately two-thirds of posts included unsolicited sharing of diabetes management strategies, over 13% of posts provided specific feedback to information requested by other users, and almost 29% of posts featured an effort by the poster to provide emotional support to others as members of a community. Approximately 27% of posts featured some type of promotional activity, generally presented as testimonials advertising non-FDA approved, "natural" products. Clinically inaccurate recommendations were infrequent, but were usually associated with promotion of a specific product or service. Thirteen percent of posts contained requests for personal information from Facebook participants. Facebook provides a forum for reporting personal experiences, asking questions, and receiving direct feedback for people living with diabetes. However, promotional activity and personal

  1. Health care professionals protocol for secure online transmission of patient data.

    Science.gov (United States)

    Goetz, C F

    1999-01-01

    One of the results of the 49th Bavarian Physician's Conference was that in 1996 the Bavarian Statutory Health Care Administration (Kassenärztliche Vereinigung Bayerns, KVB) and the Bavarian Medical Association (Bayerische Landesärztekammer, BLAK) jointly suggested a project for the development and verification of a security infrastructure for the online transmission of medical patient data. This Project, the so-called "Health Care Professionals Protocol" (HCP-Protokoll), was designed to establish the first consensus standard for a secure and probably open system to be used in the health care system operating under the constraints of the diverse and heterogeneous IT-infrastructure in Bavaria, with a view towards utilization in all of Germany. In January 1997, the HCP-Protocol was accepted as the strategic mainline project for telematics applications in medicine by the State of Bavaria and endowed with more than 1.3 million DM in the framework of "Bavaria Online II". In the meantime, various national organizations of the German medical community as well as important industrial partners have expressed support for this initiative. Mention in the Roland-Berger study "Telematics in Health Care, Perspectives of Telemedicine in Germany", designation as an "exemplary scenario" in the final report of the Working Group 7 of the Forum Info 2000 "Telematics Applications in Health Care", as well as integration of the new German health professional card, make the HCP-Protocol the most promising candidate for a de facto standard in the security infrastructure for all participants in health care telecommunication in Germany. Since the middle of 1998, an expert group under the guidance of the joint "Projektbüro Telemedizin" of the KVB and BLAK has been working on the definition of this protocol, taking into consideration the current legal framework of the German medical profession (Berufsordnung), the German signature law (SigG), and the national data security laws (BDSG), as

  2. Tax Evasion, Monopoly, and Nonneutral Profit Taxes

    OpenAIRE

    Lee, Kangoh

    1998-01-01

    It is known in the literature that tax evasion does not influence the monopolist's output decision, and hence, profit taxes are neutral, even in the presence of tax evasion. This result is based on the assumption that the audit probability and the penalty rate are fixed or depend on the understatement or overstatement of relevant economic indicators. However, under alternative and perhaps more reasonable formulations of the audit probability, the neutrality of profit taxes may not be preserve...

  3. Social media and small non profit organisations

    OpenAIRE

    Gulyás, A.

    2016-01-01

    This project sought to explore patterns of and views about social media adoption among small non-profit organisations and to identify mechanisms that could effectively support these organisations with their social media use. \\ud The following findings emerged from the study: \\ud • Social media are now part of the organisational infrastructure of small non-profits and the main ways in which they communicate with the public\\ud • Key variables that influence social media adoption among small non...

  4. Inclusive governance in non-profit organisations

    OpenAIRE

    Borzaga, Carlo; Sacchetti, Silvia

    2015-01-01

    The study of private non-profit enterprises that offer general interest services is only at the start. The understanding of existing organisations resists an inclusive, public interest view of governance. This contribution aims at providing a reflection on specific features that non-profit enterprises should have, and outlines four main justifications for including stakeholders in production governance: 1) access to knowledge and other resources, 2) trust creation, 3) internal efficiency, 4) ...

  5. DETERMINANTS OF BANK PROFITABILITY IN CROATIA

    OpenAIRE

    Ana Kundid; Blanka Škrabić; Roberto Ercegovac

    2011-01-01

    The research objective of this study is twofold. It aims to provide a synthesis of relevant empirical researches on the determinants of commercial banks’ profitability and to establish empirical verification of profitability determinants of banks in the Republic of Croatia using an econometric method of dynamic panel analysis. The empirical analysis is carried out on a data sample of 28 commercial banks in the period 2003-2008 which continuously refers to more than 95 % of assets of the overa...

  6. Determinants of commercial bank profitability in Mexico

    OpenAIRE

    Chavarín, Rubén

    2015-01-01

    The aim of the present work is to identify the main determinants of profitability for commercial banks established in Mexico. A data base of 45 banks representing virtually the whole world of commercial banking in the period 2007-2013 was used. Dynamic models using Arellano-Bover/Blundell-Bond estimators with an error that follows an MA(1) process were employed along with static models having random effects and Hausman-Taylor estimator. Findings suggest that the profitability of commercial ba...

  7. Energy Conflicts and Differential Profits: An Update

    OpenAIRE

    Bichler, Shimshon; Nitzan, Jonathan

    2014-01-01

    During the late 1980s and early 1990s, we identified a new phenomenon that we called ‘energy conflicts’ and showed that these conflicts were intimately linked to the differential profitability of the leading oil companies. This link remains as true today as it was in the early 1970s. Like earlier energy conflicts, the ‘Arab Spring’, the outsourced wars that followed and the third Gulf War against ISIS continue to march to the drum beat of differential profits.

  8. Fractal profit landscape of the stock market.

    Science.gov (United States)

    Grönlund, Andreas; Yi, Il Gu; Kim, Beom Jun

    2012-01-01

    We investigate the structure of the profit landscape obtained from the most basic, fluctuation based, trading strategy applied for the daily stock price data. The strategy is parameterized by only two variables, p and q Stocks are sold and bought if the log return is bigger than p and less than -q, respectively. Repetition of this simple strategy for a long time gives the profit defined in the underlying two-dimensional parameter space of p and q. It is revealed that the local maxima in the profit landscape are spread in the form of a fractal structure. The fractal structure implies that successful strategies are not localized to any region of the profit landscape and are neither spaced evenly throughout the profit landscape, which makes the optimization notoriously hard and hypersensitive for partial or limited information. The concrete implication of this property is demonstrated by showing that optimization of one stock for future values or other stocks renders worse profit than a strategy that ignores fluctuations, i.e., a long-term buy-and-hold strategy.

  9. TURKISH BANKING SECTOR’S PROFITABILITY FACTORS

    Directory of Open Access Journals (Sweden)

    Songül Kakilli ACARAVCI

    2013-01-01

    Full Text Available Profitability of banking sector is the most important instrument of financial system for the future of the economy. The objective of this study is to determine by using Johansen and Juselius cointegration test approach of the bank specific and macroeconomic factors that affect the profitability of commercial banks in Turkish banking sector. In study, the data are collected from the three biggest state-owned, privately-owned and foreign banks. The sample period spans from 1998 to 2011. In the study, return of asset, return of equity and net interest margin were used as proxy for profitability of banks. The bank specific determinants, which were thought to have effects on profitability are total credits/total assets, total deposits/total assets, total liquid assets/total assets, total wage and commission incomes/ total assets, total wage and commission expenses/total assets, the logarithm of total assets and total equity/total assets. The macroeconomic determinants of study are real gross domestic product, inflation rate, real exchange rate and real interest rate. Empirical findings suggest that the bank specific determinants have been more effect than macroeconomic factors on profitability of the banks. The reel gross domestic product and real exchange rate have been effective on the profitability. In addition, the 2001 economic crisis has a negative effect on all Turkish Banking sector.

  10. Online Resources

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Genetics; Online Resources. Journal of Genetics. Online Resources. Volume 96. 2017 | Online resources. Volume 95. 2016 | Online resources. Volume 94. 2015 | Online resources. Volume 93. 2014 | Online resources. Volume 92. 2013 | Online resources. Volume 91. 2012 | Online resources ...

  11. Comparison of Hospitalization Rates among For-Profit and Nonprofit Dialysis Facilities

    Science.gov (United States)

    Johansen, Kirsten L.; Romano, Patrick S.; Chertow, Glenn M.; Mu, Yi; Ishida, Julie H.; Grimes, Barbara; Kaysen, George A.; Nguyen, Danh V.

    2014-01-01

    Summary Background and objectives The vast majority of US dialysis facilities are for-profit and profit status has been associated with processes of care and outcomes in patients on dialysis. This study examined whether dialysis facility profit status was associated with the rate of hospitalization in patients starting dialysis. Design, setting, participants, & methods This was a retrospective cohort study of Medicare beneficiaries starting dialysis between 2005 and 2008 using data from the US Renal Data System. All-cause hospitalization was examined and compared between for-profit and nonprofit dialysis facilities through 2009 using Poisson regression. Companion analyses of cause-specific hospitalization that are likely to be influenced by dialysis facility practices including hospitalizations for heart failure and volume overload, access complications, or hyperkalemia were conducted. Results The cohort included 150,642 patients. Of these, 12,985 (9%) were receiving care in nonprofit dialysis facilities. In adjusted models, patients receiving hemodialysis in for-profit facilities had a 15% (95% confidence interval [95% CI], 13% to 18%) higher relative rate of hospitalization compared with those in nonprofit facilities. Among patients receiving peritoneal dialysis, the rate of hospitalization in for-profit versus nonprofit facilities was not significantly different (relative rate, 1.07; 95% CI, 0.97 to 1.17). Patients on hemodialysis receiving care in for-profit dialysis facilities had a 37% (95% CI, 31% to 44%) higher rate of hospitalization for heart failure or volume overload and a 15% (95% CI, 11% to 20%) higher rate of hospitalization for vascular access complications. Conclusions Hospitalization rates were significantly higher for patients receiving hemodialysis in for-profit compared with nonprofit dialysis facilities. PMID:24370770

  12. An online spaced-education game among clinicians improves their patients' time to blood pressure control: a randomized controlled trial.

    Science.gov (United States)

    Kerfoot, B Price; Turchin, Alexander; Breydo, Eugene; Gagnon, David; Conlin, Paul R

    2014-05-01

    Many patients with high blood pressure (BP) do not have antihypertensive medications appropriately intensified at clinician visits. We investigated whether an online spaced-education (SE) game among primary care clinicians can decrease time to BP target among their hypertensive patients. A 2-arm randomized trial was conducted over 52 weeks among primary care clinicians at 8 hospitals. Educational content consisted of 32 validated multiple-choice questions with explanations on hypertension management. Providers were randomized into 2 groups: SE clinicians were enrolled in the game, whereas control clinicians received identical educational content in an online posting. SE game clinicians were e-mailed 1 question every 3 days. Adaptive game mechanics resent questions in 12 or 24 days if answered incorrectly or correctly, respectively. Clinicians retired questions by answering each correctly twice consecutively. Posting of relative performance among peers fostered competition. Primary outcome measure was time to BP target (game was completed by 87% of clinicians (48/55), whereas 84% of control clinicians (47/56) read the online posting. In multivariable analysis of 17 866 hypertensive periods among 14 336 patients, the hazard ratio for time to BP target in the SE game cohort was 1.043 (95% confidence interval, 1.007-1.081; P=0.018). The number of hypertensive episodes needed to treat to normalize one additional patient's BP was 67.8. The number of clinicians needed to teach to achieve this was 0.43. An online SE game among clinicians generated a modest but significant reduction in the time to BP target among their hypertensive patients. http://www.clinicaltrials.gov. Unique identifier: NCT00904007. © 2014 American Heart Association, Inc.

  13. Adaptive online monitoring for ICU patients by combining just-in-time learning and principal component analysis.

    Science.gov (United States)

    Li, Xuejian; Wang, Youqing

    2016-12-01

    Offline general-type models are widely used for patients' monitoring in intensive care units (ICUs), which are developed by using past collected datasets consisting of thousands of patients. However, these models may fail to adapt to the changing states of ICU patients. Thus, to be more robust and effective, the monitoring models should be adaptable to individual patients. A novel combination of just-in-time learning (JITL) and principal component analysis (PCA), referred to learning-type PCA (L-PCA), was proposed for adaptive online monitoring of patients in ICUs. JITL was used to gather the most relevant data samples for adaptive modeling of complex physiological processes. PCA was used to build an online individual-type model and calculate monitoring statistics, and then to judge whether the patient's status is normal or not. The adaptability of L-PCA lies in the usage of individual data and the continuous updating of the training dataset. Twelve subjects were selected from the Physiobank's Multi-parameter Intelligent Monitoring for Intensive Care II (MIMIC II) database, and five vital signs of each subject were chosen. The proposed method was compared with the traditional PCA and fast moving-window PCA (Fast MWPCA). The experimental results demonstrated that the fault detection rates respectively increased by 20 % and 47 % compared with PCA and Fast MWPCA. L-PCA is first introduced into ICU patients monitoring and achieves the best monitoring performance in terms of adaptability to changes in patient status and sensitivity for abnormality detection.

  14. Lupus flares in two established end-stage renal disease patients with on-line hemodiafiltration during pregnancy - case series.

    Science.gov (United States)

    Althaf, M M; Abdelsalam, M S; Alfurayh, O I

    2014-08-01

    Many patients with established end-stage renal disease on maintenance dialysis as a result of lupus nephritis are young females in their reproductive years. We report two such patients dialyzed with on-line hemodiafiltration who developed reactivation of lupus disease activity only when they conceived after initial systemic lupus erythematosus burnout. We believe that the flare was triggered by both efficient dialysis and hormonal changes during pregnancy. The flares were treated with oral corticosteroids with an excellent response. Both patients had live births but delivered preterm. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  15. Patients views and experiences in online reporting adverse drug reactions: findings of a national pilot study in Japan

    Directory of Open Access Journals (Sweden)

    Yamamoto M

    2015-01-01

    Full Text Available Michiko Yamamoto,1 Kiyoshi Kubota,2 Mitsuhiro Okazaki,3 Akira Dobashi,3 Masayuki Hashiguchi,4 Hirohisa Doi,1 Machi Suka,5 Mayumi Mochizuki4 1Education Center for Clinical Pharmacy Practice, Showa Pharmaceutical University, Tokyo, Japan; 2Department of Pharmacoepidemiology, Graduate School of Medicine, University of Tokyo, Japan; 3Education and Research Institute of Information Science, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan; 4Division for Evaluation and Analysis of Drug Information, Faculty of Pharmacy, Keio University, Tokyo, Japan; 5Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan Background: Patients have been allowed to report adverse drug reactions (ADRs directly to the government in some countries, which would contribute to pharmacovigilance.Objective: We started a pilot study to determine whether web-based patient ADR reporting would work in Japan. This article aims to describe the characteristics of the patient reporters, and to clarify patient views and experiences of reporting.Methods: Patients who submitted online ADR reports were contacted to respond to an ADR reporting questionnaire; only consenting reporters were included. Subjects with multiple responses were excluded from analysis. The questionnaire consisted of both closed and open questions. Questionnaire responses were examined using Pearson’s chi-squared test.Results: A total of 220 web-based ADR reports were collected from January to December 2011; questionnaires were sent to 190 reporters, excluding those who gave multiple reports and those that refused to be contacted. Responses were obtained from 94 individuals (effective response rate: 49.5%. The median respondent age was 46.0 years. Sixty-three respondents found out about this pilot study on the Internet (67.0%. The numbers of respondents claiming that they had difficulty recalling the time/date of ADR occurrence were 16 patient

  16. Profits in reverse? An examination of the decisive factors for reverse supply chain profitability

    DEFF Research Database (Denmark)

    Larsen, Samuel; Jacobsen, Peter

    2015-01-01

    Although the concept of the reverse supply chain (RSC) is not unknown in industry, an inhibitor for its successful use is low (or no) profitability. A research challenge is investigating ways to establish the RSC as a profit-creating center in the organization. This paper contributes to this chal......Although the concept of the reverse supply chain (RSC) is not unknown in industry, an inhibitor for its successful use is low (or no) profitability. A research challenge is investigating ways to establish the RSC as a profit-creating center in the organization. This paper contributes...

  17. Exploring the impact of word-of-mouth about Physicians' service quality on patient choice based on online health communities.

    Science.gov (United States)

    Lu, Naiji; Wu, Hong

    2016-11-26

    Health care service is a high-credence service and patients may face difficulties ascertaining service quality in order to make choices about their available treatment options. Online health communities (OHCs) provide a convenient channel for patients to search for physicians' information, such as Word-of-Mouth (WOM), particularly on physicians' service quality evaluated by other patients. Existing studies from other service domains have proved that WOM impacts consumer choice. However, how patients make a choice based on physicians' WOM has not been studied, particularly with reference to different patient characteristics and by using real data. One thousand eight hundred fifty three physicians' real data were collected from a Chinese online health community. The data were analyzed using ordinary least squares (OLS) method. The study found that functional quality negatively moderated the relationship between technical quality and patient choice, and disease risk moderated the relationship between physicians' service quality and patient choice. Our study recommends that hospital managers need to consider the roles of both technical quality and functional quality seriously. Physicians should improve their medical skills and bedside manners based on the severity and type of disease to provide better service.

  18. Do videos improve website satisfaction and recall of online cancer-related information in older lung cancer patients?

    Science.gov (United States)

    Bol, Nadine; Smets, Ellen M A; Rutgers, M Mattijs; Burgers, Jacobus A; de Haes, Hanneke C J M; Loos, Eugène F; van Weert, Julia C M

    2013-09-01

    This study investigated the effects of personalized audiovisual information in addition to text on website satisfaction and recall of cancer-related online information in older lung cancer patients. An experiment using a 3 (condition: text only vs. text with nonpersonalized video vs. text with personalized video) by 2 (age patient: younger [video compared to text only. Text with personalized video also outperformed text with nonpersonalized video regarding emotional support from the website. Furthermore, text with video improved patients' recall of cancer-related information as compared to text only. Older patients recalled less information correctly than younger patients, except when we controlled for Internet use. Text with personalized audiovisual information can enhance website satisfaction and information recall. Internet use plays an important role in explaining recall of information. The results of this study can be used to develop effective health communication materials for cancer patients. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Insights into the impact of online physician reviews on patients' decision making: randomized experiment.

    Science.gov (United States)

    Grabner-Kräuter, Sonja; Waiguny, Martin K J

    2015-04-09

    the physician received many reviews. Furthermore, we found that review style also affected the perceived expertise of the reviewer. Fact-oriented reviews (mean 3.90, SE 0.13) lead to a higher perception of reviewer expertise compared to emotional reviews (mean 3.19, SE 0.13). However, this did not transfer to the attitude toward the physician. A similar effect of review style and number on the perceived credibility of the review was observed. While no differences between emotional and factual style were found if the physician received many reviews, a low number of reviews received lead to a significant difference in the perceived credibility, indicating that emotional reviews were rated less positively (mean 3.52, SE 0.18) compared to fact-oriented reviews (mean 4.15, SE 0.17). Our analyses also showed that perceived credibility of the review fully mediated the observed interaction effect on attitude toward the physician. Physician-rating websites are an interesting new source of information about the quality of health care from the patient's perspective. This paper makes a unique contribution to an understudied area of research by providing some insights into how people evaluate online reviews of individual doctors. Information attributes, such as review style and review number, have an impact on the evaluation of the review and on the patient's attitude toward the rated doctor. Further research is necessary to improve our understanding of the influence of such rating sites on the patient's choice of a physician.

  20. Innovation in Business Education: Developing a High Quality Online MBA

    Science.gov (United States)

    Roe, C. William; Toma, Alfred G.; Yallapragada, RamMohan R.

    2015-01-01

    Online degree programs were probably pioneered by for-profit universities such as University of Phoenix. Many online degree programs were initially considered low quality academic programs compared to traditional programs. Therefore, many public and private universities were slow to adopt the online programs. However, gradually more and more…

  1. Does procedure profitability impact whether an outpatient surgery is performed at an ambulatory surgery center or hospital?

    Science.gov (United States)

    Plotzke, Michael Robert; Courtemanche, Charles

    2011-07-01

    Ambulatory surgery centers (ASCs) are small (typically physician owned) healthcare facilities that specialize in performing outpatient surgeries and therefore compete against hospitals for patients. Physicians who own ASCs could treat their most profitable patients at their ASCs and less profitable patients at hospitals. This paper asks if the profitability of an outpatient surgery impacts where a physician performs the surgery. Using a sample of Medicare patients from the National Survey of Ambulatory Surgery, we find that higher profit surgeries do have a higher probability of being performed at an ASC compared to a hospital. After controlling for surgery type, a 10% increase in a surgery's profitability is associated with a 1.2 to 1.4 percentage point increase in the probability the surgery is performed at an ASC. Copyright © 2010 John Wiley & Sons, Ltd.

  2. PROFIT: Bayesian profile fitting of galaxy images

    Science.gov (United States)

    Robotham, A. S. G.; Taranu, D. S.; Tobar, R.; Moffett, A.; Driver, S. P.

    2017-04-01

    We present PROFIT, a new code for Bayesian two-dimensional photometric galaxy profile modelling. PROFIT consists of a low-level C++ library (libprofit), accessible via a command-line interface and documented API, along with high-level R (PROFIT) and PYTHON (PyProFit) interfaces (available at github.com/ICRAR/libprofit, github.com/ICRAR/ProFit, and github.com/ICRAR/pyprofit, respectively). R PROFIT is also available pre-built from CRAN; however, this version will be slightly behind the latest GitHub version. libprofit offers fast and accurate two-dimensional integration for a useful number of profiles, including Sérsic, Core-Sérsic, broken-exponential, Ferrer, Moffat, empirical King, point-source, and sky, with a simple mechanism for adding new profiles. We show detailed comparisons between libprofit and GALFIT. libprofit is both faster and more accurate than GALFIT at integrating the ubiquitous Sérsic profile for the most common values of the Sérsic index n (0.5 automated bulge-disc decomposition with PROFIT on SDSS, KiDS, and future LSST imaging. We find that the biggest increases in fit quality come from moving from SDSS- to KiDS-quality data, with less significant gains moving from KiDS to LSST.

  3. Survey and online discussion groups to develop a patient-rated outcome measure on acceptability of treatment response in vitiligo

    Science.gov (United States)

    2014-01-01

    Background Vitiligo is a chronic depigmenting skin disorder which affects around 0.5-1% of the world’s population. The outcome measures used most commonly in trials to judge treatment success focus on repigmentation. Patient-reported outcome measures of treatment success are rarely used, although recommendations have been made for their inclusion in vitiligo trials. This study aimed to evaluate the face validity of a new patient-reported outcome measure of treatment response, for use in future trials and clinical practice. Method An online survey to gather initial views on what constitutes treatment success for people with vitiligo or their parents/carers, followed by online discussion groups with patients to reach consensus on what constitutes treatment success for individuals with vitiligo, and how this can be assessed in the context of trials. Participants were recruited from an existing database of vitiligo patients and through posts on the social network sites Facebook and Twitter. Results A total of 202 survey responses were received, of which 37 were excluded and 165 analysed. Three main themes emerged as important in assessing treatment response: a) the match between vitiligo and normal skin (how well it blends in); b) how noticeable the vitiligo is and c) a reduction in the size of the white patches. The majority of respondents said they would consider 80% or more repigmentation to be a worthwhile treatment response after 9 months of treatment. Three online discussion groups involving 12 participants led to consensus that treatment success is best measured by asking patients how noticeable their vitiligo is after treatment. This was judged to be best answered using a 5-point Likert scale, on which a score of 4 or 5 represents treatment success. Conclusions This study represents the first step in developing a patient reported measure of treatment success in vitiligo trials. Further work is now needed to assess its construct validity and responsiveness to

  4. Survey and online discussion groups to develop a patient-rated outcome measure on acceptability of treatment response in vitiligo.

    Science.gov (United States)

    Tour, Selina K; Thomas, Kim S; Walker, Dawn-Marie; Leighton, Paul; Yong, Adrian Sw; Batchelor, Jonathan M

    2014-06-14

    Vitiligo is a chronic depigmenting skin disorder which affects around 0.5-1% of the world's population. The outcome measures used most commonly in trials to judge treatment success focus on repigmentation. Patient-reported outcome measures of treatment success are rarely used, although recommendations have been made for their inclusion in vitiligo trials. This study aimed to evaluate the face validity of a new patient-reported outcome measure of treatment response, for use in future trials and clinical practice. An online survey to gather initial views on what constitutes treatment success for people with vitiligo or their parents/carers, followed by online discussion groups with patients to reach consensus on what constitutes treatment success for individuals with vitiligo, and how this can be assessed in the context of trials. Participants were recruited from an existing database of vitiligo patients and through posts on the social network sites Facebook and Twitter. A total of 202 survey responses were received, of which 37 were excluded and 165 analysed. Three main themes emerged as important in assessing treatment response: a) the match between vitiligo and normal skin (how well it blends in); b) how noticeable the vitiligo is and c) a reduction in the size of the white patches. The majority of respondents said they would consider 80% or more repigmentation to be a worthwhile treatment response after 9 months of treatment. Three online discussion groups involving 12 participants led to consensus that treatment success is best measured by asking patients how noticeable their vitiligo is after treatment. This was judged to be best answered using a 5-point Likert scale, on which a score of 4 or 5 represents treatment success. This study represents the first step in developing a patient reported measure of treatment success in vitiligo trials. Further work is now needed to assess its construct validity and responsiveness to change.

  5. Online versus face-to-face pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: randomised controlled trial.

    Science.gov (United States)

    Bourne, Simon; DeVos, Ruth; North, Malcolm; Chauhan, Anoop; Green, Ben; Brown, Thomas; Cornelius, Victoria; Wilkinson, Tom

    2017-07-17

    To obtain evidence whether the online pulmonary rehabilitation(PR) programme 'my-PR' is non-inferior to a conventional face-to-face PR in improving physical performance and symptom scores in patients with COPD. A two-arm parallel single-blind, randomised controlled trial. The online arm carried out pulmonary rehabilitation in their own homes and the face to face arm in a local rehabilitation facility. 90 patients with a diagnosis of chronic obstructive pulmonary disease (COPD), modified Medical Research Council score of 2 or greater referred for pulmonary rehabilitation (PR), randomised in a 2:1 ratio to online (n=64) or face-to-face PR (n=26). Participants unable to use an internet-enabled device at home were excluded. Coprimary outcomes were 6 min walk distance test and the COPD assessment test (CAT) score at completion of the programme. A 6-week PR programme organised either as group sessions in a local rehabilitation facility, or online PR via log in and access to 'myPR'. The adjusted mean difference for the 6 min walk test (6MWT) between groups for the intention-to-treat (ITT) population was 23.8 m with the lower 95% CI well above the non-inferiority threshold of -40.5 m at -4.5 m with an upper 95% CI of +52.2 m. This result was consistent in the per-protocol (PP) population with a mean adjusted difference of 15 m (-13.7 to 43.8). The CAT score difference in the ITT was -1.0 in favour of the online intervention with the upper 95% CI well below the non-inferiority threshold of 1.8 at 0.86 and the lower 95% CI of -2.9. The PP analysis was consistent with the ITT. PR is an evidenced-based and guideline-mandated intervention for patients with COPD with functional limitation. A 6-week programme of online-supported PR was non-inferior to a conventional model delivered in face-to-face sessions in terms of effects on 6MWT distance, and symptom scores and was safe and well tolerated. © Article author(s) (or their employer(s) unless otherwise stated in the

  6. 48 CFR 1615.404-70 - Profit analysis factors.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Profit analysis factors... CONTRACTING BY NEGOTIATION Contract Pricing 1615.404-70 Profit analysis factors. (a) OPM contracting officers..., will likely serve to diminish this profit analysis factor in an overall determination of profit. This...

  7. DETERMINANTS OF BANK PROFITABILITY IN CROATIA

    Directory of Open Access Journals (Sweden)

    Ana Kundid

    2011-02-01

    Full Text Available The research objective of this study is twofold. It aims to provide a synthesis of relevant empirical researches on the determinants of commercial banks’ profitability and to establish empirical verification of profitability determinants of banks in the Republic of Croatia using an econometric method of dynamic panel analysis. The empirical analysis is carried out on a data sample of 28 commercial banks in the period 2003-2008 which continuously refers to more than 95 % of assets of the overall banking intermediation. Return on assets (ROA is profitability indicator used in the analysis. The presented research results and their economic interpretation may serve as a valuable foundation for the general assessment of commercial bank management in Croatia as well as for identifying several sources of potential improvement and impairment of their financial performance in the future. Thus, corrective actions could be planned and implemented in advance.

  8. IMPROVEMENTS IN ACCOUNTING OF BREWERIES’ PROFIT

    Directory of Open Access Journals (Sweden)

    I. Sklyaruk

    2013-11-01

    Full Text Available The peculiarities of formation of the profit of breweries, taking into account the specifics of the production process and business peculiarities were identified. There were found out the specificity of calculation of the expenses, considering the norms of the technological process, the duration of the operating cycle and the specifics of the production of beer and non-alcoholic products, which determine the methodology of formation of the prime price of the products and the price of its sale. The expediency of using the method for phases (with semi-ready and not semi- ready option method of calculation of the semi-finished products of own production there was proved. The irrelevance of using Account 44 “Undistributed profit (uncovered loss” according to its purpose under the current Plan of accounts is shown. The model of using the profit based on the proposed sub-accounts was built and the example of their use was shown.

  9. [Profitability analysis of clinical risk management].

    Science.gov (United States)

    Banduhn, C; Schlüchtermann, J

    2013-05-01

    Medical treatment entails many risks. Increasingly, the negative impact of these risks on patients' health is revealed and corresponding cases are reported to hospital insurances. A systematic clinical risk management can reduce risks. This analysis is designed to demonstrate the financial profitability of implementing a clinical risk management. The decision analysis of a clinical risk management includes information from published articles and studies, publicly available data from the Federal Statistical Office and expert interviews and was conducted in 2 scenarios. The 2 scenarios result from a maximum and minimum value of preventable adverse events reported in Germany. The planning horizon was a 1-year ­period. The analysis was performed from a hospital's perspective. Subsequently, a threshold-analysis of the reduction of preventable adverse events as an effect of clinical risk management was executed. Furthermore, a static capital budgeting over a 5-year period was added, complemented by a risk analysis. Regarding the given assumptions, the implementation of clinical risk management would save about 53 000 € or 175 000 €, respectively, for an average hospital within the first year. Only if the reduction of preventable adverse events is as low as 5.6 or 2.8%, respectively, will the implementation of clinical risk management produce losses. According to a comprehensive risk simulation this happens in less than one out of 1 million cases. The investment in a clinical risk management, based on a 5-year period and an interest rate of 5%, has an annually pay off of 81 000 € or 211 000 €, respectively. The implementation of clinical risk management in a hospital pays off within the first year. In the subsequent years the surplus is even higher due to the elimination of implementation costs. © Georg Thieme Verlag KG Stuttgart · New York.

  10. A Qualitative and Quantitative Comparative Analysis of Commercial and Independent Online Information for Hip Surgery: A Bias in Online Information Targeting Patients?

    Science.gov (United States)

    Kelly, Martin J; Feeley, Iain H; O'Byrne, John M

    2016-10-01

    Direct to consumer (DTC) advertising, targeting the public over the physician, is an increasingly pervasive presence in medical clinics. It is trending toward a format of online interaction rather than that of traditional print and television advertising. We analyze patient-focused Web pages from the top 5 companies supplying prostheses for total hip arthroplasties, comparing them to the top 10 independent medical websites. Quantitative comparison is performed using the Journal of American Medical Association benchmark and DISCERN criteria, and for comparative readability, we use the Flesch-Kincaid grade level, the Flesch reading ease, and the Gunning fog index. Content is analyzed for information on type of surgery and surgical approach. There is a statistically significant difference between the independent and DTC websites in both the mean DISCERN score (independent 74.6, standard deviation [SD] = 4.77; DTC 32.2, SD = 10.28; P = .0022) and the mean Journal of American Medical Association score (Independent 3.45, SD = 0.49; DTC 1.9, SD = 0.74; P = .004). The difference between the readability scores is not statistically significantly. The commercial content is found to be heavily biased in favor of the direct anterior approach and minimally invasive surgical techniques. We demonstrate that the quality of information on commercial websites is inferior to that of the independent sites. The advocacy of surgical approaches by industry to the patient group is a concern. This study underlines the importance of future regulation of commercial patient education Web pages. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Don't Give Up! A Cyber-ethnography and Discourse Analysis of an Online Infertility Patient Forum.

    Science.gov (United States)

    Lee, Mihan

    2017-09-01

    Infertility affects women across the socioeconomic spectrum; however, it is by no means egalitarian in its distribution, nor uniform in its lived experience. Evidence shows striking disparities by income, race, and education in infertility prevalence, access to infertility services, and success rates after receiving infertility treatments. However, few studies so far have investigated disparities in patients' access to psychological support during the infertility journey. This paper undertakes a cyber-ethnography of the online patient forum, "Finding a Resolution for Infertility," hosted by RESOLVE: The National Infertility Association. It also draws from interviews with 54 infertility patients recruited from the forum. Our aim was to examine how social support operates within this virtual realm, by examining how the forum's language, norms, and values create and enforce categories of deserving and belonging among site users. We find that the forum's discourse privileges an infertility narrative we term the "persistent patient," in which a patient exhaustively researches treatment options, undergoes multiple cycles of treatment despite repeated failures, and ultimately achieves success (a healthy baby). Meanwhile, there is little to no discursive space for discussion of the financial and social resources necessary to act in accordance with this script. Thus, women without such resources can be alienated, silenced, and denied mental health support by this online community.

  12. New premise in science get the word out quickly, online

    CERN Multimedia

    Harmon, A

    2002-01-01

    "A group of prominent scientists is mounting an electronic challenge to the leading scientific journals, accusing them of holding back the progress of science by restricting online access to their articles so they can reap higher profits" (1 page).

  13. The substantial burden of systemic lupus erythematosus on the productivity and careers of patients: a European patient-driven online survey

    OpenAIRE

    Gordon, Caroline; Isenberg, David; Lerstr?m, Kirsten; Norton, Yvonne; Nika?, Enkeleida; Pushparajah, Daphnee S.; Schneider, Matthias

    2013-01-01

    Objective. The objective of this study was to explore the burden of SLE and its effect on patients? lives. Methods. The Lupus European Online (LEO) survey included patient-designed questions on demographics, SLE diagnosis, and the impact of SLE on careers. Three SLE-specific patient-reported outcome (PRO) questionnaires were also completed: the Lupus Quality of Life (LupusQoL), the Fatigue Severity Scale (FSS), and the Work Productivity and Activity Impairment (WPAI)-Lupus v2.0. The survey wa...

  14. SentiHealth-Cancer: A sentiment analysis tool to help detecting mood of patients in online social networks.

    Science.gov (United States)

    Rodrigues, Ramon Gouveia; das Dores, Rafael Marques; Camilo-Junior, Celso G; Rosa, Thierson Couto

    2016-01-01

    Cancer is a critical disease that affects millions of people and families around the world. In 2012 about 14.1 million new cases of cancer occurred globally. Because of many reasons like the severity of some cases, the side effects of some treatments and death of other patients, cancer patients tend to be affected by serious emotional disorders, like depression, for instance. Thus, monitoring the mood of the patients is an important part of their treatment. Many cancer patients are users of online social networks and many of them take part in cancer virtual communities where they exchange messages commenting about their treatment or giving support to other patients in the community. Most of these communities are of public access and thus are useful sources of information about the mood of patients. Based on that, Sentiment Analysis methods can be useful to automatically detect positive or negative mood of cancer patients by analyzing their messages in these online communities. The objective of this work is to present a Sentiment Analysis tool, named SentiHealth-Cancer (SHC-pt), that improves the detection of emotional state of patients in Brazilian online cancer communities, by inspecting their posts written in Portuguese language. The SHC-pt is a sentiment analysis tool which is tailored specifically to detect positive, negative or neutral messages of patients in online communities of cancer patients. We conducted a comparative study of the proposed method with a set of general-purpose sentiment analysis tools adapted to this context. Different collections of posts were obtained from two cancer communities in Facebook. Additionally, the posts were analyzed by sentiment analysis tools that support the Portuguese language (Semantria and SentiStrength) and by the tool SHC-pt, developed based on the method proposed in this paper called SentiHealth. Moreover, as a second alternative to analyze the texts in Portuguese, the collected texts were automatically translated

  15. Democracy and non-profit housing

    DEFF Research Database (Denmark)

    Hansen, Anne Vorre; Langergaard, Luise Li

    2017-01-01

    Resident democracy as a special form of participatory democratic set-up is fundamental in the understanding, and self-understanding, of the non-profit housing sector in Denmark. Through a case study, the paper explores how resident democracy is perceived and narrated between residents and employees...... at a housing association. The study indicates that the meta-story of democracy is disconnected from practice and the lived lives of residents. Three analytical tensions structure the analysis, which relate to the conditions for realizing the democratic ideal embedded in the structure of the sector......, the article discusses conditions for prospective democracy in the Danish non-profit housing sector....

  16. E-care 4 caregivers - an online intervention for nonprofessional caregivers of patients with depression: study protocol for a pilot randomized controlled trial

    National Research Council Canada - National Science Library

    Bijker, L; Kleiboer, A; Riper, H; Cuijpers, P; Donker, T

    2016-01-01

    .... This paper describes the protocol of a pilot study to evaluate (1) the feasibility of an online self-management intervention, E-care 4 caregivers, for the nonprofessional caregiver of patients with depression, and (2...

  17. Development of an Online, Evidence-Based Patient Information Portal for Congenital Heart Disease: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Jonathan R. G. Etnel

    2017-05-01

    Full Text Available ObjectivesIn response to an increased need for patient information on congenital heart disease in the Netherlands, we initiated a nationwide initiative to develop an online, evidence-based patient information portal, starting with a pilot project aimed at the subgroup of patients with congenital aortic and pulmonary valve disease.Methods and resultsWe developed an information portal that aims to (1 improve patient knowledge and involvement and to subsequently reduce anxiety and decisional conflict and improve mental quality of life and (2 to support physicians in informing and communicating with their patients. The information portal was developed according to the systematic International Patient Decision Aid Standards development process employing Delphi techniques by a multidisciplinary workgroup of pediatric and adult congenital cardiologists, a congenital cardiothoracic surgeon, a psychologist, an epidemiologist, a patient representative, and web and industrial design experts. First, patients and physicians were surveyed and interviewed to assess the current state of patient information and explore their preferences and needs to determine the focus for the development of the information portal. We found that patient knowledge and numeracy are limited, reliable information is scarce, physicians inform patients selectively and patient involvement is suboptimal, and there is a need for more reliable, tailored, and multi-faceted information. Based on the findings of these surveys and interviews, a patient-tailored information portal was designed that presents evidence-based disease- and age-specific medical and psychosocial information about diagnosis, treatment, prognosis, and impact on daily life in a manner that is comprehensible and digestible for patients and that meets the needs expressed by both patients and physicians. The effect of the website on patient outcome is currently being assessed in a multicenter stepped-wedge implementation

  18. [Profitability of the bronchoscopy in the diagnosis of focal pulmonary malignant lesions].

    Science.gov (United States)

    García Quero, C; García Luján, R; González Torralba, F; de Miguel Poch, E; Alfaro Abreu, J; Villena Garrido, V; López Ríos, F; López Encuentra, A

    2008-12-01

    We define focal pulmonary lesion (FPL) as an intra-parenchymatous pulmonary lesion that is well circumscribed and completely surrounded by healthy lung. It is considered that the profitability of the fine needle aspiration puncture (FNAP) in FPL profitability of the FNAP in the malignant FPL and study if it varies according to site, size and histology. We analyzed all the FBCs of our Unit between 01/2000 and 12/2001 in patients with solitary FLP profitability by size, site and histology was analyzed with Pearson's chi(2) statistics. 124 patients. Mean FBC per patient was 1.3. A total of 101 cases (82%) were diagnosed with FBC, 15 by thoracotomy and 8 by FNAP. Global diagnostic profitability of the FBC was 0.82 and the transbronchial biopsy 0.76. There are no diagnostic profitability differences by size ( 2 cm) (0.81 vs 0.82 p = 0.96), site (peripheral vs central) (0.79 vs 0.85 p = 0.41) and histology (epidermoid vs adenocarcinoma) (0.89 vs 0.75 p = 0.21). Profitability of the FBC in malignant FPL in our hospital is elevated without differences by size, site or histology. In our site, the initial diagnostic approach of the FLP is done with FBC.

  19. Emotional approach coping and the effects of online peer-led support group participation among patients with breast cancer: a longitudinal study.

    Science.gov (United States)

    Batenburg, Anika; Das, Enny

    2014-11-28

    Previous research on the effects of online peer support on psychological well-being of patients with cancer showed mixed findings. There is a need for longitudinal studies explaining if and when online peer-led support groups are beneficial. How patients cope with emotions that come along with the cancer diagnosis might influence effectiveness of online participation. Emotional approach coping is a construct encompassing the intentional use of emotional processing and emotional expression in efforts to manage adverse circumstances. In this longitudinal study, we hypothesize that mixed findings in previous research are partly caused by individual differences in coping with emotions, which may moderate the effects of online support group participation on patients' well-being. A total of 133 Dutch patients with breast cancer filled out a baseline (T0) and a follow-up (T1, 6 months later) questionnaire assessing intensity of online participation within the online support community, emotional approach coping (ie, actively processing and expressing emotions), and psychological well-being (depression, emotional well-being, and breast cancer-related concerns). There were 109 patients who visited an online support community at both points in time. Repeated measures ANOVAs assessed change in well-being over time. Results showed 3-way interactions of time, online intensity of participation, and emotional approach coping on emotional well-being (F1,89=4.232, P=.04, η(2) ρ=.045) and depression (F1,88=8.167, P=.005, η(2) ρ=.085). Online support group participation increased emotional well-being over time for patients who scored low on emotional approach coping at T0, provided that they were highly active online. Patients who were highly active online with a high score on emotional approach coping reported no change in sense of well-being, but showed the highest score on well-being overall. Participating less frequently online was only beneficial for patients who scored high

  20. Exploring Machine Learning Techniques Using Patient Interactions in Online Health Forums to Classify Drug Safety

    Science.gov (United States)

    Chee, Brant Wah Kwong

    2011-01-01

    This dissertation explores the use of personal health messages collected from online message forums to predict drug safety using natural language processing and machine learning techniques. Drug safety is defined as any drug with an active safety alert from the US Food and Drug Administration (FDA). It is believed that this is the first…

  1. Management trends: Internationalization of non-profit organizations

    Directory of Open Access Journals (Sweden)

    Inić Branimir P.

    2015-01-01

    Full Text Available Non-profit organizations are increasingly gaining importance in the modern economy with their development and their numbers increasing day by day. It is very important to note that non-profit organizations are often subject to various benefits that the for-profit companies are not. Thus, for example, preferential tax status of non-profit organizations is manifested primarily in the form of exemption from corporate income tax. In addition, private non-profit organizations enjoy various other state, local and federal taxes exemptions. Under certain conditions, these organizations are exempt from taxes on donations and membership fees. A feature that differentiates various non-profit organizations and profit-oriented companies is their source of income. Profit oriented companies depend on their income, obtained from sales of their goods or services to customers, who usually cover the price and cost of goods and services plus the profit. In contrast, nonprofit organizations are very dependent on membership fees, tax exemptions, members donations or depend on funds of the sponsoring agency which covers most of their costs, for example a federal government agency. Those non-profit organizations that have substantial operating costs beyond national borders and do not identify themselves as purely domestic in their mandate are International non-profit organizations. Most non-profit organizations remain in their national boundaries, on the territory of the country in which they were created, but a large number of non-profit organizations rapidly internationalize, and some larger non-profits have grown into important global actors. The paper includes the following sections: (1 introduction, (2 why is the 'non-profit' important, (3 the internationalization of non-profit organizations, (4 sources of income of non-profit organizations (4.1. causality of impact and of strategic decisions in cases pertaining to universities, (5 the limits of strategic

  2. 48 CFR 415.404-4 - Profit.

    Science.gov (United States)

    2010-10-01

    ...) Termination settlements; and (v) Cost-plus-award-fee contracts; (b) Unless otherwise restricted by contracting... CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 415.404-4 Profit. (a)(1) USDA will use a... negotiation is based on cost analysis. (2) The following types of acquisitions are exempt from the...

  3. 48 CFR 215.404-4 - Profit.

    Science.gov (United States)

    2010-10-01

    ... prenegotiation profit or fee objective on any negotiated contract action when cost or pricing data is obtained, except for cost-plus-award-fee contracts (see 215.404-74, 216.405-2, and FAR 16.405-2) or contracts with... DEFENSE CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 215.404-4...

  4. 262 257 Profitability Analysis of Three Met

    African Journals Online (AJOL)

    2008-12-02

    Dec 2, 2008 ... Profitability Analysis of Three Methods of Suya Production and Marketing in. Maiduguri metropolitan Council, Borno State, ... N 1.25:1 and N 1.1:1 for Kilishi, Tsire and Balangu production and marketing enterprises, respectively. The marketing ... packaging and retailing. It is retailed to consumers in cement ...

  5. Profitability analysis and management practices among poultry ...

    African Journals Online (AJOL)

    Profitability analysis and management practices among poultry farmers in Yola metropolis of Adamawa state, Nigeria. ... Global Journal of Agricultural Sciences ... The major constraints includes: high input costs, unstable market, power supply, diseases, loans, government assistance and to lack of poultry management ...

  6. Profitability of Qualified-Labour-Power Production

    Science.gov (United States)

    Baldino, Roberto Ribeiro; Cabral, Tânia Cristina Baptista

    2015-01-01

    In Baldino and Cabral (2013) we introduced the concept of qualified labour-power as the commodity produced by the school system. In the present article we outline a quantitative model to evaluate the profit rate of educational programmes. We compare a medical school programme with a teacher education programme at a public university in Brazil,…

  7. EPA for Businesses and Non-Profits

    Science.gov (United States)

    Information and links to EPA web pages that are meant to help businesses and non-profits adhere to EPA regulations and otherwise protect the environment, take advantage of opportunities to collaborate with the EPA, and find training EPA training programs.

  8. Continuous sawmill studies: protocols, practices, and profits

    Science.gov (United States)

    Robert Mayer; Jan Wiedenbeck

    2005-01-01

    In today's global economy, the "opportunity cost" associated with suboptimal utilization of raw material and mill resources is significant. As a result, understanding the profit potential associated with different types of logs is critically important for sawmill survival. The conventional sawmill study typically has been conducted on a substantially...

  9. How to Generate Good Profit Maximization Problems

    Science.gov (United States)

    Davis, Lewis

    2014-01-01

    In this article, the author considers the merits of two classes of profit maximization problems: those involving perfectly competitive firms with quadratic and cubic cost functions. While relatively easy to develop and solve, problems based on quadratic cost functions are too simple to address a number of important issues, such as the use of…

  10. THE PERFORMANCE AND PROFITABILITY OF SWEET POTATO ...

    African Journals Online (AJOL)

    propagule length and cattle dung application rates on the growth, yield and profitability of sweet potato. (Ipomea batatas L.) in a humid Ultisols. ... this permits the growing of two or three crop cycles in a year. This crop is usually produced ...... vegetative growth as evidenced by number of leaves, vines, shorter internodes and ...

  11. Data Sparseness and Variance in Accounting Profitability

    NARCIS (Netherlands)

    S. Stavropoulos (Spyridon); M.J. Burger (Martijn); D. Skuras (Dimitris)

    2015-01-01

    markdownabstract__Abstract__ A central question in strategic management is why some firms perform better than others. One approach to addressing this question empirically is to decompose the variance in firm-level profitability into firm, industry, location, and year components. Although it is

  12. Cooperation and profit allocation in distribution chains

    NARCIS (Netherlands)

    Guardiola, L.A.; Meca, A.; Timmer, Judith B.

    2005-01-01

    We study the coordination of actions and the allocation of profit in distribution chains under decentralized control. We consider distribution chains in which a single supplier supplies goods for replenishment of stocks of several retailers who, in turn, sell these goods to their own separate

  13. Profitability Analysis of Groundnuts Processing in Maiduguri ...

    African Journals Online (AJOL)

    This paper examines the profitability of groundnuts processing in Maiduguri Metropolitan Council of Borno State. The specific objectives of the study were to examine the socioeconomic characteristics of groundnut processors, estimate the costs and returns in groundnut processing and determine the return on investment in ...

  14. Relative performance of for-profit psychiatric hospitals in investor-owned systems and nonprofit psychiatric hospitals.

    Science.gov (United States)

    McCue, M J; Clement, J P

    1993-01-01

    The authors analyzed the differences in operational and financial performance between 42 matched pairs of for-profit psychiatric hospitals belonging to multifacility organizations and nonprofit psychiatric hospitals for the fiscal years ending in 1986 through 1990. The pairs of short-term hospitals were matched according to location, standard metropolitan statistical area, or wage index. Analyses were based on data on these hospitals from the Health Care Financing Administration. The groups of variables studied included the hospitals' operational performance and productivity, profitability and payer mix, revenue and expenses, and capital structure. Differences in the mean values of the variables for the for-profit hospitals and the nonprofit hospitals were analyzed by pairwise t tests. The for-profit organization hospitals had significantly higher net revenue, lower salary expenses, and higher profits than the nonprofit hospitals. Patients in the for-profit hospitals had longer stays, and these hospitals had fewer full-time employees per adjusted inpatient day and per adjusted discharge. The higher prices and operating margins of the for-profit hospitals belonging to investor-owned systems reflect the profit-maximizing goal of these facilities. The ability of for-profit organization hospitals to achieve economies of scale in expenses, however, was not evident except in the case of salary expenses.

  15. How do patients perceive the British orthodontic society online information resource about orthognathic treatment? A qualitative study.

    Science.gov (United States)

    Kettle, Jennifer; Marshman, Zoe; Benson, Philip E; McCarthy, Caroline; Pye, Gurpreet; Sandler, Jonathan; Winchester, Lindsay; Flett, Andrew

    2017-09-01

    To explore the accessibility, usability and relevance of the British Orthodontic Society (BOS) online information resource (OIR), Your Jaw Surgery. Qualitative, cross-sectional study. 5 UK sites. Patients before, during and after treatment for non-cleft skeletal discrepancy. Patients were identified at joint clinics and recruited after having time to view the OIR. Semi-structured interviews were conducted with 17 patients (aged 16-46 years). The interviews were transcribed and thematic analysis was undertaken using a framework approach. The main themes identified were the overall usefulness, personal relevance and positive perceptions of the OIR. The OIR was seen to be useful for patients considering treatment, and potentially useful for patients undergoing treatment. Participants were looking for a personally relevant resource that would give them the best possible idea of how they would look and feel after surgery. The OIR was perceived as trusted, positive and reassuring. Patients at different stages of treatment found the OIR helpful and reassuring. Clinicians may find it useful to direct patients to the OIR to complement a professional consultation, but should be aware that patients may perceive it as presenting a positive image of the long-term benefits of orthognathic surgery.

  16. WE-D-BRA-04: Online 3D EPID-Based Dose Verification for Optimum Patient Safety

    Energy Technology Data Exchange (ETDEWEB)

    Spreeuw, H; Rozendaal, R; Olaciregui-Ruiz, I; Mans, A; Mijnheer, B; Herk, M van; Gonzalez, P [Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, Noord-Holland (Netherlands)

    2015-06-15

    Purpose: To develop an online 3D dose verification tool based on EPID transit dosimetry to ensure optimum patient safety in radiotherapy treatments. Methods: A new software package was developed which processes EPID portal images online using a back-projection algorithm for the 3D dose reconstruction. The package processes portal images faster than the acquisition rate of the portal imager (∼ 2.5 fps). After a portal image is acquired, the software seeks for “hot spots” in the reconstructed 3D dose distribution. A hot spot is in this study defined as a 4 cm{sup 3} cube where the average cumulative reconstructed dose exceeds the average total planned dose by at least 20% and 50 cGy. If a hot spot is detected, an alert is generated resulting in a linac halt. The software has been tested by irradiating an Alderson phantom after introducing various types of serious delivery errors. Results: In our first experiment the Alderson phantom was irradiated with two arcs from a 6 MV VMAT H&N treatment having a large leaf position error or a large monitor unit error. For both arcs and both errors the linac was halted before dose delivery was completed. When no error was introduced, the linac was not halted. The complete processing of a single portal frame, including hot spot detection, takes about 220 ms on a dual hexacore Intel Xeon 25 X5650 CPU at 2.66 GHz. Conclusion: A prototype online 3D dose verification tool using portal imaging has been developed and successfully tested for various kinds of gross delivery errors. The detection of hot spots was proven to be effective for the timely detection of these errors. Current work is focused on hot spot detection criteria for various treatment sites and the introduction of a clinical pilot program with online verification of hypo-fractionated (lung) treatments.

  17. Body image and psychological distress in women with breast cancer: a French online survey on patients' perceptions and expectations.

    Science.gov (United States)

    Pierrisnard, Camille; Baciuchka, Marjorie; Mancini, Julien; Rathelot, Pascal; Vanelle, Patrice; Montana, Marc

    2017-12-29

    Altered body image caused by alopecia, loss of eyebrows or eyelashes, or mastectomy is a major source of psychological distress in women with breast cancer. To identify and to assess patients' perceptions and expectations regarding altered body image. Opinion survey conducted among patients treated for breast cancer and member of French online support groups. Anonymous online self-administered survey sent to women with breast cancer. 85% of the women interviewed experienced alopecia during treatment and 67% of them loss of eyebrows or eyelashes. About half of patients suffering alopecia and loss of eyebrows or eyelashes reported fearing what others think. Mastectomy was experienced by 84% of the women in our study, but only 32% of them reported fearing what others think. 87% of our study cohort received information about the possibility of adverse events. 70, 56, and 60% of women felt helped by information they received for the management of alopecia, loss of eyebrows or eyelashes, or mastectomy, respectively. This study confirms that altered body image is a critical psychosocial issue for women with breast cancer. Effective information can be a source of reassurance and may constitute one of the most important sources of emotional support.

  18. If the shoe fits: development of an on-line tool to aid practitioner/patient discussions about 'healthy footwear'.

    Science.gov (United States)

    Farndon, Lisa; Robinson, Victoria; Nicholls, Emily; Vernon, Wesley

    2016-01-01

    A previous study highlighted the importance of footwear to individuals' sense of their identity, demonstrating that shoes must 'fit' someone socially, as well as functionally. However, unhealthy shoes can have a detrimental effect on both foot health and mobility. This project utilises qualitative social science methods to enable podiatrists to understand the broader contribution of footwear to patients' sense of themselves and from this an online toolkit was developed to aid footwear education. Semi-structured interviews were conducted with six podiatrists/shoe-fitters and 13 people with foot pathologies, some of whom also completed shoe diaries. These were supplemented with some follow-up interviews and photographs of participants' own shoes were taken to allow in-depth discussions. Four areas related to 'fit' were identified; practicalities, personal, purpose and pressures, all of which need to be considered when discussing changes in footwear. These were incorporated into an online toolkit which was further validated by service users and practitioners in a focus group. This toolkit can support podiatrists in partnership with patients to identify and address possible barriers to changing footwear towards a more suitable shoe. Enabling patients to make healthier shoe choices will help contribute to improvements in their foot health and mobility.

  19. Dual-tDCS Enhances Online Motor Skill Learning and Long-Term Retention in Chronic Stroke Patients

    Science.gov (United States)

    Lefebvre, S.; Laloux, P.; Peeters, A.; Desfontaines, P.; Jamart, J.; Vandermeeren, Y.

    2013-01-01

    Background: Since motor learning is a key component for stroke recovery, enhancing motor skill learning is a crucial challenge for neurorehabilitation. Transcranial direct current stimulation (tDCS) is a promising approach for improving motor learning. The aim of this trial was to test the hypothesis that dual-tDCS applied bilaterally over the primary motor cortices (M1) improves online motor skill learning with the paretic hand and its long-term retention. Methods: Eighteen chronic stroke patients participated in a randomized, cross-over, placebo-controlled, double bind trial. During separate sessions, dual-tDCS or sham dual-tDCS was applied over 30 min while stroke patients learned a complex visuomotor skill with the paretic hand: using a computer mouse to move a pointer along a complex circuit as quickly and accurately as possible. A learning index involving the evolution of the speed/accuracy trade-off was calculated. Performance of the motor skill was measured at baseline, after intervention and 1 week later. Results: After sham dual-tDCS, eight patients showed performance worsening. In contrast, dual-tDCS enhanced the amount and speed of online motor skill learning compared to sham (p skill learning both quantitatively and qualitatively, leading to successful long-term retention and generalization. The combination of motor skill learning and dual-tDCS is promising for improving post-stroke neurorehabilitation. PMID:23316151

  20. Smoke-Free Recovery from Trauma Surgery: A Pilot Trial of an Online Smoking Cessation Program for Orthopaedic Trauma Patients

    Directory of Open Access Journals (Sweden)

    Sam McCrabb

    2017-07-01

    Full Text Available Smoking increases the risk of complications associated with orthopaedic trauma surgery, however delivery of care is low. Online interventions may provide needed smoking cessation care and promote abstinence. This study aims to examine the engagement, acceptability, and retention of an online smoking cessation program (Smoke-Free Recovery; SFR among a sample of orthopaedic trauma patients, as well as themes around the smoking cessation process. A pilot study of SFR with 31 orthopaedic trauma patients admitted to a public hospital in New South Wales, Australia took place. Semi-structured telephone interviews were conducted following hospital discharge. Thematic analysis and descriptive statistics were used. Engagement was high with 28 participants accessing SFR during admission. Twenty individuals completed follow-up phone calls. Program acceptability was rated favourably. After discharge, changes in smoking habits were noted, with program retention low. Themes on program use included: lack of time or need for additional support; computer illiteracy or technology issues; feeling unready or too stressed to quit; or feeling they had reached the boundary of what could be learnt from the program. This study highlights the difficulties faced by patients following hospital admission, the lack of follow-up support received, and the need for consumer testing prior to roll out. Continuing to develop interventions to promote hospital-initiated cessation attempts that continue post-discharge should be a priority.

  1. Linguistic characteristics of patients with bulimic symptomatology in an online post-treatment program: an exploratory study.

    Science.gov (United States)

    Mezei, Ágnes; Gulec, Hayriye; Czeglédi, Edit; Fritz, Adorján; Túry, Ferenc

    2015-03-01

    No former investigation has been performed related to the linguistic characteristics of patients with eating disorders using online synchronous communication mediums like chats. The purpose of this study was to investigate the linguistic predictors of improvement in eating disorder-related attitudes, behaviours and emotional distress of patients with eating disorders. Thirty-nine women, who had received treatment for bulimia nervosa or related eating disorders not otherwise specified, utilized the moderated therapeutic group chats of an Internet-based program for 4 months. The main themes of 134 session transcripts were created using a general inductive approach. The frequency of dictionary words in the text corpus was processed by the NooJ linguistic software. Eating Disorder Examination Questionnaire and Depression Anxiety Stress Scale were administered at the beginning and at the end of 4 months. No valid questionnaire data could be obtained from 11 participants, so the statistical analyses were performed in a sample of 28 subjects. According to the results of multiple linear regression analyses, higher ratio of words related to "family of origin" was associated with improvements in eating disorder-related attitudes, emotional distress, and reduction in the frequency of binge eating episodes (β = 0.73, p linguistic predictor of improvement during group chat communication of patients with bulimic symptomatology. The results show the importance of family issues in enhancing the treatment outcome and provide preliminary evidence to address this topic during online chat moderation.

  2. Building online brand perceptual map.

    Science.gov (United States)

    Chiang, I-Ping; Lin, Chih-Ying; Wang, Kaisheng M

    2008-10-01

    Many companies have launched their products or services online as a new business focus, but only a few of them have survived the competition and made profits. The most important key to an online business's success is to create "brand value" for the customers. Although the concept of online brand has been discussed in previous studies, there is no empirical study on the measurement of online branding. As Web 2.0 emerges to be critical to online branding, the purpose of this study was to measure Taiwan's major Web sites with a number of personality traits to build a perceptual map for online brands. A pretest identified 10 most representative online brand perceptions. The results of the correspondence analysis showed five groups in the perceptual map. This study provided a practical view of the associations and similarities among online brands for potential alliance or branding strategies. The findings also suggested that brand perceptions can be used with identified consumer needs and behaviors to better position online services. The brand perception map in the study also contributed to a better understanding of the online brands in Taiwan.

  3. Online CBT Is Effective in Overcoming Cultural and Language Barriers in Patients With Depression.

    Science.gov (United States)

    Alavi, Nazanin; Hirji, Alyssa; Sutton, Chloe; Naeem, Farooq

    2016-01-01

    The goal of this study was to evaluate the efficacy of weekly email in delivering online cognitive behavioral therapy (CBT) to treat mild to moderately depressed individuals. The effectiveness of the online CBT was measured following treatment and then again at a 6-month follow-up and was compared with outcomes in a waitlist control group. Participants were recruited through announcements on psychology Web sites, Iranian organization Web sites, and weblogs and flyers. Ninety-three individuals who met inclusion criteria, including a score >18 on the Beck Depression Inventory (BDI), participated in the study, with 47 randomly assigned to the CBT group and 46 to the control group. The CBT group received 10 to 12 sessions of online CBT conducted by a psychiatrist and a psychiatry resident. Following completion of the CBT, a second BDI was sent to participants. Another BDI was then sent to participants 6 months after the completion of treatment. Email-based CBT significantly reduced BDI scores compared with results in a waitlist control group following 10 to 12 weeks of treatment and at 6-month follow-up. Email is a viable method for delivering CBT to individuals when face-to-face interaction is not possible. Limitations and future directions are discussed.

  4. The Association of Patient Factors, Digital Access, and Online Behavior on Sustained Patient Portal Use: A Prospective Cohort of Enrolled Users.

    Science.gov (United States)

    Woods, Susan S; Forsberg, Christopher W; Schwartz, Erin C; Nazi, Kim M; Hibbard, Judith H; Houston, Thomas K; Gerrity, Martha

    2017-10-17

    As electronic health records and computerized workflows expand, there are unprecedented opportunities to digitally connect with patients using secure portals. To realize the value of patient portals, initial reach across populations will need to be demonstrated, as well as sustained usage over time. The study aim was to identify patient factors associated with short-term and long-term portal usage after patients registered to access all portal functions. We prospectively followed a cohort of patients at a large Department of Veterans Affairs (VA) health care facility who recently completed identity proofing to use the VA patient portal. Information collected at baseline encompassed patient factors potentially associated with portal usage, including: demographics, Internet access and use, health literacy, patient activation, and self-reported health conditions. The primary outcome was the frequency of portal log-ins during 6-month and 18-month time intervals after study enrollment. A total of 270 study participants were followed prospectively. Almost all participants (260/268, 97.0%) reported going online, typically at home (248/268, 92.5%). At 6 months, 84.1% (227/270) of participants had visited the portal, with some variation in usage across demographic and health-related subgroups. There were no significant differences in portal log-ins by age, gender, education, marital status, race/ethnicity, distance to a VA facility, or patient activation measure. Significantly higher portal usage was seen among participants using high-speed broadband at home, greater self-reported ability using the Internet, and routinely going online. By 18 months, 91% participants had logged in to the portal, and no significant associations were found between usage and demographics, health status, or patient activation. When examining portal activity between 6 and 18 months, patients who were infrequent or high portal users remained in those categories, respectively. Short-term and long

  5. Alternative profit rate shariah-compliant for islamic banking

    Science.gov (United States)

    Gazali, Nadhirah; Halim, Nurfadhlina Abdul; Ghazali, Puspa Liza

    2017-09-01

    Profit is the aims for Islamic banking and conventional banking. Determination of profit in Islamic banking in Malaysia depends on the profit rate, whereas profit rate is essentially from reference rate which is known as the base rate (BR). However, the determination of the components contained in the BR such as benchmark cost of funds and the statutory reserve requirement (SRR) is non-compliance with the Shariah because its directly proportional to the overnight policy rate (OPR). Therefore, an alternative formula for the profit rate are proposed which is known as the base profit rate (BPR). Construction of BPR formula is based on the principle that are more Shariah-compliant.

  6. Online activity and participation in treatment affects the perceived efficacy of social health networks among patients with chronic illness.

    Science.gov (United States)

    Magnezi, Racheli; Bergman, Yoav S; Grosberg, Dafna

    2014-01-10

    The use of online health-related social networks for support, peer-to-peer connections, and obtaining health information has increased dramatically. Participation in an online health-related social network can enhance patients' self-efficacy and empowerment, as they are given knowledge and tools to manage their chronic health condition more effectively. Thus, we can deduce that patient activation, the extent to which individuals are able to manage their own health care, also increases. However, little is known about the effects of participation in online health-related social networks and patient activation on the perceived usefulness of a website across disease groups. The intent of the study was to evaluate the effects and benefits of participation in an online health-related social network and to determine which variables predict perceived site usefulness, while examining patient activation. Data were collected from "Camoni", the first health-related social network in the Hebrew language. It offers medical advice, including blogs, forums, support groups, internal mail, chats, and an opportunity to consult with experts. This study focused on the site's five largest and most active communities: diabetes, heart disease, kidney disease, spinal injury, and depression/anxiety. Recruitment was conducted during a three-month period in which a link to the study questionnaire was displayed on the Camoni home page. Three questionnaires were used: a 13-item measure of perceived usefulness (Cronbach alpha=.93) to estimate the extent to which an individual found the website helpful and informative, a 9-item measure of active involvement in the website (Cronbach alpha=.84), and The Patient Activation Measure (PAM-13, Cronbach alpha=.86), which assesses a patient's level of active participation in his or her health care. There were 296 participants. Men 30-39 years of age scored higher in active involvement than those 40-49 years (P=.03), 50-64 years (P=.004), or 65+ years (P

  7. Can Online Learning Bend the Higher Education Cost Curve?

    OpenAIRE

    Deming, David James; Claudia D. Goldin; Katz, Lawrence F.; Yuchtman, Noam

    2015-01-01

    We examine whether online learning technologies have led to lower prices in higher education. Using data from the Integrated Postsecondary Education Data System, we show that online education is concentrated in large for-profit chains and less-selective public institutions. Colleges with a higher share of online students charge lower tuition prices. We present evidence that real and relative prices for full-time undergraduate online education declined from 2006 to 2013. Although the pattern o...

  8. [Strategic measures for patient safety in the National Health System: on-line training resources and access to scientific knowledge].

    Science.gov (United States)

    Novillo-Ortíz, D; Agra, Y; Fernández-Maíllo, M M; del Peso, P; Terol, E

    2008-12-01

    Patient safety (PS) is a priority strategy included in the Quality Plan for the Spanish National Health System and its first objective is to promote PS culture among professionals and patients. The Internet is playing a key role in the access to clinical evidence and in the training of health professionals. A multidisciplinary working group was created, who defined the criteria to help improve clinical practice in the field of patient safety, by making available and using web-based patient safety training resources and information. Taking advantage of the possibilities offered by the Internet in terms of training, two online self-training tutorials were developed on risk management, patient safety and adverse event prevention. A Newsletter was also launched, together with two specific patient safety Supplements. Moreover, to extend the reach of the PS Strategy, a patient safety web page and weblog were created, in addition to a collaborative (internal) working group tool. Excelenciaclinica.net was also developed; a meta-search engine specialized in evidence-based information for health professionals, to make it easier to access reliable and valuable information. Health professionals were also allowed to consult, free of charge, reliable health information resources, such as the GuiaSalud platform, the Cochrane Library Plus and the resources of the Joanna Briggs Institute. The involvement of health professionals in these measures and the role that these measures may be expected to play in the development of a premium-quality health service.

  9. Patient Use of Email, Facebook, and Physician Websites to Communicate with Physicians: A National Online Survey of Retail Pharmacy Users.

    Science.gov (United States)

    Lee, Joy L; Choudhry, Niteesh K; Wu, Albert W; Matlin, Olga S; Brennan, Troyen A; Shrank, William H

    2016-01-01

    Patient-physician communication often occurs outside the clinic setting; many institutions discourage electronic communication outside of established electronic health record systems. Little empirical data are available on patient interest in electronic communication and Web-based health tools that are technically feasible but not widely available. To explore patient behavior and interest in using the Internet to contact physicians. National cross-sectional online survey. A sample of 4,510 CVS customers with at least one chronic condition in the household was used to target patients with chronic conditions and their caregivers. Subjects were identified from a national panel of over 100,000 retail pharmacy customers. Of those sampled, 2,252 responded (50.0 % response rate). Survey measures included demographic and health information, patient use of email and Facebook to contact physicians, and patient interest in and use of Web-based tools for health. A total of 37 % of patients reported contacting their physicians via email within the last six months, and 18 % via Facebook. Older age was negatively associated with contacting physicians using email (OR 0.57 [95 % CI 0.41-0.78]) or Facebook (OR 0.28 [0.17-0.45]). Non-white race (OR 1.61 [1.18-2.18] and OR 1.82 [1.24-2.67]) and caregiver status (OR 1.58 [1.27-1.96] and OR 1.71 [1.31- 2.23]) were positively associated with using email and Facebook, respectively. Patients were interested in using Web-based tools to fill prescriptions, track their own health, and access health information (37-57 %), but few were currently doing so (4-8 %). In this population of retail pharmacy users, there is strong interest among patients in the use of email and Facebook to communicate with their physicians. The findings highlight the gap between patient interest for online communication and what physicians may currently provide. Improving and accelerating the adoption of secure Web messaging systems is a possible solution that

  10. Development of an online information and support resource for adolescent idiopathic scoliosis patients considering surgery: perspectives of health care providers

    Directory of Open Access Journals (Sweden)

    Nicholas David

    2010-06-01

    Full Text Available Abstract Background Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS patients considering spinal surgery. Prior to website development, a user-based needs assessment was conducted. The needs assessment involved a total of six focus groups with three stakeholder groups: (1 post-operative AIS patients or surgical candidates (10-18 years (n = 11, (2 their parents (n = 6 and (3 health care providers (n = 11. This paper reports on the findings from focus groups with health care providers. Methods Focus group methodology was used to invite a range of perspectives and stimulate discussion. During audio-recorded focus groups, an emergent table of website content was presented to participants for assessment of relevance, viability and comprehensiveness in targeting global domains of need. Specifically, effective presentation of content, desired aspects of information and support, and discussions about the value of peer support and the role of health professionals were addressed. Focus group transcripts were then subject to content analysis through a constant comparative review and analysis. Results Two focus groups were held with health care providers, consisting of 5 and 6 members respectively. Clinicians provided their perceptions of the information and support needs of surgical patients and their families and how this information and support should be delivered using internet technology. Health care providers proposed four key suggestions to consider in the development of this online resource: (1 create the website with the target audience in mind; (2 clearly state the purpose of the website and organize website content

  11. Development of an online information and support resource for adolescent idiopathic scoliosis patients considering surgery: perspectives of health care providers.

    Science.gov (United States)

    Macculloch, Radha; Nyhof-Young, Joyce; Nicholas, David; Donaldson, Sandra; Wright, James G

    2010-06-29

    Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS) patients considering spinal surgery. Prior to website development, a user-based needs assessment was conducted. The needs assessment involved a total of six focus groups with three stakeholder groups: (1) post-operative AIS patients or surgical candidates (10-18 years) (n = 11), (2) their parents (n = 6) and (3) health care providers (n = 11). This paper reports on the findings from focus groups with health care providers. Focus group methodology was used to invite a range of perspectives and stimulate discussion. During audio-recorded focus groups, an emergent table of website content was presented to participants for assessment of relevance, viability and comprehensiveness in targeting global domains of need. Specifically, effective presentation of content, desired aspects of information and support, and discussions about the value of peer support and the role of health professionals were addressed. Focus group transcripts were then subject to content analysis through a constant comparative review and analysis. Two focus groups were held with health care providers, consisting of 5 and 6 members respectively. Clinicians provided their perceptions of the information and support needs of surgical patients and their families and how this information and support should be delivered using internet technology. Health care providers proposed four key suggestions to consider in the development of this online resource: (1) create the website with the target audience in mind; (2) clearly state the purpose of the website and organize website content to support the user; (3) offer a

  12. Virtual Patients in a Behavioral Medicine Massive Open Online Course (MOOC): A Qualitative and Quantitative Analysis of Participants' Perceptions.

    Science.gov (United States)

    Berman, Anne H; Biguet, Gabriele; Stathakarou, Natalia; Westin-Hägglöf, Beata; Jeding, Kerstin; McGrath, Cormac; Zary, Nabil; Kononowicz, Andrzej A

    2017-10-01

    The purpose of this article is to explore learners' perceptions of using virtual patients in a behavioral medicine Massive Open Online Course (MOOCs) and thereby describe innovative ways of disseminating knowledge in health-related areas. A 5-week MOOC on behavioral medicine was hosted on the edX platform. The authors developed two branched virtual patients consisting of video recordings of a live standardized patient, with multiple clinical decision points and narration unfolding depending on learners' choices. Students interacted with the virtual patients to treat stress and sleep problems. Answers to the exit survey and participant comments from the discussion forum were analyzed qualitatively and quantitatively. In total, 19,236 participants enrolled in the MOOC, out of which 740 received the final certificate. The virtual patients were completed by 2317 and 1640 participants respectively. Among survey respondents (n = 442), 83.1% agreed that the virtual patient exercise was helpful. The qualitative analysis resulted in themes covering what it was like to work with the virtual patient, with subthemes on learner-centered education, emotions/eustress, game comparisons, what the participants learned, what surprised them, how confident participants felt about applying interventions in practice, suggestions for improvement, and previous experiences of virtual patients. Students were enthusiastic about interacting with the virtual patients as a means to apply new knowledge about behavioral medicine interventions. The most common suggestion was to incorporate more interactive cases with various levels of complexity. Further research should include patient outcomes and focus on interprofessional aspects of learning with virtual patients in a MOOC.

  13. Design, construction, and implementation of an online platform for patients with type 1 diabetes: EncoDiab

    Science.gov (United States)

    Alvarado-Martel, Dácil; Cañas, Francesca; Velasco, Rebeca; Alcubierre, Nuria; López-Ríos, Laura; Rius, Ferran; Nóvoa, Francisco Javier; Carrillo, Armando; Hernández, Marta; Wägner, Ana María; Mauricio, Dídac

    2015-01-01

    Purpose The purpose of this study was to develop, build, and implement a virtual platform equipped with practical tools, relevant contents, and communication rooms, with the aim of facilitating patients’ self-management of type 1 diabetes mellitus (T1DM). Materials and methods The design of the platform was based on the suggestions of T1DM patients who were being managed at two reference hospitals. Patients’ needs and preferences were identified in group discussion sessions. Before having access to the platform, patients underwent a baseline assessment, which included physical examination and the administration of validated questionnaires for evaluation of clinical background, quality of life, treatment satisfaction, and well-being. Results A total of 33 patients were included in the study; 54.5% of them were men, their median age was 34 (18–50) years, the median duration of diabetes was 15 (1–38) years, and the median A1C was 7.4% (6%–12.6%). Based on their suggestions and requests, the online platform EncoDiab was built and organized into four domains: a personal domain, two domains shared by the patients and the staff of each of the two participating hospitals, and one domain that was accessible to all participants. The platform included practical tools (a body mass index calculator, a carbohydrate counting tool, and an insulin-dose calculator), a library with relevant information (documents on prevention and treatment of acute complications, nutrition, exercise, etc), and a chat room. Conclusion Although the study is still ongoing, our current results demonstrate the feasibility of building and implementing an online platform for helping T1DM patients in the self-management of their disease in the public health setting. PMID:26124644

  14. Profitability and Efficiency of Red Onion Farming

    Directory of Open Access Journals (Sweden)

    Imron Rosyadi

    2014-12-01

    Full Text Available The purpose of this research is to determine and analyze the profitability and performance of onion farming marketing margins; analyze and know the parts of prices received by farmers and analyze the efficiency of onion farming in the district of Brebes. Samples taken in this study is 30 onion farmers in the district of Brebes, who settled in six villages, each village was taken 5 farmers as the research sample. These results indicate that the location of onion farming research does not provide benefits significantly to the household economy of farmers. Higher selling prices at the retail level and supermarkets do not have a significant impact on the level of profits of farming in the study area. Farming is done by farmers in the study area is inefficient. Onion marketing chain in the study area is relatively long, which consists of 4 lines of marketing.

  15. Competition and Profitability in European Financial Services

    DEFF Research Database (Denmark)

    Balling, Morten; Lierman, F.; Mullineux, A.

    Financial services firms play a key role in the European economy. The efficiency and profitability of these firms and the competition among them have an impact on allocation of savings, financing of investment, economic growth, the stability of the financial system and the transmission of monetary...... policy. This collection of research contributions includes evaluations of trends in the European financial service industry and examinations of the driving forces of efficiency, competition and profitability of financial firms and institutions in Europe. The papers have been written by leading academics...... and researchers in the field, who specialize in strategic, systematic and policy issues related to the European financial services industry. This edited collection will be will be essential reading for students and academics but will also be of interest to financial practitioners and government officials...

  16. Competition for FDI and Profit Shifting

    DEFF Research Database (Denmark)

    Ma, Jie; Raimondos-Møller, Pascalis

    When countries compete for the location of a new multinational plant they need to be aware of the profit shifting opportunities this new plant creates for the global multinational firm. By modelling explicitly the multinational’s intra-firm transactions, we show that the home market advantage tha...... easily win the location game ahead of a large country. How lenient the small country is in implementing transfer pricing regulations turns out to be an important variable in such location games....

  17. Profitability and Efficiency of Red Onion Farming

    OpenAIRE

    Rosyadi, Imron; Purnomo, Didit

    2014-01-01

    The purpose of this research is to determine and analyze the profitability and performance of onion farming marketing margins; analyze and know the parts of prices received by farmers and analyze the efficiency of onion farming in the district of Brebes. Samples taken in this study is 30 onion farmers in the district of Brebes, who settled in six villages, each village was taken 5 farmers as the research sample. These results indicate that the location of onion farming research does not provi...

  18. Base Erosion, Profit Shifting and Developing Countries

    OpenAIRE

    Ernesto Crivelli; De Mooij, Ruud A.; Michael Keen

    2015-01-01

    International corporate tax issues are prominent in public debate, notably with the G20-OECD project addressing Base Erosion and Profit Shifting (‘BEPS’). But while there is considerable empirical evidence for advanced countries on the cross-country fiscal externalities at the heart of these issues, there is almost none for developing countries. This paper uses panel data for 173 countries over 33 years to explore their magnitude and nature, focusing particularly on developing countries a...

  19. Determinants of Bank Profitability in Nigeria

    OpenAIRE

    Osuagwu, Eze

    2014-01-01

    There are increasing scholarly debates on the direction of policy to effectively improve the performance of banks. Some scholars argue that bank performance is enhanced by improvements in the internal organization and managerial efficiency, others argue that industry wide factors are integral to bank performance. In recent times, the direction of literature has shown that macroeconomic factors play a significant role in determining bank profitability. This paper investigates the determinants ...

  20. The Determinants Of European Bank Profitability

    OpenAIRE

    Christos K. Staikouras; Wood, Geoffrey E.

    2011-01-01

    The rate of return earned by a financial institution is affected by numerous factors. These factors include elements internal to each financial institution and several important external forces shaping earnings performance. The type of explanation would determine possible policy implications and ought to be taken seriously. This paper reviews the literature on bank performance studies and classifies the bank profitability determinants. The second part of the paper quantifies how internal dete...

  1. Business strategies, profitability and efficiency of production

    OpenAIRE

    S. Alarcón; M. Sánchez

    2013-01-01

    The strategy choices of market-oriented companies are a topic now under wide investigation in the analysis of business performance antecedents. The purpose of this study is to examine the outcomes of the combination of three different organizational strategies (market orientation, innovativeness and entrepreneurial orientation) on business performance indicators. Models using profitability and efficiency indicators are proposed with the specific aim of obtaining a deeper analysis of the relat...

  2. Clinicians' Views of Educational Interventions for Carers of Patients With Breathlessness Due to Advanced Disease: Findings From an Online Survey.

    Science.gov (United States)

    Ewing, Gail; Penfold, Clarissa; Benson, John A; Mahadeva, Ravi; Howson, Sophie; Burkin, Julie; Booth, Sara; Lovick, Roberta; Gilligan, David; Todd, Christopher; Farquhar, Morag

    2017-02-01

    Carers' needs in advanced disease, and specifically in relation to breathlessness, are well evidenced. Publications on educational interventions for carers of patients with advanced disease that focus on symptoms are scarce and absent for breathlessness. To establish current education provided by clinicians for carers of patients with breathlessness in advanced disease, views about educating carers about breathlessness, and relevant outcomes for a future randomized controlled trial of an educational intervention for carers. An online survey was completed by 365 clinicians: medical, nursing, and allied health professionals from primary care, hospital, and hospice. Descriptive statistics summarized respondent characteristics and survey responses, and the Chi-squared test was applied. Content analysis of free-text comments was conducted. Most clinicians reported educating carers by educating patients at clinical contacts with patients. Carer involvement was largely an 'add-on'; an active carer education strategy, where all carers were invited to attend, was not currently apparent. Clinicians endorsed the importance of educating carers about breathlessness through increasing carer confidence and/or control, helping patients' better self-manage breathlessness and potentially reducing admissions. Joint education with patients, giving practical advice, and strategies for helping patients were advised. To inform a future trial, clinicians identified improvement in patient outcomes, particularly patient quality of life as very important in enhancing clinician adoption of an educational intervention for carers. This survey revealed an appetite among clinicians for an educational intervention for carers of patients with breathlessness in advanced disease and provided important insights to underpin a future Phase II randomized controlled trial. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  3. Profitability of Management Systems on German Fenlands

    Directory of Open Access Journals (Sweden)

    Marco Rebhann

    2016-10-01

    Full Text Available Fens are organic sites that require drainage for agricultural use. Lowering the groundwater level leads to trade-offs between economic benefits and environmental impacts (i.e., CO2 and nutrient emissions. To identify management options that are both environmentally and economically sustainable, a propaedeutic systematic analysis of the costs, income and profit of different land use and management systems on fenlands is necessary. This study provides an overview of the profitability, labor demand and comparative advantages of feasible management systems on German fenlands. Twenty management practices in four land use systems are analyzed. The results indicate that most management systems are profitable only with subsidies and payments for ecosystem services. In addition to sales revenue, these payments are indispensable to promote peat-saving agricultural practices on fenlands. Regarding the labor aspect, intensive management systems caused an increase in working hours per hectare, which may positively affect employment in rural areas. The calculations obtained in this study can be used as a basis for estimations of greenhouse gas (GHG mitigation costs when management systems are associated with GHG emission values.

  4. Online discussion groups for bulimia nervosa: an inductive approach to Internet-based communication between patients.

    Science.gov (United States)

    Wesemann, Dorette; Grunwald, Martin

    2008-09-01

    Online discussion forums are often used by people with eating disorders. This study analyses 2,072 threads containing a total of 14,903 postings from an unmoderated German "prorecovery" forum for persons suffering from bulimia nervosa (www.ab-server.de) during the period from October 2004 to May 2006. The threads were inductively analyzed for underlying structural types, and the various types found were then analyzed for differences in temporal and quantitative parameters. Communication in the online discussion forum occurred in three types of thread: (1) problem-oriented threads (78.8% of threads), (2) communication-oriented threads (15.3% of threads), and (3) metacommunication threads (2.6% of threads). Metacommunication threads contained significantly more postings than problem-oriented and communication-oriented threads, and they were viewed significantly more often. Moreover, there are temporal differences between the structural types. Topics relating to active management of the disorder receive great attention in prorecovery forums. (c) 2008 by Wiley Periodicals, Inc.

  5. Identifying the unmet health needs of patients with congenital hypogonadotropic hypogonadism using a web-based needs assessment: implications for online interventions and peer-to-peer support.

    Science.gov (United States)

    Dwyer, Andrew A; Quinton, Richard; Morin, Diane; Pitteloud, Nelly

    2014-06-11

    Patients with rare diseases such as congenital hypogonadotropic hypogonadism (CHH) are dispersed, often challenged to find specialized care and face other health disparities. The internet has the potential to reach a wide audience of rare disease patients and can help connect patients and specialists. Therefore, this study aimed to: (i) determine if web-based platforms could be effectively used to conduct an online needs assessment of dispersed CHH patients; (ii) identify the unmet health and informational needs of CHH patients and (iii) assess patient acceptability regarding patient-centered, web-based interventions to bridge shortfalls in care. A sequential mixed-methods design was used: first, an online survey was conducted to evaluate health promoting behavior and identify unmet health and informational needs of CHH men. Subsequently, patient focus groups were held to explore specific patient-identified targets for care and to examine the acceptability of possible online interventions. Descriptive statistics and thematic qualitative analyses were used. 105 male participants completed the online survey (mean age 37 ± 11, range 19-66 years) representing a spectrum of patients across a broad socioeconomic range and all but one subject had adequate healthcare literacy. The survey revealed periods of non-adherence to treatment (34/93, 37%) and gaps in healthcare (36/87, 41%) exceeding one year. Patient focus groups identified lasting psychological effects related to feelings of isolation, shame and body-image concerns. Survey respondents were active internet users, nearly all had sought CHH information online (101/105, 96%), and they rated the internet, healthcare providers, and online community as equally important CHH information sources. Focus group participants were overwhelmingly positive regarding online interventions/support with links to reach expert healthcare providers and for peer-to-peer support. The web-based needs assessment was an effective way

  6. Profit-Sharing – A Tool for Improving Productivity, Profitability and Competitiveness of Firms?

    Directory of Open Access Journals (Sweden)

    Fibirova Jana

    2013-12-01

    Full Text Available The importance of appropriate utilization of rewards for performance is still growing and therefore this type of rewards can be seen as a significant part of a total rewards package. Companies that are able to appropriately implement rewards for performance may gain competitive advantage over their competitors, but successful implementation requires a good knowledge of these rewards. The main aim of this paper is to contribute to the growth of this knowledge by identifying possible positive and negative impacts of profit-sharing on various areas that are important for the performance of a company, nevertheless, addressed are also macroeconomic consequences of profit-sharing. Furthermore, a comprehensive and up-to-date review of the relevant literature is provided, under-researched areas are identified and suggestions for further research are given. To accomplish these goals, we applied methods of bibliometric analysis to the articles indexed in ISI Web of Knowledge to identify the most important articles, authors and topics. According to our findings, the majority of studies report a neutral or positive impact of profit-sharing on productivity and profitability. This impact may be achieved by direct influence of profit-sharing on productivity of employees (due to the dependence of their pay on profit, but it seems that yet more important are various mediating mechanisms, especially effects on employment stability, absenteeism, quits and related issues, as well as effects on attitudes of employees and on relationships between employees. We argue that a well-designed profit-sharing plan is crucial for its success, but it is a relatively under-researched problem.

  7. The substantial burden of systemic lupus erythematosus on the productivity and careers of patients: a European patient-driven online survey.

    Science.gov (United States)

    Gordon, Caroline; Isenberg, David; Lerstrøm, Kirsten; Norton, Yvonne; Nikaï, Enkeleida; Pushparajah, Daphnee S; Schneider, Matthias

    2013-12-01

    The objective of this study was to explore the burden of SLE and its effect on patients' lives. The Lupus European Online (LEO) survey included patient-designed questions on demographics, SLE diagnosis, and the impact of SLE on careers. Three SLE-specific patient-reported outcome (PRO) questionnaires were also completed: the Lupus Quality of Life (LupusQoL), the Fatigue Severity Scale (FSS), and the Work Productivity and Activity Impairment (WPAI)-Lupus v2.0. The survey was available online in five languages from May through August 2010. All self-identified SLE participants were eligible to respond. Survey results were analysed using descriptive statistics. Multivariate linear regression explored factors contributing to impaired productivity. Of the 2070 European SLE patients completing the survey, 93.1% were women, 86.7% were aged careers; 27.7% changed careers within a year of diagnosis. All LupusQoL domains (score range 0-100) were impaired, with fatigue (median domain score 43.8) being the most affected and intimate relationships (median domain score 75.0) the least. Most patients (82.5%) reported fatigue (FSS score ≥4). Productivity was impaired across all WPAI domains, both at work and in general activities. Fatigue, an inability to plan and reduced physical health were significantly associated with impaired productivity. Patients whose careers were affected by SLE had worse health-related quality of life, more fatigue and worse productivity than patients whose careers were not affected. LEO survey respondents reported that SLE negatively affects their daily lives, productivity and career choices.

  8. The use of nationwide on-line prescription records improves the drug history in hospitalized patients

    DEFF Research Database (Denmark)

    Glintborg, Bente; Poulsen, Henrik E; Dalhoff, Kim P

    2008-01-01

    What is already known about this subject: Structured medication interviews improve the medication history upon hospitalization. Pharmacy records are valid lists of the prescribed medications available to individual patients. In Denmark, treating doctors now have access to their patients' pharmacy...

  9. Usage and users of online self-management programs for adult patients with atopic dermatitis and food allergy : an explorative study

    NARCIS (Netherlands)

    van Os-Medendorp, Harmieke; van Leent-de Wit, Ilse; de Bruin-Weller, Marjolein; Knulst, André

    2015-01-01

    BACKGROUND: Two online self-management programs for patients with atopic dermatitis (AD) or food allergy (FA) were developed with the aim of helping patients cope with their condition, follow the prescribed treatment regimen, and deal with the consequences of their illness in daily life. Both

  10. 26 CFR 1.1502-33 - Earnings and profits.

    Science.gov (United States)

    2010-04-01

    ... also lost in Year 1, P would have decreased its earnings and profits for Year 1 by the additional $50... 26 Internal Revenue 12 2010-04-01 2010-04-01 false Earnings and profits. 1.1502-33 Section 1.1502... (CONTINUED) INCOME TAXES Basis, Stock Ownership, and Earnings and Profits Rules § 1.1502-33 Earnings and...

  11. Relating customer satisfaction to customer profitability: an empirical ...

    African Journals Online (AJOL)

    This paper explores relationships between customer satisfactions; repurchase intentions, purchase behavior, and customer profitability with empirical data on attitudes, behavior, and profitability at the customer level of analysis. Purchase behavior and profitability data derived from the accounting system of a firm, are ...

  12. Comparative Corporate Governance of Non-Profit Organizations

    DEFF Research Database (Denmark)

    Thomsen, Steen

    2014-01-01

    Based on the impressive work of Hopt and von Hippel (2010), I review the comparative corporate governance of non-profit organizations and propose topics for future research. There is evidence of agency problems in non-profit as well as for-profit organizations, but the governance mechanisms...

  13. 26 CFR 1.312-6 - Earnings and profits.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 4 2010-04-01 2010-04-01 false Earnings and profits. 1.312-6 Section 1.312-6...) INCOME TAXES Effects on Corporation § 1.312-6 Earnings and profits. (a) In determining the amount of earnings and profits (whether of the taxable year, or accumulated since February 28, 1913, or accumulated...

  14. An Algorithm for the Nucleolus of Airport Profit Problems

    NARCIS (Netherlands)

    Brânzei, R.; Inarra, E.; Tijs, S.H.; Zarzuelo, J.

    2003-01-01

    Airport profit games are a generalization of airport cost games as well as of bankruptcy games.In this paper we present a simple algorithm to compute the nucleolus of airport profit games.In addition we prove that there exists an unique consistent allocation rule in airport profit problems, and it

  15. Taxing across Borders: Tracking Personal Wealth and Corporate Profits

    National Research Council Canada - National Science Library

    Gabriel Zucman

    2014-01-01

    ... that UScompanies are shifting profits to Bermuda, Luxembourg, and similar countries on a large and growing scale. About 20percent of all US corporate profits are now booked in such havens, a tenfoldincrease since the 1980s. This profit-shifting is typically done within the letter of the law and thus would be best described as tax avoidance rather than fraud. ...

  16. Determinants Of Profitability And Willingness To Pay For ...

    African Journals Online (AJOL)

    The study attempts to analyse the profitability of urban agriculture using metropolitan organic waste in Abuja, the Federal Capital Territory of Nigeria. The results show that the enterprise is profitable, and that output price is the most important determinant of maximum variable profit. Other price factors, specifically planting ...

  17. Wise Investment? Modeling Industry Profitability and Risk of Targeted Chemotherapy for Incurable Solid Cancers

    Science.gov (United States)

    Conter, Henry J.; Chu, Quincy S.C.

    2012-01-01

    Purpose: Pharmaceutical development involves substantial financial risk. This risk, rising development costs, and the promotion of continued research and development have been cited as major drivers in the progressive increase in drug prices. Currently, cost-effective analyses are being used to determine the value of treatment. However, cost-effective analyses practically function as a threshold for value and do not directly address the rationale for drug prices. We set out to create a functional model for industry price decisions and clarify the minimum acceptable profitability of new drugs. Methods: Assuming that industry should only invest in profitable ventures, we employed a linear cost-volume-profit breakeven analysis to equate initial capital investment and risk and post–drug-approval profits, where drug development represents the bulk of investment. A Markov decision analysis model was also used to define the relationships between investment events risk. A systematic literature search was performed to determine event probabilities, clinical trial costs, and total expenses as inputs into the model. Disease-specific inputs, current market size across regions, and lengths of treatment for cancer types were also included. Results: With development of single novel chemotherapies costing from $802 to $1,042 million (2002 US dollars), pharmaceutical profits should range from $4.3 to $5.2 billion, with an expected rate of return on investment of 11% annually. However, diversification across cancer types for chemotherapy can reduce the minimum required profit to less than $3 billion. For optimal diversification, industry should study four tumor types per drug; however, nonprofit organizations could tolerate eight parallel development tracks to minimize the risk of development failure. Assuming that pharmaceutical companies hold exclusive rights for drug sales for only 5 years after market approval, the minimum required profit per drug per month per patient ranges

  18. Patient perceptions of glucocorticoid side effects: a cross-sectional survey of users in an online health community.

    Science.gov (United States)

    Costello, Ruth; Patel, Rikesh; Humphreys, Jennifer; McBeth, John; Dixon, William G

    2017-04-03

    To identify the side effects most important to glucocorticoid (GC) users through a survey of a UK online health community (Healthunlocked.com). Online cross-sectional survey. Participants were recruited through Healthunlocked.com, an online social network for health. Adults who were currently taking GCs, or had taken GCs in the past month. Responders scored the importance of listed side effects from 1 to 10, with 10 being of high importance to them. For each side effect, histograms were plotted, and the median rating and IQR were determined. Side effects were ranked by median ranking (largest to smallest) and then IQR (smallest to largest). The scores were categorised as low (scores 1-3), medium (scores 4-7) and high (scores 8-10) importance. 604 responders completed the survey. Histograms of side effect scores showed a skew towards high importance for weight gain, a U-shaped distribution for cardiovascular disease (CVD), diabetes, eye disease and infections, and a skew towards low importance for acne. When ranked, the side effect of most importance to responders was weight gain (median score=9, IQR 6-10) followed by insomnia and moon face with equal median score (8) and IQR (5-10). Three serious side effects, CVD, diabetes and infections, were ranked of lower importance overall but had wide ranging scores (median score=8, IQR 1-10). The three most highly rated side effects were not clinically serious but remained important to patients, perhaps reflecting their impact on quality of life and high prevalence. This should be taken into consideration when discussing treatment options and planning future GC safety studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. On-line computerized diagnosis of pain-related disability and psychological status of TMD patients: a pilot study.

    Science.gov (United States)

    Yap, A U; Tan, K B; Hoe, J K; Yap, R H; Jaffar, J

    2001-01-01

    Temporomandibular disorders (TMD) is a collective term embracing a number of clinical problems, which involve the masticatory musculature, the temporomandibular joint or both. Virtually all theories dealing with the aetiology and treatment of TMD have recognized the importance of psychological factors. This paper reports the development of a computerized on-line program (NUS TMD v1.1) for the diagnosis of pain-related disability and psychological status of TMD patients based on Axis II of the research diagnostic criteria (RDC)/TMD (Dworkin, S.F. & LeResche, L. 1992. Journal of Craniomandibular Disorders: Facial Oral Pain, 6, 301), which was developed to redress the lack of diagnostic criteria in TMD research. Methods adopted by RDC/TMD for use in assessing Axis II status include a seven-item questionnaire for grading chronic pain severity, the Symptom Checklist 90 Revised (SCL-90-R) and a jaw disability checklist. A pilot study, based on 37 new TMD patient records, was conducted to study the pain-related disability and psychological status of TMD patients using this newly developed program. The mean age of the predominantly Chinese population (86.5%) was 32.19 years (range 20-72 years) with a sex distribution of 24 females and 13 males. Most patients (78%) had low disability, with 12 patients having low intensity and 17 patients having high intensity pain. Approximately 73% of the sample population were moderately or severely depressed. Patients that were moderately and severely depressed had significantly higher scores for limitation related to mandibular functioning than normal patients. The three most frequent jaw disabilities were: eating hard foods (84%), yawning (78%) and chewing (65%).

  20. Organizational Structure and Behaviour in Day Care: Differences between Non-Profit and For-Profit Centres.

    Science.gov (United States)

    Canning, Patricia M.; Lyon, Mary E.; Kienapple, Kim; Young, Jeffrey

    2002-01-01

    Examined how Canadian day care centers are operated and managed, to identify differences in organizational structure and behavior between non-profit and for-profit centers and characteristics of structure and management linked with high quality care. Found that non-profit centers were more complex, more formalized, and less centralized than…

  1. Analysis of patient organizations' needs and ICT use--The APTIC project in Spain to develop an online collaborative social network.

    Science.gov (United States)

    Hernández-Encuentra, Eulàlia; Gómez-Zúñiga, Beni; Guillamón, Noemí; Boixadós, Mercè; Armayones, Manuel

    2015-12-01

    The purpose of this first part of the APTIC (Patient Organisations and ICT) project is to design and run an online collaborative social network for paediatric patient organizations (PPOs). To analyse the needs of PPOs in Spain to identify opportunities to improve health services through the use of ICT. A convenience sample of staff from 35 PPOs (54.68% response rate) participated in a structured online survey and three focus groups (12 PPOs). Paediatric patient organizations' major needs are to provide accredited and managed information, increase personal support and assistance and promote joint commitment to health care. Moreover, PPOs believe in the Internet's potential to meet their needs and support their activities. Basic limitations to using the Internet are lack of knowledge and resources. The discussion of the data includes key elements of designing an online collaborative social network and reflections on health services provided. © 2014 John Wiley & Sons Ltd.

  2. Higher Education: The Online Teaching and Learning Experience

    Science.gov (United States)

    Barr, Betty A.; Miller, Sonya F.

    2013-01-01

    Globally, higher education, as well as K-12, utilizes online teaching to ensure that a wide array of learning opportunities are available for students in a highly competitive technological arena. The most significant influence in education in recent years is the increase and recognition of private for-profit adult distance and online education…

  3. Measuring the effects of online health information for patients: item generation for an e-health impact questionnaire.

    Science.gov (United States)

    Kelly, Laura; Jenkinson, Crispin; Ziebland, Sue

    2013-12-01

    The internet is a valuable resource for accessing health information and support. We are developing an instrument to assess the effects of websites with experiential and factual health information. This study aimed to inform an item pool for the proposed questionnaire. Items were informed through a review of relevant literature and secondary qualitative analysis of 99 narrative interviews relating to patient and carer experiences of health. Statements relating to identified themes were re-cast as questionnaire items and shown for review to an expert panel. Cognitive debrief interviews (n=21) were used to assess items for face and content validity. Eighty-two generic items were identified following secondary qualitative analysis and expert review. Cognitive interviewing confirmed the questionnaire instructions, 62 items and the response options were acceptable to patients and carers. Using a clear conceptual basis to inform item generation, 62 items have been identified as suitable to undergo further psychometric testing. The final questionnaire will initially be used in a randomized controlled trial examining the effects of online patient's experiences. This will inform recommendations on the best way to present patients' experiences within health information websites. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Results from an online survey of patient and caregiver perspectives on unmet needs in the treatment of bipolar disorder.

    Science.gov (United States)

    Masand, Prakash S; Tracy, Natasha

    2014-01-01

    To look at the manner in which patients and caregivers perceive the treatment of bipolar disorder compared with the evidence base for bipolar treatment. Between April 2013 and March 2014, 469 respondents took a 14-question online survey on demographics, medications taken, and perspectives on bipolar treatment and medications. Participants were recruited through social media outlets (Facebook and Twitter accounts) of Global Medical Education (New York, New York) and the blog Bipolar Burble, which has a primary audience of people with bipolar disorder. There were no exclusion criteria to participation, and both patients and health care professionals were encouraged to participate. Most respondents were taking ≥ 3 medications, and the greatest unmet need in treatment was for bipolar depression. In general, respondent perspectives on the effectiveness of individual medication treatments did not align with the available literature. Weight gain was the greatest side effect concern for both antipsychotics and mood stabilizers. Our survey demonstrates that there are still many unmet needs in the treatment of bipolar disorder. There is also a mismatch between the evidence base for treatments in bipolar disorder and patient perception of the relative efficacy of different medications. In order to achieve better outcomes, there is a need to provide patients and clinicians greater quality education with regard to the best evidence-based treatments for bipolar disorder.

  5. Are we effectively informing patients? A quantitative analysis of on-line patient education resources from the American Society of Neuroradiology.

    Science.gov (United States)

    Hansberry, D R; Agarwal, N; Gonzales, S F; Baker, S R

    2014-07-01

    The ubiquitous use of the Internet by the public in an attempt to better understand their health care requires the on-line resources written at an appropriate level to maximize comprehension for the average user. The National Institutes of Health and the American Medical Association recommend on-line patient education resources written at a third-to-seventh grade level. We evaluated the readability of the patient education resources provided on the Web site of the American Society of Neuroradiology (http://www.asnr.org/patientinfo/). All patient education material from the ASNR Web site and the Society of Neurointerventional Surgery Web site were downloaded and evaluated with the computer software, Readability Studio Professional Edition, by using 10 quantitative readability scales: the Flesch Reading Ease, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, Coleman-Liau Index, Gunning Fog Index, New Dale-Chall, FORCAST Formula, Fry Graph, Raygor Reading Estimate, and New Fog Count. An unpaired t test was used to compare the readability level of resources available on the American Society of Neuroradiology and the Society of Neurointerventional Surgery Web sites. The 20 individual patient education articles were written at a 13.9 ± 1.4 grade level with only 5% written at Society of Neuroradiology and Society of Neurointerventional Surgery Web sites. The patient education resources on these Web sites fail to meet the guidelines of the National Institutes of Health and American Medical Association. Members of the public may fail to fully understand these resources and would benefit from revisions that result in more comprehensible information cast in simpler language. © 2014 by American Journal of Neuroradiology.

  6. Testing an online self-management program for patients with CVR: an explorative RCT.

    NARCIS (Netherlands)

    Puijk-Hekman, S.; Gaal, B.G.I. van; Bredie, S.J.; Nijhuis-van der Sanden M.W.G.; Dulmen, S. van

    2016-01-01

    Background: Because of the large impact of cardiovascular risk (CVR), there is a growing interest in self-management for patients with CVR. To support self-management behavior for patients with CVR, an e-health self-management program has been developed. In this study, we will evaluate the

  7. Measuring organisational readiness for patient engagement (MORE): an international online Delphi consensus study

    NARCIS (Netherlands)

    Oostendorp, L.J.; Durand, M.A.; Lloyd, A.; Elwyn, G.

    2015-01-01

    BACKGROUND: Widespread implementation of patient engagement by organisations and clinical teams is not a reality yet. The aim of this study is to develop a measure of organisational readiness for patient engagement designed to monitor and facilitate a healthcare organisation's willingness and

  8. Young patients', parents', and survivors' communication preferences in paediatric oncology: results of online focus groups.

    NARCIS (Netherlands)

    Zwaanswijk, M.; Tates, K.; Dulmen, A.M. van; Hoogerbrugge, P.M.; Kamps, W.A.; Bensing, J.M.

    2007-01-01

    BACKGROUND: Guidelines in paediatric oncology encourage health care providers to share relevant information with young patients and parents to enable their active participation in decision making. It is not clear to what extent this mirrors patients' and parents' preferences. This study investigated

  9. Young patients', parents', and survivors' communication preferences in paediatric oncology: using online focus groups.

    NARCIS (Netherlands)

    Zwaanswijk, M.; Tates, K.; Dulmen, S. van; Hoogerbrugge, M.; Kamps, W.A.; Bensing, J.M.

    2007-01-01

    BACKGROUND: Guidelines in paediatric oncology encourage health care providers to share relevant information with young patients and parents to enable their active participation in decision making. It is not clear to what extent this mirrors patients' and parents' preferences. This study investigated

  10. DOD Contractor Profitability 1980-1984

    Science.gov (United States)

    1985-12-01

    compdny’s control), surf)lus, and retdined earnings. 2. Seleccion of a Profit ~~asure A number of prot1t measures have been used in s t u d y i n g de E...iC- GGG GGG GGG L"II .:)S. 0.. S.t?ACr; F1ŕC COHPOkA’l’ I ON 1. ~1C Corp. is the world’s largest ~roducer of natural sod~ ash and

  11. Use of an Online Education Platform to Enhance Patients' Knowledge About Radiation in Diagnostic Imaging.

    Science.gov (United States)

    Steele, Joseph R; Jones, A Kyle; Clarke, Ryan K; Shiao, Sue J; Wei, Wei; Shoemaker, Stowe; Parmar, Simrit

    2017-03-01

    The aim of this study was to compare the impact of a digital interactive education platform and standard paper-based education on patients' knowledge regarding ionizing radiation. Beginning in January 2015, patients at a tertiary cancer center scheduled for diagnostic imaging procedures were randomized to receive information about ionizing radiation delivered through a web-based interactive education platform (interactive education group), the same information in document format (document education group), or no specialized education (control group). Patients who completed at least some education and control group patients were invited to complete a knowledge assessment; interactive education patients were invited to provide feedback about satisfaction with their experience. A total of 2,226 patients participated. Surveys were completed by 302 of 745 patients (40.5%) participating in interactive education, 488 of 993 (49.1%) participating in document education, and 363 of 488 (74.4%) in the control group. Patients in the interactive education group were significantly more likely to say that they knew the definition of ionizing radiation, outperformed the other groups in identifying which imaging examinations used ionizing radiation, were significantly more likely to identify from a list which imaging modality had the highest radiation dose, and tended to perform better when asked about the tissue effects of radiation in diagnostic imaging, although this difference was not significant. In the interactive education group, 84% of patients were satisfied with the experience, and 79% said that they would recommend the program. Complex information on a highly technical subject with personal implications for patients may be conveyed more effectively using electronic platforms, and this approach is well accepted. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  12. An online module series to prepare pharmacists to facilitate student engagement in patient-centered care delivery: development and evaluation

    Directory of Open Access Journals (Sweden)

    Kassam R

    2012-06-01

    Full Text Available Rosemin Kassam,1 Mona Kwong,1 John B Collins21Faculty of Pharmaceutical Sciences, 2Department of Educational Studies, University of British Columbia, Vancouver, CanadaIntroduction: Accreditation bodies across North America have adopted revised standards that place increased emphasis on experiential education and preceptors to promote and demonstrate patient-centered, pharmaceutical care practices to students. Since such practices are still evolving, challenges exist in recruiting skilled preceptors who are prepared to provide such opportunities. An online educational module series titled "A Guide to Pharmaceutical Care" (The Guide was developed and evaluated to facilitate this transition. The objectives of this paper are: (1 to describe the development of the modules; and (2 to present the evaluation results from its pilot testing.Methods: The Guide was developed as an online, self-directed training program. It begins by providing an overview of patient care (PC philosophy and practice, and then discusses the tools that facilitate PC. It also provides a range of tips to support students as they provide PC during their experiential learning. Pharmacists participating in the pilot study were recruited using purposive and snowball sampling techniques. A pre–post quantitative survey with additional open-ended questions was used to evaluate the modules.Results: The modules incorporated a variety of teaching strategies: self-reflection exercises, quizzes to review important concepts, quick tips, flash cards, and video clips to illustrate more in-depth learning. Thirty-two pharmacists completed the pre–post assessment and reported significant increases in their confidence because of this training. The most influenced outcome was "Application of techniques to facilitate learning opportunities that enable pharmacy students to practice pharmaceutical care competencies." They also indicated that the training clarified necessary changes in their

  13. Presenting evidence to patients online: what do web users think of consumer summaries of cochrane musculoskeletal reviews?

    Science.gov (United States)

    Brehaut, Jamie C; Santesso, Nancy; O'Connor, Annette M; Lott, Alison; Lindgaard, Gitte; Syrowatka, Ania; Graham, Ian D; Tugwell, Peter S

    2011-01-18

    The Internet has the potential to be an effective medium for delivering health care knowledge to consumers. While computer usability research makes recommendations about how to present Web-based information generally, there remains no clear guidance on how to present specific forms of health care research evidence online in a way that facilitates understanding and good health care decision making. The two goals of this study were to describe the Cochrane Musculoskeletal Group's (CMSG's) process for developing online patient-focused summaries of systematic reviews and to evaluate the impressions of these summaries formed by users. A process for summarizing the results of systematic reviews via consumer summaries has evolved over 15 years. An evaluation of this approach took the form of Internet surveys on the Arthritis Society of Canada website and surveys of members of the Canadian Arthritis Patient Alliance (CAPA). Respondents provided information on background, relationship to the decision, their satisfaction with and preparation for decision making, and suggestions for improvements to the summaries. Survey data were collected between August 1, 2005, and February 28, 2006. A total of 261 respondents completed the survey. The majority (226/261 or 87%) of respondents reported having an arthritis-related condition. The consumer summary approach was generally reviewed favorably by respondents, with most agreeing that the summary provided appropriate information (177/261 or 68%), would be useful to others (160/261 or 61%), was well laid out (159/261 or 61%), was easy to learn from (157/261 or 60%), and was useful to the reader (153/261 or 59%). Areas of potential improvement were indicated by relatively fewer respondents agreeing that they could easily find all the information they wanted (118/261 or 45%), by a substantial proportion being unable to judge whether the providers of the information are reliable (80/261 or 31%), and by a similar proportion being unable to

  14. Comparative Readability Analysis of Online Patient Education Resources on Inflammatory Bowel Diseases

    OpenAIRE

    Rishabh Gulati; Mohammad Nawaz; Linh Lam; Pyrsopoulos,Nikolaos T

    2017-01-01

    Background. The National Institutes of Health recommend a readability grade level of less than 7th grade for patient directed information. In this study, we use validated readability metrics to analyze patient information from prominent websites pertaining to ulcerative colitis and Crohn’s disease. Methods. The terms “Crohn’s Disease,” “Ulcerative Colitis,” and “Inflammatory Bowel Disease” were queried on Google and Bing. Websites containing patient education material were saved as a text fil...

  15. Readability, content, and quality of online patient education materials on preeclampsia.

    Science.gov (United States)

    Lange, Elizabeth M S; Shah, Anuj M; Braithwaite, Brian A; You, Whitney B; Wong, Cynthia A; Grobman, William A; Toledo, Paloma

    2015-01-01

    The objective of this study was to evaluate the readability, content, and quality of patient education materials addressing preeclampsia. Websites of U.S. obstetrics and gynecology residency programs were searched for patient education materials. Readability, content, and quality were assessed. A one-sample t-test was used to evaluate mean readability level compared with the recommended 6th grade reading level. Mean readability levels were higher using all indices (p Content was variable with good website understandability, but poor actionability. The mean readability was above the recommended 6th grade reading level. The content, readability, and actionability of preeclampsia patient education materials should be improved.

  16. The online use of Violence and Journey metaphors by patients with cancer, as compared with health professionals: a mixed methods study.

    Science.gov (United States)

    Semino, Elena; Demjén, Zsófia; Demmen, Jane; Koller, Veronika; Payne, Sheila; Hardie, Andrew; Rayson, Paul

    2017-03-01

    To compare the frequencies with which patients with cancer and health professionals use Violence and Journey metaphors when writing online; and to investigate the use of these metaphors by patients with cancer, in view of critiques of war-related metaphors for cancer and the adoption of the notion of the 'cancer journey' in UK policy documents. Computer-assisted quantitative and qualitative study of two data sets totalling 753 302 words. A UK-based online forum for patients with cancer (500 134 words) and a UK-based website for health professionals (253 168 words). 56 patients with cancer writing online between 2007 and 2012; and 307 health professionals writing online between 2008 and 2013. Patients with cancer use both Violence metaphors and Journey metaphors approximately 1.5 times per 1000 words to describe their illness experience. In similar online writing, health professionals use each type of metaphor significantly less frequently. Patients' Violence metaphors can express and reinforce negative feelings, but they can also be used in empowering ways. Journey metaphors can express and reinforce positive feelings, but can also be used in disempowering ways. Violence metaphors are not by default negative and Journey metaphors are not by default a positive means of conceptualising cancer. A blanket rejection of Violence metaphors and an uncritical promotion of Journey metaphors would deprive patients of the positive functions of the former and ignore the potential pitfalls of the latter. Instead, greater awareness of the function (empowering or disempowering) of patients' metaphor use can lead to more effective communication about the experience of cancer. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  17. GPs' confidence in caring for their patients on the autism spectrum: an online self-report study.

    Science.gov (United States)

    Unigwe, Silvana; Buckley, Carole; Crane, Laura; Kenny, Lorcan; Remington, Anna; Pellicano, Elizabeth

    2017-06-01

    In the UK, GPs play a key role in the identification and management of children, young people, and adults on the autism spectrum, but there is a paucity of research on GPs' perceptions of working with these patients. To understand GPs' perceived self-efficacy in identifying and managing their patients on the autism spectrum, and the factors affecting this. An online self-report survey was developed for completion by GPs across the UK. A total of 304 GPs in the UK took part. The survey collected responses on participants' background, training, and experience, both as a GP and with regard to autism, and included a 22-item knowledge of autism questionnaire, a 14-item self-efficacy scale targeting GPs' perceived confidence in identifying and managing their autistic patients, and an open question eliciting participants' experiences of working with autistic people. In total, 39.5% (n = 120) of GP participants reported never having received formal training in autism. Despite demonstrating good knowledge of its key features, participants reported limited confidence in their abilities to identify and manage autistic patients, with many citing a number of barriers that overwhelmingly focused on perceived failings of the current healthcare system (such as a lack of clarity around referral pathways). There is an urgent need for improved local specialist service provision alongside clearer referral pathways for diagnosis to improve both GPs' confidence in caring for their autistic patients and the healthcare experiences of autistic patients and their families. Local clinical commissioning groups are best served to assist GPs in ensuring that they can reliably detect the condition and make appropriate provisions for support. © British Journal of General Practice 2017.

  18. Optimal convection volume for improving patient outcomes in an international incident dialysis cohort treated with online hemodiafiltration

    Science.gov (United States)

    Canaud, Bernard; Barbieri, Carlo; Marcelli, Daniele; Bellocchio, Francesco; Bowry, Sudhir; Mari, Flavio; Amato, Claudia; Gatti, Emanuele

    2015-01-01

    Online hemodiafiltration (OL-HDF), the most efficient renal replacement therapy, enables enhanced removal of small and large uremic toxins by combining diffusive and convective solute transport. Randomized controlled trials on prevalent chronic kidney disease (CKD) patients showed improved patient survival with high-volume OL-HDF, underlining the effect of convection volume (CV). This retrospective international study was conducted in a large cohort of incident CKD patients to determine the CV threshold and range associated with survival advantage. Data were extracted from a cohort of adult CKD patients treated by post-dilution OL-HDF over a 101-month period. In total, 2293 patients with a minimum of 2 years of follow-up were analyzed using advanced statistical tools, including cubic spline analyses for determination of the CV range over which a survival increase was observed. The relative survival rate of OL-HDF patients, adjusted for age, gender, comorbidities, vascular access, albumin, C-reactive protein, and dialysis dose, was found to increase at about 55 l/week of CV and to stay increased up to about 75 l/week. Similar analysis of pre-dialysis β2-microglobin (marker of middle-molecule uremic toxins) concentrations found a nearly linear decrease in marker concentration as CV increased from 40 to 75 l/week. Analysis of log C-reactive protein levels showed a decrease over the same CV range. Thus, a convection dose target based on convection volume should be considered and needs to be confirmed by prospective trials as a new determinant of dialysis adequacy. PMID:25945407

  19. Acceptability Study of "Ascenso": An Online Program for Monitoring and Supporting Patients with Depression in Chile.

    Science.gov (United States)

    Espinosa, H Daniel; Carrasco, Álvaro; Moessner, Markus; Cáceres, Cristian; Gloger, Sergio; Rojas, Graciela; Perez, J Carola; Vanegas, Jorge; Bauer, Stephanie; Krause, Mariane

    2016-07-01

    Major depression is a highly prevalent and severe mental disease. Despite the effective treatment options available, the risk of relapse is high. Interventions based on information and communication technologies generate innovative opportunities to provide support to patients after they completed treatment for depression. This acceptability study evaluated the Internet-based program Apoyo, Seguimiento y Cuidado de Enfermedades a partir de Sistemas Operativos (ASCENSO) in terms of its feasibility and acceptability in a sample of 35 patients in Chile. The study reveals high rates of acceptance and satisfaction among patients who actively used the program. As obstacles, patients mentioned technical problems, a lack of contact with other participants, and an insufficient connection between the program and the health service professionals. ASCENSO appears to be a promising complement to regular care for depression. Following improvements of the program based on participants' feedback, future research should evaluate its efficacy and cost-effectiveness.

  20. Readability of online patient education materials on adult reconstruction Web sites.

    Science.gov (United States)

    Polishchuk, Daniil L; Hashem, Jenifer; Sabharwal, Sanjeev

    2012-05-01

    Recommended readability of patient education materials is sixth-grade level or lower. Readability of 212 patient education materials pertaining to adult reconstruction topics available from the American Academy of Orthopaedic Surgeons, American Association of Hip and Knee Surgeons, and 3 other specialty and private practitioner Web sites was assessed using the Flesch-Kincaid grade formula. The mean Flesch-Kincaid score was 11.1 (range, 3-26.5). Only 5 (2%) articles had a readability level of sixth grade or lower. Readability of most of the articles for patient education on adult reconstruction Web sites evaluated may be too advanced for a substantial portion of patients. Further studies are needed to assess the optimal readability level of health information on the Internet. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. PatientVOICE: development of a preparatory, pre-chemotherapy online communication tool for older patients with cancer.

    NARCIS (Netherlands)

    Dulmen, S. van; Driesenaar, J.A.; Weert, J.C.M. van; Osch, M. van; Noordman, J.

    2017-01-01

    Background: Good communication around cancer treatment is essential in helping patients cope with their disease and related care, especially when this information is tailored to one’s needs. Despite its importance, communication is often complex, in particular in older patients (aged 65 years or

  2. Stream maintenance as a profit center

    Energy Technology Data Exchange (ETDEWEB)

    Bouchillon, J.L.

    1997-06-01

    Probably one of the most overlooked profit centers in industrial management strategy is savings in energy costs. Every $1 in certified energy savings is often worth over $10 in increased sales. The author has found from actual practice that there is big corporate profit in a shrewd, diligent steam trap management program. He describes a way to restructure corporate handling of trap maintenance to turn it into a source of revenue. Cited is a case history of building an intensive trap maintenance program at a large, 4000 trap chemical plant. The previously {open_quotes}good{close_quotes} maintenance program which was losing $565,000 per year in steam was turned into a $485,000 per year cost savings. This article will also give the steps that can in as few as 3 months generate over $125,000 annually in tax-free cash per 1000 traps with an investment payback of 18 months or less. The author is a businessman and energy management consultant that has no trap sales or promotion.

  3. Business strategies, profitability and efficiency of production

    Directory of Open Access Journals (Sweden)

    S. Alarcón

    2013-02-01

    Full Text Available The strategy choices of market-oriented companies are a topic now under wide investigation in the analysis of business performance antecedents. The purpose of this study is to examine the outcomes of the combination of three different organizational strategies (market orientation, innovativeness and entrepreneurial orientation on business performance indicators. Models using profitability and efficiency indicators are proposed with the specific aim of obtaining a deeper analysis of the relative roles played by each. The empirical work takes place in the agro-food industry in the Ebro Valley, one of Spain’s most competitive regions. The estimates from profitability quantile and truncated regressions of the efficiency scores reveal that market orientation has a positive effect on economic and productivity performance. The impact of pro-active, innovation-seeking, and risk-averse entrepreneurship is nevertheless more debatable, despite some influence of these entrepreneurial styles on observed performance values. This enables conclusions regarding the possibility of combining a market-oriented business culture with innovation and entrepreneurial activity with a view to obtaining business performance gains.

  4. A patient-initiated voluntary online survey of adverse medical events: the perspective of 696 injured patients and families.

    Science.gov (United States)

    Southwick, Frederick S; Cranley, Nicole M; Hallisy, Julia A

    2015-10-01

    Preventable medical errors continue to be a major cause of death in the USA and throughout the world. Many patients have written about their experiences on websites and in published books. As patients and family members who have experienced medical harm, we have created a nationwide voluntary survey in order to more broadly and systematically capture the perspective of patients and patient families experiencing adverse medical events and have used quantitative and qualitative analysis to summarise the responses of 696 patients and their families. Harm was most commonly associated with diagnostic and therapeutic errors, followed by surgical or procedural complications, hospital-associated infections and medication errors, and our quantitative results match those of previous provider-initiated patient surveys. Qualitative analysis of 450 narratives revealed a lack of perceived provider and system accountability, deficient and disrespectful communication and a failure of providers to listen as major themes. The consequences of adverse events included death, post-traumatic stress, financial hardship and permanent disability. These conditions and consequences led to a loss of patients' trust in both the health system and providers. Patients and family members offered suggestions for preventing future adverse events and emphasised the importance of shared decision-making. This large voluntary survey of medical harm highlights the potential efficacy of patient-initiated surveys for providing meaningful feedback and for guiding improvements in patient care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Knowledge about and attitude towards fertility preservation in young female cancer patients: a cross-sectional online survey.

    Science.gov (United States)

    Urech, Corinne; Ehrbar, Verena; Boivin, Jacky; Müller, Madleina; Alder, Judith; Zanetti Dällenbach, Rosanna; Rochlitz, Christoph; Tschudin, Sibil

    2017-09-22

    Recent advances in cancer therapy have resulted in an increased number of long-term cancer survivors. However, because of their treatment, women might be confronted with impaired fertility. The options of fertility preservation (FP) techniques are increasing. The goal of this study was to assess knowledge about, and attitudes towards, fertility preservation in young female cancer patients. A cross-sectional online survey was conducted including 155 former female cancer patients from English and German speaking countries. The survey consists of questions about attitude towards, and knowledge about, fertility preservation. Results show that knowledge about fertility preservation was limited among participants. Positive attitudes towards fertility preservation significantly outweighed negative attitudes. Knowledge and attitude did not differ according to language or different healthcare systems. Confidence of knowledge was significantly higher in women who underwent any FP procedure compared to those who did not. Greater emphasis should be placed on counselling opportunities, the provision of adequate information and supporting material. A better understanding of these issues will hopefully enhance patients' decision-making about FP options and assist the development of strategies to improve quality of care.

  6. Profit maximization with customer satisfaction control for electric vehicle charging in smart grids

    Directory of Open Access Journals (Sweden)

    Edwin Collado

    2017-05-01

    Full Text Available As the market of electric vehicles is gaining popularity, large-scale commercialized or privately-operated charging stations are expected to play a key role as a technology enabler. In this paper, we study the problem of charging electric vehicles at stations with limited charging machines and power resources. The purpose of this study is to develop a novel profit maximization framework for station operation in both offline and online charging scenarios, under certain customer satisfaction constraints. The main goal is to maximize the profit obtained by the station owner and provide a satisfactory charging service to the customers. The framework includes not only the vehicle scheduling and charging power control, but also the managing of user satisfaction factors, which are defined as the percentages of finished charging targets. The profit maximization problem is proved to be NPcomplete in both scenarios (NP refers to “nondeterministic polynomial time”, for which two-stage charging strategies are proposed to obtain efficient suboptimal solutions. Competitive analysis is also provided to analyze the performance of the proposed online two-stage charging algorithm against the offline counterpart under non-congested and congested charging scenarios. Finally, the simulation results show that the proposed two-stage charging strategies achieve performance close to that with exhaustive search. Also, the proposed algorithms provide remarkable performance gains compared to the other conventional charging strategies with respect to not only the unified profit, but also other practical interests, such as the computational time, the user satisfaction factor, the power consumption, and the competitive ratio.

  7. Cournot competition between a non-profit firm and a for-profit firm with uncertainty

    Science.gov (United States)

    Ferreira, Fernanda A.

    2010-03-01

    In this paper, we consider a Cournot competition between a nonprofit firm and a for-profit firm in a homogeneous goods market, with uncertain demand. Given an asymmetric tax schedule, we compute explicitly the Bayesian-Nash equilibrium. Furthermore, we analyze the effects of the tax rate and the degree of altruistic preference on market equilibrium outcomes.

  8. To Profit or Not To Profit: That Is the Tough Question.

    Science.gov (United States)

    Neugebauer, Roger

    1999-01-01

    Discusses advantages and disadvantages of organizing a child care operation as a for-profit or a nonprofit organization. Areas discussed include ease of start up; access to capital and funding; exposure to taxes; access to community support; appeal to volunteers, teaching candidates, and parents; challenge of management; risk to management;…

  9. Do non-profits make a difference? : Evaluating non-profit vis-à-vis for-profit organisations in social

    NARCIS (Netherlands)

    Koning, P.; Noailly, J.; Visser, S.

    2006-01-01

    This CPB Document provides a framework for the evaluation of non-profit organisations. This framework addresses the question under which conditions, and, if so, in what way non-profits should be stimulated. Essentially, in order to answer these questions, three steps can be followed: (i) identifying

  10. Use of an on-line patient portal in a depression collaborative care management program.

    Science.gov (United States)

    Pecina, Jennifer; North, Frederick; Williams, Mark D; Angstman, Kurt B

    2017-01-15

    Evidence for patient portals on health outcomes is still accumulating. We performed a retrospective study of patients in a depression collaborative care management (CCM) program comparing dropout rates and outcomes at six months in patients who used the portal with their CCM managers versus those who did not use the portal for this purpose. 1769 patients were analyzed, of which 272 (15.4%) used the portal to connect with their CCM managers. Portal users were more likely to be younger (mean age 37.8 years versus 42.6 years pportal users. Completion of six month PHQ 9 forms was significantly higher in the portal group (75.7% vs. 65.7%, p=0.001) with an adjusted odds ratio (AOR) of 1.68 (1.25, 2.30, pportal group (45.2% vs 38.5%, p=0.038) with an AOR of 1.32 (1.00-1.73, p=0.47). However analysis of only those who completed a PHQ-9 at six months showed no difference in depression remission (59.7% vs 58.7%, p=0.78) with an AOR of 1.02 (0.75, 1.42. p=0.87). There was no difference in dropout rates between portal users compared to non-portal users (31.6% vs. 31.7%, p=0.97) with an AOR of 0.95 (0.71, 1.27, p=0.69). Limitations include the observational study design and a predominantly white study population. Use of a patient portal in depression CCM allows additional options for patients to participate without negatively influencing clinical outcomes. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Promoting Patient "Phronesis": Communication Patterns in an Online Lifestyle Program Coordinated with Primary Care

    Science.gov (United States)

    Rief, John J.; Mitchell, Gordon R.; Zickmund, Susan L.; Bhargava, Tina D.; Bryce, Cindy L.; Fischer, Gary S.; Hess, Rachel; Kolb, N. Randall; Simkin-Silverman, Laurey R.; McTigue, Kathleen M.

    2013-01-01

    "Phronesis," or practical wisdom developed through experience, is an Aristotelian concept that can shed light on the capacities of patients to make health-related decisions and engage in healthy behaviors. In this article, the authors develop a conceptual framework for understanding the role of "phronesis" in lifestyle change as well as its…

  12. Assessing the standards of online oral hygiene instructions for patients with fixed orthodontic appliances

    NARCIS (Netherlands)

    Verhoef, Willem A.; Livas, Christos; Delli, Konstantina; Ren, Yijin

    Background. The authors conducted this study to assess the quality of the information available on the Web about oral hygiene for patients with fixed orthodontic appliances. Methods. The authors entered the search terms "cleaning braces," " brushing braces," and "oral hygiene and braces" into

  13. Treatment tolerance and patient-reported outcomes favor online hemodiafiltration compared to high-flux hemodialysis in the elderly.

    Science.gov (United States)

    Morena, Marion; Jaussent, Audrey; Chalabi, Lotfi; Leray-Moragues, Hélène; Chenine, Leila; Debure, Alain; Thibaudin, Damien; Azzouz, Lynda; Patrier, Laure; Maurice, Francois; Nicoud, Philippe; Durand, Claude; Seigneuric, Bruno; Dupuy, Anne-Marie; Picot, Marie-Christine; Cristol, Jean-Paul; Canaud, Bernard

    2017-06-01

    Large cohort studies suggest that high convective volumes associated with online hemodiafiltration may reduce the risk of mortality/morbidity compared to optimal high-flux hemodialysis. By contrast, intradialytic tolerance is not well studied. The aim of the FRENCHIE (French Convective versus Hemodialysis in Elderly) study was to compare high-flux hemodialysis and online hemodiafiltration in terms of intradialytic tolerance. In this prospective, open-label randomized controlled trial, 381 elderly chronic hemodialysis patients (over age 65) were randomly assigned in a one-to-one ratio to either high-flux hemodialysis or online hemodiafiltration. The primary outcome was intradialytic tolerance (day 30-day 120). Secondary outcomes included health-related quality of life, cardiovascular risk biomarkers, morbidity, and mortality. During the observational period for intradialytic tolerance, 85% and 84% of patients in high-flux hemodialysis and online hemodiafiltration arms, respectively, experienced at least one adverse event without significant difference between groups. As exploratory analysis, intradialytic tolerance was also studied, considering the sessions as a statistical unit according to treatment actually received. Over a total of 11,981 sessions, 2,935 were complicated by the occurrence of at least one adverse event, with a significantly lower occurrence in online hemodiafiltration with fewer episodes of intradialytic symptomatic hypotension and muscle cramps. By contrast, health-related quality of life, morbidity, and mortality were not different in both groups. An improvement in the control of metabolic bone disease biomarkers and β2-microglobulin level without change in serum albumin concentration was observed with online hemodiafiltration. Thus, overall outcomes favor online hemodiafiltration over high-flux hemodialysis in the elderly. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  14. Dose-Guided Radiotherapy: Potential Benefit of Online Dose Recalculation for Stereotactic Lung Irradiation in Patients With Non-Small-Cell Lung Cancer

    NARCIS (Netherlands)

    van Rooijen, Dominique C.; van Wieringen, Niek; Stippel, Gjenna; Crezee, Johannes; Koning, Caro C. E.; Bel, Arjan

    2012-01-01

    Purpose: To determine whether dose-guided radiotherapy (i.e., online recalculation and evaluation of the actual dose distribution) can improve decision making for lung cancer patients treated with stereotactic body radiotherapy. Methods and Materials: For this study 108 cone-beam computed tomography

  15. Determinants of profitability differences among major refiner/marketers

    Energy Technology Data Exchange (ETDEWEB)

    1985-01-01

    This report attempts to shed light on the factors affecting the differing profitabilities among companies, particularly, the effect of refinery upgrading, to contribute toward a better understanding of the performance of the domestic petroleum refining industry. The determinants of domestic refining-marketing profitability in the short run are evaluated. The focus is on those factors affecting the profitability of operations using the existing capital stock. Of particular interest is the effect on profitability of investments made for refinery upgrading. The refining-marketing segment is assumed to be operated to maximize profits of that segment rather than the profits of some other segment. The cost and financial data used in the analysis are proprietary line-of-business data from the FRS. The FRS provides detailed information on refining-marketing revenue, cost, income, and investment. The specific data used are discussed and key definitions provided later in this report. 14 refs., 1 fig., 2 tabs.

  16. Core belief content examined in a large sample of patients using online cognitive behaviour therapy.

    OpenAIRE

    Millings, Abigail; Carnelley, Katherine B.

    2015-01-01

    BACKGROUND: Computerised cognitive behavioural therapy provides a unique opportunity to collect and analyse data regarding the idiosyncratic content of people's core beliefs about the self, others and the world. \\ud \\ud METHODS: 'Beating the Blues' users recorded a core belief derived through the downward arrow technique. Core beliefs from 1813 mental health patients were coded into 10 categories. \\ud \\ud RESULTS: The most common were global self-evaluation, attachment, and competence. Women ...

  17. Health literacy and online educational resources: an opportunity to educate patients.

    Science.gov (United States)

    Hansberry, David R; Agarwal, Nitin; Baker, Stephen R

    2015-01-01

    Given the increasing accessibility of material on the Internet and the use of these materials by patients as a source of health care information, the purpose of this study was to quantitatively evaluate the level of readability of resources made available on the European Society of Radiology website to determine whether these materials meet the health literacy needs of the general public as set forth by guidelines of the U.S. National Institutes of Health (NIH) and the American Medical Association (AMA). All 41 patient education articles created by the European Society of Radiology (ESR) were downloaded and analyzed with the following 10 quantitative readability scales: the Coleman-Liau Index, Flesch-Kincaid Grade Level, Flesch Reading Ease, FORCAST Formula, Fry Graph, Gunning Fog Index, New Dale-Chall, New Fog Count, Raygor Reading Estimate, and the Simple Measure of Gobbledygook. The 41 articles were written collectively at a mean grade level of 13.0 ± 1.6 with a range from 10.8 to 17.2. For full understanding of the material, 73.2% of the articles required the reading comprehension level of, at minimum, a high school graduate (12th grade). The patient education resources on the ESR website are written at a comprehension level well above that of the average Internet viewer. The resources fail to meet the NIH and AMA guidelines that patient education material be written between the third and seventh grade levels. Recasting these resources in a simpler format would probably lead to greater comprehension by ESR website viewers.

  18. Statistical properties of online avatar numbers in a massive multiplayer online role-playing game

    Science.gov (United States)

    Jiang, Zhi-Qiang; Ren, Fei; Gu, Gao-Feng; Tan, Qun-Zhao; Zhou, Wei-Xing

    2010-02-01

    Massive multiplayer online role-playing games (MMORPGs) have been very popular in the past few years. The profit of an MMORPG company is proportional to how many users registered, and the instant number of online avatars is a key factor to assess how popular an MMORPG is. We use the online-offline logs on an MMORPG server to reconstruct the instant number of online avatars per second and investigate its statistical properties. We find that the online avatar number exhibits one-day periodic behavior and clear intraday pattern, the fluctuation distribution of the online avatar numbers has a leptokurtic non-Gaussian shape with power-law tails, and the increments of online avatar numbers after removing the intraday pattern are uncorrelated and the associated absolute values have long-term correlation. In addition, both time series exhibit multifractal nature.

  19. For-profit medicare home health agencies' costs appear higher and quality appears lower compared to nonprofit agencies.

    Science.gov (United States)

    Cabin, William; Himmelstein, David U; Siman, Michael L; Woolhandler, Steffie

    2014-08-01

    For-profit, or proprietary, home health agencies were banned from Medicare until 1980 but now account for a majority of the agencies that provide such services. Medicare home health costs have grown rapidly since the implementation of a risk-based prospective payment system in 2000. We analyzed recent national cost and case-mix-adjusted quality outcomes to assess the performance of for-profit and nonprofit home health agencies. For-profit agencies scored slightly but significantly worse on overall quality indicators compared to nonprofits (77.18 percent and 78.71 percent, respectively). Notably, for-profit agencies scored lower than nonprofits on the clinically important outcome "avoidance of hospitalization" (71.64 percent versus 73.53 percent). Scores on quality measures were lowest in the South, where for-profits predominate. Compared to nonprofits, proprietary agencies also had higher costs per patient ($4,827 versus $4,075), were more profitable, and had higher administrative costs. Our findings raise concerns about whether for-profit agencies should continue to be eligible for Medicare payments and about the efficiency of Medicare's market-oriented, risk-based home care payment system. Project HOPE—The People-to-People Health Foundation, Inc.

  20. The ART of Social Networking: How SART member clinics are connecting with patients online

    Science.gov (United States)

    OMURTAG, Kenan; JIMENEZ, Patricia T.; RATTS, Valerie; ODEM, Randall; COOPER, Amber R.

    2013-01-01

    Objective To study and describe the use of social networking websites among SART member clinics Design Cross-sectional study Setting University Based Practice Patients Not Applicable Interventions Not Applicable Main Outcome Measure Prevalence of social networking websites among SART member clinics and evaluation of content, volume and location (i.e mandated state, region) using multivariate regression analysis Results 384 SART registered clinics and 1,382 social networking posts were evaluated. Of the clinics, 96% have a website and 30% link to a social networking website. The majority of clinics (89%) with social networking websites were affiliated with non-academic centers. Social networking posts mostly provide information (31%) and/or advertise (28%), while the remaining offer support (19%) or are irrelevant (17%) to the target audience. Only 5% of posts involved patients requesting information. Clinic volume correlates with the presence of a clinic website and a social networking website (pnetworking website like Facebook, Twitter and/or a Web-log (“blog”). Larger volume clinics commonly host social networking websites. These sites provide new ways to communicate with patients, but clinics should maintain policies on the incorporation of social networks into practice. PMID:22088209

  1. Profiting from competition: Financial tools for electric generation companies

    Science.gov (United States)

    Richter, Charles William, Jr.

    work uses GP-Automata, a technique which combines genetic programming and finite state machines, to represent adaptive agents. We use a genetic algorithm to evolve these adaptive agents (each with its own bidding strategy) for use in a double auction. The agent's strategies may be judged by the amount of profit they produce and are tested by computerized agents repeatedly buying and selling electricity in an auction simulator. In addition to the obvious profit-maximization strategies, one can also design strategies which exhibit other types of trading behaviors. The resulting strategies can be used directly in on-line trading, or as realistic models of competitors in a trading simulator. In addition to developing double auction bidding strategies, we investigate and discuss methods of an energy trader's risk. This can be done using such financial vehicles as futures and options contracts or through the inclusion of risk while judging strategies used in the market simulations described above. We discuss the role of fuzzy logic in the competitive electric marketplace, including how it can be applied in developing bidding strategies. Since competition promises to drive the power system closer to its operating limits, improvements in measurement and system control will be important. We provide an example of using fuzzy logic to do automatic generation control and discuss extensions that would make it superior to traditional controllers. Since the GENCO's forte is primarily generating electricity, we examine unit commitment and discuss how to update it for the competitive environment. We discuss the role of unit commitment in developing bidding strategies, as well as, the role of bidding strategies in solving the unit commitment problem. Depending on the market structure adopted by a particular location, large amounts of bidding data may be available to regulators or market participants. Ideally, regulators could use this data to verify dig the market is efficient. Market

  2. Profitable solutions to climate, oil, and proliferation.

    Science.gov (United States)

    Lovins, Amory B

    2010-05-01

    Protecting the climate is not costly but profitable (even if avoided climate change is worth zero), mainly because saving fuel costs less than buying fuel. The two biggest opportunities, both sufficiently fast, are oil and electricity. The US, for example, can eliminate its oil use by the 2040s at an average cost of $15 per barrel ($2000), half by redoubled efficiency and half by alternative supplies, and can save three-fourths of its electricity more cheaply than operating a thermal power station. Integrative design permits this by making big energy savings cheaper than small ones, turning traditionally assumed diminishing returns into empirically observed expanding returns. Such efficiency choices accelerate climate-safe, inexhaustible, and resilient energy supply-notably the "micropower" now delivering about a sixth of the world's electricity and 90% of its new electricity. These cheap, fast, market-financeable, globally applicable options offer the most effective, yet most underestimated and overlooked, solutions for climate, proliferation, and poverty.

  3. Maximum Profit Configurations of Commercial Engines

    Directory of Open Access Journals (Sweden)

    Yiran Chen

    2011-06-01

    Full Text Available An investigation of commercial engines with finite capacity low- and high-price economic subsystems and a generalized commodity transfer law [n ∝ Δ (P m] in commodity flow processes, in which effects of the price elasticities of supply and demand are introduced, is presented in this paper. Optimal cycle configurations of commercial engines for maximum profit are obtained by applying optimal control theory. In some special cases, the eventual state—market equilibrium—is solely determined by the initial conditions and the inherent characteristics of two subsystems; while the different ways of transfer affect the model in respects of the specific forms of the paths of prices and the instantaneous commodity flow, i.e., the optimal configuration.

  4. Full truckload vehicle routing problem with profits

    Directory of Open Access Journals (Sweden)

    Jian Li

    2014-04-01

    Full Text Available A new variant of the full truckload vehicle routing problem is studied. In this problem there are more than one delivery points corresponding to the same pickup point, and one order is allowed to be served several times by the same vehicle or different vehicles. For the orders which cannot be assigned because of resource constraint, the logistics company outsources them to other logistics companies at a certain cost. To maximize its profits, logistics company decides which to be transported by private fleet and which to be outsourced. The mathematical model is constructed for the problem. Since the problem is NP-hard and it is difficult to solve the large-scale problems with an exact algorithm, a hybrid genetic algorithm is proposed. Computational results show the effectiveness of the hybrid genetic algorithm.

  5. Pharmaceutical technology management--profitable business avenue.

    Science.gov (United States)

    Puthli, Shivanand P

    2010-01-01

    Growing research expenditure, regulatory framework and generic erosion have forced pharmaceutical companies globally to resort to pharmaceutical technology management (PTM). Indeed, the pharmaceutical industry has witnessed the impact of innovative drug delivery and device technologies and their influence on business. PTM has given a new business insight with greater profits and enhancement of product franchise. Promising breakthrough technologies have not been able to reach a commercial platform largely owing to lack of capital at the preliminary stages of the product development program. Intellectual property plays a considerable role in protecting innovative technologies. Joint ventures and strategic alliances also become important for commercializing a new technology. The synergy of PTM with options of in-licensing is expected to infuse newer opportunities to the pharmaceutical business.

  6. There's no profiting from a joint venture misadventure.

    Science.gov (United States)

    Herschman, Gary W

    2004-10-01

    In St. David's vs. IRS, a not-for-profit health system effectively challenged the IRS's determination that the system should be disqualified from tax exemption because it had entered a 50/50 joint venture with a for-profit system. The court decisions in St. David's, coupled with a recent IRS ruling, Revenue Ruling 2004-51, provide insight into how a not-for-profit hospital can structure such a joint venture to avoid jeopardizing its tax-exempt status.

  7. Investigating the effect of different factors on profitability

    Directory of Open Access Journals (Sweden)

    Mohsen Hamidian

    2014-11-01

    Full Text Available This paper presents an empirical investigation to study the effects of different factors influencing on profitability of shares of petrochemical industry. The study gathers the information of three firms whose stock prices were listed on Tehran Stock Exchange over the period 2006-2012. Using different regression analysis, the study has determined that while stock price, currency rate and material influence on profitability of these firms, energy price, liquidity and gold price had no impact on profitability in petrochemical industry.

  8. Benefits and Costs of For-Profit Public Education

    Directory of Open Access Journals (Sweden)

    Alex Molnar

    2001-04-01

    Full Text Available As a policy initiative, for-profit operation of public schools has not lived up to the claims of its proponents. An examination of issues such as teaching methods, academic achievement, autonomy, local control, and the image and influence of for-profit public schools suggests that "for-profits" are unlikely to succeed in the long term in improving the overall quality of public education. They do, however, seem capable of harming public schools.

  9. Components of the Profitability of Technical Currency Trading

    OpenAIRE

    Schulmeister, Stephan

    2005-01-01

    This paper investigates the sources of the profitability of 1024 moving average and momentum models when trading in the German mark (euro)/U.S. dollar market based on daily data. The main results are as follows. First, each of these models would have been profitable over the entire sample period. Second, this profitability is exclusively due to the exploitation of persistent exchange rate trends. Third, these results do not change substantially when trading is examined within subperiods. Four...

  10. Risk Sharing and Layoff Risk in Profit Sharing

    OpenAIRE

    Fabella, Raul V.

    1995-01-01

    We show that if the employer is risk averse, however slightly, there is always a profit sharing contract that will Pareto-dominate the spot wage contract in the sense of pure risk sharing. The smaller is the employer risk aversion, the narrower is the room for profit sharing. The higher the workers value employment stability (less layoff risk), the more Pareto attractive is profit sharing regardless of employer risk aversion.

  11. Association of Online Health Information-Seeking Behavior and Self-Care Activities Among Type 2 Diabetic Patients in Saudi Arabia.

    Science.gov (United States)

    Jamal, Amr; Khan, Samina A; AlHumud, Ahmed; Al-Duhyyim, Abdulaziz; Alrashed, Mohammed; Bin Shabr, Faisal; Alteraif, Alwalid; Almuziri, Abdullah; Househ, Mowafa; Qureshi, Riaz

    2015-08-12

    Health information obtained from the Internet has an impact on patient health care outcomes. There is a growing concern over the quality of online health information sources used by diabetic patients because little is known about their health information-seeking behavior and the impact this behavior has on their diabetes-related self-care, in particular in the Middle East setting. The aim of this study was to determine the online health-related information-seeking behavior among adult type 2 diabetic patients in the Middle East and the impact of their online health-related information-seeking behavior on their self-care activities. A cross-sectional survey was conducted on 344 patients with type 2 diabetes attending inpatient and outpatient primary health care clinics at 2 teaching hospitals in Riyadh, Saudi Arabia. The main outcome measures included the ability of patients to access the Internet, their ability to use the Internet to search for health-related information, and their responses to Internet searches in relation to their self-care activities. Further analysis of differences based on age, gender, sociodemographic, and diabetes-related self-care activities among online health-related information seekers and nononline health-related information seekers was conducted. Among the 344 patients, 74.1% (255/344) were male with a mean age of 53.5 (SD 13.8) years. Only 39.0% (134/344) were Internet users; 71.6% (96/134) of them used the Internet for seeking health-related information. Most participants reported that their primary source of health-related information was their physician (216/344, 62.8%) followed by television (155/344, 45.1%), family (113/344, 32.8%), newspapers (100/344, 29.1%), and the Internet (96/344, 27.9%). Primary topics participants searched for were therapeutic diet for diabetes (55/96, 57%) and symptoms of diabetes (52/96, 54%) followed by diabetes treatment (50/96, 52%). Long history of diabetes, familial history of the disease

  12. Association of Online Health Information–Seeking Behavior and Self-Care Activities Among Type 2 Diabetic Patients in Saudi Arabia

    Science.gov (United States)

    AlHumud, Ahmed; Al-Duhyyim, Abdulaziz; Alrashed, Mohammed; Bin Shabr, Faisal; Alteraif, Alwalid; Almuziri, Abdullah; Househ, Mowafa; Qureshi, Riaz

    2015-01-01

    Background Health information obtained from the Internet has an impact on patient health care outcomes. There is a growing concern over the quality of online health information sources used by diabetic patients because little is known about their health information–seeking behavior and the impact this behavior has on their diabetes-related self-care, in particular in the Middle East setting. Objective The aim of this study was to determine the online health-related information–seeking behavior among adult type 2 diabetic patients in the Middle East and the impact of their online health-related information–seeking behavior on their self-care activities. Methods A cross-sectional survey was conducted on 344 patients with type 2 diabetes attending inpatient and outpatient primary health care clinics at 2 teaching hospitals in Riyadh, Saudi Arabia. The main outcome measures included the ability of patients to access the Internet, their ability to use the Internet to search for health-related information, and their responses to Internet searches in relation to their self-care activities. Further analysis of differences based on age, gender, sociodemographic, and diabetes-related self-care activities among online health-related information seekers and nononline health-related information seekers was conducted. Results Among the 344 patients, 74.1% (255/344) were male with a mean age of 53.5 (SD 13.8) years. Only 39.0% (134/344) were Internet users; 71.6% (96/134) of them used the Internet for seeking health-related information. Most participants reported that their primary source of health-related information was their physician (216/344, 62.8%) followed by television (155/344, 45.1%), family (113/344, 32.8%), newspapers (100/344, 29.1%), and the Internet (96/344, 27.9%). Primary topics participants searched for were therapeutic diet for diabetes (55/96, 57%) and symptoms of diabetes (52/96, 54%) followed by diabetes treatment (50/96, 52%). Long history of diabetes

  13. What Online User Innovation Communities Can Teach Us about Capturing the Experiences of Patients Living with Chronic Health Conditions. A Scoping Review.

    Directory of Open Access Journals (Sweden)

    Julia Amann

    Full Text Available In order to adapt to societal changes, healthcare systems need to switch from a disease orientation to a patient-centered approach. Virtual patient networks are a promising tool to favor this switch and much can be learned from the open and user innovation literature where the involvement of online user communities in the innovation process is well-documented.The objectives of this study were 1 to describe the use of online communities as a tool to capture and harness innovative ideas of end users or consumers; and 2 to point to the potential value and challenges of these virtual platforms to function as a tool to inform and promote patient-centered care in the context of chronic health conditions.A scoping review was conducted. A total of seven databases were searched for scientific articles published in English between 1995 and 2014. The search strategy was refined through an iterative process.A total of 144 studies were included in the review. Studies were coded inductively according to their research focus to identify groupings of papers. The first set of studies focused on the interplay of factors related to user roles, motivations, and behaviors that shape the innovation process within online communities. Studies of the second set examined the role of firms in online user innovation initiatives, identifying different organizational strategies and challenges. The third set of studies focused on the idea selection process and measures of success with respect to online user innovation initiatives. Finally, the findings from the review are presented in the light of the particularities and challenges discussed in current healthcare research.The present paper highlights the potential of virtual patient communities to inform and promote patient-centered care, describes the key challenges involved in this process, and makes recommendations on how to address them.

  14. What Online User Innovation Communities Can Teach Us about Capturing the Experiences of Patients Living with Chronic Health Conditions. A Scoping Review

    Science.gov (United States)

    Amann, Julia; Zanini, Claudia; Rubinelli, Sara

    2016-01-01

    Background In order to adapt to societal changes, healthcare systems need to switch from a disease orientation to a patient-centered approach. Virtual patient networks are a promising tool to favor this switch and much can be learned from the open and user innovation literature where the involvement of online user communities in the innovation process is well-documented. Objectives The objectives of this study were 1) to describe the use of online communities as a tool to capture and harness innovative ideas of end users or consumers; and 2) to point to the potential value and challenges of these virtual platforms to function as a tool to inform and promote patient-centered care in the context of chronic health conditions. Methods A scoping review was conducted. A total of seven databases were searched for scientific articles published in English between 1995 and 2014. The search strategy was refined through an iterative process. Results A total of 144 studies were included in the review. Studies were coded inductively according to their research focus to identify groupings of papers. The first set of studies focused on the interplay of factors related to user roles, motivations, and behaviors that shape the innovation process within online communities. Studies of the second set examined the role of firms in online user innovation initiatives, identifying different organizational strategies and challenges. The third set of studies focused on the idea selection process and measures of success with respect to online user innovation initiatives. Finally, the findings from the review are presented in the light of the particularities and challenges discussed in current healthcare research. Conclusion The present paper highlights the potential of virtual patient communities to inform and promote patient-centered care, describes the key challenges involved in this process, and makes recommendations on how to address them. PMID:27272912

  15. Internet-based procurement ups profits

    National Research Council Canada - National Science Library

    Mario Apicella

    2000-01-01

    Streamlining a company's purchasing activities is not a new frontier, but thanks to the Internet it is proving to be a lot more feasible to get your business partners to agree to go online with you than it was with EDI...

  16. A Systematic Assessment of Google Search Queries and Readability of Online Gynecologic Oncology Patient Education Materials.

    Science.gov (United States)

    Martin, Alexandra; Stewart, J Ryan; Gaskins, Jeremy; Medlin, Erin

    2018-01-20

    The Internet is a major source of health information for gynecologic cancer patients. In this study, we systematically explore common Google search terms related to gynecologic cancer and calculate readability of top resulting websites. We used Google AdWords Keyword Planner to generate a list of commonly searched keywords related to gynecologic oncology, which were sorted into five groups (cervical cancer, ovarian cancer, uterine cancer, vulvar cancer, vaginal cancer) using five patient education websites from sgo.org . Each keyword was Google searched to create a list of top websites. The Python programming language (version 3.5.1) was used to describe frequencies of keywords, top-level domains (TLDs), domains, and readability of top websites using four validated formulae. Of the estimated 1,846,950 monthly searches resulting in 62,227 websites, the most common was cancer.org . The most common TLD was *.com. Most websites were above the eighth-grade reading level recommended by the American Medical Association (AMA) and the National Institute of Health (NIH). The SMOG Index was the most reliable formula. The mean grade level readability for all sites using SMOG was 9.4 ± 2.3, with 23.9% of sites falling at or below the eighth-grade reading level. The first ten results for each Google keyword were easiest to read with results beyond the first page of Google being consistently more difficult. Keywords related to gynecologic malignancies are Google-searched frequently. Most websites are difficult to read without a high school education. This knowledge may help gynecologic oncology providers adequately meet the needs of their patients.

  17. An Online Survey of Patients' Experiences Since the Rescheduling of Hydrocodone: The First 100 Days.

    Science.gov (United States)

    Chambers, Jan; Gleason, Rae M; Kirsh, Kenneth L; Twillman, Robert; Webster, Lynn; Berner, Jon; Fudin, Jeff; Passik, Steven D

    2016-09-01

      To conduct an Internet patient survey through the National Fibromyalgia & Chronic Pain Association on reactions to the first 100 days following the rescheduling of hydrocodone.   Face-valid survey questions were created with expert consensus along with repurposed questions used on previous NFMCPA surveys covering domains such as demographics and symptoms. The questionnaire was designed to be administered over the Internet.   6,420 responders met screening criteria and completed the survey. Most (5,181, or 82.5%) had been prescribed hydrocodone for more than 1 year. 2,296, (39.0%) reported no changes in access to hydrocodone, while the majority experienced some barriers. Of those who could no longer get hydrocodone, 1,067 (18.1%) borrowed pain medications, 1,007 (17.1%) turned to marijuana, 773 (13.1%) used alcohol, and 135 (2.3%) used illicit drugs. Most respondents had to visit their healthcare providers more often (N = 3,699, 64.2%) and 1,735 (30.3%) reported some type of issue interacting with their pharmacy. Most felt that the rescheduling was neither a fair nor appropriate solution to the abuse of hydrocodone (N = 4,938, 88.3%). For those still working, 801 (46.2%) reported that they had missed work because of the stricter regulations. 1,462 (27.2%) reported having thoughts of suicide since the rescheduling.   The unintended consequences for people with chronic pain that have been caused by the rescheduling effort to impede hydrocodone abuse are negatively impacting thousands. These consequences include suffering from being placed on less effective drugs, increased cost, inconvenience, and negative influence on physician-patient and pharmacist-patient relationships. © 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Online usability and patients with long-term conditions: a mixed-methods approach.

    Science.gov (United States)

    Ossebaard, Hans C; Seydel, Erwin R; van Gemert-Pijnen, Lisette

    2012-06-01

    To improve the information position of health care consumers and to facilitate decision-making behavior in health the Dutch ministry of Health commissioned the National Institute for Public Health and the Environment to develop, host and manage a public national health and care portal (www.kiesbeter.nl) on the Internet. The portal is used by over 4 million visitors in 2010. Among them, an increasing amount of patients that use the portal for information and decision making on medical issues, healthy living, health care providers and other topics. First objective is to examine what usability aspects of the portal kiesBeter.nl matter for chronic patients and their informal carers with regard to information seeking, self-management, decision making, on line health information and other variables. Second objective is to make evidence-based practical recommendations for usability improvement. An innovative combination of techniques (semi-structured interviews; eHealth Literacy scale; scenario-based study using think-aloud protocol and screen capture software; focus group) is used to study usability and on line information seeking behavior in a non random judgment sample of three groups of patients (N=21) with long-term medical conditions (arthritis, asthma and diabetes). The search strategy mostly used (65%) by the relatively well-educated subjects is 'orienteering'. Users with long-term conditions and their carers expect tailored support from a national health portal, to help them navigate, search and find the detailed information they need. They encounter serious problems with these usability issues some of which are disease-specific. Patients indicate a need for personalized information. They report low impact on self-management and decision making. Overall judgment of usability is rated 7 on a Likert type 0-10 scale. Based on the outcomes recommendations could be formulated. These have led to major adaptations to improve usability. A non-representative composition

  19. Rates of profit as correlated sums of random variables

    Science.gov (United States)

    Greenblatt, R. E.

    2013-10-01

    Profit realization is the dominant feature of market-based economic systems, determining their dynamics to a large extent. Rather than attaining an equilibrium, profit rates vary widely across firms, and the variation persists over time. Differing definitions of profit result in differing empirical distributions. To study the statistical properties of profit rates, I used data from a publicly available database for the US Economy for 2009-2010 (Risk Management Association). For each of three profit rate measures, the sample space consists of 771 points. Each point represents aggregate data from a small number of US manufacturing firms of similar size and type (NAICS code of principal product). When comparing the empirical distributions of profit rates, significant ‘heavy tails’ were observed, corresponding principally to a number of firms with larger profit rates than would be expected from simple models. An apparently novel correlated sum of random variables statistical model was used to model the data. In the case of operating and net profit rates, a number of firms show negative profits (losses), ruling out simple gamma or lognormal distributions as complete models for these data.

  20. The ART of social networking: how SART member clinics are connecting with patients online.

    Science.gov (United States)

    Omurtag, Kenan; Jimenez, Patricia T; Ratts, Valerie; Odem, Randall; Cooper, Amber R

    2012-01-01

    To study and describe the use of social networking websites among Society for Assisted Reproductive Technology (SART) member clinics. Cross-sectional study. University-based practice. Not applicable. Not applicable. Prevalence of social networking websites among SART member clinics and evaluation of content, volume, and location (i.e., mandated state, region) using multivariate regression analysis. A total of 384 SART-registered clinics and 1,382 social networking posts were evaluated. Of the clinics, 96% had a website and 30% linked to a social networking website. The majority of clinics (89%) with social networking websites were affiliated with nonacademic centers. Social networking posts mostly provided information (31%) and/or advertising (28%), and the remaining offered support (19%) or were irrelevant (17%) to the target audience. Only 5% of posts involved patients requesting information. Clinic volume correlated with the presence of a clinic website and a social networking website. Almost all SART member clinics have a website. Nearly one-third of these clinics host a social networking website such as Facebook, Twitter, and/or a blog. Large-volume clinics commonly host social networking websites. These sites provide new ways to communicate with patients, but clinics should maintain policies on the incorporation of social networks into practice. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  1. How breast cancer patients want to search for and retrieve information from stories of other patients on the internet: an online randomized controlled experiment.

    Science.gov (United States)

    Overberg, Regina; Otten, Wilma; de Man, Andries; Toussaint, Pieter; Westenbrink, Judith; Zwetsloot-Schonk, Bertie

    2010-03-09

    Other patients' stories on the Internet can give patients information, support, reassurance, and practical advice. We examined which search facility for online stories resulted in patients' satisfaction and search success. This study was a randomized controlled experiment with a 2x2 factorial design conducted online. We facilitated access to 170 stories of breast cancer patients in four ways based on two factors: (1) no versus yes search by story topic, and (2) no versus yes search by writer profile. Dutch speaking women with breast cancer were recruited. Women who gave informed consent were randomly assigned to one of four groups. After searching for stories, women were offered a questionnaire relating to satisfaction with the search facility, the stories retrieved, and impact of the stories on coping with breast cancer. Of 353 enrolled women, 182 (51.6%) completed the questionnaire: control group (n = 37), story topics group (n = 49), writer profile group (n = 51), and combination group (n = 45). Questionnaire completers were evenly distributed over the four groups (chi(2) (3) = 3.7, P = .30). Women who had access to the story topics search facility (yes vs no): were more positive about (mean scores 4.0 vs 3.6, P = .001) and more satisfied with the search facility (mean scores 7.3 vs 6.3, P search options (mean scores 2.3 vs 2.1, P = .04); were better enabled to find desired information (mean scores 3.3 vs 2.8, P = .001); were more likely to recommend the search facility to others or intend to use it themselves (mean scores 4.1 vs 3.5, P search (yes vs no): being more positive about (mean scores 3.9 vs 3.6, P = .005) and more satisfied with the search facility (mean scores 7.1 vs 6.5, P =. 01), and being more positive about how retrieved stories were displayed (mean scores 3.8 vs 2.9, P search facility, an interaction effect was found (P = .03): at least one of the two search facilities was needed for satisfaction. Having access to the story topics search

  2. A Non-invasive, On-line Deuterium Dilution Technique for the Measurement of Total Body Water in Haemodialysis Patients

    Science.gov (United States)

    Chan, Cian; Smith, David; Spanel, Patrik; McIntyre, Christopher W.; Davies, Simon J.

    2008-01-01

    Background Despite its importance, total body water (TBW) is usually estimated rather than measured due to the complexity of isotope dilution methods. The aim of this study was to demonstrate the applicability in haemodialysis (HD) patients of a recently developed on-line breath test, previously validated in healthy subjects, that uses the gold standard deuterium dilution method to measure TBW. In particular we wished to show that a pre-dialysis estimation was as good as a post dialysis equilibrated measurement in order to avoid patients needing to remain behind after dialysis treatment. Methods The dispersal kinetics of breath HDO, measured using a flowing-afterglow mass spectrometer (FA-MS) following ingestion of D2O immediately post-dialysis, were determined in 12 haemodialysis patients and used to calculate the absolute TBWPostHD after full equilibration. TBWPreHD was then determined from breath samples taken immediately prior to the next dialysis. This measurement was adjusted for the inter-dialytic weight change and urine output (TBWPreHD-adjusted) and compared to the TBWPostHD. The accuracy and precision of FA-MS was also assessed using known concentrations deuterium enriched water samples. Results Mean TBWPostHD was 50.0 ± 9.3 L and TBWPreHD-adjusted 50.7 ± 9.0 L. They were highly correlated (R= 0.99, pdeuterium equilibration kinetics identical to normal subjects; a pre-dialysis estimation may be used to determine TBW so avoiding the necessity to remain behind after dialysis making this suitable for application in the clinical setting. PMID:18326883

  3. Determinants of adherence to the online component of a blended intervention for patients with hip and/or knee osteoarthritis : A mixed methods study embedded in the e-exercise trial

    NARCIS (Netherlands)

    De Vries, H.J.; Kloek, C.J.J.; De Bakker, Dinny H.; Dekker, J.; Bossen, D.; Veenhof, C.

    2017-01-01

    Background: Embedding Web-based interventions within physiotherapy has potential, but knowledge on patient adherence to these interventions is limited. Iintroduction: This study explores which patient-, intervention-, and environment-related factors are determinants of adherence to the online

  4. The evolving role of online virtual patients in internal medicine clerkship education nationally.

    Science.gov (United States)

    Lang, Valerie J; Kogan, Jennifer; Berman, Norm; Torre, Dario

    2013-11-01

    Despite the significant resources required to develop and maintain virtual patient (VP) programs, little is known about why this innovation has been adopted and how it is implemented. Understanding needs and implementation strategies is important for effective curriculum planning. In 2009 and 2011, surveys were offered to 110 U.S. internal medicine clerkship directors regarding their goals for adoption of Simulated Internal Medicine Patient Learning Experience VPs. In 2011, respondents were asked how they implemented VPs in their curricula. Results were analyzed using chi-square and Fisher exact test. Responses were obtained from 33 clerkship directors in 2009 and 45 in 2011. Comparing 2009 with 2011, improving students' knowledge (29/33 [88%] versus 40/45 [91%]), differential diagnoses (27/33 [82%] versus 38/45 [86%]), and ability to identify key findings (26/33 [79%] versus 38/45 [86%]) remained somewhat or very important reasons for adopting VPs. Meeting Liaison Committee on Medical Education ED-2 (31/33 [94%] versus 33/45 [73%], P = .011) and ED-8 requirements (25/33 [76%] versus 25/45 [56%], P = .004) declined in importance. Eight of 38 (21%) replaced a learning activity with VPs, 9/38 (24%) integrated VPs into other learning activities, and 21/38 (55%) simply added VPs onto their curricula. This large, multi-institutional study reports national trends in VP adoption and integration. Meeting cognitive learning objectives remained an important reason for adopting VPs, whereas meeting regulatory requirements decreased significantly in importance. Opportunities remain for m ore systematically integrating VPs into clerkship curricula. Clarifying the changing goals may help with this process.

  5. A readability assessment of online stroke information.

    Science.gov (United States)

    Sharma, Nikhil; Tridimas, Andreas; Fitzsimmons, Paul R

    2014-07-01

    Patients and carers increasingly access the Internet as a source of health information. Poor health literacy is extremely common and frequently limits patient's comprehension of health care information literature. We aimed to assess the readability of online consumer-orientated stroke information using 2 validated readability measures. The 100 highest Google ranked consumer-oriented stroke Web pages were assessed for reading difficulty using the Flesch-Kincaid and Simple Measure of Gobbledygook (SMOG) formulae. None of the included Web pages complied with the current readability guidelines when readability was measured using the gold standard SMOG formula. Mean Flesch-Kincaid grade level was 10.4 (95% confidence interval [CI] 9.97-10.9) and mean SMOG grade 12.1 (95% CI 11.7-12.4). Over half of the Web pages were produced at graduate reading levels or above. Not-for-profit Web pages were significantly easier to read (P=.0006). The Flesch-Kincaid formula significantly underestimated reading difficulty, with a mean underestimation of 1.65 grades (95% CI 1.49-1.81), P<.0001. Most consumer-orientated stroke information Web sites require major text revision to comply with readability guidelines and to be comprehensible to the average patient. The Flesch-Kincaid formula significantly underestimates reading difficulty, and SMOG should be used as the measure of choice. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  6. The relationship of CSR and the business profit: can the most responsible companies be more profitable?

    Directory of Open Access Journals (Sweden)

    Antonio Miguel Gil Salmerón

    2016-10-01

    Full Text Available Persistent financial crisis and the cases of corruption afflicting Spain have broken the trust of society that forcefully demands an ethical, responsible and sustainable management of organizations, which are not immune to environmental problems. The effects of globalization, the introduction of tecnoestructura as a management model, technological and socio-economic changes have reshaped the cultural, management and ownership system of the current company, the company nowadays is transferred the responsibility to combine growth and competitiveness with social development and environmental improvement. This reconfiguration of business management model is implemented with the introduction of Corporate Social Responsibility (CSR in the strategic plans of the companies with the purpose of achieving a competitive advantage. The question is: can the most responsible companies be more profitable? The introduction of CSR in the organizational culture of the companies involved as a vector, accelerates the profitability of the companies that apply it: the higher level of CSR used, the more profitable the companies are. These conclusions are determined from a linear regression analysis comparing the ROA –return on assets– to CSR levels in a hundred companies with higher levels of sustainability that operate in Spain, according to a survey published in 2014 by the Monitor business Corporate Reputation (Merco

  7. Design, construction, and implementation of an online platform for patients with type 1 diabetes: EncoDiab

    Directory of Open Access Journals (Sweden)

    Alvarado-Martel D

    2015-06-01

    Full Text Available Dácil Alvarado-Martel,1,2,* Francesca Cañas,3,* Rebeca Velasco,1 Nuria Alcubierre,3 Laura López-Ríos,1,2 Ferran Rius,4 Francisco Javier Nóvoa,1,2 Armando Carrillo,1,2 Marta Hernández,3,4 Ana María Wägner,1,2,* Dídac Mauricio5,6,* 1Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas, Spain; 2Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain; 3Department of Endocrinology and Nutrition, Institut de Recerca Biomèdica de Lleida (IRBLleida, Lleida, Spain; 4Department of Endocrinology and Nutrition, Hospital Universitari Arnau de Vilanova, Lleida, Spain; 5Hospital Universitari Germans Trias i Pujol, Badalona, Spain; 6Health Sciences Research Institute Germans Trias i Pujol, Badalona, Spain *These authors contributed equally to this work Purpose: The purpose of this study was to develop, build, and implement a virtual platform equipped with practical tools, relevant contents, and communication rooms, with the aim of facilitating patients’ self-management of type 1 diabetes mellitus (T1DM.Materials and methods: The design of the platform was based on the suggestions of T1DM patients who were being managed at two reference hospitals. Patients’ needs and preferences were identified in group discussion sessions. Before having access to the platform, patients underwent a baseline assessment, which included physical examination and the administration of validated questionnaires for evaluation of clinical background, quality of life, treatment satisfaction, and well-being.Results: A total of 33 patients were included in the study; 54.5% of them were men, their median age was 34 (18–50 years, the median duration of diabetes was 15 (1–38 years, and the median A1C was 7.4% (6%–12.6%. Based on their suggestions and requests, the online platform EncoDiab was built and organized into

  8. Evaluating Banking Profit Performance in Ghana during and post Profit Decline: A five Step Du-Pont Approach

    Directory of Open Access Journals (Sweden)

    Baah Aye Kusi

    2015-11-01

    Full Text Available In this study we aimed at three objectives. First, identify and rank banks based on a composite score comprising of all five du-pont variables. Second, we identify variables in the five step du-pont set up that are most likely to influence bank ROE during and post profit declining periods. And third, we estimate a model to capture the variables that drive bank ROE during and post profit declining periods. We first establish from our rankings that, foreign banks in Ghana performed better during profit declining periods while the local banks performed better in post profit decline periods using the top ten banks as a benchmark in both periods. Employing Pearson correlation coefficients matrix, we recognized that operating profit margin, asset turnover and leverage were most likely to influence bank ROE in both time periods. We further employ OLS regression and find that bank ROE was impacted by operating profit margin and leverage during profit declining periods and post profit decline while tax effect added up in post profit declining periods.

  9. Evaluating on-line health information for patients with polymyalgia rheumatica: a descriptive study.

    Science.gov (United States)

    Vivekanantham, Arani; Protheroe, Joanne; Muller, Sara; Hider, Samantha

    2017-01-26

    The Internet is increasingly used to access health information, although the quality of information varies. The aim of this study was to evaluate the readability, and quality of websites about polymyalgia rheumatica (PMR). Three UK search engines (Google, Yahoo and Bing) were searched for the term 'polymyalgia rheumatica'. After deleting duplicates, the first 50 eligible websites from each were evaluated. Readability was assessed using the Flesch Reading Ease and 'Simple Measure of Gobbledygook (SMOG) Readability' indicators. Credibility was assessed using a previously published Credibility Indicator. Of the 52 unique websites identified, the mean (standard deviation) Flesch Reading Ease and SMOG Readability scores were 48 (15) and 10 (2), respectively. The mean (SD) Credibility Indicator was 2 (1). Fifty (96%) of websites were accurate. Website design and content was good, with an average of 68 and 64% respectively, of the assessed criteria being met. Most websites about PMR require a higher readability age than is recommended. Thus whilst websites are often well designed and accurate this study suggests that their content could be refined and simplified to maximise patient benefit.

  10. Development and Pilot Evaluation of an Online Relapse-Prevention Program Based on Acceptance and Commitment Therapy for Chronic Pain Patients.

    Science.gov (United States)

    Fledderus, Martine; Schreurs, Karlein Mg; Bohlmeijer, Ernst T; Vollenbroek-Hutten, Miriam Mr

    2015-01-05

    A significant number of chronic pain patients experience a decline in therapeutic effects after rehabilitation. As face-to-face contacts with health care professionals are not always feasible after treatment, new, innovative, fully automated relapse-prevention programs are highly needed. In this study an online, automated relapse-prevention program based on acceptance and commitment therapy (ACT)-both as a website and as a mobile app-was developed and evaluated. At each step of the development, end users (ie, chronic pain patients) were consulted in order to fully address their needs. In a step-by-step process, a contextual inquiry, requirement specification, and design were executed with chronic pain patients by conducting, respectively, a focus group (n=10), interviews with rapid prototyping (n=28), and a user- and expert-based usability evaluation (n=14). Furthermore, a pilot evaluation was conducted with 14 chronic pain or fatigue patients who had received the online relapse-prevention program following a multidisciplinary ACT treatment. They were interviewed about their usage and the usefulness of the program in supporting them to maintain changed behaviors and prevent relapses in avoidance and pain control behaviors. The three stages provided information about the expected needs of end users, comments about the usefulness of the proposed features, and feedback about the design and usability of the program. This resulted in a fully operational, online relapse-prevention program. Results from the pilot evaluation showed that 9 patients used the online program after treatment, 5 of whom indicated that the program supported them after treatment. Of all the patients, 4 of them indicated that the program did not support them because they wanted more social interaction with other users. This study showed that an innovative, automated, online program that is user friendly can be developed by involving the end users in each step. The program was evaluated positively

  11. Characteristics of patients seeking health information online via social health networks versus general Internet sites: a comparative study.

    Science.gov (United States)

    Magnezi, Racheli; Grosberg, Dafna; Novikov, Ilya; Ziv, Arnona; Shani, Mordechai; Freedman, Laurence S

    2015-03-01

    Camoni.co.il, a Hebrew-language social health network offers advice, consultation, and connection to others with chronic illness. This study compared characteristics and objectives of Camoni.co.il users and individuals seeking medical information through general Internet sites. Similar questionnaires were sent to 1009 Internet and 900 Camoni users. Cluster analysis defined four modes of online social health network use: "acquiring information and support", "communicating", "networking" and "browsing". Six hundred and five Internet and 125 Camoni users responded. Diabetes, hypertension, obesity and lung diseases were found more often among general Internet users than Camoni users. Among Camoni users, "acquiring information and support" was the main motivation for individuals over age 55 years, women, those with lower income, chronic pain, obesity and depression. "Communicating" was the main incentive of men, those 20-34 years old, those with less education, or an eating disorder. "Networking" was the most significant motivation for those with multiple sclerosis or depression. Browsing was most frequent among individuals with multiple sclerosis. Identifying needs of social health network surfers will allow planning unique contents and enhancing social health sites. Physicians might advise patients to use them to obtain support and information regarding their conditions, possibly leading to improved compliance and self-management.

  12. Core belief content examined in a large sample of patients using online cognitive behaviour therapy.

    Science.gov (United States)

    Millings, Abigail; Carnelley, Katherine B

    2015-11-01

    Computerised cognitive behavioural therapy provides a unique opportunity to collect and analyse data regarding the idiosyncratic content of people's core beliefs about the self, others and the world. 'Beating the Blues' users recorded a core belief derived through the downward arrow technique. Core beliefs from 1813 mental health patients were coded into 10 categories. The most common were global self-evaluation, attachment, and competence. Women were more likely, and men were less likely (than chance), to provide an attachment-related core belief; and men were more likely, and women less likely, to provide a self-competence-related core belief. This may be linked to gender differences in sources of self-esteem. Those who were suffering from anxiety were more likely to provide power- and control-themed core beliefs and less likely to provide attachment core beliefs than chance. Finally, those who had thoughts of suicide in the preceding week reported less competence themed core beliefs and more global self-evaluation (e.g., 'I am useless') core beliefs than chance. Concurrent symptom level was not available. The sample was not nationally representative, and featured programme completers only. Men and women may focus on different core beliefs in the context of CBT. Those suffering anxiety may need a therapeutic focus on power and control. A complete rejection of the self (not just within one domain, such as competence) may be linked to thoughts of suicide. Future research should examine how individual differences and symptom severity influence core beliefs. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  13. Why public health services? Experiences from profit-driven health care reforms in Sweden.

    Science.gov (United States)

    Dahlgren, Göran

    2014-01-01

    Market-oriented health care reforms have been implemented in the tax-financed Swedish health care system from 1990 to 2013. The first phase of these reforms was the introduction of new public management systems, where public health centers and public hospitals were to act as private firms in an internal health care market. A second phase saw an increase of tax-financed private for-profit providers. A third phase can now be envisaged with increased private financing of essential health services. The main evidence-based effects of these markets and profit-driven reforms can be summarized as follows: efficiency is typically reduced but rarely increased; profit and tax evasion are a drain on resources for health care; geographical and social inequities are widened while the number of tax-financed providers increases; patients with major multi-health problems are often given lower priority than patients with minor health problems; opportunities to control the quality of care are reduced; tax-financed private for-profit providers facilitate increased private financing; and market forces and commercial interests undermine the power of democratic institutions. Policy options to promote further development of a nonprofit health care system are highlighted.

  14. Operating Profitability of For-Profit and Not-for-Profit Florida Community Hospitals During Medicare Policy Changes, 2000 to 2010

    National Research Council Canada - National Science Library

    Langland-Orban, Barbara; Large, John T; Sear, Alan M; Zhang, Hanze; Zhang, Nanhua

    2015-01-01

    ...) and not-for-profit (NFP) hospital operating margins in Florida. FP hospitals were expected to be more adversely affected as admissions growth has been one strategy to improve stock performance, which is not a consideration at NFPs...

  15. Strategy Proposal for Pelita Rakyat Hospital as Non Profit Organization in Sukabumi

    OpenAIRE

    Simanjuntak, Yosua Arthur Burhandito; Wandebori, Harimukti

    2013-01-01

    The Hospital is an institution which provides health service for people with their own characteristic. It influenced by the development of health science, technological advances, and economic-social living of society. As institution, they need to fund their activites. It could be come from government subsidies or fee charge from patient. Pelita Rakyat hospital is non-profit hospital which established in 2011. As pioneer, they did not ask charge from their patient moreover they provide free m...

  16. Effect of Financing on Profitability of Sawmill Industries in Cross ...

    African Journals Online (AJOL)

    This study examined the Effect of Financing on Profitability of Sawmill Industries in Cross River State, Nigeria. The study was conducted at enterprise level in Cross River State with a sample of 80 saw millers to ascertain the effect of finance on their profitability. The result shows that amount borrowed business experience, ...

  17. Methods utilized in evaluating the profitability of commercial space processing

    Science.gov (United States)

    Bloom, H. L.; Schmitt, P. T.

    1976-01-01

    Profitability analysis is applied to commercial space processing on the basis of business concept definition and assessment and the relationship between ground and space functions. Throughput analysis is demonstrated by analysis of the space manufacturing of surface acoustic wave devices. The paper describes a financial analysis model for space processing and provides key profitability measures for space processed isoenzymes.

  18. The relationship between size, growth and profitability of commercial banks

    NARCIS (Netherlands)

    Shehzad, C. T.; De Haan, J.; Scholtens, B.

    2013-01-01

    Using a dynamic panel model for more than 15 000 banks from 148 countries from 1988 to 2010, we investigate the interaction between size, growth and profitability of banks. For our total sample, we cannot reject the hypotheses that the variability of bank profitability and the level and variability

  19. Analysis of profitability and poverty reduction of yoghurt processing ...

    African Journals Online (AJOL)

    The study assessed the profitability of yoghurt processing with a view of determining its potentials for reducing poverty in Maiduguri Metropolitan Area. Data were collected from a survey of 10 yoghurt processing firms in Maiduguri and analysed using profit model and descriptive statistics. Results revealed that yoghurt ...

  20. A method for predicting the probability of business network profitability

    NARCIS (Netherlands)

    Johnson, P.; Iacob, Maria Eugenia; Välja, M.; van Sinderen, Marten J.; Magnusson, C; Ladhe, T.

    2014-01-01

    In the design phase of business collaboration, it is desirable to be able to predict the profitability of the business-to-be. Therefore, techniques to assess qualities such as costs, revenues, risks, and profitability have been previously proposed. However, they do not allow the modeler to properly

  1. Comparative Analysis of Profitability of Layers Production in Esan ...

    African Journals Online (AJOL)

    MICHAEL HORSFALL

    agricultural sector are rational, thus, they would increase their supply if they are sure of making higher profit ceteris paribus (Emokaro et al., 2009). Higher profit ..... Energy and Crude Protein Requirements for. Chicks of Nigeria Local Fowl and Crossbreeds. Int. J. Poult. Sci., 5:.271-274. Koutsoyiannis, A (2001). Theory of ...

  2. Profitability of Snail Production in Osun State,Nigeria | Baba ...

    African Journals Online (AJOL)

    The costs and returns analysis revealed that variable costs accounted for 96% of the production costs. Labour was the most costly single item in snail production in the area. The results further showed that snail farming was highly profitable, with the average farmer earning a net return of 40 naira per snail. There was a profit ...

  3. Summer 2012 Colorado Wildfire Non-Profit Sector Case Study

    Science.gov (United States)

    2012-11-01

    include commercial losses. Rocky Mountain Insurance Information Association is a non-profit consumer information organization . Affiliated with the...million. These estimates do not include commercial losses. Rocky Mountain Insurance Information Association is a non-profit consumer information ... organization . Affiliated with the Insurance Information Institute, RMIIA has been serving consumers and the media since 1952. 22 5.0 Observations

  4. Determinant of Profit Efficiency among Small Scale Traditional Palm ...

    African Journals Online (AJOL)

    This study was designed to examine the determinants of profit efficiency among traditional palm oil processing in Nigeria, using stochastic Cobb – Douglas profit frontier model. A Multi – Stage random sampling technique was used to select 240 traditional palm oil processors from which input – output data were collected.

  5. The implementation of customer profitability analysis: a case study

    NARCIS (Netherlands)

    van Raaij, E.M.; Vernooij, M.J.A.; Vernooij, Maarten J.A.; van Triest, S.P.

    2003-01-01

    By using customer profitability analysis (CPA), firms can determine the profit contribution of customer segments and/or individual customers. This article presents an approach for the implementation of CPA. The implementation process is illustrated using a case study of a firm producing and selling

  6. How's Business? Status Report #6 on For Profit Child Care.

    Science.gov (United States)

    Neugebauer, Roger

    1990-01-01

    Describes the growth of for-profit child care and indications of a potential slowdown. Discusses the declining expansion of major chains and the accelerated growth of midsize and small chains. Lists the nations' largest for-profit child care and center management organizations. (RJC)

  7. Profitability Analysis of Rice Processing and Marketing in Kano State ...

    African Journals Online (AJOL)

    ABSTRACT: The study determined the profitability of rice processing and marketing in Kano. State. The objective of the study was to assess the profitability levels of rice processing and marketing, evaluate the value added to the commodity at each stage in the study area and determine the most efficient services produce.

  8. Refined analysis results for multimedia network costs and profits

    DEFF Research Database (Denmark)

    Tahkokorpi, M.; Falch, Morten; Skouby, Knud Erik

    This deliverable describes the techno-economic business model developed in EURORIM WP3 and presents the refined results of the multimedia service delivery cost-profit calculations......This deliverable describes the techno-economic business model developed in EURORIM WP3 and presents the refined results of the multimedia service delivery cost-profit calculations...

  9. 45 CFR 74.81 - Prohibition against profit.

    Science.gov (United States)

    2010-10-01

    ... ORGANIZATIONS, AND COMMERCIAL ORGANIZATIONS Special Provisions for Awards to Commercial Organizations § 74.81 Prohibition against profit. Except for awards under the Small Business Innovation Research (SBIR) and Small... to any recipient even if the recipient is a commercial organization. Profit is any amount in excess...

  10. Academic Libraries in For-Profit Schools of Higher Education

    Science.gov (United States)

    Davis, Jinnie Y.; Adams, Mignon; Hardesty, Larry

    2011-01-01

    For-profit schools constitute the fastest-growing sector of higher education institutions in the United States. Yet accompanying the phenomenal growth of these proprietary colleges and universities has been considerable controversy over the role that the profit motive should play in higher education. The literature of higher education contains…

  11. The Nigerian Statements of Accounting Standards and Ribh (Profit ...

    African Journals Online (AJOL)

    However, the subject, profit (ribh), in relation to both conventional and Islamic accounting standards, has almost totally been neglected. This paper, therefore, investigates the determination of profit in line with the Nigerian Statements of Accounting Standards (SAS), conventional economics and Islamic economic ...

  12. 48 CFR 2115.404-71 - Profit analysis factors.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Profit analysis factors... TYPES CONTRACTING BY NEGOTIATION Contract Pricing 2115.404-71 Profit analysis factors. (a) The OPM... (service charge) for the FEGLI Program contract. In accordance with the factors defined in FAR 15.404-4(d...

  13. Management Control Systems in Not for Profit Organization

    OpenAIRE

    De La Cruz Marquez, Michelle

    2008-01-01

    The diploma thesis is about management control system. The first part contains the analysis of the subject, the factors, components and tools of management control. In the second part is about the difference of management control in profit and non-profit organizations.

  14. 26 CFR 509.105 - Industrial and commercial profits.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 19 2010-04-01 2010-04-01 false Industrial and commercial profits. 509.105...) REGULATIONS UNDER TAX CONVENTIONS SWITZERLAND General Income Tax § 509.105 Industrial and commercial profits... contracting States shall not be taxable by the other contracting State upon its industrial and commercial...

  15. Risk attitudes and profits among small enterprises in Nigeria

    NARCIS (Netherlands)

    Lammers, J.; Willebrands, D.; Hartog, J.

    2010-01-01

    This paper analyses the effect of risk attitudes of firm owners on profits among micro and small enterprises (MSEs) in Lagos, Nigeria. Higher risk perceptions are shown to have a significant positive effect on profits, whereas risk propensity has a negative or no effect. Education, age, being male,

  16. Profitability of cover crops for single and twin row cotton

    Science.gov (United States)

    With the increased interest in cover crops, the impact of adoption on profitability of cash crops is a common question from producers. The objective of this study was to evaluate the profitability of cover crops for single and twin row cotton (Gossypium hirsutum L.) in Alabama. This experiment inclu...

  17. Application of relationship marketing in non-profit organisations ...

    African Journals Online (AJOL)

    The concept of relationship marketing was born from this need for long-term interaction with customers. A variety of factors have over time contributed to a need for marketing in non-profit organisations, such as non-profit sports clubs and recreation centres at local and school levels, to offset the decrease in income and ...

  18. Short Term Effect of Consolidation on Profitability of Nigerian Banks ...

    African Journals Online (AJOL)

    The findings here confirm the existing controversy on whether or not mergers or acquisitions lead to improved profitability. What is however clear is that barring any effect of the present global economic meltdown; it may take some time for the EPS of most of the banks to change significantly. Key Words: EPS Profitability ...

  19. Profitability analysis of plantain marketing in Kaduna metropolis ...

    African Journals Online (AJOL)

    Descriptive statistics, Cost and return analysis, Herfindahl index, Gross ratio, Operating ratio, Expense structure ratio, Return per capital invested, Benefit cost ratio were used to analyze the data. The study showed that ... Analysis of the profit revealed that plantain marketing is a profitable business. The constraint militating ...

  20. Management and socio-economic determinants of profitability in dog ...

    African Journals Online (AJOL)

    Management and socio-economic determinants of profitability in dog breeding business in Oyo state, Nigeria. ... Descriptive statistics, univariate and multivariable analyses were done to determine predictors of profitability in dog breeding business. The mean age of respondents was 32.1 ± 7.7 years. The median year of ...

  1. Acquisition of the Profit Concept by Third-Grade Children.

    Science.gov (United States)

    Berti, Anna Emilia

    1992-01-01

    Conceptions of 50 third graders (aged 8-9 years) in Italy about shopkeepers' profit were examined using the Piagetian clinical procedure, with an interview followed by a comparison task that checked comprehension. Teaching children about profit had a higher impact at posttest on children who could compare correctly. (SLD)

  2. Distribution of Costs and Profits in Danish Urban Development

    DEFF Research Database (Denmark)

    Sørensen, Michael Tophøj; Christensen, Finn Kjær

    2009-01-01

    Most countries have a system – procedures and tools – for foreseeable, clear and fair distribution of costs and profits in urban development. However, the distribution of profits and costs between the municipality and the developers /landowners is in Denmark rather fragmented and not very transpa...

  3. Macroeconomy and Banks' Profitability in Nigeria | Chidozie | African ...

    African Journals Online (AJOL)

    It also seeks to examine the significance of microeconomic variables (cost to income ratio, loan to deposit ratio; loan to total assets ratio and total assets) on banks' profitability. It analysed the impact of banking industry concentration on banks' profitability. The estimation technique follows a panel regression which studied a ...

  4. THE PROFIT TARGET IN A RESTAURATION UNIT

    Directory of Open Access Journals (Sweden)

    Briciu Sorin

    2011-12-01

    Full Text Available The hospitality industry represents one of the most dynamic sectors of the contemporary society, with an emphasised role in the process of globalization. Currently, the hospitality industry does not only face the challenges of the economic crisis but the changes in the market, the consumers behaviour and the technological trends, too. That is why, in this time, it is extremely important to apply the management accounting and the cost calculation in any entity in the hospitality industry in order to cope with the market challenges. The main services are performed through the hospitality industry: the accommodation and the restauration. These services satisfy the vital needs of the tourists, but this industry must meet other needs or requests such as the acknowledgement of the social status, the desire to know other cultures or traditions, to spend free time in a pleasant manner etc. Our intention and goal in the current article is to approach an image of the CVP analysis in the decision making process with an emphasis on the restauration in the hospitality industry. In order to cope with this critical time, the competition and to achieve the profits estimated, the managers in the hospitality industry can apply the CVP analysis, one of the simplest and most useful analytical instruments. The paper will tackle with the problem of the break even point in a restaurant, one of the main indicators of the CVP model and also the possibility of the decision making process orientation.

  5. Determinants of the Profitability in the Czech Banking Industry

    Directory of Open Access Journals (Sweden)

    Iveta Palečková

    2016-12-01

    Full Text Available The aim of this paper is to estimate the banking profitability determinants of the Czech commercial banks during the period 2004-2014. For estimation of banking profitability we used three common measures, namely the Return on Assets, Return on Equity and Net Interest Margin. We estimated twelve determinants of banking performance. The effect of the determinants of banking profitability is estimated using panel data analysis. The data set is consists of seventeen commercial banks in the Czech Republic. The results show that the profitability was positively influenced by the bank’s size, capitalization, credit risk, level of concentration, ownership structure and bank’s market share. Number of branches of the bank had the negative impact on ROA and ROE. on the other hand, the variables Gross Domestic Product, interest rate, liquidity risk, riskiness of bank’s portfolio and affiliation with financial conglomerate have not got the significant influence on profitability of the Czech commercial banks.

  6. Analysis of alternative approach to determining of customers' profitability level

    Directory of Open Access Journals (Sweden)

    Michal Vodák

    2007-01-01

    Full Text Available This paper describes alternative approach to analysis of customers profitability based just on volume of purchased goods. By including average distance of customers' distributional places as additional criteria for profitability analysis and using cluster analysis as a method for ranking customers is proven that assessing of customers' profitability can be more accurate.This approach to evaluation of customers' profitability changes order of customers listed acordingly to profit they generate. In fact it shows that in business terms is room for improvement and harmonisation of relationship among some business partners in certain cases. Recalculation of business conditions which comes from detailed analysis can bring either increase of competitiveness by price reduction or increase of incomes by rising price of goods.

  7. A survey of Lab Tests Online-UK users: a key resource for patients to empower and help them understand their laboratory test results.

    Science.gov (United States)

    Leyland, Rebecca; Freedman, Danielle B

    2016-11-01

    Background Lab Tests Online-UK celebrated its 10th anniversary in 2014 and to mark the occasion the first comprehensive survey of website users was undertaken. Methods A pop-up box with a link to Survey Monkey was used to offer website users the chance to participate in the survey, which was live from 4 March 2014 to 11 April 2014. Results Six hundred and sixty-one participants started the questionnaire and 338 completed all of the demographic questions. Although the website is designed and aimed at patients and the public, a significant number of respondents were health-care professionals (47%). The majority of survey participants found the Lab Tests Online-UK website via a search engine and were visiting the site for themselves. The majority of participants found what they were looking for on the website and found the information very easy or fairly easy to understand. The patient respondents were keen to see their laboratory test results (87%), but the majority did not have access (60%) at the time of the survey. Conclusions This survey provides good evidence that the Lab Tests Online-UK website is a useful resource for patients and health-care professionals alike. It comes at a poignant time as the release of results direct to patients starts with access to their medical records. The Lab Tests Online-UK website has a key role in enabling patients to understand their lab test results, and therefore empowering them to take an interest and engage in their own healthcare.

  8. An online virtual-patient program to teach pharmacists and pharmacy students how to provide diabetes-specific medication therapy management.

    Science.gov (United States)

    Battaglia, Jessica N; Kieser, Mara A; Bruskiewitz, Ruth H; Pitterle, Michael E; Thorpe, Joshua M

    2012-09-10

    To develop, implement, and assess the effectiveness of an online medication therapy management (MTM) program to train pharmacists and pharmacy students in providing MTM services for patients with diabetes and to increase their intent to perform these services. An online program was created using an Internet-based learning platform to simulate 4 MTM meetings between a pharmacist and a virtual patient diagnosed with diabetes. Eighty students and 42 pharmacists completed the program. After completing the program, scores on post-intervention assessments showed significant improvement in 2 areas: control over performing MTM, and knowledge of how to perform MTM. Students had a significantly less-positive attitude about MTM and a decline in their perception of the social expectation that MTM is part of the practice of pharmacy, while pharmacists' attitudes did not change significantly in these areas. This online program using a virtual patient improved both participants' belief that they have control over performing MTM, and their knowledge of how to perform MTM for diabetic patients, which may increase the likelihood that pharmacists and pharmacy students will perform MTM in the future.

  9. Administrative stressors and nursing job outcomes in Australian public and non-profit health care organisations.

    Science.gov (United States)

    Teo, Stephen T T; Yeung, Melissa; Chang, Esther

    2012-05-01

    The main aim of this study is to develop a path model to examine the effect of administrative stressors on nursing work outcomes in a sample of Australian public and non-profit nurses. The implementation of managerial reform initiatives has negative consequences on work outcomes. However, less is known about the effects of these stressors in public and non-profit health care organisations. An online, self-completion questionnaire was sent to a random sample of nurses, employed in nursing-related occupations. Useable surveys were received from 251 nurses. The path model was analysed using SmartPLS software (SmartPLS, Hamburg, Germany). Public and non-profit nurses experienced time and resource administrative-related stressors (such as resource shortage and pay not as good as other people doing similar work). They relied on work-related social support to reduce the negative consequences. Resource stressors led to job dissatisfaction while time stressors led to psychological strain. Nursing staff who reported better psychological health reported higher job satisfaction and higher level of commitment towards their organisations. Context-specific administrative stressors have a negative impact on the work outcomes of public and non-profit nurses. Work-related social support mechanisms were found to mediate the negative consequences of administrative resourcing stressors on nursing job satisfaction. Nursing managers have to be sympathetic and care for the negative experiences of nursing staff, especially when there is an increasing level of administrative expectations during organisational change. Senior management should take note of the stressors caused by the lack of resources such as information, staffing and resources, as these were found to lead to an increase in nurses seeking work-related social support from their peers and supervisors. Effective implementation of these strategies would lead to a nursing workforce, which has higher level of psychological health

  10. Barriers and Facilitators to Online Portal Use Among Patients and Caregivers in a Safety Net Health Care System: A Qualitative Study.

    Science.gov (United States)

    Tieu, Lina; Sarkar, Urmimala; Schillinger, Dean; Ralston, James D; Ratanawongsa, Neda; Pasick, Rena; Lyles, Courtney R

    2015-12-03

    Patient portals have the potential to support self-management for chronic diseases and improve health outcomes. With the rapid rise in adoption of patient portals spurred by meaningful use incentives among safety net health systems (a health system or hospital providing a significant level of care to low-income, uninsured, and vulnerable populations), it is important to understand the readiness and willingness of patients and caregivers in safety net settings to access their personal health records online. To explore patient and caregiver perspectives on online patient portal use before its implementation at San Francisco General Hospital, a safety net hospital. We conducted 16 in-depth interviews with chronic disease patients and caregivers who expressed interest in using the Internet to manage their health. Discussions focused on health care experiences, technology use, and interest in using an online portal to manage health tasks. We used open coding to categorize all the barriers and facilitators to portal use, followed by a second round of coding that compared the categories to previously published findings. In secondary analyses, we also examined specific barriers among 2 subgroups: those with limited health literacy and caregivers. We interviewed 11 patients and 5 caregivers. Patients were predominantly male (82%, 9/11) and African American (45%, 5/11). All patients had been diagnosed with diabetes and the majority had limited health literacy (73%, 8/11). The majority of caregivers were female (80%, 4/5), African American (60%, 3/5), caregivers of individuals with diabetes (60%, 3/5), and had adequate health literacy (60%, 3/5). A total of 88% (14/16) of participants reported interest in using the portal after viewing a prototype. Major perceived barriers included security concerns, lack of technical skills/interest, and preference for in-person communication. Facilitators to portal use included convenience, health monitoring, and improvements in patient

  11. 26 CFR 1.901-2T - Income, war profits, or excess profits tax paid or accrued (temporary).

    Science.gov (United States)

    2010-04-01

    ... subject to tax on the basis of place of management, place of incorporation or similar criterion or... loss recognized by FC for country Z tax purposes, and pursuant to a group relief regime in country Z FC... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Income, war profits, or excess profits tax paid...

  12. For-profit Hospitals: A comparative and longitudinal study of the for-profit hospital sector in four Western countries

    NARCIS (Netherlands)

    P.P.T. Jeurissen (Patrick)

    2010-01-01

    textabstractMany now argue that for-profit hospital ownership is on the rise because of the retrenchment of public entitlements and – often more importantly in health care – pro-market reforms in the delivery of these services1. Most theoretical notions assume that for-profit hospitals are more

  13. Examining Not-for-Profit Higher Education Faculty Attitudes and Knowledge toward For-Profit Higher Education Institutions

    Science.gov (United States)

    Karpel, Nichole

    2013-01-01

    Over the last decade, for-profit higher education has been the fastest growing segment within higher education. Despite the growth, little research exists about for-profit higher education institutions. The purpose of this exploratory, descriptive, quantitative study was to examine the attitudes and knowledge of higher education faculty toward…

  14. Costs, commitment and locality: a comparison of for-profit and not-for-profit health plans.

    Science.gov (United States)

    2004-01-01

    Following on the heels of the first national study demonstrating differences in the community benefits provided by not-for-profit and for-profit health maintenance organizations (HMOs) (Schlesinger, Mitchell, and Gray 2003), this study of the New York state market shows significant differences in premiums, administrative overhead and commitment to safety net coverage between nonprofit and for-profit health plans. This study shows that for-profit health plans do act differently than not-for-profit plans in terms of performance, efficiency, and contribution to safety net programs. Moreover, it suggests that not-for-profit health insurers operating in a predominantly for-profit market act in many ways like for-profits. The New York state insurance market provides an ideal study environment because one can compare a large number of policyholders and plans in both business models (for-profit and not-for-profit) that share an identical legislative and regulatory environment. New York has large populations being provided coverage under both models and no allowances had to be made for state-to-state political and/or legal differences. Specifically, this study shows that: The downstate insurance market is predominantly for-profit, while the upstate market is almost entirely not-for-profit. The recent conversion of Empire Blue Cross Blue Shield to a for-profit model moves the downstate market further into the for-profit column, while the upstate region remains not-for-profit. Insurers in the upstate not-for-profit market are more administratively efficient than insurers in the downstate region. Compared to the downstate region, insurers in upstate New York spent 1.5% less of their operating revenues on administrative expenses. The additional 1.5% of spending on administrative expenses downstate totals dollars 137,000,000. Upstate insurers spend significantly more of the revenues received on payments for medical care. Downstate insurers spent 80.4% of operating revenues on

  15. Association of Resident Coverage with Cost, Length of Stay, and Profitability at a Community Hospital

    Science.gov (United States)

    Shine, Daniel; Beg, Sumbul; Jaeger, Joseph; Pencak, Dorothy; Panush, Richard

    2001-01-01

    OBJECTIVE The effect of care by medical residents on hospital length of stay (LOS), indirect costs, and reimbursement was last examined across a range of illnesses in 1981; the issue has never been examined at a community hospital. We studied resource utilization and reimbursement at a community hospital in relation to the involvement of medical residents. DESIGN This nonrandomized observational study compared patients discharged from a general medicine teaching unit with those discharged from nonteaching general medical/surgical units. SETTING A 620-bed community teaching hospital with a general medicine teaching unit (resident care) and several general medicine nonteaching units (no resident care). PATIENTS All medical discharges between July 1998 and February 1999, excluding those from designated subspecialty and critical care units. MEASUREMENTS AND MAIN RESULTS Endpoints included mean LOS in excess of expected LOS, mean cost in excess of expected mean payments, and mean profitability (payments minus total costs). Observed values were obtained from the hospital's database and expected values from a proprietary risk–cost adjustment program. No significant difference in LOS between 917 teaching-unit patients and 697 nonteaching patients was demonstrated. Costs averaged $3,178 (95% confidencence interval (CI) ± $489) less than expected among teaching-unit patients and $4,153 (95% CI ± $422) less than expected among nonteaching-unit patients. Payments were significantly higher per patient on the teaching unit than on the nonteaching units, and as a result mean, profitability was higher: $848 (95% CI ± $307) per hospitalization for teaching-unit patients and $451 (95% CI ± $327) for patients on the nonteaching units. Teaching-unit patients of attendings who rarely admitted to the teaching unit (nonteaching attendings) generated an average profit of $1,299 (95% CI ± $613), while nonteaching patients of nonteaching attendings generated an average profit of $208

  16. Profit (p-index: the degree to which authors profit from co-authors.

    Directory of Open Access Journals (Sweden)

    Nasir Ahmad Aziz

    Full Text Available Current metrics for estimating a scientist's academic performance treat the author's publications as if these were solely attributable to the author. However, this approach ignores the substantive contributions of co-authors, leading to misjudgments about the individual's own scientific merits and consequently to misallocation of funding resources and academic positions. This problem is becoming the more urgent in the biomedical field where the number of collaborations is growing rapidly, making it increasingly harder to support the best scientists. Therefore, here we introduce a simple harmonic weighing algorithm for correcting citations and citation-based metrics such as the h-index for co-authorships. This weighing algorithm can account for both the nvumber of co-authors and the sequence of authors on a paper. We then derive a measure called the 'profit (p-index', which estimates the contribution of co-authors to the work of a given author. By using samples of researchers from a renowned Dutch University hospital, Spinoza Prize laureates (the most prestigious Dutch science award, and Nobel Prize laureates in Physiology or Medicine, we show that the contribution of co-authors to the work of a particular author is generally substantial (i.e., about 80% and that researchers' relative rankings change materially when adjusted for the contributions of co-authors. Interestingly, although the top University hospital researchers had the highest h-indices, this appeared to be due to their significantly higher p-indices. Importantly, the ranking completely reversed when using the profit adjusted h-indices, with the Nobel laureates having the highest, the Spinoza Prize laureates having an intermediate, and the top University hospital researchers having the lowest profit adjusted h-indices, respectively, suggesting that exceptional researchers are characterized by a relatively high degree of scientific independency/originality. The concepts and methods

  17. Health needs assessment in patients assisted by a pharmaceutical non-profit charitable organisation: a preliminary pharmacoepidemiological survey based on the analysis of drug dispensation within Italy’s Banco Farmaceutico

    Directory of Open Access Journals (Sweden)

    Silvia Bini

    2015-06-01

    Full Text Available We performed a health needs assessment of the vulnerable population cared for by the Banco Farmaceutico, an Italian nonprofit charitable organization that supplies medicines for many centers belonging to different charities. Drugs dispensed in the first half of 2014 by a representative sample of these centers were examined. An independently conducted telephone interview on our centers complemented this data. Adult males and migrants constituted the majority of the user population, and the most dispensed drugs were those for the respiratory system. Of all patients, 40% presented with a chronic problem and more than half needed polypharmacy. Users seek help spontaneously in 70% of the cases, with the centers being able to meet 80% of the existing demand. Patients that could not be managed were referred to local hospitals or collaborating doctors and reasons were explored. We believe our study to be a first attempt to characterise a growing population that is also increasingly represented in emergency departments and internal medicine wards. It is also an evaluation of the quality of data collected by charitable institutions, highlighting a significant need for improvement as they could be the only basis to monitor the health needs of this type of population.

  18. Protein production: planet, profit, plus people?

    Science.gov (United States)

    Aiking, Harry

    2014-07-01

    Food sustainability and food security are increasingly in the spotlight and increasingly intertwined. According to some projections we will need to nearly double food production in the next 4 decades. This article argues that protein production and consumption are pivotal to sustainability, because anthropogenic contributions to the nitrogen cycle are 100-200% compared with a contribution of 1-2% to the carbon cycle by mineral fuel combustion, with biodiversity as the main casualty. Because 1 kg animal protein requires ∼ 6 kg plant protein, its large-scale production by means of factory farming is a major driver of biodiversity loss, climate change, and freshwater depletion. Furthermore, intensive livestock production is associated with antibiotics resistance and increasing incidence of emerging diseases. Therefore, a "reversed" diet transition back to less animal protein could make a difference. Some European countries, such as the United Kingdom, Sweden, and The Netherlands, have published integrated policy reports addressing food security, sustainability, and health combined. The food industry is focusing on food safety and increasingly on sustainability. An important issue is consumer communication, because consumer "framing" is radically different from that of governmental and industrial policy makers. There is no "one size fits all." A huge range of differences exists between countries and between distinct groups of consumers within countries; getting consumers to change their diets in a more sustainable direction is likely to require much more than gentle nudging. National governments and the United Nations should assume their responsibilities and initiate a global strategy integrating sustainability, food security, nutrition, and equity. To date, the profit pillar of sustainability has taken precedence over planet and people. It is time to redress the balance. © 2014 American Society for Nutrition.

  19. Online dating

    OpenAIRE

    Pilecká, Jarmila

    2014-01-01

    The usage of online dating sides has increased in last few decades. This kind of meeting potential new partner is specific in many ways. Especially in communication, ways of selection and initiation of the relationship online. The reduction of information is another phenomenon in this kind of interaction as a result of creating impression. This contains lying and deception in self-presentation on online dating sides as well. Analysis of data suggests, that men tell lies more than women. They ...

  20. Gamers Online

    OpenAIRE

    Zulkarnaen, Alfi

    2015-01-01

    Komunitas gamers online merupakan suatu bentuk komunitas masa kini yang menyandarkan segala bentuk kegiatannya pada penggunaan teknologi berupa komputer dan jaringan internet untuk dapat menghubungkan diantara sesama pengguna, komunitas gamers online adalah suatu kelompok yang terdiri dari beragam individu dengan beragam latar belakang yang diikat oleh satu ide maupun tujuan, yakni games online. Perkembangan teknologi berupa komputer tidak hanya bertujuan sebagai alat bantu dalam kehidupan me...