Sample records for providing outcomes information
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The strategic use of outcome information.
Thompson, D I; Sirio, C; Holt, P
2000-10-01
Most health care executives see outcome measurement as a technical or tactical matter rather than as a strategic tool. Accordingly, provider investment in outcome measurement and management is relatively small. Nevertheless, outcome information can be key to achieving an organization's strategic objectives. Advances in risk adjustment and improvements in technology for data collection and analysis have made outcome measurement a practical tool for individual hospital use. Strategically integrated outcome measurement efforts can give providers a competitive advantage over organizations that only use outcomes tactically. One of the best examples of an acute care provider that has used outcome information for strategic advantage is Intermountain Health Care (IHC; Salt Lake City). In 1997 IHC made clinical quality and outcomes the primary focus of its five-year strategic plan. To support the new strategy IHC's board of trustees approved the development of an outcome information system that generated data along clinical processes of care and the creation of a new management structure to use these data to hold professionals accountable and to set and achieve clinical improvement goals. From 1996 to 1999, IHC's share of the commercial health care market in Utah increased from roughly 50% to about 62% of the market, with the result that it has stopped actively marketing its services. Health care executives will not willingly invest in outcomes until they believe that they have business value. Therefore, making the business case for outcomes can help improve the quality of health care and the lives of individuals.
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Internet health information in the patient-provider dialogue.
Hong, Traci
2008-10-01
A patient discussing Internet health information with a health care provider (referred to as "patient-provider communication about Internet health information") can contribute positively to health outcomes. Although research has found that once Internet access is achieved, there are no ethnic differences in Internet health information seeking, it is unclear if there are ethnic differences in patient-provider communication about Internet health information. To help fill this gap in the literature, the National Cancer Institute's Health Information National Trends Survey 2005 was analyzed with Stata 9. Two sets of logistic regression analyses were conducted, one for a subsample of Internet users (n = 3,244) and one for a subsample of Internet users who are first-generation immigrants (n = 563). The dependent variable was patient-provider communication about Internet health information, which assessed whether survey participants had discussed online health information with a health care provider. The predictor variables included trust of health care provider, trust of online health information, Internet use, health care coverage, frequency of visits to health care provider, health status, and demographics. Among all Internet users, Whites had higher levels of patient-provider communication about Internet health information than Blacks and Asians. Similarly, among Internet users who are immigrants, Whites had higher levels of patient-provider communication about Internet health information than Blacks and Asians. While the digital divide is narrowing in terms of Internet access, racial differences in patient-provider communication about Internet health information may undermine the potential benefits of the information age.
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Hirth, Richard A; Turenne, Marc N; Wheeler, John RC; Pan, Qing; Ma, Yu; Messana, Joseph M
2009-01-01
Objective To characterize the influence of dialysis facilities and nephrologists on resource use and patient outcomes in the dialysis population and to illustrate how such information can be used to inform payment system design. Data Sources Medicare claims for all hemodialysis patients for whom Medicare was the primary payer in 2004, combined with the Medicare Enrollment Database and the CMS Medical Evidence Form (CMS Form 2728), which is completed at onset of renal replacement therapy. Study Design Resource use (mainly drugs and laboratory tests) per dialysis session and two clinical outcomes (achieving targets for anemia management and dose of dialysis) were modeled at the patient level with random effects for nephrologist and dialysis facility, controlling for patient characteristics. Results For each measure, both the physician and the facility had significant effects. However, facilities were more influential than physicians, as measured by the standard deviation of the random effects. Conclusions The success of tools such as P4P and provider profiling relies upon the identification of providers most able to enhance efficiency and quality. This paper demonstrates a method for determining the extent to which variation in health care costs and quality of care can be attributed to physicians and institutional providers. Because variation in quality and cost attributable to facilities is consistently larger than that attributable to physicians, if provider profiling or financial incentives are targeted to only one type of provider, the facility appears to be the appropriate locus. PMID:19555398
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Provider volume and outcomes for oncological procedures.
LENUS (Irish Health Repository)
Killeen, S D
2012-02-03
BACKGROUND: Oncological procedures may have better outcomes if performed by high-volume providers. METHODS: A review of the English language literature incorporating searches of the Medline, Embase and Cochrane collaboration databases was performed. Studies were included if they involved a patient cohort from 1984 onwards, were community or population based, and assessed health outcome as a dependent variable and volume as an independent variable. The studies were also scored quantifiably to assess generalizability with respect to any observed volume-outcome relationship and analysed according to organ system; numbers needed to treat were estimated where possible. RESULTS: Sixty-eight relevant studies were identified and a total of 41 were included, of which 13 were based on clinical data. All showed either an inverse relationship, of variable magnitude, between provider volume and mortality, or no volume-outcome effect. All but two clinical reports revealed a statistically significant positive relationship between volume and outcome; none demonstrated the opposite. CONCLUSION: High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection.
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Understanding Midwives’ Preferences for Providing Information About Newborn Bloodspot Screening
Directory of Open Access Journals (Sweden)
Stuart James Wright
2018-01-01
Full Text Available Background: Understanding preferences for information provision in the context of health care service provision is challenging because of the number of potential attributes that may influence preferences. This study aimed to identify midwives’ preferences for the process and outcomes of information provision in an expanded national newborn bloodspot screening program. Design: A sample of practicing midwives completed a hybrid-stated preference survey including a conjoint analysis (CA and discrete choice experiment to quantify preferences for the types of, and way in which, information should be provided in a newborn bloodspot screening program. Six conjoint analysis questions captured the impact of different types of information on parents’ ability to make a decision, and 10 discrete choice experiment questions identified preferences for four process attributes (including parents’ ability to make a decision. Results: Midwives employed by the UK National Health Service (n = 134 completed the survey. All types of information content were perceived to improve parents’ ability to make a decision except for the possibility of false-positive results. Late pregnancy was seen to be the best time to provide information, followed by day 3 postbirth. Information before 20 weeks of pregnancy was viewed as reducing parents’ ability to make a decision. Midwives preferred information to be provided by an individual discussion and did not think parents should receive information on the Internet. Conclusion: A hybrid stated preference survey design identified that a wide variety of information should be provided to maximize parents’ ability to make a decision ideally provided late in pregnancy or on day 3 postbirth.
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Delany, Clare M
2007-01-01
How do physiotherapists working in private practice understand and interpret the meaning and significance of informed consent in everyday clinical practice? Qualitative study using semi-structured interviews. Seventeen physiotherapists purposefully recruited from metropolitan private practices where treatment was on a one-on-one basis. Therapists defined informed consent as an implicit component of their routine clinical explanations, rather than a process of providing explicit patient choices. Therapists' primary concern was to provide information that led to a (therapist-determined) beneficial therapeutic outcome, rather than to enhance autonomous patient choice. Explicit patient choice and explicit informed consent were defined as important only if patients requested information or therapists recognised risks associated with the treatment. Physiotherapists defined informed consent within a context of achieving therapeutic outcomes rather than a context of respect for patient autonomy and autonomous choice. Physiotherapy practice guidelines developed to ensure compliance with ethical and legal obligations may therefore be followed only if they fit with therapists' understanding and interpretation of a desired therapeutic outcome.
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Therapy Provider Phase Information
U.S. Department of Health & Human Services — The Therapy Provider Phase Information dataset is a tool for providers to search by their National Provider Identifier (NPI) number to determine their phase for...
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Using imputation to provide location information for nongeocoded addresses.
Directory of Open Access Journals (Sweden)
Frank C Curriero
2010-02-01
Full Text Available The importance of geography as a source of variation in health research continues to receive sustained attention in the literature. The inclusion of geographic information in such research often begins by adding data to a map which is predicated by some knowledge of location. A precise level of spatial information is conventionally achieved through geocoding, the geographic information system (GIS process of translating mailing address information to coordinates on a map. The geocoding process is not without its limitations, though, since there is always a percentage of addresses which cannot be converted successfully (nongeocodable. This raises concerns regarding bias since traditionally the practice has been to exclude nongeocoded data records from analysis.In this manuscript we develop and evaluate a set of imputation strategies for dealing with missing spatial information from nongeocoded addresses. The strategies are developed assuming a known zip code with increasing use of collateral information, namely the spatial distribution of the population at risk. Strategies are evaluated using prostate cancer data obtained from the Maryland Cancer Registry. We consider total case enumerations at the Census county, tract, and block group level as the outcome of interest when applying and evaluating the methods. Multiple imputation is used to provide estimated total case counts based on complete data (geocodes plus imputed nongeocodes with a measure of uncertainty. Results indicate that the imputation strategy based on using available population-based age, gender, and race information performed the best overall at the county, tract, and block group levels.The procedure allows for the potentially biased and likely under reported outcome, case enumerations based on only the geocoded records, to be presented with a statistically adjusted count (imputed count with a measure of uncertainty that are based on all the case data, the geocodes and imputed
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Non-local setting and outcome information for violation of Bell's inequality
International Nuclear Information System (INIS)
Pawlowski, Marcin; Kofler, Johannes; Paterek, Tomasz; Brukner, Caslav; Seevinck, Michael
2010-01-01
Bell's theorem is a no-go theorem stating that quantum mechanics cannot be reproduced by a physical theory based on realism, freedom to choose experimental settings and two locality conditions: setting (SI) and outcome (OI) independence. We provide a novel analysis of what it takes to violate Bell's inequality within the framework in which both realism and freedom of choice are assumed, by showing that it is impossible to model a violation without having information in one laboratory about both the setting and the outcome at the distant one. While it is possible that outcome information can be revealed from shared hidden variables, the assumed experimenter's freedom to choose the settings ensures that the setting information must be non-locally transferred even when the SI condition is obeyed. The amount of transmitted information about the setting that is sufficient to violate the CHSH inequality up to its quantum mechanical maximum is 0.736 bits.
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Information Literacy for Archives and Special Collections: Defining Outcomes
Carini, Peter
2016-01-01
This article provides the framework for a set of standards and outcomes that would constitute information literacy with primary sources. Based on a working model used at Dartmouth College's Rauner Special Collections Library in Hanover, New Hampshire, these concepts create a framework for teaching with primary source materials intended to produce…
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5 CFR 890.910 - Provider information.
2010-01-01
... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Provider information. 890.910 Section 890.910 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS..., and FEHB Benefit Payments § 890.910 Provider information. The hospital provider information used to...
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Jesus, Tiago Silva; Silva, Isabel Lopes
2016-04-01
There is a growing interest in linking aspects of patient-provider communication to rehabilitation outcomes. However, the field lacks a conceptual understanding on: (a) 'how' rehabilitation outcomes can be improved by communication; and (b) through 'which' elements in particular. This article elaborates on the conceptual developments toward informing further practice and research. Existing models of communication in healthcare were adapted to rehabilitation, and its outcomes through a comprehensive literature review. After depicting mediating mechanisms and variables (e.g. therapeutic engagement, adjustment toward disability), this article presents the '4 Rehab Communication Elements' deemed likely to underpin rehabilitation outcomes. The four elements are: (a) knowing the person and building a supportive relationship; (b) effective information exchange and education; (c) shared goal-setting and action planning; and (d) fostering a more positive, yet realistic, cognitive and self-reframing. This article describes an unprecedented, outcomes-oriented approach toward the design of rehabilitation communication, which has resulted in the development of a new intervention model: the '4 Rehab Communication Elements'. Further trials are needed to evaluate the impact of this whole intervention model on rehabilitation outcomes. © The Author(s) 2015.
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An Intelligent Virtual Human System For Providing Healthcare Information And Support
2011-01-01
healthcare system, and also to other SMs and Veterans by way of a variety of social networking tools (e.g., 2nd Life, Facebook, etc.). The user can progress... CyberPsychology and Behavior 8, 3 (2005), 187-211. [2] T. Parsons & A.A. Rizzo, Affective Outcomes of Virtual Reality Exposure Therapy for Anxiety...VH System for Providing Healthcare Information and Support508 [4] G. Riva, Virtual Reality in Psychotherapy: Review, CyberPsychology and Behavior 8
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Informed consent - Providing information about prenatal examinations
DEFF Research Database (Denmark)
Dahl, Katja; Kesmodel, Ulrik; Hvidman, Lone
as well.The review is based on systematic search strategy in the electronic databases Medline and Science Citation. Additional studies were identified through reference lists of individual papers obtained. Improving knowledge scores and reducing decisional conflict can be obtained by group counselling...... pregnant women about prenatal examinations. Women's knowledge, decisional conflict, satisfaction and anxiety will be explored as compared with different ways and different groups of health professionals providing information. To what extent information empowers informed decision making will be explored...
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Risk classification priorities in an emergency unit and outcomes of the service provided
Directory of Open Access Journals (Sweden)
Rafael Silva Marconato
2017-12-01
Full Text Available ABSTRACT Objective: to check the association of the proposed priorities of the institutional protocol of risk classification with the outcomes and evaluate the profile of the care provided in an emergency unit. Method: observational epidemiological study based on data from the computerized files of a Reference Emergency Unit. Care provided to adults was evaluated regarding risk classification and outcomes (death, hospitalization and hospital discharge based on the information recorded in the emergency bulletin. Results: the mean age of the 97,099 registered patients was 43.4 years; 81.5% cases were spontaneous demand; 41.2% had been classified as green, 15.3% yellow, 3.7% blue, 3% red and 36.and 9% had not received a classification; 90.2% of the patients had been discharged, 9.4% hospitalized and 0.4% had died. Among patients who were discharged, 14.7% had been classified as yellow or red, 13.6% green or blue, and 1.8% as blue or green. Conclusion: the protocol of risk classification showed good sensitivity to predict serious situations that can progress to death or hospitalization.
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Comics as a Medium for Providing Information on Adult Immunizations.
Muzumdar, Jagannath M; Pantaleo, Nicholas L
2017-10-01
This study compared the following effects of two vaccine information flyers-one developed by the Centers for Disease Control and Prevention (CDC) versus one adapted from this information to a comic medium (comic)-on adults: (a) attitude toward the flyer; (b) perceived informativeness of the flyer; (c) intention to seek more information about adult immunizations after viewing the flyer; and (d) intention to get immunized after viewing the flyer. A between-group, randomized trial was used to randomly assign adults (age 18 years or older) at an ambulatory care center to review the CDC or comic flyer. Participants were asked to complete a survey to measure several outcome variables. Items were measured using a 7-point semantic differential scale. Independent-samples t-test was used for comparisons. A total of 265 surveys (CDC n = 132 vs comic n = 133) were analyzed. The comic flyer had a statistically significant effect on participants' attitudes and their perception of the flyer's informativeness compared to the CDC flyer. Flyer type did not have a statistically significant effect on intention-related variables. The study findings showed that the comic flyer was positively evaluated compared to the CDC flyer. These findings could provide a new direction for developing adult educational materials.
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Sakai, Hitomi; Katsumata, Noriyuki; Takahashi, Miyako
2017-07-01
The Institute of Medicine (IOM) of the United States recommends that all cancer survivors be provided with a survivorship care plan (SCP), which includes a patient treatment summary and a follow-up care plan. However, SCPs have not been widely adopted in Japan. To provide basic data necessary for implementing SCPs in Japan, we aimed to investigate the forms of clinical and survivorship-related information that Japanese cancer survivors receive from their healthcare providers, and to examine whether written information increases their satisfaction. We performed a cross-sectional online survey of cancer survivors who underwent acute cancer treatment and had at least one follow-up with a physician in the past year. Cancer survivors provided the elements and forms (verbally and/or written) of information they received, as well as the degree of satisfaction with the information provided. Responses were obtained from 545 cancer survivors. Information elements such as surgical procedure (98.3%), surgical outcome (98.1%), and names of administered chemotherapy agents (97.8%) were commonly provided, whereas mental care resources and providers (29.7%), effects on marital relationship and sexual health (35.7%), and effects on fertility (43.4%) were less common. A large proportion of cancer survivors received verbal information only. For 18 of 20 elements, except for effects on fertility and duration of hormonal therapy, satisfaction was significantly higher when both forms of information were provided (P information can better meet the needs of Japanese cancer survivors. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
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Network information improves cancer outcome prediction.
Roy, Janine; Winter, Christof; Isik, Zerrin; Schroeder, Michael
2014-07-01
Disease progression in cancer can vary substantially between patients. Yet, patients often receive the same treatment. Recently, there has been much work on predicting disease progression and patient outcome variables from gene expression in order to personalize treatment options. Despite first diagnostic kits in the market, there are open problems such as the choice of random gene signatures or noisy expression data. One approach to deal with these two problems employs protein-protein interaction networks and ranks genes using the random surfer model of Google's PageRank algorithm. In this work, we created a benchmark dataset collection comprising 25 cancer outcome prediction datasets from literature and systematically evaluated the use of networks and a PageRank derivative, NetRank, for signature identification. We show that the NetRank performs significantly better than classical methods such as fold change or t-test. Despite an order of magnitude difference in network size, a regulatory and protein-protein interaction network perform equally well. Experimental evaluation on cancer outcome prediction in all of the 25 underlying datasets suggests that the network-based methodology identifies highly overlapping signatures over all cancer types, in contrast to classical methods that fail to identify highly common gene sets across the same cancer types. Integration of network information into gene expression analysis allows the identification of more reliable and accurate biomarkers and provides a deeper understanding of processes occurring in cancer development and progression. © The Author 2012. Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.
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Evaluation of poison information services provided by a new poison information center.
Churi, Shobha; Abraham, Lovin; Ramesh, M; Narahari, M G
2013-01-01
The aim of this study is to assess the nature and quality of services provided by poison information center established at a tertiary-care teaching hospital, Mysore. This was a prospective observational study. The poison information center was officially established in September 2010 and began its functioning thereafter. The center is equipped with required resources and facility (e.g., text books, Poisindex, Drugdex, toll free telephone service, internet and online services) to provide poison information services. The poison information services provided by the center were recorded in documentation forms. The documentation form consists of numerous sections to collect information on: (a) Type of population (children, adult, elderly or pregnant) (b) poisoning agents (c) route of exposure (d) type of poisoning (intentional, accidental or environmental) (e) demographic details of patient (age, gender and bodyweight) (f) enquirer details (background, place of call and mode of request) (g) category and purpose of query and (h) details of provided service (information provided, mode of provision, time taken to provide information and references consulted). The nature and quality of poison information services provided was assessed using a quality assessment checklist developed in accordance with DSE/World Health Organization guidelines. Chi-Square test (χ(2)). A total of 419 queries were received by the center. A majority (n = 333; 79.5%) of the queries were asked by the doctors to provide optimal care (n = 400; 95.5%). Most of the queries were received during ward rounds (n = 201; 48.0%), followed by direct access (n = 147; 35.1%). The poison information services were predominantly provided through verbal communication (n = 352; 84.0%). Upon receipt of queries, the required service was provided immediately (n = 103; 24.6%) or within 10-20 min (n = 296; 70.6%). The queries were mainly related to intentional poisoning (n = 258; 64.5%), followed by accidental poisoning
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Short Term Gain, Long Term Pain:Informal Job Search Methods and Post-Displacement Outcomes
Green, Colin
2012-01-01
This paper examines the role of informal job search methods on the labour market outcomes of displaced workers. Informal job search methods could alleviate short-term labour market difficulties of displaced workers by providing information on job opportunities, allowing them to signal their productivity and may mitigate wage losses through better post-displacement job matching. However if displacement results from reductions in demand for specific sectors/skills, the use of informal job searc...
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Gerber, Elisabeth R.; Lupia, Arthur
1993-01-01
Previous research suggests that voters in mass elections tend to be badly informed. If these voters do not know enough about the relationship between the policy consequences of electoral outcomes and their own interests, then electoral outcomes may not provide meaningful expressions of voter interests. Can campaign activity affect the relationship between voter interests and electoral outcomes? To answer this question, we use survey data from 35 comparable elections and a new empirical method...
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Directory of Open Access Journals (Sweden)
Yuri Masaoka
2013-01-01
Full Text Available No previous report has described whether information regarding an odor used in aromatherapy has placebo effects. We investigated whether placebo analgesia was engendered by verbal information regarding the analgesic effects of an odor. Twelve of 24 subjects were provided with the information that a lavender odor would reduce pain (informed, whereas the other 12 subjects were not (not-informed. Concurrent with respiration recording, the subjects were administered a lavender-odor or no-odor treatment during application of painful stimulation to the forefinger. The subjects reported their experience of pain and its unpleasantness on a visual analogue scale after the painful stimulation. The lavender-odor treatment significantly alleviated pain and unpleasantness compared with the no-odor treatment in the informed (P<0.01 and not-informed groups (P<0.05. The no-odor treatment in the informed group significantly alleviated pain and unpleasantness compared with both the no-odor and lavender-odor treatments in the not-informed group (P<0.05. Rapid and shallow breathing induced by the painful stimulation became slow and deep during the lavender-odor and no-odor treatments in both groups. Information regarding a lavender odor, the lavender odor itself, and slower breathing contributed to reduced perceptions of pain and unpleasantness during painful stimulation, suggesting that placebo effects significantly contribute to analgesia in aromatherapy.
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Bobb, Morgan R.; Van Heukelom, Paul G.; Faine, Brett A.; Ahmed, Azeemuddin; Messerly, Jeffrey T.; Bell, Gregory; Harland, Karisa K.; Simon, Christian; Mohr, Nicholas M.
2016-01-01
Objective Telemedicine networks are beginning to provide an avenue for conducting emergency medicine research, but using telemedicine to recruit participants for clinical trials has not been validated. The goal of this consent study is to determine whether patient comprehension of telemedicine-enabled research informed consent is non-inferior to standard face-to-face research informed consent. Methods A prospective, open-label randomized controlled trial was performed in a 60,000-visit Midwestern academic Emergency Department (ED) to test whether telemedicine-enabled research informed consent provided non-inferior comprehension compared with standard consent. This study was conducted as part of a parent clinical trial evaluating the effectiveness of oral chlorhexidine gluconate 0.12% in preventing hospital-acquired pneumonia among adult ED patients with expected hospital admission. Prior to being recruited into the study, potential participants were randomized in a 1:1 allocation ratio to consent by telemedicine versus standard face-to-face consent. Telemedicine connectivity was provided using a commercially available interface (REACH platform, Vidyo Inc., Hackensack, NJ) to an emergency physician located in another part of the ED. Comprehension of research consent (primary outcome) was measured using the modified Quality of Informed Consent (QuIC) instrument, a validated tool for measuring research informed consent comprehension. Parent trial accrual rate and qualitative survey data were secondary outcomes. Results One-hundred thirty-one patients were randomized (n = 64, telemedicine), and 101 QuIC surveys were completed. Comprehension of research informed consent using telemedicine was not inferior to face-to-face consent (QuIC scores 74.4 ± 8.1 vs. 74.4 ± 6.9 on a 100-point scale, p = 0.999). Subjective understanding of consent (p=0.194) and parent trial study accrual rates (56% vs. 69%, p = 0.142) were similar. Conclusion Telemedicine is non-inferior to face
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Tröster, Alexander I
2017-01-01
Abstract Deep brain stimulation (DBS) is an effective (but non-curative) treatment for some of the motor symptoms and treatment complications associated with dopaminergic agents in Parkinson's disease (PD). DBS can be done relatively safely and is associated with quality of life gains. In most DBS centers, neuropsychological evaluations are performed routinely before surgery, and sometimes after surgery. The purpose of such evaluation is not to decide solely on its results whether or not to offer DBS to a given candidate, but to provide the patient and treatment team with the best available information to make reasonable risk-benefit assessments. This review provides information relevant to the questions often asked by patients and their carepartners, neurologists, and neurosurgeons about neuropsychological outcomes of DBS, including neuropsychological adverse event rates, magnitude of cognitive changes, outcomes after unilateral versus bilateral surgery directed at various targets, impact of mild cognitive impairment (MCI) on outcome, factors implicated in neurobehavioral outcomes, and safety of newer interventions or techniques such as asleep surgery and current steering. PMID:29077802
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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.
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Providing information about prenatal screening for Down syndrome
DEFF Research Database (Denmark)
Skjøth, Mette Maria; Draborg, Eva; Pedersen, Claus Duedal
2015-01-01
BACKGROUND: In recent decades there have been advances in the options for prenatal screening. Screening programmes for Down syndrome are well established in many countries. It is important that pregnant women are well informed about the benefits and risks of screening. A variety of interventions...... screening for Down syndrome. DESIGN: SYSTEMATIC REVIEW: METHODS: A systematic search was performed using the PUBMED and EMBASE databases. The search terms included MeSH terms and free text and were combined by Boolean terms (AND, OR) with no restriction on language or time. MAIN OUTCOME MEASURES: Main...... information about prenatal screening for Down syndrome can improve their ability to make an informed choice. This article is protected by copyright. All rights reserved....
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Directory of Open Access Journals (Sweden)
Tor Biering-Sørensen
Full Text Available Global longitudinal systolic strain (GLS has recently been demonstrated to be a superior prognosticator to conventional echocardiographic measures in patients after myocardial infarction (MI. The aim of this study was to evaluate the prognostic value of regional longitudinal myocardial deformation in comparison to GLS, conventional echocardiography and clinical information.In total 391 patients were admitted with ST-Segment elevation myocardial infarction (STEMI, treated with primary percutaneous coronary intervention and subsequently examined by echocardiography. All patients were examined by tissue Doppler imaging (TDI and two-dimensional strain echocardiography (2DSE.During a median-follow-up of 5.3 (IQR 2.5-6.1 years the primary endpoint (death, heart failure or a new MI was reached by 145 (38.9% patients. After adjustment for significant confounders (including conventional echocardiographic parameters and culprit lesion, reduced longitudinal performance in the anterior septal and inferior myocardial regions (but not GLS remained independent predictors of the combined outcome. Furthermore, inferior myocardial longitudinal deformation provided incremental prognostic information to clinical and conventional echocardiographic information (Harrell's c-statistics: 0.63 vs. 0.67, p = 0.032. In addition, impaired longitudinal deformation outside the culprit lesion perfusion region was significantly associated with an adverse outcome (p<0.05 for all deformation parameters.Regional longitudinal myocardial deformation measures, regardless if determined by TDI or 2DSE, are superior prognosticators to GLS. In addition, impaired longitudinal deformation in the inferior myocardial segment provides prognostic information over and above clinical and conventional echocardiographic risk factors. Furthermore, impaired longitudinal deformation outside the culprit lesion perfusion region seems to be a paramount marker of adverse outcome.
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Outcomes Assessment in Accredited Health Information Management Programs
Bennett, Dorine
2010-01-01
The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…
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Satisfaction with information provided to Danish cancer patients
DEFF Research Database (Denmark)
Ross, Lone; Petersen, Morten Aagaard; Johnsen, Anna Thit
2013-01-01
To validate five items (CPWQ-inf) regarding satisfaction with information provided to cancer patients from health care staff, assess the prevalence of dissatisfaction with this information, and identify factors predicting dissatisfaction.......To validate five items (CPWQ-inf) regarding satisfaction with information provided to cancer patients from health care staff, assess the prevalence of dissatisfaction with this information, and identify factors predicting dissatisfaction....
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Sieverding, Maia; Liu, Jenny; Beyeler, Naomi
2015-10-01
The social and institutional environments in which informal healthcare providers operate shape their health and business practices, particularly in contexts where regulatory enforcement is weak. In this study, we adopt a social capital perspective to understanding the social networks on which proprietary and patent medicine vendors (PPMVs) in Nigeria rely for support in the operation of their shops. Data are drawn from 70 in-depth interviews with PPMVs in three states, including interviews with local leaders of the PPMV professional association. We find that PPMVs primarily relied on more senior colleagues and formal healthcare professionals for informational support, including information about new medicines and advice on how to treat specific cases of illness. For instrumental support, including finance, start-up assistance, and intervention with regulatory agencies, PPMVs relied on extended family, the PPMVs with whom they apprenticed, and the leaders of their professional association. PPMVs' networks also provided continual reinforcement of what constitutes good PPMV practice through admonishments to follow scope of practice limitations. These informal reminders, as well as monitoring activities conducted by the professional association, served to reinforce PPMVs' concern with avoiding negative customer health outcomes, which were perceived to be detrimental to their business reputations. That PPMVs' networks both encouraged practices to reduce the likelihood of poor health outcomes, and provided advice regarding customers' health conditions, highlights the potential impact of informal providers' access to different forms of social capital on their delivery of health services, as well as their success as microenterprises. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Achana, Felix A; Cooper, Nicola J; Bujkiewicz, Sylwia; Hubbard, Stephanie J; Kendrick, Denise; Jones, David R; Sutton, Alex J
2014-07-21
Network meta-analysis (NMA) enables simultaneous comparison of multiple treatments while preserving randomisation. When summarising evidence to inform an economic evaluation, it is important that the analysis accurately reflects the dependency structure within the data, as correlations between outcomes may have implication for estimating the net benefit associated with treatment. A multivariate NMA offers a framework for evaluating multiple treatments across multiple outcome measures while accounting for the correlation structure between outcomes. The standard NMA model is extended to multiple outcome settings in two stages. In the first stage, information is borrowed across outcomes as well across studies through modelling the within-study and between-study correlation structure. In the second stage, we make use of the additional assumption that intervention effects are exchangeable between outcomes to predict effect estimates for all outcomes, including effect estimates on outcomes where evidence is either sparse or the treatment had not been considered by any one of the studies included in the analysis. We apply the methods to binary outcome data from a systematic review evaluating the effectiveness of nine home safety interventions on uptake of three poisoning prevention practices (safe storage of medicines, safe storage of other household products, and possession of poison centre control telephone number) in households with children. Analyses are conducted in WinBUGS using Markov Chain Monte Carlo (MCMC) simulations. Univariate and the first stage multivariate models produced broadly similar point estimates of intervention effects but the uncertainty around the multivariate estimates varied depending on the prior distribution specified for the between-study covariance structure. The second stage multivariate analyses produced more precise effect estimates while enabling intervention effects to be predicted for all outcomes, including intervention effects on
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Paradoxical effects of alcohol information on alcohol outcome expectancies.
Krank, Marvin D; Ames, Susan L; Grenard, Jerry L; Schoenfeld, Tara; Stacy, Alan W
2010-07-01
Cognitive associations with alcohol predict both current and future use in youth and young adults. Much cognitive and social cognitive research suggests that exposure to information may have unconscious influences on thinking and behavior. The present study assessed the impact of information statements on the accessibility of alcohol outcome expectancies. The 2 studies reported here investigated the effects of exposure to alcohol statements typical of informational approaches to prevention on the accessibility of alcohol outcome expectancies. High school and university students were presented with information statements about the effects of alcohol and other commercial products. The alcohol statements were taken from expectancy questionnaires. Some of these statements were presented as facts and others as myths. The retention of detailed information about these statements was manipulated by (i) divided attention versus focused attention or (ii) immediate versus delayed testing. Accessibility of personal alcohol outcome expectancies was subsequently measured using an open-ended question about the expected effects of alcohol. Participants reported more alcohol outcomes seen during the information task as personal expectations about the effects of alcohol use than similar unseen items. Paradoxically, myth statements were also more likely to be reported as expectancies than unseen items in all conditions. Additionally, myth statements were generated less often than fact statements only under the condition of immediate testing with strong content processing instructions. These observations are consistent with findings from cognitive research where familiarity in the absence of explicit memory can have an unconscious influence on performance. In particular, the exposure to these items in an informational format increases accessibility of the seen items even when the participants were told that they were myths. The findings have implications for the development of
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User Impact of Literacy on Treatment Outcomes Quality Regional Financial Information System
Directory of Open Access Journals (Sweden)
Iskandar MUDA
2017-06-01
Full Text Available This study aims to determine the effectiveness of the Outcomes of the Quality Regional Financial Information System. The research is an explanatory survey exploration that explains the relationship between some variables. The population of this study is formed by 7 District Municipalities in North Sumatra. The sample comprises 197 respondents; the sampling process is a purposive random one. Variables used include User Literacy, Regional Information System, Role Ambiguity, Training and Local Government Finance Report. Treatment Outcomes Quality systems have a significant effect on the accuracy of Local Government Financial Statement Presentation. Role Ambiguity has no significant effect on the accuracy of Local Government Financial Statement Presentation. Training does not significantly influence the accuracy of Government Financial Statements literacy. The findings of this study provide recommendations for improvement of the performance manager in North Sumatra, which thus supporting the implementation of a good government system.
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DEFF Research Database (Denmark)
Biering-Sorensen, Tor; Jensen, Jan Skov; Pedersen, Sune H
2016-01-01
deformation in comparison to GLS, conventional echocardiography and clinical information. Method In total 391 patients were admitted with ST-Segment elevation myocardial infarction (STEMI), treated with primary percutaneous coronary intervention and subsequently examined by echocardiography. All patients were...... information to clinical and conventional echocardiographic information (Harrell's c-statistics: 0.63 vs. 0.67, p = 0.032). In addition, impaired longitudinal deformation outside the culprit lesion perfusion region was significantly associated with an adverse outcome (p...). Conclusion Regional longitudinal myocardial deformation measures, regardless if determined by TDI or 2DSE, are superior prognosticators to GLS. In addition, impaired longitudinal deformation in the inferior myocardial segment provides prognostic information over and above clinical and conventional...
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Kolowitz, Brian J; Lauro, Gonzalo Romero; Venturella, James; Georgiev, Veliyan; Barone, Michael; Deible, Christopher; Shrestha, Rasu
2014-04-01
The adoption of social media technologies appears to enhance clinical outcomes through improved communications as reported by Bacigalupe (Fam Syst Heal 29(1):1-14, 2011). The ability of providers to more effectively, directly, and rapidly communicate among themselves as well as with patients should strengthen collaboration and treatment as reported by Bacigalupe (Fam Syst Heal 29(1):1-14, 2011). This paper is a case study in one organization's development of an internally designed and developed social technology solution termed "Unite." The Unite system combines social technologies' features including push notifications, messaging, community groups, and user lists with clinical workflow and applications to construct dynamic provider networks, simplify communications, and facilitate clinical workflow optimization. Modeling Unite as a social technology may ease adoption barriers. Developing a social network that is integrated with healthcare information systems in the clinical space opens the doors to capturing and studying the way in which providers communicate. The Unite system appears to have the potential to breaking down existing communication paradigms. With Unite, a rich set of usage data tied to clinical events may unravel alternative networks that can be leveraged to advance patient care.
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Information Architecture of Web-Based Interventions to Improve Health Outcomes: Systematic Review.
Pugatch, Jillian; Grenen, Emily; Surla, Stacy; Schwarz, Mary; Cole-Lewis, Heather
2018-03-21
The rise in usage of and access to new technologies in recent years has led to a growth in digital health behavior change interventions. As the shift to digital platforms continues to grow, it is increasingly important to consider how the field of information architecture (IA) can inform the development of digital health interventions. IA is the way in which digital content is organized and displayed, which strongly impacts users' ability to find and use content. While many information architecture best practices exist, there is a lack of empirical evidence on the role it plays in influencing behavior change and health outcomes. Our aim was to conduct a systematic review synthesizing the existing literature on website information architecture and its effect on health outcomes, behavioral outcomes, and website engagement. To identify all existing information architecture and health behavior literature, we searched articles published in English in the following databases (no date restrictions imposed): ACM Digital Library, CINAHL, Cochrane Library, Google Scholar, Ebsco, and PubMed. The search terms used included information terms (eg, information architecture, interaction design, persuasive design), behavior terms (eg, health behavior, behavioral intervention, ehealth), and health terms (eg, smoking, physical activity, diabetes). The search results were reviewed to determine if they met the inclusion and exclusion criteria created to identify empirical research that studied the effect of IA on health outcomes, behavioral outcomes, or website engagement. Articles that met inclusion criteria were assessed for study quality. Then, data from the articles were extracted using a priori categories established by 3 reviewers. However, the limited health outcome data gathered from the studies precluded a meta-analysis. The initial literature search yielded 685 results, which was narrowed down to three publications that examined the effect of information architecture on
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DEFF Research Database (Denmark)
Seferovic, Jelena P; Pfeffer, Marc A; Claggett, Brian
2018-01-01
AIMS/HYPOTHESIS: The self-administered Michigan Neuropathy Screening Instrument (MNSI) is used to diagnose diabetic peripheral neuropathy. We examined whether the MNSI might also provide information on risk of death and cardiovascular outcomes. METHODS: In this post hoc analysis of the Aliskiren...
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Chen, Ingrid T; Aung, Tin; Thant, Hnin Nwe Nwe; Sudhinaraset, May; Kahn, James G
2015-02-05
The emergence of artemisinin-resistant Plasmodium falciparum parasites in Southeast Asia threatens global malaria control efforts. One strategy to counter this problem is a subsidy of malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT) within the informal private sector, where the majority of malaria care in Myanmar is provided. A study in Myanmar evaluated the effectiveness of financial incentives vs information, education and counselling (IEC) in driving the proper use of subsidized malaria RDTs among informal private providers. This cost-effectiveness analysis compares intervention options. A decision tree was constructed in a spreadsheet to estimate the incremental cost-effectiveness ratios (ICERs) among four strategies: no intervention, simple subsidy, subsidy with financial incentives, and subsidy with IEC. Model inputs included programmatic costs (in dollars), malaria epidemiology and observed study outcomes. Data sources included expenditure records, study data and scientific literature. Model outcomes included the proportion of properly and improperly treated individuals with and without P. falciparum malaria, and associated disability-adjusted life years (DALYs). Results are reported as ICERs in US dollars per DALY averted. One-way sensitivity analysis assessed how outcomes depend on uncertainty in inputs. ICERs from the least to most expensive intervention are: $1,169/DALY averted for simple subsidy vs no intervention, $185/DALY averted for subsidy with financial incentives vs simple subsidy, and $200/DALY averted for a subsidy with IEC vs subsidy with financial incentives. Due to decreasing ICERs, each strategy was also compared to no intervention. The subsidy with IEC was the most favourable, costing $639/DALY averted compared with no intervention. One-way sensitivity analysis shows that ICERs are most affected by programme costs, RDT uptake, treatment-seeking behaviour, and the prevalence and virulence of non
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Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers.
Wang, Virginia; Maciejewski, Matthew L; Patel, Uptal D; Stechuchak, Karen M; Hynes, Denise M; Weinberger, Morris
2013-01-18
Demand for dialysis treatment exceeds its supply within the Veterans Health Administration (VA), requiring VA to outsource dialysis care by purchasing private sector dialysis for veterans on a fee-for-service basis. It is unclear whether outcomes are similar for veterans receiving dialysis from VA versus non-VA providers. We assessed the extent of chronic dialysis treatment utilization and differences in all-cause hospitalizations and mortality between veterans receiving dialysis from VA versus VA-outsourced providers. We constructed a retrospective cohort of veterans in 2 VA regions who received chronic dialysis treatment financed by VA between January 2007 and December 2008. From VA administrative data, we identified veterans who received outpatient dialysis in (1) VA, (2) VA-outsourced settings, or (3) both ("dual") settings. In adjusted analyses, we used two-part and logistic regression to examine associations between dialysis setting and all-cause hospitalization and mortality one-year from veterans' baseline dialysis date. Of 1,388 veterans, 27% received dialysis exclusively in VA, 47% in VA-outsourced settings, and 25% in dual settings. Overall, half (48%) were hospitalized and 12% died. In adjusted analysis, veterans in VA-outsourced settings incurred fewer hospitalizations and shorter hospital stays than users of VA due to favorable selection. Dual-system dialysis patients had lower one-year mortality than veterans receiving VA dialysis. VA expenditures for "buying" outsourced dialysis are high and increasing relative to "making" dialysis treatment within its own system. Outcomes comparisons inform future make-or-buy decisions and suggest the need for VA to consider veterans' access to care, long-term VA savings, and optimal patient outcomes in its placement decisions for dialysis services.
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Salet, Nèwel; Bremmer, Rolf H; Verhagen, Marc A M T; Ekkelenkamp, Vivian E; Hansen, Bettina E; de Jonge, Pieter J F; de Man, Rob A
2018-03-01
To develop a feasible model for monitoring short-term outcome of clinical care trajectories for hospitals in the Netherlands using data obtained from hospital information systems for identifying hospital variation. Retrospective analysis of collected data from hospital information systems combined with clinical indicator definitions to define and compare short-term outcomes for three gastrointestinal pathways using the concept of Textbook Outcome. 62 Dutch hospitals. 45 848 unique gastrointestinal patients discharged in 2015. A broad range of clinical outcomes including length of stay, reintervention, readmission and doctor-patient counselling. Patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) for gallstone disease (n=4369), colonoscopy for inflammatory bowel disease (IBD; n=19 330) and colonoscopy for colorectal cancer screening (n=22 149) were submitted to five suitable clinical indicators per treatment. The percentage of all patients who met all five criteria was 54%±9% (SD) for ERCP treatment. For IBD this was 47%±7% of the patients, and for colon cancer screening this number was 85%±14%. This study shows that reusing data obtained from hospital information systems combined with clinical indicator definitions can be used to express short-term outcomes using the concept of Textbook Outcome without any excess registration. This information can provide meaningful insight into the clinical care trajectory on the level of individual patient care. Furthermore, this concept can be applied to many clinical trajectories within gastroenterology and beyond for monitoring and improving the clinical pathway and outcome for patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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Wynn, Matthew J; Carpenter, Brian D
2017-12-13
Receiving a diagnosis of dementia has major implications. Although protocols for disclosing difficult information have been developed for other health conditions, no such evidence-based method exists for dementia. As a step toward that goal, this study analyzed the discourse within dementia diagnosis disclosure sessions to identify conversational features associated with psychological outcomes. The Roter Interaction Analysis System (RIAS) was used to code the discourse among patients, their companions, and providers during 84 dementia diagnosis disclosure sessions following an initial evaluation at an Alzheimer's Disease Research Center. Providers dominated the conversation in terms of overall time spent talking. With more severe dementia, patients spoke less and companions spoke more. Provider-positive rapport building was associated with lower patient depression and anxiety following the disclosure session. Patient-positive rapport building was associated with higher companion anxiety, but only when the patient was not suspected to have dementia. No associations were found between other types of discourse and patient or companion psychological outcomes. A relatively small amount of positive rapport building by providers can lead to reduced distress following dementia disclosure. Dementia disclosure best practices should emphasize patient-centered communication techniques in order to minimize psychological distress following diagnosis. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Pluye, Pierre; Thoër, Christine; Rodriguez, Charo
2018-01-01
Background There has been an exponential increase in the general population’s usage of the internet and of information accessibility; the current demand for online consumer health information (OCHI) is unprecedented. There are multiple studies on internet access and usage, quality of information, and information needs. However, few studies explored negative outcomes of OCHI in detail or from different perspectives, and none examined how these negative outcomes could be reduced. Objective The aim of this study was to describe negative outcomes associated with OCHI use in primary care and identify potential preventive strategies from consumers’, health practitioners’, and health librarians’ perspectives. Methods This included a two-stage interpretive qualitative study. In the first stage, we recruited through a social media survey, a purposeful sample of 19 OCHI users who had experienced negative outcomes associated with OCHI. We conducted semistructured interviews and performed a deductive-inductive thematic analysis. The results also informed the creation of vignettes that were used in the next stage. In the second stage, we interviewed a convenient sample of 10 key informants: 7 health practitioners (3 family physicians, 2 nurses, and 2 pharmacists) and 3 health librarians. With the support of the vignettes, we asked participants to elaborate on (1) their experience with patients who have used OCHI and experienced negative outcomes and (2) what strategies they suggest to reduce these outcomes. We performed a deductive-inductive thematic analysis. Results We found that negative outcomes of OCHI may occur at three levels: internal (such as increased worrying), interpersonal (such as a tension in the patient-clinician relationship), and service-related (such as postponing a clinical encounter). Participants also proposed three types of strategies to reduce the occurrence of these negative outcomes, namely, providing consumers with reliable OCHI, educating
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INTEGRATED INFORMATION SYSTEM ARCHITECTURE PROVIDING BEHAVIORAL FEATURE
Directory of Open Access Journals (Sweden)
Vladimir N. Shvedenko
2016-11-01
Full Text Available The paper deals with creation of integrated information system architecture capable of supporting management decisions using behavioral features. The paper considers the architecture of information decision support system for production system management. The behavioral feature is given to an information system, and it ensures extraction, processing of information, management decision-making with both automated and automatic modes of decision-making subsystem being permitted. Practical implementation of information system with behavior is based on service-oriented architecture: there is a set of independent services in the information system that provides data of its subsystems or data processing by separate application under the chosen variant of the problematic situation settlement. For creation of integrated information system with behavior we propose architecture including the following subsystems: data bus, subsystem for interaction with the integrated applications based on metadata, business process management subsystem, subsystem for the current state analysis of the enterprise and management decision-making, behavior training subsystem. For each problematic situation a separate logical layer service is created in Unified Service Bus handling problematic situations. This architecture reduces system information complexity due to the fact that with a constant amount of system elements the number of links decreases, since each layer provides communication center of responsibility for the resource with the services of corresponding applications. If a similar problematic situation occurs, its resolution is automatically removed from problem situation metamodel repository and business process metamodel of its settlement. In the business process performance commands are generated to the corresponding centers of responsibility to settle a problematic situation.
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Distortion of Probability and Outcome Information in Risky Decisions
DeKay, Michael L.; Patino-Echeverri, Dalia; Fischbeck, Paul S.
2009-01-01
Substantial evidence indicates that information is distorted during decision making, but very few studies have assessed the distortion of probability and outcome information in risky decisions. In two studies involving six binary decisions (e.g., banning blood donations from people who have visited England, because of "mad cow disease"),…
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Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers
Directory of Open Access Journals (Sweden)
Wang Virginia
2013-01-01
Full Text Available Abstract Background Demand for dialysis treatment exceeds its supply within the Veterans Health Administration (VA, requiring VA to outsource dialysis care by purchasing private sector dialysis for veterans on a fee-for-service basis. It is unclear whether outcomes are similar for veterans receiving dialysis from VA versus non-VA providers. We assessed the extent of chronic dialysis treatment utilization and differences in all-cause hospitalizations and mortality between veterans receiving dialysis from VA versus VA-outsourced providers. Methods We constructed a retrospective cohort of veterans in 2 VA regions who received chronic dialysis treatment financed by VA between January 2007 and December 2008. From VA administrative data, we identified veterans who received outpatient dialysis in (1 VA, (2 VA-outsourced settings, or (3 both (“dual” settings. In adjusted analyses, we used two-part and logistic regression to examine associations between dialysis setting and all-cause hospitalization and mortality one-year from veterans’ baseline dialysis date. Results Of 1,388 veterans, 27% received dialysis exclusively in VA, 47% in VA-outsourced settings, and 25% in dual settings. Overall, half (48% were hospitalized and 12% died. In adjusted analysis, veterans in VA-outsourced settings incurred fewer hospitalizations and shorter hospital stays than users of VA due to favorable selection. Dual-system dialysis patients had lower one-year mortality than veterans receiving VA dialysis. Conclusions VA expenditures for “buying” outsourced dialysis are high and increasing relative to “making” dialysis treatment within its own system. Outcomes comparisons inform future make-or-buy decisions and suggest the need for VA to consider veterans’ access to care, long-term VA savings, and optimal patient outcomes in its placement decisions for dialysis services.
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Improving Information Technology Curriculum Learning Outcomes
Directory of Open Access Journals (Sweden)
Derrick L Anderson
2017-06-01
The case study research methodology has been selected to conduct the inquiry into this phenomenon. This empirical inquiry facilitates exploration of a contemporary phenomenon in depth within its real-life context using a variety of data sources. The subject of analysis will be two Information Technology classes composed of a combination of second year and third year students; both classes have six students, the same six students. Contribution It is the purpose of this research to show that the use of improved approaches to learning will produce more desirable learning outcomes. Findings The results of this inquiry clearly show that the use of the traditional behaviorist based pedagogic model to achieve college and university IT program learning outcomes is not as effective as a more constructivist based andragogic model. Recommendations Instruction based purely on either of these does a disservice to the typical college and university level learner. The correct approach lies somewhere in between them; the most successful outcome attainment would be the product of incorporating the best of both. Impact on Society Instructional strategies produce learning outcomes; learning outcomes demonstrate what knowledge has been acquired. Acquired knowledge is used by students as they pursue professional careers and other ventures in life. Future Research Learning and teaching approaches are not “one-size-fits-all” propositions; different strategies are appropriate for different circumstances and situations. Additional research should seek to introduce vehicles that will move learners away from one the traditional methodology that has been used throughout much of their educational careers to an approach that is better suited to equip them with the skills necessary to meet the challenges awaiting them in the professional world.
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Outcomes after intrauterine insemination are independent of provider type
Goldman, Randi H.; Batsis, Maria; Hacker, Michele R.; Souter, Irene; Petrozza, John C.
2015-01-01
OBJECTIVE We sought to determine whether the success of intrauterine insemination (IUI) varies based on the type of health care provider performing the procedure. STUDY DESIGN This was a retrospective cohort study set at an infertility clinic at an academic institution. The patients who comprised this study were 1575 women who underwent 3475 IUI cycles from late 2003 through early 2012. Cycles were stratified into 3 groups according to the type of provider who performed the procedure: attending physician, fellow physician, or registered nurse (RN). The primary outcome was live birth. Additional outcomes of interest included positive pregnancy test and clinical pregnancy. Repeated measures log binomial regression was used to estimate the risk ratios (RR) and 95% confidence intervals (CI) for the outcomes and to evaluate the effect of potential confounders. All tests were 2-sided, and P values < .05 were considered statistically significant. RESULTS Of the 3475 IUI cycles, 2030 (58.4%) were gonadotropin stimulated, 929 (26.7%) were clomiphene citrate stimulated, and 516 (14.9%) were natural. The incidences of clinical pregnancy and live birth among all cycles were 11.8% and 8.8%, respectively. After adjusting for female age, male partner age, and cycle type, the incidence of live birth was similar for RNs compared with attending physicians (RR, 0.80; 95% CI, 0.58–1.1) and fellow physicians compared with attending physicians (RR, 0.84; 95% CI, 0.58–1.2). Similar results were seen for positive pregnancy test and clinical pregnancy. CONCLUSION There was no significant difference in live birth following IUI cycles in which the procedure was performed by a fellow physician or RN compared with an attending physician. PMID:24881820
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Reconciling Sex Differences in Information-Processing and Career Outcomes.
Wolleat, Patricia L.
1990-01-01
Information processing theory could be made more sensitive to differences in career outcomes for males and females by (1) examining the nature of the career decision; (2) expanding the notion of information; (3) relating the vocational schema to the gender schema; and (4) noting whether variables are general, sex related, or sex specific. (SK)
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Gentles, Stephen James; Lokker, Cynthia; McKibbon, K Ann
2010-06-18
Pediatric patients with health conditions requiring follow-up typically depend on a caregiver to mediate at least part of the necessary two-way communication with health care providers on their behalf. Health information technology (HIT) and its subset, information communication technology (ICT), are increasingly being applied to facilitate communication between health care provider and caregiver in these situations. Awareness of the extent and nature of published research involving HIT interventions used in this way is currently lacking. This scoping review was designed to map the health literature about HIT used to facilitate communication involving health care providers and caregivers (who are usually family members) of pediatric patients with health conditions requiring follow-up. Terms relating to care delivery, information technology, and pediatrics were combined to search MEDLINE, EMBASE, and CINAHL for the years 1996 to 2008. Eligible studies were selected after three rounds of duplicate screening in which all authors participated. Data regarding patient, caregiver, health care provider, HIT intervention, outcomes studied, and study design were extracted and maintained in a Microsoft Access database. Stage of research was categorized using the UK's Medical Research Council (MRC) framework for developing and evaluating complex interventions. Quantitative and qualitative descriptive summaries are presented. We included 104 eligible studies (112 articles) conducted in 17 different countries and representing 30 different health conditions. The most common conditions were asthma, type 1 diabetes, special needs, and psychiatric disorder. Most studies (88, 85%) included children 2 to 12 years of age, and 73 (71%) involved home care settings. Health care providers operated in hospital settings in 96 (92%) of the studies. Interventions featured 12 modes of communication (eg, Internet, intranets, telephone, video conferencing, email, short message service [SMS], and
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Directory of Open Access Journals (Sweden)
Carl Marnewick
2009-12-01
Full Text Available Purpose: In developing countries such as South Africa, many organisations are reliant on information and communication technology (ICT to provide accurate, relevant and timely information. For organisations to obtain and sustain a competitive advantage, ICT systems are constantly implemented, upgraded, modified or replaced. These initiatives are often managed as projects. While there is an increasing amount of both financial resources and effort being spent on ICT, these projects are not always delivered within the predetermined project constraints. This implies additional time to complete, as well as additional costs, as resources are not released in time to participate in other projects. It is therefore important to understand the factors that influence the outcome of South African ICT projects relative to their original constraints. Problem Investigated: The goal of this article is to determine the factors that influence South African ICT projects, taking into consideration the fact that most current published research on this topic was done within the context of a developed country such as the USA and Europe. Design and/or methodology: The outcomes of ICT projects in South Africa as well as the factors that influence them were determined through an extensive survey. An analysis was done on the factors together with a correlation between the main factors contributing to project outcomes. The purpose of this was to establish if a factor's presence or absence influenced the eventual outcome. Findings: The factors that contribute to a successful outcome are often outside the direct control of the project manager and tend to be complex in nature. One factor that does stand out is that the alignment of projects with business objectives influences their perceived success. Originality/Value: The benefits of this article are that it firstly provides a South African perspective of current ICT project management practices, and secondly, it highlights
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Pu, Xiaohong; Zhu, Liya; Fu, Yao; Fan, Zhiwen; Zheng, Jinyu; Zhang, Biao; Yang, Jun; Guan, Wenyan; Wu, Hongyan; Ye, Qing; Huang, Qing
2018-04-01
SPEC P16/CEN3/7/17 Probe fluorescence-in-situ-hybridization (FISH) has become the most sensitive method in indentifying the urothelial tumors and loss of P16 has often been identified in low-grade urothelial lesions; however, little is known about the significations of other P16 genetic status (normal and amplification) in bladder cancer.We detected P16 gene status by FISH in 259 urine samples and divided these samples into 3 groups: 1, normal P16; 2, loss of P16; and 3, amplified P16. Meanwhile, p16 protein expression was measured by immunocytochemistry and we characterized the clinicopathologic features of cases with P16 gene status.Loss of P16 occurred in 26.2%, P16 amplification occurred in 41.3% and P16 gene normal occurred in 32.4% of all cases. P16 genetic status was significantly associated with tumor grade and primary tumor status (P = .008 and .017), but not with pathological tumor stage, overall survival, and p16 protein expression. However, P16 gene amplification accompanied protein high-expression has shorter overall survival compared with the overall patients (P = .023), and P16 gene loss accompanied loss of protein also had the tendency to predict bad prognosis (P = .067).Studies show that the genetic status of P16 has a close relation with the stages of bladder cancer. Loss of P16 is associated with low-grade urothelial malignancy while amplified P16 donotes high-grade. Neither P16 gene status nor p16 protein expression alone is an independent predictor of urothelial bladder carcinoma, but combine gene and protein status together providing useful information on the clinical outcome of these patients.
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The impact of health information technology adoption by outpatient facilities on pregnancy outcomes.
Deily, Mary E; Hu, Tianyan; Terrizzi, Sabrina; Chou, Shin-Yi; Meyerhoefer, Chad D
2013-02-01
Examine whether health information technology (HIT) at nonhospital facilities (NHFs) improves health outcomes and decreases resource use at hospitals within the same heath care network, and whether the impact of HIT varies as providers gain experience using the technologies. Administrative claims data on 491,832 births in Pennsylvania during 1998-2004 from the Pennsylvania Health Care Cost Containment Council and HIT applications data from the Dorenfest Institute. Fixed-effects regression analysis of the impact of HIT at NHFs on adverse birth outcomes and resource use. Greater use of clinical HIT applications by NHFs is associated with reduced incidence of obstetric trauma and preventable complications, as well as longer lengths of stay. In addition, the beneficial effects of HIT increase the longer that technologies have been in use. However, we find no consistent evidence on whether or how nonclinical HIT in NHFs affects either resource use or health outcomes. Clinical HIT applications at NHFs may reduce the likelihood of adverse birth outcomes, particularly after physicians and staff gain experience using the technologies. © Health Research and Educational Trust.
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Strategic information systems planning for health service providers.
Moriarty, D D
1992-01-01
There is significant opportunity for health service providers to gain competitive advantage through the innovative use of strategic information systems. This analysis presents some key strategic information systems issues that will enable managers to identify opportunities within their organizations.
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Pectus patient information website has improved access to care and patient reported outcomes.
Tikka, Theofano; Webb, Joanne; Agostini, Paula; Kerr, Amy; Mannion, Glenn; Steyn, Richard S; Bishay, Ehab; Kalkat, Maninder S; Rajesh, Pala B; Naidu, Babu
2016-04-26
Pectus is the most common congenital disorder. Awareness amongst primary care physicians and the general public is poor. NHS commissioning bodies plan to withdraw funding for this surgery because they deem a lack of sufficient evidence of benefit. The purpose of this study is to assess the effects of introducing a patient information website on referral and activity patterns and on patients reported outcomes. We produced an innovative information website, www.pectus.co.uk , accessible to the general public, providing information about pectus deformities; management options and advice about surgery. Referral patterns and number of cases where studied before and after the introduction of the website in 2010. Patients' satisfaction post-op was assessed using the Brompton's single step questionnaire (SSQ). The website had considerable traffic with 2179 hits in 2012, 4983 in 2013 and 7416 in 2014. This has led to 1421 contacts and 372 email enquiries. These emails have resulted in an increased number of patients who have been assessed and go on to have surgery. We asked 59 pectus excavatum patients who were operated from 2008 to 2014 to complete the SSQ. We received 32 replies. Eighty-four percent (16/19) of patients who visited the website and then underwent surgery, found the website useful. All patients scored satisfactorily in SSQ. Even though those who visited the website tended to be more satisfied with the surgical outcomes this did not reach statistical significance. This group of patients said that would have the operation again given the option compared to 76.9 % of the group who did not visit the website before surgery (p=0.031). Despite the fact that patients who visited the website experienced more post-operative complications were equally or more satisfied with post-operative outcomes. The overall SSQ obtainable score was not different for the two subgroups, being more widespread in the group that did not visit the website. The introduction of a pectus
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Perrault, Evan K
2018-07-01
Campus health centers are a convenient, and usually affordable, location for college students to obtain health care. Staffed by licensed and trained professionals, these providers can generally offer similar levels of care that providers at off-campus clinics can deliver. Yet, previous research finds students may forgo this convenient, on-campus option partially because of a lack of knowledge regarding the quality of providers at these campus clinics. This study sought to examine where this information deficit may come from by analyzing campus health centers' online provider information. All Division-I colleges or universities with an on-campus health center, which had information on their websites about their providers (n = 294), had their providers' online information analyzed (n = 2,127 providers). Results revealed that schools commonly offer professional information (e.g., provider specialties, education), but very little about their providers outside of the medical context (e.g., hobbies) that would allow a prospective student patient to more easily relate. While 181 different kinds of credentials were provided next to providers' names (e.g., MD, PA-C, FNP-BC), only nine schools offered information to help students understand what these different credentials meant. Most schools had information about their providers within one-click of the homepage. Recommendations for improving online information about campus health center providers are offered.
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Directory of Open Access Journals (Sweden)
Soyeon Cheon
2018-01-01
Full Text Available Abstract Background While full disclosure of information on placebo control in participant information leaflets (PILs in a clinical trial is ethically required during informed consent, there have been concerning voices such complete disclosures may increase unnecessary nocebo responses, breach double-blind designs, and/or affect direction of trial outcomes. Taking an example of acupuncture studies, we aimed to examine what participants are told about placebo controls in randomized, placebo-controlled trials, and how it may affect blinding and trial outcomes. Methods Authors of published randomized, placebo-controlled trials of acupuncture were identified from PubMed search and invited to provide PILs for their trials. The collected PILs were subjected to content analysis and categorized based on degree of information disclosure on placebo. Blinding index (BI as a chance-corrected measurement of blinding was calculated and its association with different information disclosure was examined. The impact of different information disclosure from PILs on primary outcomes was estimated using a random effects model. Results In 65 collected PILs, approximately 57% of trials fully informed the participants of placebo control, i.e. full disclosure, while the rest gave deceitful or no information on placebo, i.e. no disclosure. Placebo groups in the studies with no disclosure tended to make more opposite guesses on the type of received intervention than those with disclosure, which may reflect wishful thinking (BI −0.21 vs. −0.16; p = 0.38. In outcome analysis, studies with no disclosure significantly favored acupuncture than those with full disclosure (standardized mean difference − 0.43 vs. −0.12; p = 0.03, probably due to enhanced expectations. Conclusions How participants are told about placebos can be another potential factor that may influence participant blinding and study outcomes by possibly modulating patient expectation. As we
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Informal Care and Labor Market Outcomes: Evidence From Chinese Married Women.
Chen, Lu; Zhao, Na; Fan, Hongli; Coyte, Peter C
2015-10-16
Data were used from the 1991-2009 China Health and Nutrition Survey to examine the influence of informal care on labor market outcomes for married women of working aged, with emphasis on caregiving intensity. After accounting for potential endogeneity between caregiving and labor force participation (LFP) through simultaneous equations modeling, caregivers who provided more than 15 or 20 hr of caregiving per week were 4.5-7.7% less likely to be LFPs. Intensive caregivers who remained working had significantly lower (4.97-7.20) weekly hours of work. The significant positive effect of informal care on LFP only existed in the rural sample, and these women also had much lower hours of work than their urban counterparts. Opportunities exist for policy interventions that target intensive caregivers in order to allow them to balance both work and caregiving. © The Author(s) 2015.
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The use of qualitative methods to inform Delphi surveys in core outcome set development.
Keeley, T; Williamson, P; Callery, P; Jones, L L; Mathers, J; Jones, J; Young, B; Calvert, M
2016-05-04
Core outcome sets (COS) help to minimise bias in trials and facilitate evidence synthesis. Delphi surveys are increasingly being used as part of a wider process to reach consensus about what outcomes should be included in a COS. Qualitative research can be used to inform the development of Delphi surveys. This is an advance in the field of COS development and one which is potentially valuable; however, little guidance exists for COS developers on how best to use qualitative methods and what the challenges are. This paper aims to provide early guidance on the potential role and contribution of qualitative research in this area. We hope the ideas we present will be challenged, critiqued and built upon by others exploring the role of qualitative research in COS development. This paper draws upon the experiences of using qualitative methods in the pre-Delphi stage of the development of three different COS. Using these studies as examples, we identify some of the ways that qualitative research might contribute to COS development, the challenges in using such methods and areas where future research is required. Qualitative research can help to identify what outcomes are important to stakeholders; facilitate understanding of why some outcomes may be more important than others, determine the scope of outcomes; identify appropriate language for use in the Delphi survey and inform comparisons between stakeholder data and other sources, such as systematic reviews. Developers need to consider a number of methodological points when using qualitative research: specifically, which stakeholders to involve, how to sample participants, which data collection methods are most appropriate, how to consider outcomes with stakeholders and how to analyse these data. A number of areas for future research are identified. Qualitative research has the potential to increase the research community's confidence in COS, although this will be dependent upon using rigorous and appropriate
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Obtaining and providing health information in the community pharmacy setting.
Iwanowicz, Susan L; Marciniak, Macary Weck; Zeolla, Mario M
2006-06-15
Community pharmacists are a valuable information resource for patients and other healthcare providers. The advent of new information technology, most notably the Internet, coupled with the rapid availability of new healthcare information, has fueled this demand. Pharmacy students must receive training that enables them to meet this need. Community advanced pharmacy practice experiences (APPEs) provide an excellent opportunity for students to develop and master drug information skills in a real-world setting. Preceptors must ensure that students are familiar with drug information resources and can efficiently identify the most useful resource for a given topic. Students must also be trained to assess the quality of resources and use this information to effectively respond to drug or health information inquiries. This article will discuss key aspects of providing drug information in the community pharmacy setting and can serve as a guide and resource for APPE preceptors.
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Metagenomes provide valuable comparative information on soil microeukaryotes
DEFF Research Database (Denmark)
Jacquiod, Samuel Jehan Auguste; Stenbæk, Jonas; Santos, Susana
2016-01-01
has been identified. Our analyses suggest that publicly available metagenome data can provide valuable information on soil microeukaryotes for comparative purposes when handled appropriately, complementing the current view provided by ribosomal amplicon sequencing methods......., providing microbiologists with substantial amounts of accessible information. We took advantage of public metagenomes in order to investigate microeukaryote communities in a well characterized grassland soil. The data gathered allowed the evaluation of several factors impacting the community structure......, including the DNA extraction method, the database choice and also the annotation procedure. While most studies on soil microeukaryotes are based on sequencing of PCR-amplified taxonomic markers (18S rRNA genes, ITS regions), this work represents, to our knowledge, the first report based solely...
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Directory of Open Access Journals (Sweden)
Braunack-Mayer Annette J
2007-06-01
Full Text Available Abstract Background This paper reports the findings of an exploratory study about the information women diagnosed with Polycystic Ovarian Syndrome (PCOS want to know about their condition and the consequences of this information for future treatment and health outcomes. Methods In-depth qualitative interviews regarding their information needs were undertaken with ten South Australian women diagnosed with PCOS. These women were aged 28–38 years and at differing stages of their fertility experience. The time since diagnosis ranged from 1–17 years. The main outcome measures sought were the identification of the information needs of women diagnosed with Polycystic Ovarian Syndrome (PCOS during different periods of their lives; how and where they obtain this information, and the consequences of this information for future treatment and health outcomes. Results The women with PCOS in this study preferentially used the Internet for their information needs, as it had the advantages of convenience, privacy and accessibility, when compared with traditional mechanisms of information provision. Conclusion Giving a name to a collection of symptoms may bring relief and provide recognition that there really is a problem. However, with a diagnosis comes the need to have questions answered. A diagnosis of a chronic condition such as PCOS necessitates decision-making regarding possible treatment strategies and lifestyle choices. Information is needed in order to participate in shared decision making. The Internet proved to be a most versatile and beneficial source of information source for women with PCOS, if its limitations are taken into consideration.
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Human and Citizen Rights Guarantees While Providing Information Security
Directory of Open Access Journals (Sweden)
Serhii Yesimov
2018-05-01
Full Text Available With the development of information and communication technologies, issues of providing information security are becoming more and more aggravated. These are crimes related to the use of electronic computers, systems and computer networks and telecommunication networks, the propaganda of separatism and extremism, etc. While providing information security in the digital environment, the role of technical and legal human rights guarantees, due to technical means of protection, is increasing. Relying on the developers of technical means of protection determines the difference between the aforesaid concepts and the traditional approach to ensuring the protection of human and citizen rights, in which responsibilities are put on information intermediaries, owners of confidential information. Technical guarantees of human rights are a necessary component of ensuring information security, but the effectiveness of the application is provided in conjunction with the legal guarantees of human rights, as evidenced by the tendency to recognize the principles of inviolability of privacy on the basis of design decisions in the law of the European Union as legal acts. Providing information security is a legitimate goal of establishing constraints of human rights, since it can be correlated with the norms of international law. The establishment of constraints of human rights is permissible in order to attain other objectives–ensuring state security, public order, health, rights and freedoms of the person in the information sphere. The legitimacy of this goal is determined by its compliance with the objectives envisaged by international agreements ratified in an established order. The article examines the impact of the use of technical means in the field of providing information security in the aspect of following the fundamental human and civil rights in Ukraine, taking into account the legislation of the European Union and the decision of the European Court
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30 CFR 206.108 - Does MMS protect information I provide?
2010-07-01
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Does MMS protect information I provide? 206.108... MANAGEMENT PRODUCT VALUATION Federal Oil § 206.108 Does MMS protect information I provide? Certain information you submit to MMS regarding valuation of oil, including transportation allowances, may be exempt...
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30 CFR 206.365 - Does MMS protect information I provide?
2010-07-01
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Does MMS protect information I provide? 206.365... MANAGEMENT PRODUCT VALUATION Geothermal Resources § 206.365 Does MMS protect information I provide? Certain information you submit to MMS regarding royalties or fees on geothermal resources or byproducts, including...
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THE USE OF INFORMATION RESOURCES OF THE KNUKIM SCIENTIFIC LIBRARY FOR INFORMATION SERVICES PROVIDING
Directory of Open Access Journals (Sweden)
В. В. Степко
2017-10-01
Full Text Available The article highlights information resources of the scientific library of the Kiev National University of Culture and Arts and characterizes its use in the system of providing librarian and informational services for users. It is proved that the important information resource of the library is website, which provides additional opportunities for users, forming a positive image of the library in the virtual space. The site contains information on various directions of the library’s activities, librarian services, projects and media products. One of the main tasks of the library is formation and presentation on the website of the electronic catalog as a multifunctional bibliographic resource, which is the basis for informational services and the basic information product of the library. The creation of an electronic library continues as the essential element of providing qualitative and effective services to users. The article discusses the functioning of the “Virtual Help” service as an effective form of working with remote users. The authors also consider such an actual direction of the library’s activity as the presentation of the scientific and creative heritage of the university with help of “12 + books of the year” project. The aim of the project is to inform about new editions of university’s teachers published this year and presented in the library fund. The implementation of the patriotic innovation and educational project “Treasures of the Nation”, whose purpose is to study and popularize the elements of the intangible cultural heritage ofUkraine, is analyzed. The booktrails and flash presentations are considered as a means of presenting books prepared by the library staff. The preparation of longreed, a new format for submitting information on the Internet, is also considered. Thanks to the use of Tilda Publishing and ThingLink services, innovative products were created: a complex multimedia story that combined photos
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Konetzka, R Tamara; Stuart, Elizabeth A; Werner, Rachel M
2018-02-07
In this paper we examine empirically the effect of integration on Medicare payment and rehospitalization. We use 2005-2013 data on Medicare beneficiaries receiving post-acute care (PAC) in the U.S. to examine integration between hospitals and the two most common post-acute care settings: skilled nursing facilities (SNFs) and home health agencies (HHA), using two measures of integration-formal vertical integration and informal integration representing preferential relationships between providers without formal relationships. Our identification strategy is twofold. First, we use longitudinal models with a fixed effect for each hospital-PAC pair in a market to test how changes in integration impact patient outcomes. Second, we use an instrumental variable approach to account for patient selection into integrated providers. We find that vertical integration between hospitals and SNFs increases Medicare payments and reduces rehospitalization rates. However, vertical integration between hospitals and HHAs has little effect, nor does informal integration between hospitals and either PAC setting. Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.
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Informative providing of processes of development on industrial enterprises
Kalinichenko, L.
2010-01-01
Information is definite by the basic resource of activity of enterprises. Suggestion in relation to the selection of informative subsystems of strategic, tactical, operative management is borne. The list of indexes in relation to estimation of the informative providing of functional processes of enterprise is offered.
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Moran, Valerie; Jacobs, Rowena
2018-06-01
Provider payment systems for mental health care that incentivize cost control and quality improvement have been a policy focus in a number of countries. In England, a new prospective provider payment system is being introduced to mental health that should encourage providers to control costs and improve outcomes. The aim of this research is to investigate the relationship between costs and outcomes to ascertain whether there is a trade-off between controlling costs and improving outcomes. The main data source is the Mental Health Minimum Data Set (MHMDS) for the years 2011/12 and 2012/13. Costs are calculated using NHS reference cost data while outcomes are measured using the Health of the Nation Outcome Scales (HoNOS). We estimate a bivariate multi-level model with costs and outcomes simultaneously. We calculate the correlation and plot the pairwise relationship between residual costs and outcomes at the provider level. After controlling for a range of demographic, need, social, and treatment variables, residual variation in costs and outcomes remains at the provider level. The correlation between residual costs and outcomes is negative, but very small, suggesting that cost-containment efforts by providers should not undermine outcome-improving efforts under the new payment system.
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Pilkonis, Paul A; Yu, Lan; Dodds, Nathan E; Johnston, Kelly L; Lawrence, Suzanne M; Daley, Dennis C
2016-04-01
The Patient-Reported Outcomes Measurement Information System (PROMIS) includes five item banks for alcohol use. There are limited data, however, regarding their validity (e.g., convergent validity, responsiveness to change). To provide such data, we conducted a prospective study with 225 outpatients being treated for substance abuse. Assessments were completed shortly after intake and at 1-month and 3-month follow-ups. The alcohol item banks were administered as computerized adaptive tests (CATs). Fourteen CATs and one six-item short form were also administered from eight other PROMIS domains to generate a comprehensive health status profile. After modeling treatment outcome for the sample as a whole, correlates of outcome from the PROMIS health status profile were examined. For convergent validity, the largest correlation emerged between the PROMIS alcohol use score and the Alcohol Use Disorders Identification Test (r=.79 at intake). Regarding treatment outcome, there were modest changes across the target problem of alcohol use and other domains of the PROMIS health status profile. However, significant heterogeneity was found in initial severity of drinking and in rates of change for both abstinence and severity of drinking during follow-up. This heterogeneity was associated with demographic (e.g., gender) and health-profile (e.g., emotional support, social participation) variables. The results demonstrated the validity of PROMIS CATs, which require only 4-6 items in each domain. This efficiency makes it feasible to use a comprehensive health status profile within the substance use treatment setting, providing important prognostic information regarding abstinence and severity of drinking. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
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Koltsov, Jayme C B; Greenfield, Stephen T; Soukup, Dylan; Do, Huong T; Ellis, Scott J
2017-08-01
The field of foot and ankle surgery lacks a widely accepted gold-standard patient-reported outcome instrument. With the changing infrastructure of the medical profession, more efficient patient-reported outcome tools are needed to reduce respondent burden and increase participation while providing consistent and reliable measurement across multiple pathologies and disciplines. The primary purpose of the present study was to validate 3 Patient-Reported Outcomes Measurement Information System computer adaptive tests (CATs) most relevant to the foot and ankle discipline against the Foot and Ankle Outcome Score (FAOS) and the Short Form 12 general health status survey in patients with 6 common foot and ankle pathologies. Patients (n = 240) indicated for operative treatment for 1 of 6 common foot and ankle pathologies completed the CATs, FAOS, and Short Form 12 at their preoperative surgical visits, 1 week subsequently (before surgery), and at 6 months postoperatively. The psychometric properties of the instruments were assessed and compared. The Patient-Reported Outcomes Measurement Information System CATs each took less than 1 minute to complete, whereas the FAOS took 6.5 minutes, and the Short Form 12 took 3 minutes. CAT scores were more normally distributed and had fewer floor and ceiling effects than those on the FAOS, which reached as high as 24%. The CATs were more precise than the FAOS and had similar responsiveness and test-retest reliability. The physical function and mobility CATs correlated strongly with the activities subscale of the FAOS, and the pain interference CAT correlated strongly with the pain subscale of the FAOS. The CATs and FAOS were responsive to changes with operative treatment for 6 common foot and ankle pathologies. The CATs performed as well as or better than the FAOS in all aspects of psychometric validity. The Patient-Reported Outcomes Measurement Information System CATs show tremendous potential for improving the study of patient
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Informing parents about expanded newborn screening: influences on provider involvement.
Hayeems, Robin Z; Miller, Fiona A; Little, Julian; Carroll, June C; Allanson, Judith; Chakraborty, Pranesh; Wilson, Brenda J; Bytautas, Jessica P; Christensen, Robert J
2009-09-01
Expanded newborn screening (NBS) identifies some disorders for which clinical benefit is uncertain, as well as "incidental" findings (eg, carrier status), thus enhancing the need to inform parents about NBS before sample collection. A self-complete survey was sent to a cross-sectional, stratified, random sample of 5 provider groups in Ontario (obstetricians, midwives, family physicians, pediatricians, and nurses). Univariate and multivariate analyses were used to investigate the effects of core beliefs, perceived barriers, and demographic characteristics on the reported frequency of informing parents about NBS before sample collection. Virtually all of the midwives and almost half of the nurses reported discussing NBS with parents, whereas less than one sixth of the physicians did so. Providers who perceived a responsibility to inform parents were 3 times more likely to report doing so than those who did not perceive this responsibility (odds ratio: 2.9 [95% confidence interval: 2.1-4.1]). Those who lacked confidence to inform parents were 70% less likely to discuss NBS with parents compared with those who did not experience this cognitive barrier (odds ratio: 0.3 [95% confidence interval: 0.2-0.4]). Controlling for these covariates, family physicians and obstetricians were more likely than pediatricians to inform parents. These results provide guidance for capacity building among providers who are positioned to inform parents about NBS before sample collection. Our findings call for targeted educational interventions that consider patterns of provider practice related to prenatal and NBS care, seek to redress confidence limitations, and engage key provider groups in the importance of this professional responsibility.
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Metz, M.J.; Franx, G.C.; Verbeek, M.A.; de Beurs, E.; van der Feltz-Cornelis, C.M.; Beekman, A.T.
2015-01-01
Background Shared Decision Making (SDM) is a way to empower patients when decisions are made about treatment. In order to be effective agents in this process, patients need access to information of good quality. Routine Outcome Monitoring (ROM) may provide such information and therefore may be a key
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LENUS (Irish Health Repository)
Killeen, Shane D
2012-02-03
BACKGROUND: Intuitively, vascular procedures performed by high-volume vascular subspecialists working at high-volume institutions should be associated with improved patient outcome. Although a large number of studies assess the relationship between volume and outcome, a single contemporary compilation of such studies is lacking. METHODS: A review of the English language literature was performed incorporating searches of the Medline, EMBASE, and Cochrane collaboration databases for abdominal aortic aneurysm repair (elective and emergent), carotid endarterectomy, and arterial lower limb procedures for any volume outcome relationship. Studies were included if they involved a patient cohort from 1980 onwards, were community or population based, and assessed health outcomes (mortality and morbidity) as a dependent variable and volume as an independent variable. RESULTS: We identified 74 relevant studies, and 54 were included. All showed either an inverse relationship of variable magnitude between provider volume and mortality, or no volume-outcome effect. The reduction in the risk-adjusted mortality rate (RAMR) for high-volume providers was 3% to 11% for elective abdominal aortic aneurysm (AAA) repair, 2.5 to 5% for emergent AAA repair, 0.7% to 4.7% carotid endarterectomy, and 0.3% to 0.9% for lower limb arterial bypass procedures. Subspeciality training also conferred a considerable morbidity and mortality benefit for emergent AAA repair, carotid endarterectomy, and lower limb arterial procedures. CONCLUSION: High-volume providers have significantly better outcomes for vascular procedures both in the elective and emergent setting. Subspeciality training also has a considerable impact. These data provide further evidence for the specialization of vascular services, whereby vascular procedures should generally be preformed by high-volume, speciality trained providers.
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30 CFR 206.62 - Does MMS protect information I provide?
2010-07-01
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Does MMS protect information I provide? 206.62 Section 206.62 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT PRODUCT VALUATION Indian Oil § 206.62 Does MMS protect information I provide? The MMS will keep...
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McGuire, Alan B; White, Dominique A; Bartholomew, Tom; Flanagan, Mindy E; McGrew, John H; Rollins, Angela L; Mueser, Kim T; Salyers, Michelle P
2017-01-01
Provider competence may affect the impact of a practice. The current study examined this relationship in sixty-three providers engaging in Illness Management and Recovery with 236 consumers. Improving upon previous research, the present study utilized a psychometrically validated competence measure in the ratings of multiple Illness Management and Recovery sessions from community providers, and mapped outcomes onto the theory underlying the practice. Provider competence was positively associated with illness self-management and adaptive coping. Results also indicated baseline self-management skills and working alliance may affect the relationship between competence and outcomes.
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Kleib, Manal; Simpson, Nicole; Rhodes, Beverly
2016-05-31
Information and communication technology (ICT) is integral in today’s healthcare as a critical piece of support to both track and improve patient and organizational outcomes. Facilitating nurses’ informatics competency development through continuing education is paramount to enhance their readiness to practice safely and accurately in technologically enabled work environments. In this article, we briefly describe progress in nursing informatics (NI) and share a project exemplar that describes our experience in the design, implementation, and evaluation of a NI educational event, a one-day boot camp format that was used to provide foundational knowledge in NI targeted primarily at frontline nurses in Alberta, Canada. We also discuss the project outcomes, including lessons learned and future implications. Overall, the boot camp was successful to raise nurses’ awareness about the importance of informatics in nursing practice.
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Multiagency Initiative to Provide Greenhouse Gas Information
Boland, Stacey W.; Duren, Riley M.
2009-11-01
Global Greenhouse Gas Information System Workshop; Albuquerque, New Mexico, 20-22 May 2009; The second Greenhouse Gas Information System (GHGIS) workshop brought together 74 representatives from 28 organizations including U.S. government agencies, national laboratories, and members of the academic community to address issues related to the understanding, operational monitoring, and tracking of greenhouse gas emissions and carbon offsets. The workshop was held at Sandia National Laboratories and organized by an interagency collaboration among NASA centers, Department of Energy laboratories, and the U.S. National Oceanic and Atmospheric Administration. It was motivated by the perceived need for an integrated interagency, community-wide initiative to provide information about greenhouse gas sources and sinks at policy-relevant temporal and spatial scales. Such an initiative could significantly enhance the ability of national and regional governments, industry, and private citizens to implement and evaluate effective climate change mitigation policies.
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Lorincz, Ilona S.; Lawson, Brittany C. T.
2012-01-01
Incentive programs directed at both providers and patients have become increasingly widespread. Pay-for-performance (P4P) where providers receive financial incentives to carry out specific care or improve clinical outcomes has been widely implemented. The existing literature indicates they probably spur initial gains which then level off or partially revert if incentives are withdrawn. The literature also indicates that process measures are easier to influence through P4P programs but that intermediate outcomes such as glucose, blood pressure, and cholesterol control are harder to influence, and the long term impact of P4P programs on health is largely unknown. Programs directed at patients show greater promise as a means to influence patient behavior and intermediate outcomes such as weight loss; however, the evidence for long term effects are lacking. In combination, both patient and provider incentives are potentially powerful tools but whether they are cost-effective has yet to be determined. PMID:23225214
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Khader, A. I.; Rosenberg, D. E.; McKee, M.
2013-05-01
Groundwater contaminated with nitrate poses a serious health risk to infants when this contaminated water is used for culinary purposes. To avoid this health risk, people need to know whether their culinary water is contaminated or not. Therefore, there is a need to design an effective groundwater monitoring network, acquire information on groundwater conditions, and use acquired information to inform management options. These actions require time, money, and effort. This paper presents a method to estimate the value of information (VOI) provided by a groundwater quality monitoring network located in an aquifer whose water poses a spatially heterogeneous and uncertain health risk. A decision tree model describes the structure of the decision alternatives facing the decision-maker and the expected outcomes from these alternatives. The alternatives include (i) ignore the health risk of nitrate-contaminated water, (ii) switch to alternative water sources such as bottled water, or (iii) implement a previously designed groundwater quality monitoring network that takes into account uncertainties in aquifer properties, contaminant transport processes, and climate (Khader, 2012). The VOI is estimated as the difference between the expected costs of implementing the monitoring network and the lowest-cost uninformed alternative. We illustrate the method for the Eocene Aquifer, West Bank, Palestine, where methemoglobinemia (blue baby syndrome) is the main health problem associated with the principal contaminant nitrate. The expected cost of each alternative is estimated as the weighted sum of the costs and probabilities (likelihoods) associated with the uncertain outcomes resulting from the alternative. Uncertain outcomes include actual nitrate concentrations in the aquifer, concentrations reported by the monitoring system, whether people abide by manager recommendations to use/not use aquifer water, and whether people get sick from drinking contaminated water. Outcome costs
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47 CFR 79.2 - Accessibility of programming providing emergency information.
2010-10-01
..., widespread fires, discharge of toxic gases, widespread power failures, industrial explosions, civil disorders... of programming providing emergency information. (a) Definitions. (1) For purposes of this section, the definitions in §§ 79.1 and 79.3 apply. (2) Emergency information. Information, about a current...
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Information needs for problem holders/solution providers: EnviroTRADE
International Nuclear Information System (INIS)
Robson, W.M.; Harrington, M.W.; Harlan, C.P.
1994-01-01
EnviroTRADE (or Environmental Technologies for Remedial Actions Data Exchange) is a domestic and international information system that matches environmental problems with potential technologies solutions by combining state of the art information management techniques, graphical interfaces and a Geographic Information System (GIS). Its search and match algorithms locate technologies relevant to specific environmental problems and identify sites where technology may be applicable. EnviroTRADE also provides many other kinds of database searches and reports. EnviroTRADE is a graphical/textural information management system being developed for the cleanup program of US Department of energy's nuclear weapons complex. Its principal purpose is to provide a single, powerful, interactive data source on the many environmental restoration and waste management (ER/WM) problems and on the technologies currently under development and available to resolve them. Because the volume and complexity of the information is so large, a sophisticated Relational database Management System (RDBMS) is employed for EnviroTRADE which accommodates graphical images, technical data, structured textural descriptions, and a variety of advanced multi-media data types. EnviroTRADE is a multi-purpose, multi-user system capable of addressing a broad range of environmental assessment and cleanup issues
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Information needs for problem holders/solution providers: EnviroTRADE
Energy Technology Data Exchange (ETDEWEB)
Robson, W.M. [Lawrence Livermore National Lab., CA (United States); Harrington, M.W.; Harlan, C.P. [Sandia National Labs., Livermore, CA (United States)
1994-12-31
EnviroTRADE (or Environmental Technologies for Remedial Actions Data Exchange) is a domestic and international information system that matches environmental problems with potential technologies solutions by combining state of the art information management techniques, graphical interfaces and a Geographic Information System (GIS). Its search and match algorithms locate technologies relevant to specific environmental problems and identify sites where technology may be applicable. EnviroTRADE also provides many other kinds of database searches and reports. EnviroTRADE is a graphical/textural information management system being developed for the cleanup program of US Department of energy`s nuclear weapons complex. Its principal purpose is to provide a single, powerful, interactive data source on the many environmental restoration and waste management (ER/WM) problems and on the technologies currently under development and available to resolve them. Because the volume and complexity of the information is so large, a sophisticated Relational database Management System (RDBMS) is employed for EnviroTRADE which accommodates graphical images, technical data, structured textural descriptions, and a variety of advanced multi-media data types. EnviroTRADE is a multi-purpose, multi-user system capable of addressing a broad range of environmental assessment and cleanup issues.
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Information Interaction: Providing a Framework for Information Architecture.
Toms, Elaine G.
2002-01-01
Discussion of information architecture focuses on a model of information interaction that bridges the gap between human and computer and between information behavior and information retrieval. Illustrates how the process of information interaction is affected by the user, the system, and the content. (Contains 93 references.) (LRW)
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Meltzer, Andrew J; Agrusa, Christopher; Connolly, Peter H; Schneider, Darren B; Sedrakyan, Art
2017-11-01
The purpose of this study is to explore the impact of surgeon characteristics (including annual volume, specialty, and years in practice) on outcomes of carotid endarterectomy (CEA) for asymptomatic carotid atherosclerosis in New York State. The New York Statewide Planning and Cooperation System database was utilized to identify patients undergoing CEA from 2004 to 2011. Provider characteristics were determined by linkage to the New York Office of Professions and National Provider Identification databases. Provider-level factors were characterized by defining 5 quintiles of equal size for each factor. Hierarchical logistic regression models were created to evaluate the impact of provider characteristics on outcome. In total, 36,495 patients underwent CEA for asymptomatic disease performed by vascular (75.7%), general (16.1%), cardiac (6%), and neuro (2.1%) surgeons. Outcomes of interest included in-hospital mortality (0.26%), stroke (0.45%), and the composite end point of mortality, stroke, or cardiac complication (2.2%). Unadjusted outcomes improved with increasing surgeon annual CEA volume. Mid-career surgeons had lower mortality and stroke rates than early or late-career surgeons. Odds of mortality were increased when surgery was performed by the lowest volume providers (quintile 1; 0-11 CEA/year) (odds ratio [OR] 2.62, 95% confidence interval [CI] 1.3-5.28) or a nonspecialty trained (general) surgeon (OR 1.64, 95% 1.01-2.67). After adjustment for all patient-level factors, provider volume remained an independent predictor of outcome, with significantly increased odds of mortality for volume quintile 1 (OR 2.57, 95% CI 1.27-5.23) and quintile 2 (12-22 CEA/year) (0.30%; OR 2.07, 95% CI 1-4.27) surgeons. Adverse events after CEA for asymptomatic disease are comparatively rare. However, surgeon characteristics impact outcome, with the best results offered by high-volume, mid-career, specialty-trained surgeons. Efforts to define the optimal treatment of asymptomatic
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Wallace, Jacqueline
2018-06-04
The world is becoming increasingly urban. For the first time in history, more than 50% of human beings live in cities (United Nations, Department of Economic and Social Affairs, Population Division, ed. (2015)). Rapid urbanization is often chaotic and unstructured, leading to the formation of informal settlements or slums. Informal settlements are frequently located in environmentally hazardous areas and typically lack adequate sanitation and clean water, leading to poor health outcomes for residents. In these difficult circumstances women and children fair the worst, and reproductive outcomes for women living in informal settlements are grim. Insufficient uptake of antenatal care, lack of skilled birth attendants and poor-quality care contribute to maternal mortality rates in informal settlements that far outpace wealthier urban neighborhoods (Chant and McIlwaine (2016)). In response, a birth center model of maternity care is proposed for informal settlements. Birth centers have been shown to provide high quality, respectful, culturally appropriate care in high resource settings (Stapleton et al. J Midwifery Women's Health 58(1):3-14, 2013; Hodnett et al. Cochrane Database Syst Rev CD000012, 2012; Brocklehurst et al. BMJ 343:d7400, 2011). In this paper, three case studies are described that support the use of this model in low resource, urban settings.
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Kauh, Tina J.
2011-01-01
This executive summary highlights the main findings from our participation and outcomes analysis of the "AfterZone" initiative--a citywide system-building effort in Providence, Rhode Island, that aims to provide high-quality, accessible out-of-school-time services to middle school youth. The summary briefly defines the AfterZone's unique…
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Vest, Joshua R; Abramson, Erika
2015-01-01
Health information exchange (HIE) systems facilitate access to patient information for a variety of health care organizations, end users, and clinical and organizational goals. While a complex intervention, organizations' usage of HIE is often conceptualized and measured narrowly. We sought to provide greater specificity to the concept of HIE as an intervention by formulating a typology of organizational HIE usage. We interviewed representatives of a regional health information organization and health care organizations actively using HIE information to change patient utilization and costs. The resultant typology includes three dimensions: user role, usage initiation, and patient set. This approach to categorizing how health care organizations are actually applying HIE information to clinical and business tasks provides greater clarity about HIE as an intervention and helps elucidate the conceptual linkage between HIE an organizational and patient outcomes.
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The Content-Provider Paradox: Universities in the Information Ecosystem.
Vaidhyanathan, Siva
2002-01-01
Asserts that universities' rush to abandon their role as "national parks" in the information ecosystem in favor of becoming profitable "content providers" has led to a paradox: to generate new knowledge, researchers and teachers need broad content freedom, but the role of content provider requires highly restrictive policies to…
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Brett, Jo; Staniszewska, Sophie; Newburn, Mary; Jones, Nicola; Taylor, Lesley
2011-06-02
Background and objective The birth of a preterm infant can be an overwhelming experience of guilt, fear and helplessness for parents. Provision of interventions to support and engage parents in the care of their infant may improve outcomes for both the parents and the infant. The objective of this systematic review is to identify and map out effective interventions for communication with, supporting and providing information for parents of preterm infants. Design Systematic searches were conducted in the electronic databases Medline, Embase, PsychINFO, the Cochrane library, the Cumulative Index to Nursing and Allied Health Literature, Midwives Information and Resource Service, Health Management Information Consortium, and Health Management and Information Service. Hand-searching of reference lists and journals was conducted. Studies were included if they provided parent-reported outcomes of interventions relating to information, communication and/or support for parents of preterm infants prior to the birth, during care at the neonatal intensive care unit and after going home with their preterm infant. Titles and abstracts were read for relevance, and papers judged to meet inclusion criteria were included. Papers were data-extracted, their quality was assessed, and a narrative summary was conducted in line with the York Centre for Reviews and Dissemination guidelines. Studies reviewed Of the 72 papers identified, 19 papers were randomised controlled trials, 16 were cohort or quasi-experimental studies, and 37 were non-intervention studies. Results Interventions for supporting, communicating with, and providing information to parents that have had a premature infant are reported. Parents report feeling supported through individualised developmental and behavioural care programmes, through being taught behavioural assessment scales, and through breastfeeding, kangaroo-care and baby-massage programmes. Parents also felt supported through organised support groups and
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Hammarberg, Karin; Prentice, Tess; Purcell, Isabelle; Johnson, Louise
2018-06-01
Many factors influence the chance of having a baby with assisted reproductive technologies (ART). A 2016 Australian Competition and Consumer Commission (ACCC) investigation concluded that ART clinics needed to improve the quality of information they provide about chance of ART success. To evaluate changes in the quality of information about success rates provided on the websites of ART clinics in Australia and New Zealand before and after the ACCC investigation. Desktop audits of websites of ART clinics in Australia and New Zealand were conducted in 2016 and 2017 and available information about success rates was scored using a matrix with eight variables and a possible range of scores of 0-9. Of the 54 clinic websites identified in 2016, 32 had unique information and were eligible to be audited. Of these, 29 were also eligible to be audited in 2017. While there was a slight improvement in the mean score from 2016 to 2017 (4.93-5.28), this was not statistically significantly different. Of the 29 clinics, 14 had the same score on both occasions, 10 had a higher and five a lower information quality score in 2017. To allow people who consider ART to make informed decisions about treatment they need comprehensive and accurate information about what treatment entails and what the likely outcomes are. As measured by a scoring matrix, most ART clinics had not improved the quality of the information about success rates following the ACCC investigation. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
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The Innovative Activity of Enterprises in the Context of Providing Information Security
Directory of Open Access Journals (Sweden)
Sazonets Olga M.
2015-03-01
Full Text Available The aim of the article is to study the peculiarities of the innovative activity in the context of providing the enterprise information security. By analyzing, systematizing and summarizing the scientific works of many scientists the essence of the concept of «information security» has been considered and components of the innovation development process from the standpoint of providing information security have been identified. The article discusses issues of providing information security on the basis of introducing innovations, which will allow achieving a state in which there would be realized a sustainable, protected from threats, development of the enterprise. It has been proved that the formation of the innovative enterprise policy should include measures to ensure information security. As a result of the study the types of threats to the enterprise information security have been identified. It has been determined that the innovation process in the field of information security is provided by means of research, administrative, industrial, technological and commercial activities leading to the emergence and commercialization of innovations. The prospect for further research in this area is determining a system of indicators for forecasting the integral innovation indicator of economic information security. The system of indicators for diagnostics of the enterprise information security level enables monitoring the indicators of the state of the enterprise innovation and information activity in order to prevent the emergence of threats.
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30 CFR 210.40 - Will MMS keep the information I provide confidential?
2010-07-01
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Will MMS keep the information I provide... MINERALS REVENUE MANAGEMENT FORMS AND REPORTS General Provisions § 210.40 Will MMS keep the information I provide confidential? The MMS will treat information obtained under this part as confidential to the...
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Directory of Open Access Journals (Sweden)
Евгений Геннадьевич Панкратов
2014-03-01
Full Text Available This article analyzes the existing methods of e-government systems audit, their shortcomings are examined. The approaches to improve existing techniques and adapt them to the specific characteristics of e-government systems are suggested. The paper describes the methodology, providing possibilities of integrated assessment of information systems. This methodology uses systems maturity models and can be used in the construction of e-government rankings, as well as in the audit of their implementation process. Maturity models are based on COBIT, COSO methodologies and models of e-government, developed by the relevant committee of the UN. The methodology was tested during the audit of information systems involved in the payment of temporary disability benefits. The audit was carried out during analysis of the outcome of the pilot project for the abolition of the principle of crediting payments for disability benefits.DOI: http://dx.doi.org/10.12731/2218-7405-2014-2-5
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Ballermann, Mark; Shaw, Nicola T; Mayes, Damon C; Gibney, R T Noel
2011-01-01
Electronic documentation methods may assist critical care providers with information management tasks in Intensive Care Units (ICUs). We conducted a quasi-experimental observational study to investigate patterns of information tool use by ICU physicians, nurses, and respiratory therapists during verbal communication tasks. Critical care providers used tools less at 3 months after the CCIS introduction. At 12 months, care providers referred to paper and permanent records, especially during shift changes. The results suggest potential areas of improvement for clinical information systems in assisting critical care providers in ensuring informational continuity around their patients.
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Hancock, Rebecca L; Ungar, Wendy J; Einarson, Adrienne; Goodstadt, Michael; Koren, Gideon
2008-04-01
Teratology Information Services (TIS) provide information on exposures during pregnancy and breast-feeding. Maintaining ongoing funding is a challenge. The purpose was to gather descriptive information on current TIS operations. All North American TIS (16 American, 2 Canadian) completed a detailed survey. Service goal ranked as most important was correction of risk misperceptions. Inquiries were primarily for medications (mean 43.5%, S.D. 14.1), lactation exposures, and workplace exposures. Median employees per TIS: three (range 1-12.5). Two TIS only counsel health care professionals (HCPs). Main callers to remaining TIS were pregnant women (mean 46.8%, S.D. 22.8), physicians, and nurses. Calls per week varied (median 20, range 4-600). Median annual budget: US dollars 69,000 (range dollars 3000-335,000). Seventeen TIS collect patient data for research. This survey was the first to document TIS operations in North America and demonstrates a spectrum of clinical and research activities, and provides data for a future cost-benefit analysis of TIS.
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Dimensions of Anticipated Reaction in Information Management: Anticipating Responses and Outcomes.
Magsamen-Conrad, Kate
Many models, theories, and frameworks of information management (e.g., privacy, disclosure, secrets) incorporate the concept of receiver response, both anticipated and actual. Although most if not all information management literature highlights the importance of the response variable, each perspective conceptualizes and/or operationalizes response differently. The lack of consistency across perspectives limits research design, theory testing, and scholars' ability to make comparisons among and across theoretical frameworks, as well as their ability to evaluate research findings within the broader context of information management theory. This project presents a review and synthesis of receiver response within the context of information sharing and decision making, including both immediate responses and longer-term outcomes of sharing the information.
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Secor-Turner, Molly; Sieving, Renee E.; Eisenberg, Marla E.; Skay, Carol
2011-01-01
The objective of this study was to describe prevalent informal sources of information about sex and examine associations between informal sources of information about sex and sexual risk outcomes among sexually experienced adolescents. Work involved the secondary analysis of data from the Minnesota Student Survey, a statewide survey to monitor…
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Yan, Yu-Hua; Kung, Chih-Ming; Fang, Shih-Chieh; Chen, Yi
2017-01-09
This study analyzed differences between transparency of information disclosure and related demands from the health service consumer's perspective. It also compared how health service providers and consumers are associated by different levels of mandatory information disclosure. We obtained our research data using a questionnaire survey (health services providers, n = 201; health service consumers, n = 384). Health service consumers do not have major concerns regarding mandatory information disclosure. However, they are concerned about complaint channels and settlement results, results of patient satisfaction surveys, and disclosure of hospital financial statements ( p transparency of information disclosure ( p information provided by hospitals. Thus, when a hospital discloses information, it is necessary for the government to consider the information's applicability. Toward improving medical expertise and information asymmetry, the government has to reduce the burden among health service consumers in dealing with this information, and it has to use the information effectively.
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Current food chain information provides insufficient information for modern meat inspection of pigs.
Felin, Elina; Jukola, Elias; Raulo, Saara; Heinonen, Jaakko; Fredriksson-Ahomaa, Maria
2016-05-01
Meat inspection now incorporates a more risk-based approach for protecting human health against meat-borne biological hazards. Official post-mortem meat inspection of pigs has shifted to visual meat inspection. The official veterinarian decides on additional post-mortem inspection procedures, such as incisions and palpations. The decision is based on declarations in the food chain information (FCI), ante-mortem inspection and post-mortem inspection. However, a smooth slaughter and inspection process is essential. Therefore, one should be able to assess prior to slaughter which pigs are suitable for visual meat inspection only, and which need more profound inspection procedures. This study evaluates the usability of the FCI provided by pig producers and considered the possibility for risk ranking of incoming slaughter batches according to the previous meat inspection data and the current FCI. Eighty-five slaughter batches comprising 8954 fattening pigs were randomly selected at a slaughterhouse that receives animals from across Finland. The mortality rate, the FCI and the meat inspection results for each batch were obtained. The current FCI alone provided insufficient and inaccurate information for risk ranking purposes for meat inspection. The partial condemnation rate for a batch was best predicted by the partial condemnation rate calculated for all the pigs sent for slaughter from the same holding in the previous year (p<0.001) and by prior information on cough declared in the current FCI (p=0.02) statement. Training and information to producers are needed to make the FCI reporting procedures more accurate. Historical meat inspection data on pigs slaughtered from the same holdings and well-chosen symptoms/signs for reporting, should be included in the FCI to facilitate the allocation of pigs for visual inspection. The introduced simple scoring system can be easily used for additional information for directing batches to appropriate meat inspection procedures. To
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Spetz, Joanne; Burgess, James F; Phibbs, Ciaran S
2014-03-01
The impact of health information technology (HIT) in hospitals is dependent in large part on how it is used by nurses. This study examines the impact of HIT on the quality of care in hospitals in the Veterans Health Administration (VA), focusing on nurse-sensitive outcomes from 1995 to 2005. Data were obtained from VA databases and original data collection. Fixed-effects Poisson regression was used, with the dependent variables measured using the Agency for Healthcare Research and Quality Inpatient Quality Indicators and Patient Safety Indicators software. Dummy variables indicated when each facility began and completed implementation of each type of HIT. Other explanatory variables included hospital volume, patient characteristics, nurse characteristics, and a quadratic time trend. The start of computerized patient record implementation was associated with significantly lower mortality for two diagnoses but significantly higher pressure ulcer rates, and full implementation was associated with significantly more hospital-acquired infections. The start of bar-code medication administration implementation was linked to significantly lower mortality for one diagnosis, but full implementation was not linked to any change in patient outcomes. The commencement of HIT implementation had mixed effects on patient outcomes, and the completion of implementation had little or no effect on outcomes. This longitudinal study provides little support for the perception of VA staff and leaders that HIT has improved mortality rates or nurse-sensitive patient outcomes. Future research should examine patient outcomes associated with specific care processes affected by HIT. Copyright © 2014 Elsevier Inc. All rights reserved.
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Managing minor incidents - Providing information for the public
International Nuclear Information System (INIS)
Joukovskaia, O.
1999-01-01
, it is needed to design a model of an effective system of informatively influencing human mind, given peculiarities of the present stage of the republic's development and features of its evolution under the post- Chernobyl conditions. To provide the public with real and objective information is a forefront problem while resolving these tasks. In this situation it is very important to define the most effective forms and ways of informing the public, to find out a degree to which people trust whatever information. To that end in 1997 conducted a sociological survey among attendees of re-training courses in the field of radiation control (employees of the Ministry of Health, Belarus Consumers' Cooperation Union, Ministry of Agriculture and Foodstuffs, those of Chernobyl divisions of district and region executive committees). It has been revealed that 27 of the respondents trust information of local authorities; Radio and television - 7.2%; foreign scientists - 51.1%; Belarussian scientists and specialists - 51.6% of the respondents. 82.5% of the responders think that the population is insufficiently informed about the questions of safe activity. Information on radio-ecological problems threatens only 72% of the respondents. This kind of information stimulate others to find recommendations on safe activity provision, to understand the situation. As a result of the investigation one can draw a conclusion that the current system of public informing on the Chernobyl problem is insufficient and ineffective, since on the background of a high interest to this problem one can notice a decrease in trust to the majority of information sources, which leads to blocking of adequate perception of the information provided. Bearing this in mind one must: 1. attract specialists working on the affected territories, specialists of radiation control network, doctors, teachers, journalists to information work with population of the affected territories; 2. organise open information data
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Understanding and Motivating Human Control: Outcome and Reward Information in Action
Marien, H.|info:eu-repo/dai/nl/323242529
2014-01-01
In this thesis motivated goal-directed behavior is investigated from a self-emergent process perspective. This perspective supposes that motivation for goal-directed behavior can be the result of a pattern of relatively simple interactions between reward and outcome information. In this thesis three
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Internet-based information system of digital geological data providing
Yuon, Egor; Soukhanov, Mikhail; Markov, Kirill
2015-04-01
One of the Russian Federal аgency of mineral resources problems is to provide the geological information which was delivered during the field operation for the means of federal budget. This information should be present in the current, conditional form. Before, the leading way of presenting geological information were paper geological maps, slices, borehole diagrams reports etc. Technologies of database construction, including distributed databases, technologies of construction of distributed information-analytical systems and Internet-technologies are intensively developing nowadays. Most of geological organizations create their own information systems without any possibility of integration into other systems of the same orientation. In 2012, specialists of VNIIgeosystem together with specialists of VSEGEI started the large project - creating the system of providing digital geological materials with using modern and perspective internet-technologies. The system is based on the web-server and the set of special programs, which allows users to efficiently get rasterized and vectorised geological materials. These materials are: geological maps of scale 1:1M, geological maps of scale 1:200 000 and 1:2 500 000, the fragments of seamless geological 1:1M maps, structural zoning maps inside the seamless fragments, the legends for State geological maps 1:200 000 and 1:1 000 000, full author's set of maps and also current materials for international projects «Atlas of geological maps for Circumpolar Arctic scale 1:5 000 000» and «Atlas of Geologic maps of central Asia and adjacent areas scale 1:2 500 000». The most interesting and functional block of the system - is the block of providing structured and well-formalized geological vector materials, based on Gosgeolkart database (NGKIS), managed by Oracle and the Internet-access is supported by web-subsystem NGKIS, which is currently based on MGS-Framework platform, developed by VNIIgeosystem. One of the leading elements
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The Effects of Website Information Utility on the Outcomes of User-Website Interactions
Hasley, Joseph Paul
2010-01-01
This study investigates the relationships between website information content utility and various outcomes of user interactions with e-tail websites. Although previous research has consistently identified high quality information content as a critical factor of successful e-commerce websites, those studies have not reported how to identify the…
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Yan, Yu-Hua; Kung, Chih-Ming; Fang, Shih-Chieh; Chen, Yi
2017-01-01
Background: This study analyzed differences between transparency of information disclosure and related demands from the health service consumer’s perspective. It also compared how health service providers and consumers are associated by different levels of mandatory information disclosure. Methods: We obtained our research data using a questionnaire survey (health services providers, n = 201; health service consumers, n = 384). Results: Health service consumers do not have major concerns regarding mandatory information disclosure. However, they are concerned about complaint channels and settlement results, results of patient satisfaction surveys, and disclosure of hospital financial statements (p transparency of information disclosure (p < 0.001). Conclusions: It may not be possible for outsiders to properly interpret the information provided by hospitals. Thus, when a hospital discloses information, it is necessary for the government to consider the information’s applicability. Toward improving medical expertise and information asymmetry, the government has to reduce the burden among health service consumers in dealing with this information, and it has to use the information effectively. PMID:28075362
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Application of Ethics for Providing Telemedicine Services and Information Technology.
Langarizadeh, Mostafa; Moghbeli, Fatemeh; Aliabadi, Ali
2017-10-01
Advanced technology has increased the use of telemedicine and Information Technology (IT) in treating or rehabilitating diseases. An increased use of technology increases the importance of the ethical issues involved. The need for keeping patients' information confidential and secure, controlling a number of therapists' inefficiency as well as raising the quality of healthcare services necessitates adequate heed to ethical issues in telemedicine provision. The goal of this review is gathering all articles that are published through 5 years until now (2012-2017) for detecting ethical issues for providing telemedicine services and Information technology. The reason of this time is improvement of telemedicine and technology through these years. This article is important for clinical practice and also to world, because of knowing ethical issues in telemedicine and technology are always important factors for physician and health providers. the required data in this research were derived from published electronic sources and credible academic articles published in such databases as PubMed, Scopus and Science Direct. The following key words were searched for in separation and combination: tele-health, telemedicine, ethical issues in telemedicine. A total of 503 articles were found. After excluding the duplicates (n= 93), the titles and abstracts of 410 articles were skimmed according to the inclusion criteria. Finally, 64 articles remained. They were reviewed in full text and 36 articles were excluded. At the end, 28 articles were chosen which met our eligibility criteria and were included in this study. Ethics has been of a great significance in IT and telemedicine especially the Internet since there are more chances provided for accessing information. It is, however, accompanied by a threat to patients' personal information. Therefore, suggestions are made to investigate ethics in technology, to offer standards and guidelines to therapists. Due to the advancement in
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Gelkopf, Marc; Pagorek-Eshel, Shira; Trauer, Tom; Roe, David
2015-06-01
This study examined whether mental health community service users completed outcome self-reports differently when assessments were supervised by internal vs. external staff. The examination of potential differences between the two has useful implications for mental health systems that take upon themselves the challenge of Routine Outcome Measurement (ROM), as it might impact allocation of public resources and managed care program planning. 73 consumers completed the Manchester Short Assessment of Quality of Life (MANSA), a shortened version of the Recovery Assessment Scale (RAS), and a functioning questionnaire. Questionnaires were administered, once using support provided by internal staff and once using support provided by external professional staff, with a one-month time interval and in random order. A MANOVA Repeated Measures showed no differences in outcomes of quality of life and recovery between internal and external support. Functioning scores were higher for the internal support when the internal assessments were performed first. Overall, except for the differences in functioning assessment, outcome scores were not determined by the supporting agency. This might indicate that when measuring quality of life and recovery, different supporting methods can be used to gather outcome measures and internal staff might be a good default agency to do this. Differences found in functioning assessment are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.
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40 CFR 310.24 - What happens if I provide incorrect or false information?
2010-07-01
... false information? 310.24 Section 310.24 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... § 310.24 What happens if I provide incorrect or false information? (a) You must not knowingly or recklessly make any statement or provide any information in your reimbursement application that is false...
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Dolce, Maria C
2011-05-01
To describe the experiences of cancer survivors and caregivers with healthcare providers in the context of the Internet as a source of health information. Qualitative description. Online cancer communities hosted by the Association of Cancer Online Resources. Purposive sample of 488 cancer survivors, with varying cancer types and survivorship stages, and caregivers. Secondary data analysis using Krippendorff's thematic clustering technique of qualitative content analysis. Survivorship, healthcare relationships, and the Internet. Disenchantment with healthcare relationships was associated with failed expectations related to evidence-based practice, clinical expertise, informational support, and therapeutic interpersonal communication. Survivors and caregivers exercised power in healthcare relationships through collaboration, direct confrontation, becoming expert, and endorsement to influence and control care decisions. Disenchantment propelled cancer survivors and caregivers to search the Internet for health information and resources. Conversely, Internet information-seeking precipitated the experience of disenchantment. Through online health information and resources, concealed failures in healthcare relationships were revealed and cancer survivors and caregivers were empowered to influence and control care decisions. The findings highlight failures in cancer survivorship care and underscore the importance of novel interdisciplinary programs and models of care that support evidence-informed decision making, self-management, and improved quality of life. Healthcare professionals need to receive education on survivors' use of the Internet as a source of health information and its impact on healthcare relationships. Future research should include studies examining the relationship between disenchantment and survivorship outcomes.
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47 CFR 64.707 - Public dissemination of information by providers of operator services.
2010-10-01
... 47 Telecommunication 3 2010-10-01 2010-10-01 false Public dissemination of information by providers of operator services. 64.707 Section 64.707 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... § 64.707 Public dissemination of information by providers of operator services. Providers of operator...
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Providing Global Change Information for Decision-Making: Capturing and Presenting Provenance
Ma, Xiaogang; Fox, Peter; Tilmes, Curt; Jacobs, Katherine; Waple, Anne
2014-01-01
Global change information demands access to data sources and well-documented provenance to provide evidence needed to build confidence in scientific conclusions and, in specific applications, to ensure the information's suitability for use in decision-making. A new generation of Web technology, the Semantic Web, provides tools for that purpose. The topic of global change covers changes in the global environment (including alterations in climate, land productivity, oceans or other water resources, atmospheric composition and or chemistry, and ecological systems) that may alter the capacity of the Earth to sustain life and support human systems. Data and findings associated with global change research are of great public, government, and academic concern and are used in policy and decision-making, which makes the provenance of global change information especially important. In addition, since different types of decisions benefit from different types of information, understanding how to capture and present the provenance of global change information is becoming more of an imperative in adaptive planning.
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Does providing nutrition information at vending machines reduce calories per item sold?
Dingman, Deirdre A; Schulz, Mark R; Wyrick, David L; Bibeau, Daniel L; Gupta, Sat N
2015-02-01
In 2010, the United States (US) enacted a restaurant menu labeling law. The law also applied to vending machine companies selling food. Research suggested that providing nutrition information on menus in restaurants might reduce the number of calories purchased. We tested the effect of providing nutrition information and 'healthy' designations to consumers where vending machines were located in college residence halls. We conducted our study at one university in Southeast US (October-November 2012). We randomly assigned 18 vending machines locations (residence halls) to an intervention or control group. For the intervention we posted nutrition information, interpretive signage, and sent a promotional email to residents of the hall. For the control group we did nothing. We tracked sales over 4 weeks before and 4 weeks after we introduced the intervention. Our intervention did not change what the residents bought. We recommend additional research about providing nutrition information where vending machines are located, including testing formats used to present information.
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The development of web program for providing RI-biomics technical information
International Nuclear Information System (INIS)
KI, Na Kyung; Kim, Joo Yeon; Jang, Sol Ah; Park, Tai Jin
2014-01-01
For designing the model of the web program, the demand survey for the technology and information has been performed for the students of the related departments, industrialists and researchers. And, the survey, such as advantages and disadvantages, for the current situations has been examined through comparison and analysis by the establishment type and operational process for the present operating web programs having the similar functions in Korea. The contents and web program for the technology and information system have been also developed by the question investigation and the expert opinions. This system for RI-Biomics has been developed by focusing the convenience for the information provision and the information search as the first constructing direction. Information has been collected by the operator in our institute and making contract with Global Trend Briefing of KISTI in Korea. The information collection in the web program has been designed as the direction regularly provided with RSS. Information has been then analyzed by constructing the expert pool provided from the advisory committee for the technology and information, and using them. The publicity for this web program has been performed by webzines and then it is noted that the publicity programs such as some events should be regularly developed when expanded and advanced to a community in future
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International Nuclear Information System (INIS)
Shobu, Nobuhiro; Yokomizo, Shirou; Umezawa, Sayaka
2004-06-01
'Risk information navigator (http://www.ricotti.jp/risknavi/)', an internet tool for arousing public interest and fostering people's risk literacy, has been developed as the contents for the official website of Techno Community Square 'RICOTTI' (http://www.ricotti.jp) at TOKAI village. In this report we classified the risk information into the fields, Health/Daily Life', 'Society/Crime/Disaster' and Technology/Environment/Energy', for the internet tool contents. According to these categories we discussed a method for providing various risk information on general fields by linking with the information on nuclear field. The web contents are attached to this report with the CD-R media. (author)
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Directory of Open Access Journals (Sweden)
Yu-Hua Yan
2017-01-01
Full Text Available Background: This study analyzed differences between transparency of information disclosure and related demands from the health service consumer’s perspective. It also compared how health service providers and consumers are associated by different levels of mandatory information disclosure. Methods: We obtained our research data using a questionnaire survey (health services providers, n = 201; health service consumers, n = 384. Results: Health service consumers do not have major concerns regarding mandatory information disclosure. However, they are concerned about complaint channels and settlement results, results of patient satisfaction surveys, and disclosure of hospital financial statements (p < 0.001. We identified significant differences in health service providers’ and consumers’ awareness regarding the transparency of information disclosure (p < 0.001. Conclusions: It may not be possible for outsiders to properly interpret the information provided by hospitals. Thus, when a hospital discloses information, it is necessary for the government to consider the information’s applicability. Toward improving medical expertise and information asymmetry, the government has to reduce the burden among health service consumers in dealing with this information, and it has to use the information effectively.
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Improving palliative care outcomes for Aboriginal Australians: service providers' perspectives.
Shahid, Shaouli; Bessarab, Dawn; van Schaik, Katherine D; Aoun, Samar M; Thompson, Sandra C
2013-07-23
Aboriginal Australians have a lower rate of utilisation of palliative care services than the general population. This study aimed to explore care providers' experiences and concerns in providing palliative care for Aboriginal people, and to identify opportunities for overcoming gaps in understanding between them and their Aboriginal patients and families. In-depth, qualitative interviews with urban, rural and remote palliative care providers were undertaken in inpatient and community settings in Western Australia. Interviews were audio-recorded, transcribed verbatim and coded independently by two researchers with QSR NVivo 10 software used to help manage data. Data analysis was informed by multiple theoretical standpoints, including the social ecological model, critical cultural theories and the 'cultural security' framework. Thematic analysis was carried out that identified patterns within data. Fifteen palliative care providers were interviewed. Overall they reported lack of understanding of Aboriginal culture and being uncertain of the needs and priorities of Aboriginal people during end-of-life care. According to several participants, very few Aboriginal people had an understanding of palliative care. Managing issues such as anger, denial, the need for non-medical support due to socioeconomic disadvantage, and dealing with crises and conflicts over funeral arrangements were reported as some of the tensions between Aboriginal patients and families and the service providers. Early referral to palliative care is important in demonstrating and maintaining a caring therapeutic relationship. Paramount to meeting the needs for Aboriginal patients was access to appropriate information and logistical, psychological and emotional support. These were often seen as essential but additional to standard palliative care services. The broader context of Aboriginal history and historical distrust of mainstream services was seen to impinge on Aboriginal people's willingness and
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Health Information Provided by Retail Health Food Outlets
Directory of Open Access Journals (Sweden)
Jaclyn Calder
2000-01-01
Full Text Available Alternative health practices have become increasingly popular in recent years. Many patients visit specific complementary practitioners, while others attempt to educate themselves, trusting advice from employees at local health food stores or the Internet. Thirty-two retail health food stores were surveyed on the nature of the information provided by their staff. A research assistant visited the stores and presented as the mother of a child in whom Crohn’s disease had been diagnosed. Seventy-two per cent (23 of 32 of store employees offered advice, such as to take nutritional and herbal supplements. Of the 23 stores where recommendations were made, 15 (65% based their recommendation on a source of information. Fourteen of the 15 stores using information sources used the same reference book. This had a significant impact on the recommendations; the use of nutritional supplements was favoured. In conclusion, retail health food stores are not as inconsistent as hypothesized, although there are many variances in the types of supplements recommended for the same chronic disease.
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Satisfaction with information provided to Danish cancer patients: validation and survey results.
Ross, Lone; Petersen, Morten Aagaard; Johnsen, Anna Thit; Lundstrøm, Louise Hyldborg; Groenvold, Mogens
2013-11-01
To validate five items (CPWQ-inf) regarding satisfaction with information provided to cancer patients from health care staff, assess the prevalence of dissatisfaction with this information, and identify factors predicting dissatisfaction. The questionnaire was validated by patient-observer agreement and cognitive interviews. The prevalence of dissatisfaction was assessed in a cross-sectional sample of all cancer patients in contact with hospitals during the past year in three Danish counties. The validation showed that the CPWQ performed well. Between 3 and 23% of the 1490 participating patients were dissatisfied with each of the measured aspects of information. The highest level of dissatisfaction was reported regarding the guidance, support and help provided when the diagnosis was given. Younger patients were consistently more dissatisfied than older patients. The brief CPWQ performs well for survey purposes. The survey depicts the heterogeneous patient population encountered by hospital staff and showed that younger patients probably had higher expectations or a higher need for information and that those with more severe diagnoses/prognoses require extra care in providing information. Four brief questions can efficiently assess information needs. With increasing demands for information, a wide range of innovative initiatives is needed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
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Unfree markets: socially embedded informal health providers in northern Karnataka, India.
George, Asha; Iyer, Aditi
2013-11-01
The dynamics of informal health markets in marginalised regions are relevant to policy discourse in India, but are poorly understood. We examine how informal health markets operate from the viewpoint of informal providers (those without any government-recognised medical degrees, otherwise known as RMPs) by drawing upon data from a household survey in 2002, a provider census in 2004 and ongoing field observations from a research site in Koppal district, Karnataka, India. We find that despite their illegality, RMPs depend on government and private providers for their training and referral networks. Buffeted by unregulated market pressures, RMPs are driven to provide allopathic commodities regardless of need, but can also be circumspect in their practice. Though motivated by profit, their socially embedded practice at community level at times undermines their ability to ensure payment of fees for their services. In addition, RMPs feel that communities can threaten them via violence or malicious rumours, leading them to seek political favour and social protection from village elites and elected representatives. RMPs operate within negotiated quid pro quo bargains that lead to tenuous reciprocity or fragile trust between them and the communities in which they practise. In the context of this 'unfree' market, some RMPs reported being more embedded in health systems, more responsive to communities and more vulnerable to unregulated market pressures than others. Understanding the heterogeneity, nuanced motivations and the embedded social relations that mark informal providers in the health systems, markets and communities they work in, is critical for health system reforms. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Providing Consumers with Web-Based Information on the Environmental Effects of Automobiles
Energy Technology Data Exchange (ETDEWEB)
Saulsbury, J.W.
2003-08-25
The Department of Energy (DOE) and the Environmental Protection Agency (EPA) provide consumers with web-based information on the environmental effects of automobiles so that individuals can make informed choices about the vehicles they use or may purchase. DOE and EPA maintain a web site (www.fueleconomy.gov) that provides users with information about fuel economy [as well as greenhouse gas (GHG) emissions and air pollution emissions] for the cars and trucks they use or may consider purchasing. EPA also maintains a separate web site (www.epa.gov/greenvehicles) that offers similar information, with the focus on air pollution emissions rather than fuel economy. The American Council for an Energy-Efficient Economy (ACEEE) (www.greenercars.com) and the California Air Resources Board (CARB) (www.arb.ca.gov/msprog/ccbg/ccbg.htm) also maintain web sites that provide consumers with information on the environmental effects of automobiles. Through the National Transportation Research Center (NTRC) at Oak Ridge National Laboratory, DOE has supported some initial qualitative research with people who are interested in purchasing a new or used vehicle and whose actions identify them as at least somewhat concerned about the environment. The purpose of this research was to explore and understand how these people respond to the different ratings and measurements of environmental effects provided by the four web sites. The goal of the research is to optimize the communication of information provided on the DOE/EPA web site (www.fueleconomy.gov). Working with a private marketing research firm (The Looking Glass Group of Knoxville, Tennessee), NTRC staff initiated this research by meeting with two focus groups in Knoxville on February 27, 2001. To obtain information for comparison, staff from the NTRC and the Looking Glass Group also met with two focus groups in Los Angeles, California, on August 13, 2001.
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Directory of Open Access Journals (Sweden)
Minna M Boström
Full Text Available Inflammation is an important feature of carcinogenesis. Tumor-associated macrophages (TAMs can be associated with either poor or improved prognosis, depending on their properties and polarization. Current knowledge of the prognostic significance of TAMs in bladder cancer is limited and was investigated in this study. We analyzed 184 urothelial bladder cancer patients undergoing transurethral resection of a bladder tumor or radical cystectomy. CD68 (pan-macrophage marker, MAC387 (polarized towards type 1 macrophages, and CLEVER-1/Stabilin-1 (type 2 macrophages and lymphatic/blood vessels were detected immunohistochemically. The median follow-up time was 6.0 years. High macrophage counts associated with a higher pT category and grade. Among patients undergoing transurethral resection, all studied markers apart from CLEVER-1/Stabilin-1 were associated with increased risk of progression and poorer disease-specific and overall survival in univariate analyses. High levels of two macrophage markers (CD68/MAC387+/+ or CD68/CLEVER-1+/+ groups had an independent prognostic role after transurethral resection in multivariate analyses. In the cystectomy cohort, MAC387, alone and in combination with CD68, was associated with poorer survival in univariate analyses, but none of the markers were independent predictors of outcome in multivariate analyses. In conclusion, this study demonstrates that macrophage phenotypes provide significant independent prognostic information, particularly in bladder cancers undergoing transurethral resection.
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30 CFR 291.111 - How does MMS treat the confidential information I provide?
2010-07-01
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false How does MMS treat the confidential information... SHELF LANDS ACT § 291.111 How does MMS treat the confidential information I provide? (a) Any person who provides documents under this part in response to a request by MMS to inform a decision on whether open...
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Handelsman, D J; Sivananathan, T; Andres, L; Bathur, F; Jayadev, V; Conway, A J
2013-11-01
Semen is collected to evaluate male fertility or cryostore sperm preferentially in laboratories but such collection facilities have no standard fit-out. It is widely believed but untested whether providing erotic material (EM) is required to collect semen by masturbation in the unfamiliar environment. To test this assumption, 1520 men (1046 undergoing fertility evaluation, 474 sperm cryostorage, providing 1932 semen collection episodes) consecutively attending the semen laboratory of a major metropolitan teaching hospital for semen analysis were eligible for randomization to be provided or not with printed erotic material EM (X-rated, soft-core magazines) during semen collection. Randomization was performed by providing magazines in the collection rooms (as a variation on non-standard fit-out) on alternate weeks using a schedule concealed from participants. In the pilot study, men were randomized without seeking consent. In the second part of the study, which continued on from the first without interruption, an approved informed consent procedure was added. The primary outcome, the time to collect semen defined as the time from receiving to returning the sample receptacle, was significantly longer (by ~6%, 14.9 ± 0.3 [mean ± standard error of mean] vs. 14.0 ± 0.2 minutes, p = 0.02) among men provided with EM than those randomized to not being provided. There was no significant increase in the failure to collect semen samples (2.6% overall) nor any difference in age, semen volume or sperm concentration, output or motility according to whether EM was provided or not. The significantly longer time to collect was evident in the pilot study and the study overall, but not in the main study where the informed consent procedure was used. This study provides evidence that refutes the assumption that EM needs to be provided for semen collection in a laboratory. It also provides an example of a usually unobservable participation bias influencing study outcome of a
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Metz, Margot J; Franx, Gerdien C; Veerbeek, Marjolein A; de Beurs, Edwin; van der Feltz-Cornelis, Christina M; Beekman, Aartjan T F
2015-12-15
Shared Decision Making (SDM) is a way to empower patients when decisions are made about treatment. In order to be effective agents in this process, patients need access to information of good quality. Routine Outcome Monitoring (ROM) may provide such information and therefore may be a key element in SDM. This trial tests the effectiveness of SDM using ROM, primarily aiming to diminish decisional conflict of the patient while making decisions about treatment. The degree of decisional conflict, the primary outcome of this study, encompasses personal certainty about choosing an appropriate treatment, information about options, clarification of patient values, support from others and patients experience of an effective decision making process. Secondary outcomes of the study focus on the working alliance between patient and clinician, adherence to treatment, and clinical outcome and quality of life. This article presents the study protocol of a multi-centre two-arm cluster randomised controlled trial (RCT). The research is conducted in Dutch specialised mental health care teams participating in the ROM Quality Improvement Collaborative (QIC), which aims to implement ROM in daily clinical practice. In the intervention teams, ROM is used as a source of information during the SDM process between the patient and clinician. Control teams receive no specific SDM or ROM instructions and apply decision making as usual. Randomisation is conducted at the level of the participating teams within the mental health organisations. A total of 12 teams from 4 organisations and 364 patients participate in the study. Prior to data collection, the intervention teams are trained to use ROM during the SDM process. Data collection will be at baseline, and at 3 and 6 months after inclusion of the patient. Control teams will implement the SDM and ROM model after completion of the study. This study will provide useful information about the effectiveness of ROM within a SDM framework
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Schwartz, Peter H; Perkins, Susan M; Schmidt, Karen K; Muriello, Paul F; Althouse, Sandra; Rawl, Susan M
2017-08-01
Guidelines recommend that patient decision aids should provide quantitative information about probabilities of potential outcomes, but the impact of this information is unknown. Behavioral economics suggests that patients confused by quantitative information could benefit from a "nudge" towards one option. We conducted a pilot randomized trial to estimate the effect sizes of presenting quantitative information and a nudge. Primary care patients (n = 213) eligible for colorectal cancer screening viewed basic screening information and were randomized to view (a) quantitative information (quantitative module), (b) a nudge towards stool testing with the fecal immunochemical test (FIT) (nudge module), (c) neither a nor b, or (d) both a and b. Outcome measures were perceived colorectal cancer risk, screening intent, preferred test, and decision conflict, measured before and after viewing the decision aid, and screening behavior at 6 months. Patients viewing the quantitative module were more likely to be screened than those who did not ( P = 0.012). Patients viewing the nudge module had a greater increase in perceived colorectal cancer risk than those who did not ( P = 0.041). Those viewing the quantitative module had a smaller increase in perceived risk than those who did not ( P = 0.046), and the effect was moderated by numeracy. Among patients with high numeracy who did not view the nudge module, those who viewed the quantitative module had a greater increase in intent to undergo FIT ( P = 0.028) than did those who did not. The limitations of this study were the limited sample size and single healthcare system. Adding quantitative information to a decision aid increased uptake of colorectal cancer screening, while adding a nudge to undergo FIT did not increase uptake. Further research on quantitative information in decision aids is warranted.
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Zika Virus: Critical Information for Emergency Providers.
Shastry, Siri; Koenig, Kristi L; Hirshon, Jon Mark
2016-08-01
Zika virus is an arbovirus of the Flaviviridae family. It is primarily a minimally symptomatic mosquito-borne infection. However, with Zika's 2015 to 2016 introduction into the Western Hemisphere and its dramatic and rapid spread, it has become a public health concern, in large part due to congenital abnormalities associated with infection in pregnant women. In early 2016, the World Health Organization declared the microcephaly and other neurologic conditions associated with Zika virus infection a public health emergency of international concern. This article discusses the current epidemiologic and clinical understanding of Zika virus, focusing on critical information needed by emergency providers. Copyright © 2016 Elsevier Inc. All rights reserved.
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Kruse, Clemens Scott; Beane, Amanda
2018-01-01
Background Health information technology (HIT) has been introduced into the health care industry since the 1960s when mainframes assisted with financial transactions, but questions remained about HIT’s contribution to medical outcomes. Several systematic reviews since the 1990s have focused on this relationship. This review updates the literature. Objective The purpose of this review was to analyze the current literature for the impact of HIT on medical outcomes. We hypothesized that there is...
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Krive, Jacob
2015-01-01
Despite the fast pace of recent innovation within the health information technology and research informatics domains, there remains a large gap between research and academia, while interest in translating research innovations into implementations in the patient care settings is lacking. This is due to absence of common outcomes and performance measurement targets, with health information technology industry employing financial and operational measures and academia focusing on patient outcome concerns. The paper introduces methodology for and roadmap to introduction of common objectives as a way to encourage better collaboration between industry and academia using patient outcomes as a composite measure of demonstrated success from health information systems investments. Along the way, the concept of economics of health informatics, or "infonomics," is introduced to define a new way of mapping future technology investments in accordance with projected clinical impact.
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Hodges, Kay; Wotring, James R
2012-04-01
An outcomes management system (OMS) greatly facilitates an organization or state achieving requirements regarding accountability and use of empirically based interventions. A case example of the authors' experience with a successful and enduring OMS is presented, followed by a review of the literature and a proposed model delineating the key components and benefits of an OMS. Building capacity to measure performance requires embedding utilization of youth-specific, clinically meaningful outcome data into the organization's processes and structures. An OMS measures outcomes associated with services, facilitates implementation of evidence-based practices, informs case decision making, enables better and more efficient clinical management, and provides aggregated information used to improve services. A case-specific supervisory model based on instantaneously available information, including progress to date, helps maximize consumer outcomes. Continuous quality improvement activities, which are databased and goal-oriented, become a positive change management tool. This paper describes organizational processes that facilitate the development of a highly functional OMS.
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Duty to provide pre-contractual information of crop insurance
Directory of Open Access Journals (Sweden)
Ivančević Katarina
2016-01-01
Full Text Available Crop insurance is one of the most important types of agricultural insurance. From the aspect of insurance technique, this insurance is very challenging and requires careful drafting of insurance terms and tariffs. This type of insurance can provide security to farmers in case of financial losses caused by numerous risks which they are exposed to. Insufficient knowledge of the opportunities that the insurance provides is caused in part by inaccurate and vague explanations that have been offered by insurers in negotiation stage to interested farmers. In this regard, an important novelty in Serbian law is the obligation of contractual information which was introduced by the new Insurance Law (IL. In this way, additional protection to users of the service of insurance in relation to the provisions of the obligation law is provided. The goal of this obligation is to allow a negotiator to gain a clear idea of the essential elements of the insurance contract, to consider the proposed coverage and make a reasonable decision whether to accept the conclusion of the insurance contract or not, i.e. under what conditions it should be concluded. Sanctions for failure in the obligation to inform act preventively and repressively on insurers. The aim of this study is analyse the legal and factual position of the service beneficiaries in terms of obligation of economically and experientially superior contractor of lawful and full information of a policyholder prior to the conclusion of an insurance contract in a very specific branch of insurance, such as crop insurance. The application of inductive-deductive and comparative-legal research method, points to certain doctrinal and normative solutions from other legal systems, legal provisions applicable in the law of the Republic of Serbia are critically set out, as well as the daily practice of insurance companies.
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Tucker, Joan S; Stucky, Brian D; Edelen, Maria Orlando; Shadel, William G; Klein, David J
2018-05-21
The U.S. Public Health Service Clinical Practice Guideline on treating tobacco use and dependence recommends providing advice to quit to every tobacco user seen in a healthcare setting. However, the mechanism through which counseling encourages patients to quit has not been adequately studied. This study tests whether the association between receiving healthcare provider counseling and desire to quit is accounted for by negative health and psychosocial outcome expectancies of smoking. Data were collected online from 721 adult smokers who had seen a healthcare provider in the past 12 months. Associations between counseling to quit, negative outcome expectancies of smoking, and desire to quit were tested, as well as whether outcome expectancies and desire to quit differed by type of counseling (counseling only vs. counseling plus assistance) and level of smoking. Bivariate associations indicated a stronger desire to quit among patients receiving counseling, particularly when it included healthcare provider assistance to quit. SEM results indicated that the association between counseling and desire to quit was fully accounted for by patients' negative health and psychosocial outcome expectancies for smoking. These associations were found across levels of smoking in the case of health expectancies, but were limited to moderate and heavy smokers in the case of psychosocial expectancies. Results suggest that the time devoted to counseling patients about smoking should include providing some assistance to quit, such as recommending a product, prescription or program. Regardless of smoking level, this counseling should incorporate techniques to elicit patients' negative health and psychosocial expectancies of smoking. Copyright © 2018. Published by Elsevier Ltd.
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Information Problem-Solving Skills in Small Virtual Groups and Learning Outcomes
Garcia, Consuelo; Badia, Antoni
2017-01-01
This study investigated the frequency of use of information problem-solving (IPS) skills and its relationship with learning outcomes. During the course of the study, 40 teachers carried out a collaborative IPS task in small virtual groups in a 4-week online training course. The status of IPS skills was collected through self-reports handed in over…
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Rogers, M; Zach, L; An, Y; Dalrymple, P
2012-01-01
This paper reports on work carried out to elicit information needs at a trans-disciplinary, nurse-managed health care clinic that serves a medically disadvantaged urban population. The trans-disciplinary model provides a "one-stop shop" for patients who can receive a wide range of services beyond traditional primary care. However, this model of health care presents knowledge sharing challenges because little is known about how data collected from the non-traditional services can be integrated into the traditional electronic medical record (EMR) and shared with other care providers. There is also little known about how health information technology (HIT) can be used to support the workflow in such a practice. The objective of this case study was to identify the information needs of care providers in order to inform the design of HIT to support knowledge sharing and distributed decision making. A participatory design approach is presented as a successful technique to specify requirements for HIT applications that can support a trans-disciplinary model of care. Using this design approach, the researchers identified the information needs of care providers working at the clinic and suggested HIT improvements to integrate non-traditional information into the EMR. These modifications allow knowledge sharing among care providers and support better health decisions. We have identified information needs of care providers as they are relevant to the design of health information systems. As new technology is designed and integrated into various workflows it is clear that understanding information needs is crucial to acceptance of that technology.
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Geometric information provider platform
Directory of Open Access Journals (Sweden)
Meisam Yousefzadeh
2015-07-01
Full Text Available Renovation of existing buildings is known as an essential stage in reduction of the energy loss. Considerable part of renovation process depends on geometric reconstruction of building based on semantic parameters. Following many research projects which were focused on parameterizing the energy usage, various energy modelling methods were developed during the last decade. On the other hand, by developing accurate measuring tools such as laser scanners, the interests of having accurate 3D building models are rapidly growing. But the automation of 3D building generation from laser point cloud or detection of specific objects in that is still a challenge. The goal is designing a platform through which required geometric information can be efficiently produced to support energy simulation software. Developing a reliable procedure which extracts required information from measured data and delivers them to a standard energy modelling system is the main purpose of the project.
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Directory of Open Access Journals (Sweden)
Gill PS
2013-02-01
Full Text Available Preetinder S GillCollege of Technology, Eastern Michigan University, Ypsilanti, MI, USABackground: Health literacy impacts health outcomes. Health literacy is a measure of a person's competence to find, access, contextualize, and understand the information needed to make health decisions. Low levels of health literacy have been associated with poor health status. Health literacy can be enhanced by improving the readability of health literature. Misuse and abuse of prescription medicines and controlled substances is rising. It could be argued that improving the readability of the drug-information documents associated with these medicines could serve to alleviate this situation in a small, albeit incremental, manner. This paper provides a readability assessment of 71 such documents.Methods: The readability of drug-information documents associated with 12 commonly misused and abused painkiller medicines and controlled substances published by the top six US pharmacies was assessed. The Flesch-Kincaid Grade Level, Flesch Reading Ease, and Simple Measure of Gobbledygook (SMOG indices were used to assess the readability of these drug-information documents. One-way analysis of variance (ANOVA was used to compare the readability of the documents.Results: The average Flesch-Kincaid Grade Level index score was found to be 11.16. The average Flesch Reading Ease index score was found to be 45.94. The average SMOG index score was found to be 13.60. Pharmacies C and E had the best average readability scores, whereas pharmacies A and B had the worst average readability scores.Conclusion: Access, contents, and formatting of the documents were qualitatively analyzed to make recommendations to improve readability. Pharmacies C and E were used as benchmarks to identify the seven best practices. Good drug-information documents should have: (1 clear purpose, (2 limited scope, (3 summary/brief review, (4 well-placed graphics, (5 informative illustrations, (6 clean
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Messer, Lynne C; Parnell, Heather; Huffaker, Renee; Wooldredge, Rich; Wilkin, Aimee
2012-10-01
The Regional Health Information Integration Project (RHIIP) has developed the Carolina HIV Information Cooperative regional health information organization (CHIC RHIO). The CHIC RHIO was implemented to improve patient care and health outcomes by enhancing communication among geographically disconnected networks of HIV care providers in rural North Carolina. CHIC RHIO comprises one medical clinic and five AIDS Service Organizations (ASOs) serving clients in eight rural counties. Communication among the CHIC RHIO members is facilitated by CAREWare software. The RHIIP team assessed organizational readiness to change, facilitated relationship-building for CHIC RHIO, created the CHIC RHIO and used both qualitative and quantitative approaches to evaluate the process-related effects of implementing a data-sharing intervention. We found the CHIC RHIO member organizations were ready to engage in the IT intervention prior to its implementation, which most likely contributed to its successful adoption. The qualitative findings indicate that CHIC RHIO members personally benefited - and perceived their clients benefited - from participation in the information exchange. The quantitative results echoed the qualitative findings; following the CHIC RHIO intervention, quality improvements were noted in the ASO and medical clinic relationships, information exchange, and perceived level of patient care. Furthermore, hopes for what data sharing would accomplish were overly high at the beginning of the project, thus requiring a recalibration of expectations as the project came to a close. Innovative strategies for health information exchange can be implemented in rural communities to increase communication among providers. With this increased communication comes the potential for improved health outcomes and, in turn, healthier communities. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
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Improving Educational Outcomes by Providing Educational Services through Mobile Technology
Directory of Open Access Journals (Sweden)
Hosam Farouk El-Sofany
2013-01-01
Full Text Available The use of Computers, Networks, and Internet has successfully enabled educational institutions to provide their students and instructors with various online educational services. With the recent developments in M-learning and mobile technology, further possibilities are emerging to provide such services through mobile devices such as mobile phones and PDAs. By providing the educational services using wireless and mobile technologies, the educational institutions can potentially bring great convenience to those off-campus students who do not always have time to find Internet enabled computers to get the important educational information from their academic institutions. With the mobile or M-educational services, both the students and the instructors can access the services anytime and anywhere they want. This paper discusses those M-educational services that can be moved to the mobile platform and then presents the system prototype and architecture that integrate these services into the mobile technology platform. The paper will conclude with a description of the formative evaluation of the system prototype.
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30 CFR 250.1406 - When will MMS notify me and provide penalty information?
2010-07-01
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false When will MMS notify me and provide penalty information? 250.1406 Section 250.1406 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE... (OCS) Civil Penalties § 250.1406 When will MMS notify me and provide penalty information? If the...
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7 CFR 2902.6 - Providing product information to Federal agencies.
2010-01-01
... manufacturers and vendors to provide product, business contacts, and product information for designated items... characteristics, including verification of such characteristics if requested. (b) Advertising, labeling and marketing claims. Manufacturers and vendors are reminded that their advertising, labeling, and other...
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Doran, Diane M; Sidani, Souraya
2007-01-01
Regularly accessing information that is current and reliable continues to be a challenge for front-line staff nurses. Reconceptualizing how nurses access information and designing appropriate decision support systems to facilitate timely access to information may be important for increasing research utilization. An outcomes-focused knowledge translation framework was developed to guide the continuous improvement of patient care through the uptake of research evidence and feedback data about patient outcomes. The framework operationalizes the three elements of the PARIHS framework at the point of care. Outcomes-focused knowledge translation involves four components: (a) patient outcomes measurement and real-time feedback about outcomes achievement; (b) best-practice guidelines, embedded in decision support tools that deliver key messages in response to patient assessment data; (c) clarification of patients' preferences for care; and (d) facilitation by advanced practice nurses and practice leaders. In this paper the framework is described and evidence is provided to support theorized relationships among the concepts in the framework. The framework guided the design of a knowledge translation intervention aimed at continuous improvement of patient care and evidence-based practice, which are fostered through real-time feedback data about patient outcomes, electronic access to evidence-based resources at the point of care, and facilitation by advanced practice nurses. The propositions in the framework need to be empirically tested through future research.
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LENUS (Irish Health Repository)
2017-11-01
Oocyte donation pregnancies- non-disclosure of oocyte recipient (OR) status to obstetric care providers and perinatal outcomes.Many studies report a higher rate of pregnancy-induced hypertension (PIH) and severe pre-eclampsia (PET) in OR pregnancies. The objective is to determine the rates of non-disclosure of OR pregnancy to obstetric care providers and also the rates of perinatal complications.
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Providing public information in the Slovenian Nuclear Safety Administration
International Nuclear Information System (INIS)
Fon Jager, Mojca
2000-01-01
Full text: Good safety culture is strongly related to transparent and timely information. Experience has shown that radiation and nuclear safety are under continuous surveillance by the public. The provision of open and authentic information to the public is a fundamental policy of the SNSA. The SNSA endeavors to provide substantial and reliable information to the interested institutions, mass media and to the citizens through press conferences, public statements, media discussions, and active participation in domestic and international meetings, symposia and congresses, through publications, the Internet and direct contacts with the interested public. The SNSA regularly provides information on nuclear safety to the Government, the National Assembly and the citizens of the Republic of Slovenia. The Annual Report on Nuclear and Radiation Safety is published in Poroeevalec (Reporter) - the publication of the National Assembly - in autumn, and is available in public libraries throughout Slovenia. Annual Report is available also on the Internet (http://www.sigov.si/ursjv/uvod.html) in Slovene and English. Access to data of the Central Radiation Early Warning System of Slovenia (CROSS), recording the real time (at half-hour intervals) gamma dose rate levels, is also available through Internet. The report in English is sent every year to Slovenian embassies world-wide, to certain foreign embassies in Slovenia and to other organizations participating in the activities in the nuclear and radiological field. Reports on the SNSA activities are also published in the bulletin Okolje in prostor (Environment and Spatial Planning), published by the Ministry of Environment and Spatial Planning. The SNSA regularly contributes articles on courses, seminars and symposia attended at home and abroad. The articles are intended to give basic information on training and the names of contact persons to provide additional information on certain topics to those interested. More than half of
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Camp, J M; Krakow, M; McCarty, D; Argeriou, M
1992-01-01
There is increased interest in documenting the characteristics and treatment outcomes of clients served with Alcohol, Drug Abuse, and Mental Health Block Grant funds. The evolution of federal client-based management systems for substance abuse treatment services demonstrates that data collection systems are important but require continued support. A review of the Massachusetts substance abuse management information system illustrates the utility of a client-based data set. The development and implementation of a comprehensive information system require overcoming organizational barriers and project delays, fostering collaborative efforts among staff from diverse agencies, and employing considerable resources. In addition, the need to develop mechanisms for increasing the reliability of the data and ongoing training for the users is presented. Finally, three applications of the management information system's role in shaping policy are reviewed: developing services for special populations (communities of color, women, and pregnant substance abusers, and injection drug users), utilizing MIS data for evaluation purposes, and determining funding allocations.
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30 CFR 203.70 - What information must I provide after MMS approves relief?
2010-07-01
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What information must I provide after MMS... information must I provide after MMS approves relief? You must submit reports to us as indicated in the following table. Sections 203.81, 203.90, and 203.91 describe what these reports must include. The MMS...
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Mendelsohn, Steven; Edyburn, Dave L; Rust, Kathy L; Schwanke, Todd D; Smith, Roger O
2008-01-01
We know that work is recognized as a central component of life for individuals with and without disabilities. It yields many physical and psychological benefits to the individual while simultaneously contributing numerous benefits to society. Lawmakers have enacted a plethora of laws designed to prevent discrimination, provide incentives for employers to hire individuals with disabilities, and facilitate job training/career preparation. Assistive technology figures prominently in disability employment law as a critical strategy for gaining access and supporting employment and upward mobility in the workplace. However, little systematic effort has been devoted to examining assistive technology use and outcomes as they relate to the employment of individuals with disabilities. The purpose of this article is to articulate a series of issues that permeate assistive technology outcome measurement in employment settings and subsequently affect the use of research knowledge for federal and state policy makers. For each issue, the authors pose three questions for critical analysis: Does the law compel the provision of assistive technology? Does outcome data play any part in the operation of the law? When it does, what kind of data would be useful to collect and where could it be found? Finally, the authors provide a brief glimpse of the current and future research efforts concerning the RSA-911 database. The recent database summaries exemplify the importance of such a national data collection system for informing federal policy, particularly concerning the contributions of assistive technology device use and services on improving the employment of individuals with disabilities.
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Whitmore, Rebecca; Crooks, Valorie A; Snyder, Jeremy
2017-01-01
Canadians travelling abroad for privately arranged surgeries paid for out-of-pocket are engaging in what has come to be known as medical tourism. They are often accompanied by friends or family members, who we call caregiver-companions. Caregiver-companions provide care in and across a variety of formal and informal settings, such as in hotels, airplanes and at home. This qualitative study examines the experiences of informal caregivers in medical tourism to learn more about the lived experiences or 'experiential resources' they draw upon to cope with providing care and avoiding caregiver burden. The care-giving literature has demonstrated that such burden can negatively impact caregivers' well-being. The unique, transnational context of care-giving in medical tourism and recent growth in popularity of this practice means that there are few supports or resources currently in place to assist informal caregivers. In this article, we report on an analysis that sought to detail how caregiver-companions draw upon their previous lived experiences to cope with providing transnational care and to minimise or avoid the onset of caregiver burden. We conducted semi-structured telephone interviews with 20 Canadians who had accompanied their friends or family members abroad for surgery between September 2013 and January 2014. Thematic analysis revealed the ways that participants had developed practical strategies to deal with the challenges they faced in medical tourism. The interviews revealed three important experiential resources drawn upon by participants: (i) previous experiences of international travel; (ii) previous experiences of informal care-giving; and (iii) dimensions of the existing relationship with the care recipient. Differences in access to and use of these experiential resources related to participants' perspectives on medical tourism and the outcomes of the trip. By identifying the experiential resources drawn upon by informal caregivers in medical tourism
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Family benefits - Obligation to provide information
HR Department
2015-01-01
Pursuant to Article R V 1.38 of the Staff Regulations, members of the personnel are reminded that they are required to inform the Organization in writing, within 30 calendar days, of any change in their family situation (marriage, partnership, birth of a child, etc.) and of the amount of any financial benefit of a similar nature to those provided for in the Staff Regulations (e.g. family allowance, child allowance, infant allowance, non-resident allowance or international indemnity) to which they or a member of their family may be entitled from a source other than CERN. The procedures to be followed are available in the Admin e-guide: https://admin-eguide.web.cern.ch/en/procedure/change-family-situation Members of the personnel are also reminded that any false declaration or failure to make a declaration with a view to deceiving others or achieving a gain resulting in a loss of funds or reputation for CERN constitutes fraud and may lead to disciplinary action in accordance with Article S ...
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Perceptions of climate change and trust in information providers in rural Australia.
Buys, Laurie; Aird, Rosemary; van Megen, Kimberley; Miller, Evonne; Sommerfeld, Jeffrey
2014-02-01
Disagreement within the global science community about the certainty and causes of climate change has led the general public to question what to believe and whom to trust on matters related to this issue. This paper reports on qualitative research undertaken with Australian residents from two rural areas to explore their perceptions of climate change and trust in information providers. While overall, residents tended to agree that climate change is a reality, perceptions varied in terms of its causes and how best to address it. Politicians, government, and the media were described as untrustworthy sources of information about climate change, with independent scientists being the most trusted. The vested interests of information providers appeared to be a key reason for their distrust. The findings highlight the importance of improved transparency and consultation with the public when communicating information about climate change and related policies.
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Embedding Affective Learning Outcomes in Library Instruction
Directory of Open Access Journals (Sweden)
Ellysa Stern Cahoy
2012-12-01
Full Text Available While information literacy in higher education has long been focused on cognitive learning outcomes, attention must be paid to students’ affective, emotional needs throughout the research process. This article identifies models for embedding affective learning outcomes within information literacy instruction, and provides strategies to help librarians discover, articulate, and address students’ self-efficacy, motivation, emotions and attitudes. Worksheets to assist in creating affective learning outcomes are included to bring structure to an area of learning that is often challenging to articulate and measure. Also included in the article are the results of a recent survey of instruction librarians’ familiarity and inclusion of affective learning outcomes within teaching and learning initiatives.
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Microtubules provide directional information for core PCP function
Matis, Maja; Russler-Germain, David A; Hu, Qie; Tomlin, Claire J; Axelrod, Jeffrey D
2014-01-01
Planar cell polarity (PCP) signaling controls the polarization of cells within the plane of an epithelium. Two molecular modules composed of Fat(Ft)/Dachsous(Ds)/Four-jointed(Fj) and a ‘PCP-core’ including Frizzled(Fz) and Dishevelled(Dsh) contribute to polarization of individual cells. How polarity is globally coordinated with tissue axes is unresolved. Consistent with previous results, we find that the Ft/Ds/Fj-module has an effect on a MT-cytoskeleton. Here, we provide evidence for the model that the Ft/Ds/Fj-module provides directional information to the core-module through this MT organizing function. We show Ft/Ds/Fj-dependent initial polarization of the apical MT-cytoskeleton prior to global alignment of the core-module, reveal that the anchoring of apical non-centrosomal MTs at apical junctions is polarized, observe that directional trafficking of vesicles containing Dsh depends on Ft, and demonstrate the feasibility of this model by mathematical simulation. Together, these results support the hypothesis that Ft/Ds/Fj provides a signal to orient core PCP function via MT polarization. DOI: http://dx.doi.org/10.7554/eLife.02893.001 PMID:25124458
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Perrin, B M; Barnett, B J; Walrath, L; Grossman, J D
2001-01-01
Findings that decision makers can come to different conclusions depending on the order in which they receive information have been termed the "information order bias." When trained, experienced individuals exhibit similar behaviors; however, it has been argued that this result is not a bias, but rather, a pattern-matching process. This study provides a critical examination of this claim. It also assesses both experts' susceptibility to an outcome framing bias and the effects of varying task loads on judgment. Using a simulation of state-of-the-art ship defensive systems operated by experienced, active-duty U.S. Navy officers, we found no evidence of a framing bias, while task load had a minor, but systematic effect. The order in which information was received had a significant impact, with the effect being consistent with a judgment bias. Nonetheless, we note that pattern-matching processes, similar to those that produce inferential and reconstructive effects on memory, could also explain our results. Actual or potential applications of this research include decision support system interfaces or training programs that might be developed to reduce judgment bias.
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Homer, Dawn; Nightingale, Peter; Jobanputra, Paresh
2009-06-01
Communicating information about disease-modifying anti-rheumatic drugs (DMARDs) before patients start treatment is a key role for some rheumatology clinical nurse specialists. This is done in our unit to promote understanding of the risks and benefits of drug therapy and encourage timely and reliable use of DMARDs. Information is routinely provided individually but this can lead to delays in starting treatment because of limited nursing resources. In this randomized trial we tested the feasibility of giving patients, who were about to start on a DMARD, information about the drug in groups and compared this with information given individually. Adults with a clinical diagnosis of rheumatoid arthritis or psoriatic arthritis who were referred to the nursing team for counselling about starting on methotrexate, sulfasalazine or leflunomide were included. Patients who had previously taken a DMARD were not excluded and those consenting were randomized to receive drug information individually or in groups (of three to six patients). We provided all patients with written materials about the relevant drug and discussed the risks and benefits of drug use verbally. Patients allocated to group counselling received this intervention in a teaching room, with a slide presentation. The primary outcome was adherence with medication use, ascertained by pill counts, self-report diaries and prescription dispensation. Secondary outcomes included satisfaction with information about medicines (SIMS) by questionnaire; time taken to provide information; adherence to scheduled hospital appointments and blood monitoring schedules; and DMARD continuation rates at four and twelve months. Of 127 eligible patients referred for counselling about DMARDs, 62 consented to take part: 32 were randomized to receive drug information individually and 30 to receiving it in groups. Patients allocated to the two different interventions were comparable for age and diagnoses at baseline but more patients
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Fiander, Michelle; McGowan, Jessie; Grad, Roland; Pluye, Pierre; Hannes, Karin; Labrecque, Michel; Roberts, Nia W; Salzwedel, Douglas M; Welch, Vivian; Tugwell, Peter
2015-03-14
There is a large volume of health information available, and, if applied in clinical practice, may contribute to effective patient care. Despite an abundance of information, sub-optimal care is common. Many factors influence practitioners' use of health information, and format (electronic or other) may be one such factor. To assess the effects of interventions aimed at improving or increasing healthcare practitioners' use of electronic health information (EHI) on professional practice and patient outcomes. We searched The Cochrane Library (Wiley), MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO), and LISA (EBSCO) up to November 2013. We contacted researchers in the field and scanned reference lists of relevant articles. We included studies that evaluated the effects of interventions to improve or increase the use of EHI by healthcare practitioners on professional practice and patient outcomes. We defined EHI as information accessed on a computer. We defined 'use' as logging into EHI. We considered any healthcare practitioner involved in patient care. We included randomized, non-randomized, and cluster randomized controlled trials (RCTs, NRCTs, CRCTs), controlled clinical trials (CCTs), interrupted time series (ITS), and controlled before-and-after studies (CBAs).The comparisons were: electronic versus printed health information; EHI on different electronic devices (e.g. desktop, laptop or tablet computers, etc.; cell / mobile phones); EHI via different user interfaces; EHI provided with or without an educational or training component; and EHI compared to no other type or source of information. Two review authors independently extracted data and assessed the risk of bias for each study. We used GRADE to assess the quality of the included studies. We reassessed previously excluded studies following our decision to define logins to EHI as a measure of professional behavior. We reported results in natural units. When possible, we calculated and reported median effect size
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Directory of Open Access Journals (Sweden)
Bolge SC
2017-06-01
Full Text Available Susan C Bolge,1 Natalia M Flores,2 Shu Huang,3 Jennifer Cai1 1Janssen Scientific Affairs, LLC, Titusville, NJ, 2Kantar Health, Foster City, CA, 3Kantar Health, New York, NY, USA Purpose: This study describes how health care providers approach canagliflozin for the treatment of patients with type 2 diabetes mellitus (T2DM in the real world.Patients and methods: An Internet-based questionnaire was completed by 101 endocrinologists, 101 primary care physicians, and 100 nurse practitioners/physician assistants (NP/PAs. Health care providers were required to have experience prescribing or managing patients using canagliflozin to be included in the study. Health care providers compared canagliflozin with other T2DM medication classes on clinical characteristics, costs, and patient satisfaction. Confidence in canagliflozin was also measured. Health care providers reported their canagliflozin prescribing experience and good candidate characteristics for treatment. Finally, providers reported on patient outcomes among those receiving canagliflozin. All variables were compared across provider type.Results: Health care providers reported higher favorability for canagliflozin for blood pressure and body weight compared with dipeptidyl peptidase-4 (DPP-4 inhibitors and higher favorability for effect on blood pressure, body weight, treatment satisfaction, and glycosylated hemoglobin (HbA1c compared with sulfonylureas (SUs, with differences observed for effect on blood pressure. Health care providers reported being very/extremely confident (55%–74% with canagliflozin as a second- to fourth-line treatment. The top 3 characteristics reported by the providers, in terms of describing a good candidate for canagliflozin, include those concerned about their weight, insurance coverage/affordability, and avoiding injectable treatments. Finally, providers reported often/always observing patients’ lowering or controlling HbA1c (82%–88% and improvement in overall
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The changing face of government information providing access in the twenty-first century
Kumar, Suhasini L
2006-01-01
Learn what innovative changes lie in the future of government information The Changing Face of Government Information comprehensively examines the way government documents' librarians acquire, provide access, and provide reference services in the new electronic environment. Noted experts discuss the impact electronic materials have had on the Government Printing Office (GPO), the reference services within the Federal Depository Library Program (FDLP), and the new opportunities in the transition from paper-based information policy to an electronic e-government. This source reveals the latest changes in the field of government documents librarianship and the knowledge and expertise needed to teach users how to access what they need from this enormous wealth of government information. Major changes have taken place in the way government information is created, disseminated, accessed, and preserved. The Changing Face of Government Information explains in detail the tremendous change taking place in libraries and ...
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2012-06-18
...] Solicitation of Information and Recommendations for Revising OIG's Provider Self-Disclosure Protocol AGENCY... Register notice informs the public that OIG: (1) Intends to update the Provider Self-Disclosure Protocol... Provider Self-Disclosure Protocol (the Protocol) to establish a process for health care providers to...
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Chang, Sherilyn; Zhang, Yunjue; Jeyagurunathan, Anitha; Lau, Ying Wen; Sagayadevan, Vathsala; Chong, Siow Ann; Subramaniam, Mythily
2016-03-25
The responsibility of caring for relatives with mental illness often falls on the family members. It has been reported that the reactions to or consequences of providing care are what rendered the role of a caregiver challenging and hence a source of distress. This present study thus aimed to identify socio-demographic correlates of caregiving experiences using the Caregiver Reaction Assessment (CRA) and to examine the associations between reactions to caregiving and psychological distress. A total of 350 caregivers with relatives seeking outpatient care at a tertiary psychiatric hospital were recruited for this study. Distress among caregivers was assessed using the Patient Health Questionnaire (PHQ-9). The CRA was administered to measure reactions from caregiving in four domains including impact on schedule and health (ISH), impact on finance (IF), lack of family support (LFS) and caregiver esteem (CE). Participants also completed a questionnaire that asked for their socio-demographic information. Multivariable linear regression analysis was first used with domains of CRA as outcome variables and socio-demographic variables as predictors in the models. The next set of multivariable linear regression analysis tested for the association between CRA domains and distress with CRA domain scores as outcome variables and PHQ-9 score as predictor, controlling for socio-demographic variables. Socio-demographic correlates of CRA domains identified were age, education, employment, income and ethnicity. Domain scores of CRA were significantly associated with PHQ-9 score even after controlling for socio-demographic variables. A higher distress score was associated with greater impact felt in the domain of ISH (β = 0.080, P social care support in these domains may help to address caregiver distress.
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Measuring Learning Outcomes in Auditing Education
DEFF Research Database (Denmark)
Holm, Claus; Steenholdt, Niels
2003-01-01
The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education, which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... firms. Hence knowledge about learning outcomes for different groups of students is essential information for educators as well as the accounting profession. This paper extends prior research on the role of declarative and procedural knowledge in performing auditing tasks. Measuring learning outcomes......). The study provides evidence, which confirms an interrelationship between declarative and procedural knowledge in auditing, and the findings also suggest that students with auditing experience perform better than students without experience on procedural questions....
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Opinion On Drug Information Services Provided In A Multi- Specialty Teaching Hospital
Directory of Open Access Journals (Sweden)
Vijayakumar TM, Poovi G & Dhanaraju MD
2011-05-01
Full Text Available Objective: To evaluate the various drug information queriesreceived, and to access the drug information services providedby the pharmacy practice department.Method: Drug information queries received during wardrounds, direct communication, telephone or internet etc. weredocumented in the drug information request anddocumentation forms prepared by the department over theperiod of January 2010 to June 2010. Various parameters likestatus of enquirer, their specialty, mode of receipt of query,purpose of query, type of query etc. were consider forevaluation.Results: Out of 208 queries received, major 56 (26.9% frommale medical ward. Maximum [82 (39.4 %] queries were fromthe physicians. 73 (35.0 % of the queries were about therecent advances and the updating of the information, It wasfound that mostly the mode of request was during wardrounds 85 (40.9%. Most of the queries [126 (60.6%] wereanswered by written or printout format. Majority of thequeries [195 (93.8 %] were answered directly to theenquirers through direct access. Most of the queries wereanswered through books in the department [86 (41.3 %].Conclusion: Results of the external auditing revealed thatrequestors were generally satisfied with the service provided.The drug information services provided by clinical pharmacistsat the hospital were found to be useful and beneficial to thehealthcare professionals and patients.
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Quality and use of consumer information provided with home test kits: room for improvement.
Grispen, Janaica E J; Ickenroth, Martine H P; de Vries, Nanne K; van der Weijden, Trudy; Ronda, Gaby
2014-10-01
Diagnostic self-tests (tests on body materials that are initiated by consumers with the aim of diagnosing a disorder or risk factor) are becoming increasingly available. Although the pros and cons of self-testing are currently not clear, it is an existing phenomenon that is likely to gain further popularity. To examine consumers' use of and needs for information about self-testing, and to assess the quality of consumer information provided with home test kits, as perceived by consumers and as assessed using a checklist of quality criteria. A cross-sectional Internet survey among 305 self-testers assessed their use of and needs for information and their perception of the quality of consumer information provided with self-test kits. A meta-search engine was used to identify Dutch and English consumer information for home diagnostic tests available online at the time of the study. The quality of this consumer information was evaluated using a checklist of quality criteria. The consumers' information needs were in line with the most frequently used information, and the information was perceived as being of moderate to good quality. The information was mostly in agreement with clinical practice guidelines, although information on reliability and follow-up behaviour was limited. Approximately half of the instruction leaflets did not include information on the target group of the test. Although generally of moderate to good quality, some aspects of the information provided were in many cases insufficient. European legislation concerning self-tests and accompanying information needs to be adapted and adhered to more closely. © 2012 John Wiley & Sons Ltd.
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Explaining Differences in Learning Outcomes in Auditing Education
DEFF Research Database (Denmark)
Holm, Claus; Steenholdt, Niels
2014-01-01
In this paper we use a learner perspective on learning outcomes which reflects that some students taking accounting classes are also provided with on-the-job training in accounting firms. Hence knowledge about learning outcomes for different groups of students is essential information for educators...
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Rizzo, Erika; Pizzol, Lisa; Zabeo, Alex; Giubilato, Elisa; Critto, Andrea; Cosmo, Luca; Marcomini, Antonio
2018-07-01
In the EU brownfield presence is still considered a widespread problem. Even though, in the last decades, many research projects and initiatives developed a wealth of methods, guidelines, tools and technologies aimed at supporting brownfield regeneration. However, this variety of products had and still has a limited practical impact on brownfield revitalisation success, because they are not used in their entire potential due to their scarce visibility. Also, another problem that stakeholders face is finding customised information. To overcome this non-visibility and not-sufficient customisation of information, the Information System for Brownfield Regeneration (ISBR) has been developed, based on Artificial Neural Networks, which allows understanding stakeholders' information needs by providing tailored information. The ISBR has been tested by stakeholders from the EU project TIMBRE case studies, located in the Czech Republic, Germany, Poland and Romania. Data gained during tests allowed to understand stakeholders' information needs. Overall, stakeholders showed to be concerned first on remediation aspects, then on benchmarking information, which are valuable to improve practices in the complex field of brownfield regeneration, and then on the relatively new issue of sustainability applied to brownfield regeneration and remediation. Mature markets confirmed their interest for remediation-related aspects, highlighting the central role that risk assessment plays in the process. Emerging markets showed to seek information and tools for strategic and planning issues, like brownfield inventories and georeferenced data sets. Results led to conclude that a new improved platform, combining the ISBR functionalities with geo-referenced ones, would be useful and could represent a further research application. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Farooq, Saeed; Green, Debra J; Singh, Swaran P
2018-05-04
First-episode psychosis (FEP) can be a serious and debilitating disease, but there is limited literature on how to inform patients and carers about its diagnosis and outcome. We aimed to examine the attitudes, practices and views of clinicians working in Early Intervention Service about sharing information on diagnosis and outcome of FEP. A 26-item questionnaire was sent electronically to clinical staff who have been involved in the discussion of FEP diagnosis in Early Intervention Services in the West Midlands, UK. A total of 51 clinicians completed the questionnaire. All respondents stated that patients or carers of those presenting with FEP wish to be informed of their diagnosis, and three-quarters (76%) felt there is a need to develop guidelines on how to inform about diagnosis; 57% stated that they usually use broad diagnostic groups such as psychosis when discussing diagnosis, and only 11% use the term schizophrenia. A total of 40% thought that the therapeutic relationship and treatment adherence (58%) would improve if patients know about their diagnosis; 42 (88%) respondents felt that the likely outcome of the illness should also be discussed with patients when the diagnosis is communicated. The clinicians were aware that service users wished to be informed about the diagnosis and outcome of FEP but had no guidance on the subject. Despite the limitations of an online self-administered survey, the study highlights the need for guidance and improving clinical practice in discussing the diagnosis of FEP in a vulnerable population. © 2018 John Wiley & Sons Australia, Ltd.
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Ahmed, Sara; Ware, Patrick; Gardner, William; Witter, James; Bingham, Clifton O; Kairy, Dahlia; Bartlett, Susan J
2017-09-01
Given that the goal of health care systems is to improve and maintain the health of the populations they serve, the indicators of performance must include outcomes that are meaningful to patients. The growth of health technologies provides an unprecedented opportunity to integrate the patient voice into clinical care by linking electronic health records (EHRs) to patient-reported outcome (PRO) data collection. However, PRO data must be relevant, meaningful, and actionable for those who will have to invest the time and effort to collect it. In this study, we highlight opportunities to integrate PRO data collection into EHRs. We consider how stakeholder perspectives should influence the selection of PROs and ways to enhance engagement in and commitment to PRO implementation. We propose a research and policy agenda to address unanswered questions and facilitate the widespread adoption of PRO data collection into EHRs. Building a learning health care system that gathers PRO data in ways that can inform individual patient care, quality improvement, and comparative effectiveness research has the potential to accelerate the application of new evidence and knowledge to patient care. Copyright © 2017 Elsevier Inc. All rights reserved.
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McCaffrey, Nikki; Agar, Meera; Harlum, Janeane; Karnon, Jonathon; Currow, David; Eckermann, Simon
2015-01-01
Comparing multiple, diverse outcomes with cost-effectiveness analysis (CEA) is important, yet challenging in areas like palliative care where domains are unamenable to integration with survival. Generic multi-attribute utility values exclude important domains and non-health outcomes, while partial analyses-where outcomes are considered separately, with their joint relationship under uncertainty ignored-lead to incorrect inference regarding preferred strategies. The objective of this paper is to consider whether such decision making can be better informed with alternative presentation and summary measures, extending methods previously shown to have advantages in multiple strategy comparison. Multiple outcomes CEA of a home-based palliative care model (PEACH) relative to usual care is undertaken in cost disutility (CDU) space and compared with analysis on the cost-effectiveness plane. Summary measures developed for comparing strategies across potential threshold values for multiple outcomes include: expected net loss (ENL) planes quantifying differences in expected net benefit; the ENL contour identifying preferred strategies minimising ENL and their expected value of perfect information; and cost-effectiveness acceptability planes showing probability of strategies minimising ENL. Conventional analysis suggests PEACH is cost-effective when the threshold value per additional day at home (1) exceeds $1,068 or dominated by usual care when only the proportion of home deaths is considered. In contrast, neither alternative dominate in CDU space where cost and outcomes are jointly considered, with the optimal strategy depending on threshold values. For example, PEACH minimises ENL when 1=$2,000 and 2=$2,000 (threshold value for dying at home), with a 51.6% chance of PEACH being cost-effective. Comparison in CDU space and associated summary measures have distinct advantages to multiple domain comparisons, aiding transparent and robust joint comparison of costs and multiple
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Sergi, Brian; Davis, Alex; Azevedo, Inês
2018-02-01
Support for addressing climate change and air pollution may depend on the type of information provided to the public. We conduct a discrete choice survey assessing preferences for combinations of electricity generation portfolios, electricity bills, and emissions reductions. We test how participants’ preferences change when emissions information is explicitly provided to them. We find that support for climate mitigation increases when mitigation is accompanied by improvements to air quality and human health. We estimate that an average respondent would accept an increase of 19%-27% in their electricity bill if shown information stating that either CO2 or SO2 emissions are reduced by 30%. Furthermore, an average respondent is willing to pay an increase of 30%-40% in electricity bills when shown information stating that both pollutants are reduced by 30% simultaneously. Our findings suggest that the type of emissions information provided to the public will affect their support for different electricity portfolios.
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Factors Informing Outcomes for Older Cats and Dogs in Animal Shelters
Directory of Open Access Journals (Sweden)
Sloane Hawes
2018-03-01
Full Text Available With advances in veterinary medicine that can increase the lifespan of cats and dogs and the effectiveness of spay/neuter programs in reducing the juvenile population of pets, animal shelters are experiencing an increasing population of older companion animals in their care. The purpose of this study was to assess the factors that inform the outcomes of these older cats and dogs. The sample consisted of 124 cats and 122 dogs that were over the age of 84 months (seven years who were taken into a shelter over a one-year period. To assess the impact of condition at intake on the outcome for the senior animals, a multinomial logistic regression was performed. These findings indicate that preventative programming that can address the reasons these older animals are surrendered, as well as advancements in specialized medical or behavioral programs for ageing companion animals, may support an increase in live outcomes for older cats and dogs in shelters. Further study is needed to evaluate how the quality of life of older animals is impacted by remaining in the care of shelters rather than being euthanized.
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Directory of Open Access Journals (Sweden)
Magali Michaut
Full Text Available Genetic interactions help map biological processes and their functional relationships. A genetic interaction is defined as a deviation from the expected phenotype when combining multiple genetic mutations. In Saccharomyces cerevisiae, most genetic interactions are measured under a single phenotype - growth rate in standard laboratory conditions. Recently genetic interactions have been collected under different phenotypic readouts and experimental conditions. How different are these networks and what can we learn from their differences? We conducted a systematic analysis of quantitative genetic interaction networks in yeast performed under different experimental conditions. We find that networks obtained using different phenotypic readouts, in different conditions and from different laboratories overlap less than expected and provide significant unique information. To exploit this information, we develop a novel method to combine individual genetic interaction data sets and show that the resulting network improves gene function prediction performance, demonstrating that individual networks provide complementary information. Our results support the notion that using diverse phenotypic readouts and experimental conditions will substantially increase the amount of gene function information produced by genetic interaction screens.
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Weiss, N; Venot, M; Verdonk, F; Chardon, A; Le Guennec, L; Llerena, M C; Raimbourg, Q; Taldir, G; Luque, Y; Fagon, J-Y; Guerot, E; Diehl, J-L
2015-05-01
The accurate prediction of outcome after out-of-hospital cardiac arrest (OHCA) is of major importance. The recently described Full Outline of UnResponsiveness (FOUR) is well adapted to mechanically ventilated patients and does not depend on verbal response. To evaluate the ability of FOUR assessed by intensivists to accurately predict outcome in OHCA. We prospectively identified patients admitted for OHCA with a Glasgow Coma Scale below 8. Neurological assessment was performed daily. Outcome was evaluated at 6 months using Glasgow-Pittsburgh Cerebral Performance Categories (GP-CPC). Eighty-five patients were included. At 6 months, 19 patients (22%) had a favorable outcome, GP-CPC 1-2, and 66 (78%) had an unfavorable outcome, GP-CPC 3-5. Compared to both brainstem responses at day 3 and evolution of Glasgow Coma Scale, evolution of FOUR score over the three first days was able to predict unfavorable outcome more precisely. Thus, absence of improvement or worsening from day 1 to day 3 of FOUR had 0.88 (0.79-0.97) specificity, 0.71 (0.66-0.76) sensitivity, 0.94 (0.84-1.00) PPV and 0.54 (0.49-0.59) NPV to predict unfavorable outcome. Similarly, the brainstem response of FOUR score at 0 evaluated at day 3 had 0.94 (0.89-0.99) specificity, 0.60 (0.50-0.70) sensitivity, 0.96 (0.92-1.00) PPV and 0.47 (0.37-0.57) NPV to predict unfavorable outcome. The absence of improvement or worsening from day 1 to day 3 of FOUR evaluated by intensivists provides an accurate prognosis of poor neurological outcome in OHCA. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
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Nakano, Kikuo; Kitahara, Yoshihiro; Mito, Mineyo; Seno, Misato; Sunada, Shoji
2018-02-27
Without explicit prognostic information, patients may overestimate their life expectancy and make poor choices at the end of life. We sought to design the Japanese version of an information aid (IA) to provide accurate information on prognosis to patients with advanced non-small-cell lung cancer (NSCLC) and to assess the effects of the IA on hope, psychosocial status, and perception of curability. We developed the Japanese version of an IA, which provided information on survival and cure rates as well as numerical survival estimates for patients with metastatic NSCLC receiving first-line chemotherapy. We then assessed the pre- and post-intervention effects of the IA on hope, anxiety, and perception of curability and treatment benefits. A total of 20 (95%) of 21 patients (65% male; median age, 72 years) completed the IA pilot test. Based on the results, scores on the Distress and Impact Thermometer screening tool for adjustment disorders and major depression tended to decrease (from 4.5 to 2.5; P = 0.204), whereas no significant changes were seen in scores for anxiety on the Japanese version of the Support Team Assessment Schedule or in scores on the Hearth Hope Index (from 41.9 to 41.5; p = 0.204). The majority of the patients (16/20, 80%) had high expectations regarding the curative effects of chemotherapy. The Japanese version of the IA appeared to help patients with NSCLC maintain hope, and did not increase their anxiety when they were given explicit prognostic information; however, the IA did not appear to help such patients understand the goal of chemotherapy. Further research is needed to test the findings in a larger sample and measure the outcomes of explicit prognostic information on hope, psychological status, and perception of curability.
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Self-esteem and outcome fairness judgments: Differential use of procedural and outcome information
Vermunt, R; van Knippenberg, D.; van Knippenberg, B.M.; Blaauw, E.
2001-01-01
Results of a survey of 222 detainees in Dutch jails and police stations showed that outcome-fairness judgments of individuals with high self-esteem were more strongly related to outcome considerations than to procedural considerations, whereas outcome-fairness judgments of individuals with low
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29 CFR 37.38 - What information must grant applicants and recipients provide to CRC?
2010-07-01
... provide to CRC? 37.38 Section 37.38 Labor Office of the Secretary of Labor IMPLEMENTATION OF THE... information must grant applicants and recipients provide to CRC? In addition to the information which must be collected, maintained, and, upon request, submitted to CRC under § 37.37: (a) Each grant applicant and...
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Schaack, Diana D.; Le, Vi Nhuan; Messan Setodji, Claude
2017-01-01
Research Findings: Although there has been considerable research on the associations between the qualifications of teachers in center-based settings and preschool-age children's developmental outcomes, very little is known about the relationships between home provider qualifications and the developmental outcomes of toddlers who attend licensed…
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Public service providers and users in the information society
Directory of Open Access Journals (Sweden)
Bernt Krohn Solvang
2015-03-01
Full Text Available The issue to be discussed in this article is to what extent does ICT create new challenges for the relationship between public service providers and users? It is important to recognize the concept of social capital because the concept is vital to the understanding of access to the information society and efficient functioning of government in its service to citizens. In this way we see social capital as a mediating “institution” between public authorities and the citizens (users.
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Providing Information about Reading Lists via a Dashboard Interface
Directory of Open Access Journals (Sweden)
Dr Jason Cooper
2013-01-01
Full Text Available As developers of the open source LORLS Resource/Reading List Management System we have developed a dashboard to better support academic staffs’ understanding of how their students use reading lists. This dashboard provides both graphical and tabulated information drawn from LORLS and the Aleph Integrated Library System. Development of the dashboard required changes to back-end functionality of LORLS such as logging views of reading lists and caching of loan data. Changes to the front end included the use of HTML5 canvas elements to generate pie charts and line graphs. Recently launched to academic staff at Loughborough University, the dashboard has already garnered much praise. It is hoped that further development of the dashboard will provide even more support for academics in the compilation of their reading lists.
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Chen, Chia-Ching; Yamada, Tetsuji; Nakashima, Taeko; Chiu, I-Ming
2017-01-01
The purposes of this study are: (1) to empirically identify decision-making preferences of long-term health-care use, especially informal and formal home care (FHC) service use; (2) to evaluate outcomes vs. costs based on substitutability of informal and FHC service use; and (3) to investigate health outcome disparity based on substitutability. The methods of ordinary least squares, a logit model, and a bivariate probit model are used by controlling for socioeconomic, demographic, and physical/mental health factors to investigate outcomes and costs based substitutability of informal and formal health-care use. The data come from the 2013 Japanese Study of Aging and Retirement (JSTAR), which is designed by Keizai-Sangyo Kenkyu-jo, Hitotsubashi University, and the University of Tokyo. The JSTAR is a globally comparable data survey of the elderly. There exists a complement relationship between the informal home care (IHC) and community-based FHC services, and the elasticity's ranges from 0.18 to 0.22. These are reasonable results, which show that unobservable factors are positively related to IHC and community-based FHC, but negatively related to nursing home (NH) services based on our bivariate probit model. Regarding health-care outcome efficiency issue, the IHC is the best one among three types of elderly care: IHC, community-based FHC, and NH services. Health improvement/outcome of elderly with the IHC is heavier concentrated on IHC services than the elderly care services by community-based FHC and NH care services. Policy makers need to address a diversity of health outcomes and efficiency of services based on providing services to elderly through resource allocation to the different types of long-term care. A provision of partial or full compensation for elderly care at home is recommendable and a viable option to improve their quality of lives.
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Directory of Open Access Journals (Sweden)
Chia-Ching Chen
2017-11-01
Full Text Available ObjectivesThe purposes of this study are: (1 to empirically identify decision-making preferences of long-term health-care use, especially informal and formal home care (FHC service use; (2 to evaluate outcomes vs. costs based on substitutability of informal and FHC service use; and (3 to investigate health outcome disparity based on substitutability.Methodology and dataThe methods of ordinary least squares, a logit model, and a bivariate probit model are used by controlling for socioeconomic, demographic, and physical/mental health factors to investigate outcomes and costs based substitutability of informal and formal health-care use. The data come from the 2013 Japanese Study of Aging and Retirement (JSTAR, which is designed by Keizai-Sangyo Kenkyu-jo, Hitotsubashi University, and the University of Tokyo. The JSTAR is a globally comparable data survey of the elderly.ResultsThere exists a complement relationship between the informal home care (IHC and community-based FHC services, and the elasticity’s ranges from 0.18 to 0.22. These are reasonable results, which show that unobservable factors are positively related to IHC and community-based FHC, but negatively related to nursing home (NH services based on our bivariate probit model. Regarding health-care outcome efficiency issue, the IHC is the best one among three types of elderly care: IHC, community-based FHC, and NH services. Health improvement/outcome of elderly with the IHC is heavier concentrated on IHC services than the elderly care services by community-based FHC and NH care services.ConclusionPolicy makers need to address a diversity of health outcomes and efficiency of services based on providing services to elderly through resource allocation to the different types of long-term care. A provision of partial or full compensation for elderly care at home is recommendable and a viable option to improve their quality of lives.
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Rethinking Educational Evaluation for Quality Educational Outcomes
African Journals Online (AJOL)
Rethinking Educational Evaluation for Quality Educational Outcomes. ... Educational Evaluation (EE) provides information for action by offering invaluable knowledge in terms of theoretical and practical ... AJOL African Journals Online.
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Does a ban on informal health providers save lives? Evidence from Malawi
Godlonton, Susan; Okeke, Edward N.
2015-01-01
Informal health providers ranging from drug vendors to traditional healers account for a large fraction of health care provision in developing countries. They are, however, largely unlicensed and unregulated leading to concern that they provide ineffective and, in some cases, even harmful care. A new and controversial policy tool that has been proposed to alter household health seeking behavior is an outright ban on these informal providers. The theoretical effects of such a ban are ambiguous. In this paper, we study the effect of a ban on informal (traditional) birth attendants imposed by the Malawi government in 2007. To measure the effect of the ban, we use a difference-in-difference strategy exploiting variation across time and space in the intensity of exposure to the ban. Our most conservative estimates suggest that the ban decreased use of traditional attendants by about 15 percentage points. Approximately three quarters of this decline can be attributed to an increase in use of the formal sector and the remainder is accounted for by an increase in relative/friend-attended births. Despite the rather large shift from the informal to the formal sector, we do not find any evidence of a statistically significant reduction in newborn mortality on average. The results are robust to a triple difference specification using young children as a control group. We examine several explanations for this result and find evidence consistent with quality of formal care acting as a constraint on improvements in newborn health. PMID:26681821
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Health care providers' use of a drug information service for pregnancy-related inquiries.
Patil, Avinash S; Patil, Neelima P; Lewis, Ashley N; Swamy, Geeta K; Murtha, Amy P
2014-01-01
To characterize pregnancy and lactation-related medication inquiries to a drug information center to identify classes of medications of most concern to providers. A secondary objective was to identify any trends in provider inquiries over the study period. A retrospective descriptive study of pregnancy and lactation-related inquiries to the University of North Carolina Health Care System Drug Information Center database between January 2001 and December 2010. University of North Carolina Health Care System Drug Information Center. Provider inquiries and responses were extracted and characterized by indication for treatment and reason for inquiry. Comparison of the first and second 5-year periods was performed to delineate trends. Descriptive statistics, Fisher's Exact and χ2 tests were used for analysis. Inquiry origin, time, and subject. 433 inquiries were retrieved over the study period from physicians (50%), pharmacists (21%), and nurses (18%). Inquiries were most often made during the antepartum period (34%), followed by the postpartum (28%) and preconception (22%) periods. The most frequent indications for inquiry were psychiatry (15%) and infectious diseases (14%), which remained constant throughout the study period. Safety was the most common reason for inquiry (52%). The responses provided to callers were limited due to lack of information availability 37% of the time. Psychiatry and infectious disease-related indications are the most frequent subjects of provider inquiry regarding medication use in pregnancy. Rates of inquiry remained constant throughout the past decade in most therapeutic areas. These findings are consistent with previous observations in other developed countries and suggest high-yield areas for pharmacist education.
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Ploeg, Jenny; Markle-Reid, Maureen; Valaitis, Ruta; McAiney, Carrie; Duggleby, Wendy; Bartholomew, Amy; Sherifali, Diana
2017-07-28
Most adults with chronic conditions live at home and rely on informal caregivers to provide support. Caregiving can result in negative impacts such as poor mental and physical health. eHealth interventions may offer effective and accessible ways to provide education and support to informal caregivers. However, we know little about the impact of Web-based interventions for informal caregivers of community-dwelling adults with chronic conditions. The purpose of this rapid evidence review was to assess the impact of Web-based interventions on mental health, general caregiving outcomes, and general health for informal caregivers of persons with chronic conditions living in the community. A rapid evidence review of the current literature was employed to address the study purpose. EMBASE, MEDLINE, PsychInfo, CINAHL, Cochrane, and Ageline were searched covering all studies published from January 1995 to July 2016. Papers were included if they (1) included a Web-based modality to deliver an intervention; (2) included informal, unpaid adult caregivers of community-living adults with a chronic condition; (3) were either a randomized controlled trial (RCT) or controlled clinical trial (CCT); and (4) reported on any caregiver outcome as a result of use or exposure to the intervention. A total of 20 papers (17 studies) were included in this review. Study findings were mixed with both statistically significant and nonsignificant findings on various caregiver outcomes. Of the 17 included studies, 10 had at least one significant outcome. The most commonly assessed outcome was mental health, which included depressive symptoms, stress or distress, and anxiety. Twelve papers examined the impact of interventions on the outcome of depressive symptoms; 4 found a significant decrease in depressive symptoms. Eight studies examined the outcome of stress or distress; 4 of these found a significant reduction in stress or distress as a result of the intervention. Three studies examined the
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Featherall, Joseph; Lapin, Brittany; Chaitoff, Alexander; Havele, Sonia A; Thompson, Nicolas; Katzan, Irene
2018-04-19
Consumer health information technology can improve patient engagement in their health care and assist in navigating the complexities of health care delivery. However, the consumer health information technology offerings of health systems are often driven by provider rather than patient perspectives and inadequately address patient needs, thus limiting their adoption by patients. Consideration given to patients as stakeholders in the development of such technologies may improve adoption, efficacy, and consumer health information technology resource allocation. The aims of this paper were to measure patient interest in different health system consumer health information technology apps and determine the influence of patient characteristics on consumer health information technology interest. Patients seen at the Cleveland Clinic Neurological Institute were electronically surveyed on their interest in using different consumer health information technology apps. A self-efficacy scale, Patient Health Questionnaire-9 depression screen, and EuroQol 5 dimensions health-related quality of life scale were also completed by patients. Logistic regression was used to determine the influence of patient characteristics on interest in consumer health information technology in the categories of self-management, education, and communication. The majority of 3852 patient respondents had an interest in all technology categories assessed in the survey. The highest interest was in apps that allow patients to ask questions of providers (3476/3852, 90.24%) and to schedule appointments (3211/3839, 83.64%). Patient interest in consumer health information technology was significantly associated with greater depression symptoms, worse quality of life, greater health self-efficacy, and smartphone ownership (Pinformation technology development and their perspectives should consistently guide development efforts. Health systems should consider focusing on consumer health information technologies
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Composite Indexes Economic and Social Performance: Do they Provide Valuable Information?
Directory of Open Access Journals (Sweden)
Nasierowski Wojciech
2016-01-01
Full Text Available This paper examines the information content of the selected composite indexes, namely the Global Competitiveness Report Index, the Human Development Index, the Knowledge Economy Index, the Innovation Union Scoreboard, and the like. These indexes are examined from the viewpoint of country rankings. It is argued that these indexes provide highly similar information, which brings to question the usefulness of such a variety of approaches. This paper also explores the drawbacks of composite indexes, and questions whether these indexes can adequately serve as policy-setting mechanisms.
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The Utility of Outcome Studies in Plastic Surgery
Directory of Open Access Journals (Sweden)
Hani Sinno, MD, MEng
2014-07-01
Full Text Available Summary: Outcome studies help provide the evidence-based science rationalizing treatment end results that factor the experience of patients and the impact on society. They improve the recognition of the shortcoming in clinical practice and provide the foundation for the development of gold standard care. With such evidence, health care practitioners can develop evidence-based justification for treatments and offer patients with superior informed consent for their treatment options. Furthermore, health care and insurance agencies can recognize improved cost-benefit options in the purpose of disease prevention and alleviation of its impact on the patient and society. Health care outcomes are ultimately measured by the treatment of disease, the reduction of symptoms, the normalization of laboratory results and physical measures, saving a life, and patient satisfaction. In this review, we outline the tools available to measure outcomes in plastic surgery and subsequently allow the objective measurements of plastic surgical conditions. Six major outcome categories are discussed: (1 functional measures; (2 preference-based measures and utility outcome scores; (3 patient satisfaction; (4 health outcomes and time; (5 other tools: patient-reported outcome measurement information system, BREAST-Q, and Tracking Operations and Outcomes for Plastic Surgeons; and (6 cost-effectiveness analysis. We use breast hypertrophy requiring breast reduction as an example throughout this review as a representative plastic surgical condition with multiple treatments available.
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2013-02-19
...] Draft Guidance for Industry and Food and Drug Administration Staff; Providing Information About... Guidance for Industry and Food and Drug Administration Staff: Providing Information About Pediatric Uses of...ComplianceRegulatoryInformation/default.htm . To receive ``Draft Guidance for Industry and Food and Drug...
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Geraghty, Estella M; Balsbaugh, Thomas; Nuovo, Jim; Tandon, Sanjeev
2010-01-01
Geographic information systems (GIS) tools can help expand our understanding of disparities in health outcomes within a community. The purpose of this project was (1) to demonstrate the methods to link a disease management registry with a GIS mapping and analysis program, (2) to address the challenges that occur when performing this link, and (3) to analyze the outcome disparities resulting from this assessment tool in a population of patients with type 2 diabetes mellitus. We used registry data derived from the University of California Davis Health System's electronic medical record system to identify patients with diabetes mellitus from a network of 13 primary care clinics in the greater Sacramento area. This information was converted to a database file for use in the GIS software. Geocoding was performed and after excluding those who had unknown home addresses we matched 8528 unique patient records with their respective home addresses. Socioeconomic and demographic data were obtained from the Geolytics, Inc. (East Brunswick, NJ), a provider of US Census Bureau data, with 2008 estimates and projections. Patient, socioeconomic, and demographic data were then joined to a single database. We conducted regression analysis assessing A1c level based on each patient's demographic and laboratory characteristics and their neighborhood characteristics (socioeconomic status [SES] quintile). Similar analysis was done for low-density lipoprotein cholesterol. After excluding ineligible patients, the data from 7288 patients were analyzed. The most notable findings were as follows: There was, there was found an association between neighborhood SES and A1c. SES was not associated with low-density lipoprotein control. GIS methodology can assist primary care physicians and provide guidance for disease management programs. It can also help health systems in their mission to improve the health of a community. Our analysis found that neighborhood SES was a barrier to optimal glucose
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Directory of Open Access Journals (Sweden)
Van Houtven Courtney
2011-11-01
Full Text Available Abstract Background Caregiver interventions may help improve the quality of informal care. Yet the lack of a systematic framework specifying the targets and outcomes of caregiver interventions hampers our ability to understand what has been studied, to evaluate existing programs, and to inform the design of future programs. Our goal was to develop an organizing framework detailing the components of the caregiving activities and the caregiver and care recipient outcomes that should be affected by an intervention. In so doing, we characterize what has been measured in the published literature to date and what should be measured in future studies to enable comparisons across interventions and across time. Methods Our data set comprises 121 reports of caregiver interventions conducted in the United States and published between 2000 and 2009. We extracted information on variables that have been examined as primary and secondary outcomes. These variables were grouped into categories, which then informed the organizing framework. We calculated the frequency with which the interventions examined each framework component to identify areas about which we have the most knowledge and under-studied areas that deserve attention in future research. Results The framework stipulates that caregiver interventions seek to change caregiving activities, which in turn affect caregiver and care recipient outcomes. The most frequently assessed variables have been caregiver psychological outcomes (especially depression and burden and care recipient physical and health care use outcomes. Conclusions Based on the organizing framework, we make three key recommendations to guide interventions and inform research and policy. First, all intervention studies should assess quality and/or quantity of caregiving activities to help understand to what extent and how well the intervention worked. Second, intervention studies should assess a broad range of caregiver and care recipient
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Characterizing Urban Air Quality to Provide Actionable Information
Lary, D. J.
2017-12-01
The urbanization of national and global populations is associated with increasing challenges to creation of sustainable and livable communities. In urban environments, there is currently a lack of accurate actionable information on atmospheric composition on fine spatial and temporal scales. There is a pressing need to better characterize the complex spatial distribution of environmental features of cityscapes and improve understanding of their relationship to health and quality of life. This talk gives an overview of integrating sensing of atmospheric composition on multiple scales using a wide range of devices from distributed low cost-sensors, to aerial vehicles, to satellites. Machine learning plays a key role in providing both the cross-calibration and turning the exposure dosimetry into actionable insights for urban environments.
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Scientific support, soil information and education provided by the Austrian Soil Science Society
Huber, Sigbert; Baumgarten, Andreas; Birli, Barbara; Englisch, Michael; Tulipan, Monika; Zechmeister-Boltenstern, Sophie
2015-04-01
The Austrian Soil Science Society (ASSS), founded in 1954, is a non-profit organisation aiming at furthering all branches of soil science in Austria. The ASSS provides information on the current state of soil research in Austria and abroad. It organizes annual conferences for scientists from soil and related sciences to exchange their recent studies and offers a journal for scientific publications. Annually, ASSS awards the Kubiena Research Prize for excellent scientific studies provided by young scientists. In order to conserve and improve soil science in the field, excursions are organized, also in cooperation with other scientific organisations. Due to well-established contacts with soil scientists and soil science societies in many countries, the ASSS is able to provide its members with information about the most recent developments in the field of soil science. This contributes to a broadening of the current scientific knowledge on soils. The ASSS also co-operates in the organisation of excursions and meetings with neighbouring countries. Several members of the ASSS teach soil science at various Austrian universities. More detail on said conferences, excursions, publications and awards will be given in the presentation. Beside its own scientific journal, published once or twice a year, and special editions such as guidebooks for soil classification, the ASSS runs a website providing information on the Society, its activities, meetings, publications, awards and projects. Together with the Environment Agency Austria the ASSS runs a soil platform on the internet. It is accessible for the public and thus informs society about soil issues. This platform offers a calendar with national and international soil events, contacts of soil related organisations and networks, information on national projects and publications. The society has access to products, information material and information on educational courses. Last but not least information on specific soil
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McCaffrey, Nikki; Agar, Meera; Harlum, Janeane; Karnon, Jonathon; Currow, David; Eckermann, Simon
2015-01-01
Introduction Comparing multiple, diverse outcomes with cost-effectiveness analysis (CEA) is important, yet challenging in areas like palliative care where domains are unamenable to integration with survival. Generic multi-attribute utility values exclude important domains and non-health outcomes, while partial analyses—where outcomes are considered separately, with their joint relationship under uncertainty ignored—lead to incorrect inference regarding preferred strategies. Objective The objective of this paper is to consider whether such decision making can be better informed with alternative presentation and summary measures, extending methods previously shown to have advantages in multiple strategy comparison. Methods Multiple outcomes CEA of a home-based palliative care model (PEACH) relative to usual care is undertaken in cost disutility (CDU) space and compared with analysis on the cost-effectiveness plane. Summary measures developed for comparing strategies across potential threshold values for multiple outcomes include: expected net loss (ENL) planes quantifying differences in expected net benefit; the ENL contour identifying preferred strategies minimising ENL and their expected value of perfect information; and cost-effectiveness acceptability planes showing probability of strategies minimising ENL. Results Conventional analysis suggests PEACH is cost-effective when the threshold value per additional day at home ( 1) exceeds $1,068 or dominated by usual care when only the proportion of home deaths is considered. In contrast, neither alternative dominate in CDU space where cost and outcomes are jointly considered, with the optimal strategy depending on threshold values. For example, PEACH minimises ENL when 1=$2,000 and 2=$2,000 (threshold value for dying at home), with a 51.6% chance of PEACH being cost-effective. Conclusion Comparison in CDU space and associated summary measures have distinct advantages to multiple domain comparisons, aiding
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Directory of Open Access Journals (Sweden)
Bender Ralf
2011-09-01
Full Text Available Abstract Background To assess the reporting of loss to follow-up (LTFU information in articles on randomised controlled trials (RCTs with time-to-event outcomes, and to assess whether discrepancies affect the validity of study results. Methods Literature survey of all issues of the BMJ, Lancet, JAMA, and New England Journal of Medicine published between 2003 and 2005. Eligible articles were reports of RCTs including at least one Kaplan-Meier plot. Articles were classified as "assessable" if sufficient information was available to assess LTFU. In these articles, LTFU information was derived from Kaplan-Meier plots, extracted from the text, and compared. Articles were then classified as "consistent" or "not consistent". Sensitivity analyses were performed to assess the validity of study results. Results 319 eligible articles were identified. 187 (59% were classified as "assessable", as they included sufficient information for evaluation; 140 of 319 (44% presented consistent LTFU information between the Kaplan-Meier plot and text. 47 of 319 (15% were classified as "not consistent". These 47 articles were included in sensitivity analyses. When various imputation methods were used, the results of a chi2-test applied to the corresponding 2 × 2 table changed and hence were not robust in about half of the studies. Conclusions Less than half of the articles on RCTs using Kaplan-Meier plots provide assessable and consistent LTFU information, thus questioning the validity of the results and conclusions of many studies presenting survival analyses. Authors should improve the presentation of both Kaplan-Meier plots and LTFU information, and reviewers of study publications and journal editors should critically appraise the validity of the information provided.
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Kruse, Clemens Scott; Beane, Amanda
2018-02-05
Health information technology (HIT) has been introduced into the health care industry since the 1960s when mainframes assisted with financial transactions, but questions remained about HIT's contribution to medical outcomes. Several systematic reviews since the 1990s have focused on this relationship. This review updates the literature. The purpose of this review was to analyze the current literature for the impact of HIT on medical outcomes. We hypothesized that there is a positive association between the adoption of HIT and medical outcomes. We queried the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDLINE) by PubMed databases for peer-reviewed publications in the last 5 years that defined an HIT intervention and an effect on medical outcomes in terms of efficiency or effectiveness. We structured the review from the Primary Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and we conducted the review in accordance with the Assessment for Multiple Systematic Reviews (AMSTAR). We narrowed our search from 3636 papers to 37 for final analysis. At least one improved medical outcome as a result of HIT adoption was identified in 81% (25/37) of research studies that met inclusion criteria, thus strongly supporting our hypothesis. No statistical difference in outcomes was identified as a result of HIT in 19% of included studies. Twelve categories of HIT and three categories of outcomes occurred 38 and 65 times, respectively. A strong majority of the literature shows positive effects of HIT on the effectiveness of medical outcomes, which positively supports efforts that prepare for stage 3 of meaningful use. This aligns with previous reviews in other time frames. ©Clemens Scott Kruse, Amanda Beane. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 05.02.2018.
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Browne, John; Jamieson, Liz; Lewsey, Jim; van der Meulen, Jan; Copley, Lynn; Black, Nick
2008-04-09
There has been considerable concern expressed about the outcomes achieved in Independent Sector Treatment Centres (ISTCs) introduced in England since 2003. Our aim was to compare the case-mix and patients' reported outcomes of surgery in ISTCs and in NHS providers. Prospective cohort study of 769 patients treated in six ISTCs and 1895 treated in 20 NHS providers (acute hospitals and treatment centres) in England during 2006-07. Participants underwent one of three day surgery procedures (inguinal hernia repair, varicose vein surgery, cataract extraction) or hip or knee replacement. Change in patient-reported health status and health related quality of life (measured using a disease-specific and a generic (EQ-5D) instrument) was assessed either 3-months (day surgery) or 6-months (hip/knee) after surgery. In addition patient-reported post-operative complications and an overall assessment of success of surgery were collected. Outcome measures were adjusted (using multivariable regression) for patient characteristics (disease severity, duration of symptoms, age, sex, socioeconomic status, general health, previous similar surgery, comorbidity). Post-operative response rates varied by procedure (73%-88%) and were similar for those treated in ISTCs and NHS facilities. Patients treated in ISTCs were healthier, were less likely to have any comorbidity and, for those undergoing cataract surgery or joint replacement, their primary condition was less severe. Those undergoing hernia repair or joint replacement were less likely to have had similar surgery before. When adjustment was made for pre-operative characteristics, patients undergoing cataract surgery or hip replacement in ISTCs achieved a slightly greater improvement in functional status and quality of life than those treated in NHS facilities, while the opposite was true of patients undergoing hernia repair. No significant differences were found for the two other procedures. Patients treated in ISTCs were less likely to
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The Utility of Social Media in Providing Information on Zika Virus.
Chandrasekaran, Neeraja; Gressick, Kimberly; Singh, Vivek; Kwal, Jaclyn; Cap, Natalia; Koru-Sengul, Tulay; Curry, Christine L
2017-10-23
Introduction In 2015, there was an outbreak of Zika virus in Brazil that spread throughout the Americas. The association of Zika virus with birth defects in infants born to infected pregnant women created concern for women of childbearing age. Social media is an important platform for health promotion, communication, and education on preventative methods during Zika virus outbreaks. Methods We evaluated the utility of social media on providing information regarding Zika virus. Facebook, Instagram, Twitter, and YouTube were utilized for our study. A search of the term "#Zikavirus" on Twitter and Instagram, and "Zika virus" on Facebook and YouTube was performed. The first 50 search results were analyzed from each source. Only English, Spanish, or Portuguese results were included. Results were categorized into three groups: "Useful", "Not Useful", or "Misleading". Results Search was conducted on December 17th, 2016, with 185 results. Forty (21.6%) were from Facebook, 50 (27%) from Twitter, 48 (25.9%) from YouTube, and 47 (25.4%) from Instagram. A total of 104 (56.22%) results were "Useful", 67 (36.2%) "Not Useful", and 14 (7.5%) were "Misleading". There were significantly more "Useful" results compared to "Not Useful" and "Misleading" results (Fisher's exact: p < 0.0001). Conclusion Social media is a useful resource for providing relevant information on Zika virus. Young women can utilize social media for Zika virus information. The role of social media in public health should be further investigated and established. Patient education interventions should focus on social media impact on behavior modification and education of public to recognize useful information.
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The Outcome and Assessment Information Set (OASIS): A Review of Validity and Reliability
O’CONNOR, MELISSA; DAVITT, JOAN K.
2015-01-01
The Outcome and Assessment Information Set (OASIS) is the patient-specific, standardized assessment used in Medicare home health care to plan care, determine reimbursement, and measure quality. Since its inception in 1999, there has been debate over the reliability and validity of the OASIS as a research tool and outcome measure. A systematic literature review of English-language articles identified 12 studies published in the last 10 years examining the validity and reliability of the OASIS. Empirical findings indicate the validity and reliability of the OASIS range from low to moderate but vary depending on the item studied. Limitations in the existing research include: nonrepresentative samples; inconsistencies in methods used, items tested, measurement, and statistical procedures; and the changes to the OASIS itself over time. The inconsistencies suggest that these results are tentative at best; additional research is needed to confirm the value of the OASIS for measuring patient outcomes, research, and quality improvement. PMID:23216513
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Kampen, D.A. van
2013-01-01
In this thesis we investigated the use of clinical information and Patient Reported Outcome Measures (PROMs) for patient evaluation in orthopaedic surgery and sports medicine. In the first part, we showed that the Dutch version of the Simple Shoulder Test (SST) is a valid and reliable
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Directory of Open Access Journals (Sweden)
Tsung-Hsien Yu
Full Text Available Equal access to healthcare facilities and high-level quality of care are important strategies to eliminate the disparity in outcome of care. However, the existing literature regarding how urban or rural dwelling patients with different income level select healthcare providers is insufficient. The purposes of this study were to examine whether differences of healthcare provider selection exist among urban and rural coronary artery bypass surgery (CABG patients with different income level. If so, we further investigated the associated impact on mortality.A retrospective, multilevel study design was conducted using claims data from 2007-2011 Taiwan's Universal Health Insurance Scheme. Healthcare providers' performance and patients' travelling distance to hospitals were used to define the patterns of healthcare provider selection. Baron and Kenny's procedures for mediation effect were conducted.There were 10,108 CABG surgeries included in this study. The results showed that urban dwelling and higher income patients were prone to receive care from better-performance providers. The travelling distances of urban dwelling patients was 15 KM shorter, especially when they received better-performance provider's care. The results also showed that the difference of healthcare provider selection and mortality rate existed between rural and urban dwelling patients with different income levels. After the procedure of mediation effect testing, the results showed that the healthcare provider selection partially mediated the relationships between patients' residential areas with different income levels and 30-day mortality.Preferences of healthcare provider selection vary among rural and urban patients with different income, and such differences partially mediated the outcome of care. Health authorities should pay attention to this issue, and propose appropriate solutions to eliminate the disparity in outcome of CABG care.
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Yu, Tsung-Hsien; Chung, Kuo-Piao; Wei, Chung-Jen; Chien, Kuo-Liong; Hou, Yu-Chang
2016-01-01
Equal access to healthcare facilities and high-level quality of care are important strategies to eliminate the disparity in outcome of care. However, the existing literature regarding how urban or rural dwelling patients with different income level select healthcare providers is insufficient. The purposes of this study were to examine whether differences of healthcare provider selection exist among urban and rural coronary artery bypass surgery (CABG) patients with different income level. If so, we further investigated the associated impact on mortality. A retrospective, multilevel study design was conducted using claims data from 2007-2011 Taiwan's Universal Health Insurance Scheme. Healthcare providers' performance and patients' travelling distance to hospitals were used to define the patterns of healthcare provider selection. Baron and Kenny's procedures for mediation effect were conducted. There were 10,108 CABG surgeries included in this study. The results showed that urban dwelling and higher income patients were prone to receive care from better-performance providers. The travelling distances of urban dwelling patients was 15 KM shorter, especially when they received better-performance provider's care. The results also showed that the difference of healthcare provider selection and mortality rate existed between rural and urban dwelling patients with different income levels. After the procedure of mediation effect testing, the results showed that the healthcare provider selection partially mediated the relationships between patients' residential areas with different income levels and 30-day mortality. Preferences of healthcare provider selection vary among rural and urban patients with different income, and such differences partially mediated the outcome of care. Health authorities should pay attention to this issue, and propose appropriate solutions to eliminate the disparity in outcome of CABG care.
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Buchanan, Robert; Radin, Dagmar; Chakravorty, Bonnie J; Tyry, Tuula
2010-01-01
About 30% of people with multiple sclerosis (MS) need some form of home care assistance, with 80% of that assistance provided by informal or unpaid care givers. This study focuses on the care givers to 530 more disabled people with MS, with the objective to learn more about informal care giving to people with greater dependency and need for assistance. The data presented in this study were collected in a national survey of 530 informal care givers to people with MS who have greater levels of physical dependency. About 70% of informal care givers responded that assisting the person with MS perform daily activities or personal care took up the largest amount of their care giving time. Care givers also reported a range of home and community-based services that would make care giving easier or improve the care provided. However, informal care givers generally reported low satisfaction with health insurance coverage of these services, especially coverage by health maintenance organizations and other managed care plans. Lack of health insurance coverage of needed home and community-based services can reduce the quality of informal care provided, as well as increase the burden of informal care giving.
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de Bock, Élodie; Hardouin, Jean-Benoit; Blanchin, Myriam; Le Neel, Tanguy; Kubis, Gildas; Sébille, Véronique
2015-01-01
The purpose of this study was to identify the most adequate strategy for group comparison of longitudinal patient-reported outcomes in the presence of possibly informative intermittent missing data. Models coming from classical test theory (CTT) and item response theory (IRT) were compared. Two groups of patients' responses to dichotomous items with three times of assessment were simulated. Different cases were considered: presence or absence of a group effect and/or a time effect, a total of 100 or 200 patients, 4 or 7 items and two different values for the correlation coefficient of the latent trait between two consecutive times (0.4 or 0.9). Cases including informative and non-informative intermittent missing data were compared at different rates (15, 30 %). These simulated data were analyzed with CTT using score and mixed model (SM) and with IRT using longitudinal Rasch mixed model (LRM). The type I error, the power and the bias of the group effect estimations were compared between the two methods. This study showed that LRM performs better than SM. When the rate of missing data rose to 30 %, estimations were biased with SM mainly for informative missing data. Otherwise, LRM and SM methods were comparable concerning biases. However, regardless of the rate of intermittent missing data, power of LRM was higher compared to power of SM. In conclusion, LRM should be favored when the rate of missing data is higher than 15 %. For other cases, SM and LRM provide similar results.
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Twenty years of providing information on nuclear power. The experience of EDF
International Nuclear Information System (INIS)
Durr, M.; Ansel, P.; Chaussade, J.P.; Haller, P.; Hezard, L.; Hue, L.
1995-01-01
In France, the anti-nuclear protest movement became a real problem after 1968, as new sites were sought. Initially, information on nuclear power involved communication by the entities responsible for building the plants. Once Government officials and politicians overcame their initial hesitation, their support, which underscores the continuity of France's energy policy, came to play a major role in the public acceptance of nuclear power. Electricite de France (EDF) then had to master the art of informing and communicating with the public. The change in the parliamentary majority in 1981 did not call into question the nuclear programme, and new plants were commissioned with relative ease. The situation changed dramatically with the Chernobyl disaster. It therefore became vital to establish an efficient structure for crisis communications, and transparency became crucial. The focus shifted from launching new plants to operating existing facilities and restoring public confidence. While not neglecting the general public, the emphasis was on certain strategic segments of the population, notably teachers and health care professionals. Advertising campaigns are today aimed at certain segments of the public, whose opinion could well shift in favour of nuclear power. Lastly, EDF, as power plant operator, has to realize the importance of providing information on nuclear waste. Starting from a strategic policy of informing politicians and senior decision makers, in 1974 EDF began to focus on providing information that would 'educate' the public. This information was issued via technicians who had no specific training in communications techniques. In addition to the need to explain and justify its projects, EDF had to adopt a policy of transparency, and to dispense with the esoteric language of specialists and their preference for secrecy. After Chernobyl, EDF's managers made communications with the 'outside world' an integral part of their jobs. Nuclear information became a
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Using health outcomes data to inform decision-making: formulary committee perspective.
Janknegt, R
2001-01-01
When healthcare resources are limited, decisions about the treatments to fund can be complex and difficult to make, involving the careful balancing of multiple factors. The decisions taken may have far-reaching consequences affecting many people. Clearly, decisions such as the choice of products on a formulary must be taken using a selection process that is fully transparent and that can be justified to all parties concerned. Although everyone would agree that drug selection should be a rational process that follows the guidelines of evidence-based medicine, many other factors may play a role in decision-making. Although some of these are explicit and rational, others are less clearly defined, and decision-makers may be unaware of the influence exerted by some of these factors. In order to facilitate transparent decision-making that makes rational use of health outcomes information, the System of Objectified Judgement Analysis (SOJA) has been developed by the author. SOJA includes interactive software that combines the quality advantages of the 'top-down' approach to drug selection, based on a thorough literature review, with the compliance advantages of a 'bottom-up' approach, where the final decision is made by the individual formulary committee and not by the authors of the review. The SOJA method, based on decision-making processes in economics, ensures that health outcomes information is given appropriate weight. Such approaches are valuable tools in discussions about product selection for formularies.
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International Nuclear Information System (INIS)
Fore, C.S.; Pfuderer, H.A.
1983-01-01
The Nevada Applied Ecology Information Center (NAEIC) was established in January 1972 to serve the needs of the Nevada Applied Ecology Group (NAEG) by identifying, collecting, analyzing, and disseminating technical information relevant to NAEG programs. Since its inception, the NAEIC has been active in providing specialized information support to NAEG staff in the following research areas: (1) environmental aspects of the transuranics; (2) historic literature (pre-1962) on plutonium and uranium; (3) cleanup and treatment of radioactively contaminated land; (4) bioenvironmental aspects of europium and rhodium; (5) NAEG contractor reports; and (6) uptake of radioactivity by food crops
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Sudhinaraset, May; Briegleb, Christina; Aung, Moe; Khin, Hnin Su Su; Aung, Tin
2015-02-06
Rapid diagnostic tests (RDTs) for malaria enable proper diagnosis and have been shown to reduce overuse of artemisinin combination therapy. Few studies have evaluated the feasibility and use of RDTs in the private sector in Myanmar. The objectives of the study were to: 1) understand the acceptability of using RDTs in the informal sector in Myanmar; 2) examine motivations for use among informal providers; and, 3) highlight decision-making and knowledge of providers for diagnostic testing and treatment. Qualitative interviews were conducted with 30 informal providers. Purposeful sampling was used to enrol study participants in the Mon and Shan State in Myanmar. All interviews were conducted in Burmese, translated into English, and two researchers coded all interviews using Atlas ti. Major themes identified included: 1) informal provider and outlet characteristics, including demographic and background characteristics; 2) the benefits and challenges of using RDTs according to providers; 3) provider experiences with using RDTs, including motivations for using the RDT; 4) adherence to test results, either positive or negative; and, 5) recommendations from informal providers to promote increased use of RDTs in their communities. This study found that introducing RDTs to informal providers in Myanmar was feasible, resulting in improved provider empowerment and patient-provider relationships. Specific challenges included facility infrastructure to use and dispose RDTs and provider knowledge. This varied across the type of informal provider, with itinerant drug vendors more comfortable and knowledgeable about RDTs compared to general retail sellers and medical drug representatives. This study found informal providers in Myanmar found the introduction of RDTs to be highly acceptable. Providers discussed improvement in service quality including provider empowerment and patient-provider relationships. The study also highlighted a number of challenges that informal providers
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Baker, David W; Hasnain-Wynia, Romana; Kandula, Namratha R; Thompson, Jason A; Brown, E Richard
2007-11-01
Experts recommend that health care providers (HCPs) collect patients' race/ethnicity and language, but we know little about public attitudes towards this. To determine attitudes towards HCPs collecting race/ethnicity and language data. A telephone survey was held with 563 Californians, including 105 whites, 97 blacks, 199 Hispanics (162 Spanish-speaking), 129 Asians (73 Chinese-speaking), and 33 multiracial individuals. Attitudes towards HCPs asking patients their race/ethnicity and preferred language, concerns about providing their own information, reactions to statements explaining the rationale for data collection, and attitudes towards possible policies. Most (87.8%) somewhat or strongly agreed that HCPs should collect race/ethnicity information and use this to monitor disparities, and 73.6% supported state legislation requiring this. Support for collection of patients' preferred language was even higher. However, 17.2% were uncomfortable (score 1-4 on 10-point scale) reporting their own race/ethnicity, and 46.3% of participants were somewhat or very worried that providing information could be used to discriminate against them. In addition, 35.9% of Hispanics were uncomfortable reporting their English proficiency. All statements explaining the rationale for data collection modestly increased participants' comfort level; the statement that this would be used for staff training increased comfort the most. Although most surveyed believe that HCPs should collect information about race/ethnicity and language, many feel uncomfortable giving this information and worry it could be misused. Statements explaining the rationale for collecting data may assuage concerns, but community engagement and legislation to prevent misuse may be needed to gain more widespread trust and comfort.
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Snyder, Claire F.; Jensen, Roxanne E.; Segal, Jodi B.; Wu, Albert W.
2013-01-01
Patient-centered outcomes research (PCOR) aims to improve care quality and patient outcomes by providing information that patients, clinicians, and family members need regarding treatment alternatives, and emphasizing patient input to inform the research process. PCOR capitalizes on available data sources and generates new evidence to provide timely and relevant information and can be conducted using prospective data collection, disease registries, electronic medical records, aggregated results from prior research, and administrative claims. Given PCOR’s emphasis on the patient perspective, methods to incorporate patient-reported outcomes (PROs) are critical. PROs are defined by the U.S. Food & Drug Administration as “Any report coming directly from patients… about a health condition and its treatment.” However, PROs have not routinely been collected in a way that facilitates their use in PCOR. Electronic medical records, disease registries, and administrative data have only rarely collected, or been linked to, PROs. Recent technological developments facilitate the electronic collection of PROs and linkage of PRO data, offering new opportunities for putting the patient perspective in PCOR. This paper describes the importance of and methods for using PROs for PCOR. We (1) define PROs; (2) identify how PROs can be used in PCOR, and the critical role of electronic data methods for facilitating the use of PRO data in PCOR; (3) outline the challenges and key unanswered questions that need to be addressed for the routine use of PROs in PCOR; and (4) discuss policy and research interventions to accelerate the integration of PROs with clinical data. PMID:23774513
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The Persistence of Informality: Small-Scale Water Providers in Manila’s Post-Privatisation Era
Directory of Open Access Journals (Sweden)
Deborah Cheng
2014-02-01
Full Text Available This article troubles the notion of a formal-informal dichotomy in urban water provision. Whereas expansion of a water utility typically involves the replacement of informal providers, the experience in Manila demonstrates that the rapid connection of low-income areas actually hinges, in part, on the selective inclusion and exclusion of these smaller actors. In this sense, privatisation has not eliminated small-scale water provision, but has led to the reconfiguration of its usage, blurring the boundaries between formal and informal. By examining the spatial and temporal evolution of small-scale water provision in Manila’s post-privatisation era, I show how certain spaces are seen as less serviceable than others. Critically, small providers working in partnership with the utilities are sanctioned because they supplement the utilities’ operations. The areas in which they work are considered served, factoring into aggregate coverage statistics, even though their terms of service are often less desirable than those of households directly connected to the utilities. In contrast, small providers that operate outside of the utilities’ zones of coverage are considered inferior, to be replaced. The result is a differentiation in informality – one in which the private utilities largely determine modes of access and thus the spatialisation of informal water provision.
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Kumar, Manish; Mostafa, Javed; Ramaswamy, Rohit
2018-05-01
Health information systems (HIS) in India, as in most other developing countries, support public health management but fail to enable healthcare providers to use data for delivering quality services. Such a failure is surprising, given that the population healthcare data that the system collects are aggregated from patient records. An important reason for this failure is that the health information architecture (HIA) of the HIS is designed primarily to serve the information needs of policymakers and program managers. India has recognised the architectural gaps in its HIS and proposes to develop an integrated HIA. An enabling HIA that attempts to balance the autonomy of local systems with the requirements of a centralised monitoring agency could meet the diverse information needs of various stakeholders. Given the lack of in-country knowledge and experience in designing such an HIA, this case study was undertaken to analyse HIS in the Bihar state of India and to understand whether it would enable healthcare providers, program managers and policymakers to use data for decision-making. Based on a literature review and data collected from interviews with key informants, this article proposes a federated HIA, which has the potential to improve HIS efficiency; provide flexibility for local innovation; cater to the diverse information needs of healthcare providers, program managers and policymakers; and encourage data-based decision-making.
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Krejci, Katherine T.
2010-01-01
The purpose of this qualitative descriptive study was to describe the learning outcomes of the cooperative-education experience from an Information Technology student's perspective at a large Fortune 500 manufacturing/sales company located in the Midwest United States. Open-ended interview questions were developed based on the four-component model…
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Nuttall, David; Parkin, David; Devlin, Nancy
2015-01-01
This paper describes the development of a methodology for the case-mix adjustment of patient-reported outcome measures (PROMs) data permitting the comparison of outcomes between providers on a like-for-like basis. Statistical models that take account of provider-specific effects form the basis of the proposed case-mix adjustment methodology. Indirect standardisation provides a transparent means of case mix adjusting the PROMs data, which are updated on a monthly basis. Recently published PROMs data for patients undergoing unilateral knee replacement are used to estimate empirical models and to demonstrate the application of the proposed case-mix adjustment methodology in practice. The results are illustrative and are used to highlight a number of theoretical and empirical issues that warrant further exploration. For example, because of differences between PROMs instruments, case-mix adjustment methodologies may require instrument-specific approaches. A number of key assumptions are made in estimating the empirical models, which could be open to challenge. The covariates of post-operative health status could be expanded, and alternative econometric methods could be employed. © 2013 Crown copyright.
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Ethical principles of informed consent: exploring nurses' dual role of care provider and researcher.
Judkins-Cohn, Tanya M; Kielwasser-Withrow, Kiersten; Owen, Melissa; Ward, Jessica
2014-01-01
This article describes the ethical principles of autonomy, beneficence, and justice within the nurse researcher-participant relationship as these principles relate to the informed consent process for research. Within this process, the nurse is confronted with a dual role. This article describes how nurses, who are in the dual role of care provider and researcher, can apply these ethical principles to their practice in conjunction with the American Nurses Association's code of ethics for nurses. This article also describes, as an element of ethical practice, the importance of using participant-centered quality measures to aid informed decision making of participants in research. In addition, the article provides strategies for improving the informed consent process in nursing research. Finally, case scenarios are discussed, along with the application of ethical principles within the awareness of the dual role of the nurse as care provider and researcher. Copyright 2014, SLACK Incorporated.
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Community-acquired pneumonia management and outcomes in the era of health information technology.
Mecham, Ian D; Vines, Caroline; Dean, Nathan C
2017-11-01
Pneumonia continues to be a leading cause of hospitalization and mortality. Implementation of health information technology (HIT) can lead to cost savings and improved care. In this review, we examine the literature on the use of HIT in the management of community-acquired pneumonia. We also discuss barriers to adoption of technology in managing pneumonia, the reliability and quality of electronic health data in pneumonia research, how technology has assisted pneumonia diagnosis and outcomes research. The goal of using HIT is to develop and deploy generalizable, real-time, computerized clinical decision support integrated into usual pneumonia care. A friendly user interface that does not disrupt efficiency and demonstrates improved clinical outcomes should result in widespread adoption. © 2017 Asian Pacific Society of Respirology.
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Nishikawa, Mariko; Yamanaka, Masaaki; Kiriya, Junko; Jimba, Masamine
2018-05-21
Over 24 million international visitors came to Japan in 2016 and the number is expected to increase. Visitors could be at a risk of illness or injury that may result in hospitalization in Japan. We assessed the effects of a four-minute digital animation titled Mari Info Japan on the level of anxiety experienced by international visitors to Japan. We conducted a non-randomized, controlled study at Narita International Airport outside Tokyo in December 2014. On the first day, we recruited international visitors for the intervention group at predetermined departure gates and, the following day, we sampled visitors for the control group at the same gates. We repeated this procedure twice over 4 days. The intervention group watched the digital animation and the control group read a standard travel guidebook in English. After receiving either intervention, they completed a questionnaire on their level of anxiety. The outcome was assessed using the Mari Meter-X, The State-Trait Anxiety Inventory Form Y (STAI-Y), and a face scale, before and immediately after the intervention. We analyzed data with Wilcoxon rank sum tests. We recruited 265 international visitors (134 in the intervention group, 131 in the control group), 241 (91%) of whom completed the questionnaire. Most of them had no previous Japanese health information before arrival in Japan. The level of anxiety about health services in Japan was significantly reduced in the intervention group (Mari Meter-X median: - 5 and 0, p animation is more effective in reducing anxiety among international visitors to Japan compared with reading a standard brochure or guidebook. Such effective animations of health information should be more widely distributed to international visitors. UMIN-CTR (University Hospital Medical Information Network Center Clinical Trials Registry), UMIN000015023 , September 3, 2014.
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Directory of Open Access Journals (Sweden)
Oshikoya KA
2009-06-01
manufacturer on both the container and pack of the drug} were mentioned in 65.6% and 50% adverts, respectively. The product and package descriptions were provided in 57 (72.2% Nigerian medical journals, which was significantly higher than in other African medical journals 39 (37.9% (P<0.001.Conclusions: None of the drug advertisements in the journals adequately provided the basic information required by the WHO for appropriate prescribing. More guidance and regulation is needed to ensure adequate information is provided.
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Directory of Open Access Journals (Sweden)
van der Meulen Jan
2008-04-01
Full Text Available Abstract Background There has been considerable concern expressed about the outcomes achieved in Independent Sector Treatment Centres (ISTCs introduced in England since 2003. Our aim was to compare the case-mix and patients' reported outcomes of surgery in ISTCs and in NHS providers. Methods Prospective cohort study of 769 patients treated in six ISTCs and 1895 treated in 20 NHS providers (acute hospitals and treatment centres in England during 2006–07. Participants underwent one of three day surgery procedures (inguinal hernia repair, varicose vein surgery, cataract extraction or hip or knee replacement. Change in patient-reported health status and health related quality of life (measured using a disease-specific and a generic (EQ-5D instrument was assessed either 3-months (day surgery or 6-months (hip/knee after surgery. In addition patient-reported post-operative complications and an overall assessment of success of surgery were collected. Outcome measures were adjusted (using multivariable regression for patient characteristics (disease severity, duration of symptoms, age, sex, socioeconomic status, general health, previous similar surgery, comorbidity. Results Post-operative response rates varied by procedure (73%–88% and were similar for those treated in ISTCs and NHS facilities. Patients treated in ISTCs were healthier, were less likely to have any comorbidity and, for those undergoing cataract surgery or joint replacement, their primary condition was less severe. Those undergoing hernia repair or joint replacement were less likely to have had similar surgery before. When adjustment was made for pre-operative characteristics, patients undergoing cataract surgery or hip replacement in ISTCs achieved a slightly greater improvement in functional status and quality of life than those treated in NHS facilities, while the opposite was true of patients undergoing hernia repair. No significant differences were found for the two other
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The application of volume-outcome contouring in data warehousing.
Studnicki, James; Berndt, Donald J; Luther, Stephen L; Fisher, John W
2004-01-01
Despite a compelling body of published research on the nature of provider volume and clinical outcomes, healthcare executives and policymakers have not managed to develop and implement systems that are useful in directing patients to higher volume providers via selective referral or avoidance. A specialized data warehouse application, utilizing hospital discharge data linked to physician biographical information, allows detailed analysis of physician and hospital volume and the resulting pattern (contour) of related outcomes such as mortality, complications, and medical errors. The approach utilizes a historical repository of hospital discharge data in which the outcomes of interest, important patient characteristics and risk factors used in severity-adjusting of the outcomes are derived from the coding structure of the data.
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Trevena, L.J.; Zikmund-Fisher, B.J.; Edwards, A.; Gaissmaier, W.; Galesic, M.; Han, P.K.J.; King, J.; Lawson, M.L.; Linder, S.K.; Lipkus, I.; Ozanne, E.; Peters, E.; Timmermans, D.R.M.; Woloshin, S.
2013-01-01
Background: Making evidence-based decisions often requires comparison of two or more options. Research-based evidence may exist which quantifies how likely the outcomes are for each option. Understanding these numeric estimates improves patients' risk perception and leads to better informed decision
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Sushko, O. P.; Kaznin, A. A.; Babkin, A. V.; Bogdanov, D. A.
2017-10-01
The study we are conducting involves the analysis of information security levels achieved by energy providers operating in the North Arctic Region. We look into whether the energy providers’ current information security levels meet reliability standards and determine what further actions may be needed for upgrading information security in the context of the digital transformation that the world community is undergoing. When developing the information security systems for electric energy providers or selecting the protection means for them, we are governed by the fact that the assets to be protected are process technologies. While information security risk can be assessed using different methods, the evaluation of the economic damage from these risks appears to be a difficult task. The most probable and harmful risks we have identified when evaluating the electric energy providers’ information security will be used by us as variables. To provide the evaluation, it is necessary to calculate the costs relating to elimination of the risks identified. The final stage of the study will involve the development of an operation algorithm for the North Arctic Region’s energy provider’s business information protection security system - a set of information security services, and security software and hardware.
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Van Houtven, Courtney Harold; Voils, Corrine I; Weinberger, Morris
2011-01-01
Abstract Background Caregiver interventions may help improve the quality of informal care. Yet the lack of a systematic framework specifying the targets and outcomes of caregiver interventions hampers our ability to understand what has been studied, to evaluate existing programs, and to inform the design of future programs. Our goal was to develop an organizing framework detailing the components of the caregiving activities and the caregiver and care recipient outcomes that should be affected...
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Kyndt, Eva; Vermeire, Eva; Cabus, Shana
2016-01-01
Purpose: This paper aims to examine which organisational learning conditions and individual characteristics predict the learning outcomes nurses achieve through informal learning activities. There is specific relevance for the nursing profession because of the rapidly changing healthcare systems. Design/Methodology/Approach: In total, 203 nurses…
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Clearly written, easily comprehended? The readability of websites providing information on epilepsy.
Brigo, Francesco; Otte, Willem M; Igwe, Stanley C; Tezzon, Frediano; Nardone, Raffaele
2015-03-01
There is a general need for high-quality, easily accessible, and comprehensive health-care information on epilepsy to better inform the general population about this highly stigmatized neurological disorder. The aim of this study was to evaluate the health literacy level of eight popular English-written websites that provide information on epilepsy in quantitative terms of readability. Educational epilepsy material on these websites, including 41 Wikipedia articles, were analyzed for their overall level of readability and the corresponding academic grade level needed to comprehend the published texts on the first reading. The Flesch Reading Ease (FRE) was used to assess ease of comprehension while the Gunning Fog Index, Coleman-Liau Index, Flesch-Kincaid Grade Level, Automated Readability Index, and Simple Measure of Gobbledygook scales estimated the corresponding academic grade level needed for comprehension. The average readability of websites yielded results indicative of a difficult-to-fairly-difficult readability level (FRE results: 44.0±8.2), with text readability corresponding to an 11th academic grade level (11.3±1.9). The average FRE score of the Wikipedia articles was indicative of a difficult readability level (25.6±9.5), with the other readability scales yielding results corresponding to a 14th grade level (14.3±1.7). Popular websites providing information on epilepsy, including Wikipedia, often demonstrate a low level of readability. This can be ameliorated by increasing access to clear and concise online information on epilepsy and health in general. Short "basic" summaries targeted to patients and nonmedical users should be added to articles published in specialist websites and Wikipedia to ease readability. Copyright © 2014 Elsevier Inc. All rights reserved.
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Measuring HIV-related stigma among healthcare providers: a systematic review.
Alexandra Marshall, S; Brewington, Krista M; Kathryn Allison, M; Haynes, Tiffany F; Zaller, Nickolas D
2017-11-01
In the United States, HIV-related stigma in the healthcare setting is known to affect the utilization of prevention and treatment services. Multiple HIV/AIDS stigma scales have been developed to assess the attitudes and behaviors of the general population in the U.S. towards people living with HIV/AIDS, but fewer scales have been developed to assess HIV-related stigma among healthcare providers. This systematic review aimed to identify and evaluate the measurement tools used to assess HIV stigma among healthcare providers in the U.S. The five studies selected quantitatively assessed the perceived HIV stigma among healthcare providers from the patient or provider perspective, included HIV stigma as a primary outcome, and were conducted in the U.S. These five studies used adapted forms of four HIV stigma scales. No standardized measure was identified. Assessment of HIV stigma among providers is valuable to better understand how this phenomenon may impact health outcomes and to inform interventions aiming to improve healthcare delivery and utilization.
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An evaluation of dental information sessions provided to childcare educators in NSW in 2010-2011.
Noller, Jennifer M
2013-12-01
Childcare services provide ideal settings to promote good oral health and help reduce tooth decay in young children. This paper reports the results of an evaluation of the dental information session component of the NSW Little Smiles Program provided by public oral health service professionals to childcare educators in NSW in 2010-2011. The evaluation sought to determine if a face-to-face information session provided to childcare educators by oral health professionals: (i) can improve the confidence of childcare educators to reach national quality standards that relate to oral health; and (ii) is an appropriate model to use. In 2010-2011, 163 dental information sessions were provided to 1716 participants from over 526 childcare centres across NSW. Results showed that a dental information session can improve the confidence of childcare educators to assist their service to reach the required national quality standards for oral hygiene and diet-related oral health issues. Further evaluation is required to determine if oral health can be embedded in the daily practice of childcare services and other options need to be explored to deliver the sessions in a more cost-effective way.
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Quan-Hoang, Vuong
2016-10-01
Patients have to acquire information to support their decision on choosing a suitable healthcare provider. But in developing countries like Vietnam, accessibility issues remain an obstacle, thus adversely affect both quality and costliness of healthcare information. Vietnamese use both sources from health professionals and friends/relatives, especially when quality of the Internet-based cheaper sources appear to be still questionable. The search of information from both professionals and friends/relatives incurs some cost, which can be viewed as low or high depending low or high accessibility to the sources. These views potentially affect their choices. To investigate the effects that medical/health services information on perceived expensiveness of patients' labor costs. Two related objectives are a) establishing empirical relations between accessibility to sources and expensiveness; and, b) probabilistic trends of probabilities for perceived expensiveness. There is evidence for established relations among the variables "Convexp" and "Convrel" (all p's perceived expensiveness. a) Probabilistic trends show Vietnamese patients have propensity to value healthcare information highly and do not see it as "expensive"; b) The majority of Vietnamese households still take non-professional advices at their own risks; c) There is more for the public healthcare information system to do to reduce costliness and risk of information. The Internet-based health service users communities cannot replace this system.
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The Effect of Peer Review on Information Literacy Outcomes in a Chemical Literature Course
Zwicky, David A.; Hands, Michael D.
2016-01-01
This article describes the use of peer review in a writing project involving upper-level chemistry students in a chemical literature course, with the goal of improving student performance in meeting information literacy outcomes. Students were asked to find articles on a topic of their choice over the course of a semester and assemble the results…
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Is Perceived Expressivity of Game Players a Cue to Game Outcome Prediction Accuracy?
Mui, H.C.; Goudbeek, M.B.; Swerts, M.G.J.
Games can be won or lost, and the outcome of the game often determines our facial expression. Thus, game players’ facial expression possibly provides information about the game outcome. The connection between such nonverbal cues and accuracy at which game outcome could be deduced is investigated in
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Data governance for health care providers.
Andronis, Katerina; Moysey, Kevin
2013-01-01
Data governance is characterised from broader definitions of governance. These characteristics are then mapped to a framework that provides a practical representation of the concepts. This representation is further developed with operating models and roles. Several information related scenarios covering both clinical and non-clinical domains are considered in information terms and then related back to the data governance framework. This assists the reader in understanding how data governance would help address the issues or achieve a better outcome. These elements together enable the reader to gain an understanding of the data governance framework and how it applies in practice. Finally, some practical advice is offered for establishing and operating data governance as well as approaches for justifying the investment.
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Beehler, Gregory P; Lilienthal, Kaitlin R; Possemato, Kyle; Johnson, Emily M; King, Paul R; Shepardson, Robyn L; Vair, Christina L; Reyner, Jacqueline; Funderburk, Jennifer S; Maisto, Stephen A; Wray, Laura O
2017-09-01
Primary care behavioral health (PCBH) is a population-based approach to delivering mental and behavioral health care in the primary care setting. Implementation of the PCBH model varies across practice settings, which can impact how PCBH providers deliver services to patients and in turn may predict a variety of important outcomes. This article aims to characterize PCBH provider engagement in key processes of integrated care as demonstrated in results from empirical studies of real-world clinical practice. For this narrative review of published studies on PCBH provider engagement in processes of care, PubMed and PsycINFO databases were searched from January 1990 through May 2016 to identify relevant articles. Provider adherence to the brief, time-limited treatment model appears suboptimal. Common mental health conditions, such as depression, were often the primary focus of provider attention, with less consistent emphasis on behavioral medicine concerns. Whereas providers regularly conducted qualitative functional assessments with patients, routine use of standardized measures was low. Engagement in interprofessional collaboration with the primary care team was also low, but engagement in behaviors that fostered therapeutic relationships was high. This review identified several strengths and weaknesses of typical PCBH provider practices. Results are discussed in relation to their value as areas for future quality improvement initiatives that can improve PCBH service delivery and, ultimately, patient outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
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Tomamichel, M; Sessa, C; Herzig, S; de Jong, J; Pagani, O; Willems, Y; Cavalli, F
1995-04-01
the patients. In 71% of the consultations the three dimensions of information scored more than 3 and balanced one another, indicating a successful consultation by the Meerwein model. The informed consent procedure applied was satisfactory from a quantitative point of view, and the main items of information were acceptable to the patients. Meerweins's model proved to be applicable and useful for identifying pitfalls in communication. Greater attention should be paid to the indirect messages and implied criticisms of the patients to improve their participation in decision making. Physicians should become more skillful in providing adequate information and improve their methods of communication.
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Pande, Sami; Hiller, Janet E; Nkansah, Nancy; Bero, Lisa
2013-02-28
The role of pharmacists has expanded beyond dispensing and packaging over the past two decades, and now includes ensuring rational use of drugs, improving clinical outcomes and promoting health status by working with the public and other healthcare professionals. To examine the effect of pharmacist-provided non-dispensing services on patient outcomes, health service utilisation and costs in low- and middle-income countries. Studies were identified by electronically searching the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (February 2010), MEDLINE (1949 to February 2010), Scopus (1960 to March 2010) and International Pharmaceutical Abstracts (1970 to January 2010) databases. An update of this review is currently ongoing. The search was re-run September 2012 and the potentially relevant studies are awaiting classification. Randomised controlled trials, non-randomised controlled trials, controlled before-after studies and interrupted time series analyses comparing 1. pharmacist-provided non-dispensing services targeted at patients versus (a) the same services provided by other healthcare professionals, (b) the same services provided by untrained health workers, and (c) usual care; and 2. pharmacist-provided non-dispensing services targeted at healthcare professionals versus (a) the same services provided by other healthcare professionals, (b) the same services provided by untrained health workers, and (c) usual care in low- and middle-income countries. The research sites must have been located in low or middle income countries according to World Bank Group 2009 at the time of the study, regardless of the location or the origin of the researchers. Two authors independently reviewed studies for inclusion in the review. Two review authors independently extracted data for each study. Risk of bias of the included studies was also assessed independently by two authors. Twelve studies comparing pharmacist-provided services versus usual
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Kyriakos, Margaret Helen Gallo
2009-01-01
This study compares the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) Board of Commissioner and Panel of Accreditation Reviewer understanding of what constitutes student learning outcomes and an effective program evaluation plan with that of campus-based health information technology (HIT) program…
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Pillemer, Karl; Meador, Rhoda H; Teresi, Jeanne A; Chen, Emily K; Henderson, Charles R; Lachs, Mark S; Boratgis, Gabriel; Silver, Stephanie; Eimicke, Joseph P
2012-02-01
To examine the effects of electronic health information technology (HIT) on nursing home residents. The study evaluated the impact of implementing a comprehensive HIT system on resident clinical, functional, and quality of care outcome indicators as well as measures of resident awareness of and satisfaction with the technology. The study used a prospective, quasi-experimental design, directly assessing 761 nursing home residents in 10 urban and suburban nursing homes in the greater New York City area. No statistically significant impact of the introduction of HIT on residents was found on any outcomes, with the exception of a significant negative effect on behavioral symptoms. Residents' subjective assessment of the HIT intervention were generally positive. The absence of effects on most indicators is encouraging for the future development of HIT in nursing homes. The single negative finding suggests that further investigation is needed on possible impact on resident behavior. © The Author(s) 2012
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Fujiwara, Hiroyuki; Shimoda, Akihiro; Ishikawa, Yoshiki; Taneichi, Akiyo; Ohashi, Mai; Takahashi, Yoshifumi; Koyanagi, Takahiro; Morisawa, Hiroyuki; Takahashi, Suzuyo; Sato, Naoto; Machida, Shizuo; Takei, Yuji; Saga, Yasushi; Suzuki, Mitsuaki
2015-01-01
In Japan, the cervical cancer screening rate is extremely low. Towards improving the cervical cancer screening rate, encouraging eligible people to make an informed choice, which is a decision-making process that relies on beliefs informed by adequate information about the possible benefits and risks of screening, has attracted increased attention in the public health domain. However, there is concern that providing information on possible risks of screening might prevent deter from participating. In total, 1,912 women aged 20-39 years who had not participated in screening in the fiscal year were selected from a Japanese urban community setting. Participants were randomly divided into 3 groups. Group A received a printed reminder with information about the possible benefits of screening, group B received a printed reminder with information about possible benefits and risks, and group C received a printed reminder with simple information only (control group). Out of 1,912 participants, 169 (8.8%) participated in cervical cancer screening. In the intervention groups, 137 (10.9%) participated in cervical cancer screening, compared to only 32 (4.9%) of the control group (p < 0.001). In addition, logistic regression analysis revealed that there was no significant difference in screening rate between group A and group B (p = 0.372). Providing information on the possible risks of screening may not prevent people from taking part in cervical cancer screening among a Japanese non-adherent population.
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Friedman, Lee; Harvey, Robert J.
1986-01-01
Job-naive raters provided with job descriptive information made Position Analysis Questionnaire (PAQ) ratings which were validated against ratings of job analysts who were also job content experts. None of the reduced job descriptive information conditions enabled job-naive raters to obtain either acceptable levels of convergent validity with…
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Amoakoh-Coleman, M.
2016-01-01
Ghana’s slow progress towards attaining millennium development goal 5 has been associated with gaps in quality of care, particularly quality of clinical decision making for clients. This thesis reviews the relevance and effect of clinical decision making support tools on pregnancy outcomes. Relevance of three clinical decision making support tools available to frontline providers of care in the Greater Accra region is discussed. These are routine maternal health service delivery data populati...
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Ritchie, A; Sowter, B
2000-01-01
This article reports on the results of an exploratory survey of the availability and accessibility of evidence-based information resources provided by medical libraries in Australia. Although barriers impede access to evidence-based information for hospital clinicians, the survey revealed that Medline and Cinahl are available in over 90% of facilities. In most cases they are widely accessible via internal networks and the Internet. The Cochrane Library is available in 69% of cases. The Internet is widely accessible and most libraries provide access to some full-text, electronic journals. Strategies for overcoming restrictions and integrating information resources with clinical workflow are being pursued. State, regional and national public and private consortia are developing agreements utilising on-line technology. These could produce cost savings and more equitable access to a greater range of evidence-based resources.
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Medicare Provider Data - Hospice Providers
U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...
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Garoufallou, Emmanouel; Balatsoukas, Panos; Siatri, Rania; Zafeiriou, Georgia; Asderi, S.; Ekizoglou; P.
2008-01-01
The increased popularity of Google search engine in the daily routine in one's workplace and in the academic information seeking process is undeniable. "Googling" challenges the traditional skills of librarians as information providers and the role of library and information service provision in the digital era. This paper reports on the…
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Rayess, Hani; Zuliani, Giancarlo F; Gupta, Amar; Svider, Peter F; Folbe, Adam J; Eloy, Jean Anderson; Carron, Michael A
2017-03-01
grade 11 and grade 10, respectively, significantly higher than the grade 7 level recommended by the National Institutes of Health. Assessment of technical criteria demonstrated room for improvement in providing links to social media and blogs and reducing advertisements. Improving the quality and readability of online information may result in increased patient understanding, more active patient involvement, and ultimately better outcomes. Enhancing the technical aspects of websites may increase website traffic and patient volume. NA.
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Do Dogs Provide Information Helpfully?
Directory of Open Access Journals (Sweden)
Patrizia Piotti
Full Text Available Dogs are particularly skilful during communicative interactions with humans. Dogs' abilities to use human communicative cues in cooperative contexts outcompete those of other species, and might be the result of selection pressures during domestication. Dogs also produce signals to direct the attention of humans towards outside entities, a behaviour often referred to as showing behaviour. This showing behaviour in dogs is thought to be something dogs use intentionally and referentially. However, there is currently no evidence that dogs communicate helpfully, i.e. to inform an ignorant human about a target that is of interest to the human but not to the dog. Communicating with a helpful motive is particularly interesting because it might suggest that dogs understand the human's goals and need for information. In study 1, we assessed whether dogs would abandon an object that they find interesting in favour of an object useful for their human partner, a random novel distractor, or an empty container. Results showed that it was mainly self-interest that was driving the dogs' behaviour. The dogs mainly directed their behaviour towards the object they had an interest in, but dogs were more persistent when showing the object relevant to the human, suggesting that to some extent they took the humans interest into account. Another possibility is that dogs' behaviour was driven by an egocentric motivation to interact with novel targets and that the dogs' neophila might have masked their helpful tendencies. Therefore, in study 2 the dogs had initial access to both objects, and were expected to indicate only one (relevant or distractor. The human partner interacted with the dog using vocal communication in half of the trials, and remaining silent in the other half. Dogs from both experimental groups, i.e. indicating the relevant object or indicating the distractor, established joint attention with the human. However, the human's vocal communication and the
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Do Dogs Provide Information Helpfully?
Piotti, Patrizia; Kaminski, Juliane
2016-01-01
Dogs are particularly skilful during communicative interactions with humans. Dogs' abilities to use human communicative cues in cooperative contexts outcompete those of other species, and might be the result of selection pressures during domestication. Dogs also produce signals to direct the attention of humans towards outside entities, a behaviour often referred to as showing behaviour. This showing behaviour in dogs is thought to be something dogs use intentionally and referentially. However, there is currently no evidence that dogs communicate helpfully, i.e. to inform an ignorant human about a target that is of interest to the human but not to the dog. Communicating with a helpful motive is particularly interesting because it might suggest that dogs understand the human's goals and need for information. In study 1, we assessed whether dogs would abandon an object that they find interesting in favour of an object useful for their human partner, a random novel distractor, or an empty container. Results showed that it was mainly self-interest that was driving the dogs' behaviour. The dogs mainly directed their behaviour towards the object they had an interest in, but dogs were more persistent when showing the object relevant to the human, suggesting that to some extent they took the humans interest into account. Another possibility is that dogs' behaviour was driven by an egocentric motivation to interact with novel targets and that the dogs' neophila might have masked their helpful tendencies. Therefore, in study 2 the dogs had initial access to both objects, and were expected to indicate only one (relevant or distractor). The human partner interacted with the dog using vocal communication in half of the trials, and remaining silent in the other half. Dogs from both experimental groups, i.e. indicating the relevant object or indicating the distractor, established joint attention with the human. However, the human's vocal communication and the presence of the
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INFORMATIVE ADVERTISING: A MARKET INFORMATION PROVIDER OR A SEED OF MARKET POWER?
Directory of Open Access Journals (Sweden)
Anzhelika G. GERASYMENKO
2012-07-01
Full Text Available This paper investigates the role of informative advertising in creation and augment of market power as well as the ability of an advertiser to maximize the value of its economic rent. Informative advertising is considered to be a merit good unlike a persuasive one that is mostly associated with a bad. But analysis of the advertisement breakdown in Ukraine shows that the share of price advertisements, which are the most beneficial for the public, is negligible today. Further still those advertisements are mostly situated in the sectors, where price competition is the least strong. Another kind of informative advertising – differentiating advertising – turns from an instrument of informing consumers into the vehicle of manipulation of consumer choice. Using the blind tests the author has compared the quality and the prices of the range of advertised goods and has found out a low level of correlation between the variables. That means that informative advertising serves a function of informing consumers inefficiently. At the same time phantom differentiation and misleading advertising proliferation as well as informative advertising concentration on experience and credible goods instead search ones testify to effective serving a function of maximizing advertiser welfare.
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Directory of Open Access Journals (Sweden)
Chesta Sharma
2014-12-01
Full Text Available To understand the knowledge and services of informal providers and to explore their role in addressing the human resource gap in Uttar Pradesh, India, within the context of maternal health.The study is exploratory in nature, conducted in four blocks of four districts of Uttar Pradesh state, India. Semi-structured interviews were conducted with 114 informal providers.More than one-third (38% providers have some formal education and unrecognized degrees. Approximately three-fourths (74% of them have more than 5 years of work experience. They also provide delivery and in-patient services and have basic equipment available. However, they lack essential knowledge about maternal health. They have mixed opinion about their contribution towards maternal health but the only ones available. Therefore, despite lacking requisite knowledge, training and services, they become indispensable due to lack of emergency and timely public health services, and being the only ones existing in the community.Informal sector practitioners are a critical link in reaching out to population for health services in developing countries. As opposed to the general notion, they possess years of formal education, experience, informal trainings along with trust of communities. Thus, it becomes important to accept their presence and manage them to the best of their abilities even for specialized care like maternal health.
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2010-07-01
... providing information or technical assistance? 86.302 Section 86.302 Education Office of the Secretary... information or technical assistance? (a) The Secretary provides information or technical assistance to an IHE in writing, through site visits, or by other means. (b) The IHE shall inform the Secretary of any...
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Discrepancies between sources providing the medication histories of acutely hospitalised patients
DEFF Research Database (Denmark)
Karkov, Louise Lindved; Schytte-Hansen, Simon; Nørgaard, Lotte Stig
2010-01-01
practitioner (GP) and the in-home care provider. A discrepancy was defined as any disagreement or omission of information between the four sources concerning name, form, strength and dose for each drug with which the patient was being treated. Main outcome measure The number of discrepancies between the data...
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Considerations for Providing Etymological Information in the Advanced Ndebele Dictionary
Directory of Open Access Journals (Sweden)
Langa Khumalo
2011-10-01
Full Text Available
Abstract: This article discusses the presentation of etymological information in the prospective Advanced Ndebele Dictionary (henceforth the AND which is still in its planning stage. The AND will be a successor to Isichazamazwi SesiNdebele (henceforth the ISN, a medium-sized, general-purpose, monolingual Ndebele dictionary published in 2001. The AND will not just be larger than the ISN, but will be more advanced with regard to the depth and scope of its lexical items and definitions. Whereas the ISN was based on a corpus size of about a million running words, the AND is envisaged to have as basis a corpus size of about five million. To this end, corpus expansion is an ongoing process. Again, unlike its forerunner, the AND will provide additional grammatical information for ach lexical item, including phonetic transcription, tone marking and etymology. It is the inclusion of etymological information in the AND that is critically examined in this article. There is a long tradition of providing etymological information in modern dictionaries from Oxford's New English Dictionary to ALRI's Duramazwi Guru reChiShona.
Keywords: ETYMOLOGY, ADVANCED NDEBELE DICTIONARY, CULTURE, HERITAGE, LANGUAGE CONTACT
Opsomming: Oorwegings vir die verskaffing van etimologiese inligting in die Gevorderde Ndebelewoordeboek. Hierdie artikel bespreek die aanbieding van etimo-logiese inligting in die toekomstige Gevorderde Ndebelewoordeboek (voortaan die GNW wat nog in sy beplanningstadium is. Die GNW sal 'n opvolger wees van die Isichazamazwi SesiNdebele (voortaan die ISN, 'n middelgroot, meerdoelige, eentalige Ndebelewoordeboek wat in 2001 gepubliseer is. Die GNW sal nie net groter as die ISN wees nie, maar sal meer gevorderd wees wat betref die diepte en omvang van sy leksikale items en definisies. Waar die ISN gebaseer was op 'n korpus-grootte van ongeveer 'n miljoen woordoptekeninge, word voorsien dat die GNW 'n korpusgrootte van ongeveer vyf miljoen as
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DEFF Research Database (Denmark)
Campbell, Duncan J; Nussberger, Juerg; Stowasser, Michael
2009-01-01
into focus the differences in information provided by activity assays and immunoassays for renin and prorenin measurement and has drawn attention to the need for precautions to ensure their accurate measurement. CONTENT: Renin activity assays and immunoassays provide related but different information...... provided by these assays and of the precautions necessary to ensure their accuracy....
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Wan, Shaowei; Teichman, Peter G; Latif, David; Boyd, Jennifer; Gupta, Rahul
2018-03-01
To meet the needs of an aging population who often have multiple chronic conditions, interprofessional care is increasingly adopted by patient-centred medical homes and Accountable Care Organisations to improve patient care coordination and decrease costs in the United States, especially in underserved areas with primary care workforce shortages. In this cross-sectional survey across multiple clinical settings in an underserved area, healthcare providers perceived overall outcomes associated with interprofessional care teams as positive. This included healthcare providers' beliefs that interprofessional care teams improved patient outcomes, increased clinic efficiency, and enhanced care coordination and patient follow-up. Teams with primary care physician available each day were perceived as better able to coordinate care and follow up with patients (p = .031), while teams that included clinical pharmacists were perceived as preventing medication-associated problems (p care model as a useful strategy to improve various outcomes across different clinical settings in the context of a shortage of primary care physicians.
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Factors influencing the use of outcome measures in physical therapy practice.
Wedge, Frances M; Braswell-Christy, Jennifer; Brown, Cynthia J; Foley, Kathleen T; Graham, Cecilia; Shaw, Sharon
2012-02-01
Use of outcome measures in physical therapy practice is central to evaluating the effectiveness of treatment interventions, providing accountability and addressing quality of physical therapy programs. There is limited discussion on barriers and facilitators to using outcome measures in physical therapy practice. The purpose of this study was to identify factors that influence a physical therapist when deciding to use outcome measures in clinical practice. Participants were 21 physical therapists, seven each from skilled nursing facilities, outpatient clinics, and inpatient rehabilitation facilities. A grounded theory approach was used for interview and data collection. Common themes were determined from the data and a theory developed to explain the rationale behind physical therapists' decisions to use or not use outcome measures in clinical practice. Three overlapping themes related to (1) concepts of time, (2) knowledge, and (3) facility culture were indentified as factors influencing the use of outcome measures. A fourth encompassing theme, professionalism, identified the value placed on the use of outcome measures in practice. Data revealed that therapists require more information on the outcome measures available, and this information needs to be easily accessible within the workplace. Therapists value information generated by using outcome measures in the clinical setting, but need information on what measures are available and psychometric properties. Information must be easily accessible and measures easy to use. Newer graduates and recent learners have a foundation in the use of outcome measures, but more needs to be done in the clinic and through continuing education to promote increased use and understanding.
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Do Dogs Provide Information Helpfully?
Piotti, Patrizia; Kaminski, Juliane
2016-01-01
Dogs are particularly skilful during communicative interactions with humans. Dogs’ abilities to use human communicative cues in cooperative contexts outcompete those of other species, and might be the result of selection pressures during domestication. Dogs also produce signals to direct the attention of humans towards outside entities, a behaviour often referred to as showing behaviour. This showing behaviour in dogs is thought to be something dogs use intentionally and referentially. However, there is currently no evidence that dogs communicate helpfully, i.e. to inform an ignorant human about a target that is of interest to the human but not to the dog. Communicating with a helpful motive is particularly interesting because it might suggest that dogs understand the human’s goals and need for information. In study 1, we assessed whether dogs would abandon an object that they find interesting in favour of an object useful for their human partner, a random novel distractor, or an empty container. Results showed that it was mainly self-interest that was driving the dogs’ behaviour. The dogs mainly directed their behaviour towards the object they had an interest in, but dogs were more persistent when showing the object relevant to the human, suggesting that to some extent they took the humans interest into account. Another possibility is that dogs’ behaviour was driven by an egocentric motivation to interact with novel targets and that the dogs’ neophila might have masked their helpful tendencies. Therefore, in study 2 the dogs had initial access to both objects, and were expected to indicate only one (relevant or distractor). The human partner interacted with the dog using vocal communication in half of the trials, and remaining silent in the other half. Dogs from both experimental groups, i.e. indicating the relevant object or indicating the distractor, established joint attention with the human. However, the human’s vocal communication and the presence
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Predicting Social Anxiety Treatment Outcome based on Therapeutic Email Conversations
Hoogendoorn, M.; Berger, Thomas; Schulz, Ava; Stolz, Timo; Szolovits, Peter
2016-01-01
Predicting therapeutic outcome in the mental health domain is of utmost importance to enable therapists to provide the most effective treatment to a patient. Using information from the writings of a patient can potentially be a valuable source of information, especially now that more and more
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Bapat, Shweta S; Patel, Harshali K; Sansgiry, Sujit S
2017-10-16
In this study, we evaluate the role of information anxiety and information load on the intention to read information from prescription drug information leaflets (PILs). These PILs were developed based on the principals of information load and consumer information processing. This was an experimental prospective repeated measures study conducted in the United States where 360 (62% response rate) university students (>18 years old) participated. Participants were presented with a scenario followed by exposure to the three drug product information sources used to operationalize information load. The three sources were: (i) current practice; (ii) pre-existing one-page text only; and (iii) interventional one-page prototype PILs designed for the study. Information anxiety was measured as anxiety experienced by the individual when encountering information. The outcome variable of intention to read PILs was defined as the likelihood that the patient will read the information provided in the leaflets. A survey questionnaire was used to capture the data and the objectives were analyzed by performing a repeated measures MANOVA using SAS version 9.3. When compared to current practice and one-page text only leaflets, one-page PILs had significantly lower scores on information anxiety ( p information load ( p Information anxiety and information load significantly impacted intention to read ( p < 0.001). Newly developed PILs increased patient's intention to read and can help in improving the counseling services provided by pharmacists.
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Epstein, Richard H; Dexter, Franklin; Patel, Neil
2015-09-01
In this review article, we address issues related to using data from anesthesia information management systems (AIMS) to deliver near real-time alerts via AIMS workstation popups and/or alphanumeric pagers and post hoc reports via e-mail. We focus on reports and alerts for influencing the behavior of anesthesia providers (i.e., anesthesiologists, anesthesia residents, and nurse anesthetists). Multiple studies have shown that anesthesia clinical decision support (CDS) improves adherence to protocols and increases financial performance through facilitation of billing, regulatory, and compliance documentation; however, improved clinical outcomes have not been demonstrated. We inform developers and users of feedback systems about the multitude of concerns to consider during development and implementation of CDS to increase its effectiveness and to mitigate its potentially disruptive aspects. We discuss the timing and modalities used to deliver messages, implications of outlier-only versus individualized feedback, the need to consider possible unintended consequences of such feedback, regulations, sustainability, and portability among systems. We discuss statistical issues related to the appropriate evaluation of CDS efficacy. We provide a systematic review of the published literature (indexed in PubMed) of anesthesia CDS and offer 2 case studies of CDS interventions using AIMS data from our own institution illustrating the salient points. Because of the considerable expense and complexity of maintaining near real-time CDS systems, as compared with providing individual reports via e-mail after the fact, we suggest that if the same goal can be accomplished via delayed reporting versus immediate feedback, the former approach is preferable. Nevertheless, some processes require near real-time alerts to produce the desired improvement. Post hoc e-mail reporting from enterprise-wide electronic health record systems is straightforward and can be accomplished using system
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A Review of Psychotherapy Outcome Research: Considerations for School-Based Mental Health Providers
Zirkelback, Emily A.; Reese, Robert J.
2010-01-01
Evaluating psychotherapeutic outcome is an important endeavor given psychology's focus on identifying effective treatments. There is ample evidence to suggest that psychotherapy interventions for children and adolescents are effective. Unfortunately, the child and adolescent psychotherapy outcome literature lags behind the adult-focused outcome…
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Raphaelis, Silvia; Mayer, Hanna; Ott, Stefan; Mueller, Michael D; Steiner, Enikö; Joura, Elmar; Senn, Beate
2017-07-01
To determine whether written information and/or counseling based on the WOMAN-PRO II Program decreases symptom prevalence in women with vulvar neoplasia by a clinically relevant degree, and to explore the differences between the 2 interventions in symptom prevalence, symptom distress prevalence, and symptom experience. A multicenter randomized controlled parallel-group phase II trial with 2 interventions provided to patients after the initial diagnosis was performed in Austria and Switzerland. Women randomized to written information received a predefined set of leaflets concerning wound care and available healthcare services. Women allocated to counseling were additionally provided with 5 consultations by an Advanced Practice Nurse (APN) between the initial diagnosis and 6months post-surgery that focused on symptom management, utilization of healthcare services, and health-related decision-making. Symptom outcomes were simultaneously measured 5 times to the counseling time points. A total of 49 women with vulvar neoplasia participated in the study. Symptom prevalence decreased in women with counseling by a clinically relevant degree, but not in women with written information. Sporadically, significant differences between the 2 interventions could be observed in individual items, but not in the total scales or subscales of the symptom outcomes. The results indicate that counseling may reduce symptom prevalence in women with vulvar neoplasia by a clinically relevant extent. The observed group differences between the 2 interventions slightly favor counseling over written information. The results justify testing the benefit of counseling thoroughly in a comparative phase III trial. Copyright © 2017 Elsevier Inc. All rights reserved.
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25 CFR 115.803 - What information will be provided in a statement of performance?
2010-04-01
... 25 Indians 1 2010-04-01 2010-04-01 false What information will be provided in a statement of performance? 115.803 Section 115.803 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL... provided in a statement of performance? The statement of performance will identify the source, type, and...
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Hans, Parminder K; Gray, Carolyn Steele; Gill, Ashlinder; Tiessen, James
2018-03-01
Aim This qualitative study investigates how the Electronic Patient-Reported Outcome (ePRO) mobile application and portal system, designed to capture patient-reported measures to support self-management, affected primary care provider workflows. The Canadian health system is facing an ageing population that is living with chronic disease. Disruptive innovations like mobile health technologies can help to support health system transformation needed to better meet the multifaceted needs of the complex care patient. However, there are challenges with implementing these technologies in primary care settings, in particular the effect on primary care provider workflows. Over a six-week period interdisciplinary primary care providers (n=6) and their complex care patients (n=12), used the ePRO mobile application and portal to collaboratively goal-set, manage care plans, and support self-management using patient-reported measures. Secondary thematic analysis of focus groups, training sessions, and issue tracker reports captured user experiences at a Toronto area Family Health Team from October 2014 to January 2015. Findings Key issues raised by providers included: liability concerns associated with remote monitoring, increased documentation activities due to a lack of interoperability between the app and the electronic patient record, increased provider anxiety with regard to the potential for the app to disrupt and infringe upon appointment time, and increased demands for patient engagement. Primary care providers reported the app helped to focus care plans and to begin a collaborative conversation on goal-setting. However, throughout our investigation we found a high level of provider resistance evidenced by consistent attempts to shift the app towards fitting with existing workflows rather than adapting much of their behaviour. As health systems seek innovative and disruptive models to better serve this complex patient population, provider change resistance will need to
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Information Systems Outsourcing Relationship Model
Directory of Open Access Journals (Sweden)
Richard Flemming
2007-09-01
Full Text Available Increasing attention is being paid to what determines the success of an information systems outsourcing arrangement. The current research aims to provide an improved understanding of the factors influencing the outcome of an information systems outsourcing relationship and to provide a preliminary validation of an extended outsourcing relationship model by interviews with information systems outsourcing professionals in both the client and vendor of a major Australian outsourcing relationship. It also investigates whether the client and the vendor perceive the relationship differently and if so, how they perceive it differently and whether the two perspectives are interrelated.
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42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.
2010-10-01
... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... a provider of mental health services. (a) Except as provided in paragraph (b) of this section, if a... of mental health services, it may not disclose information from such records to the individual who is...
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Indicators of fetal and infant health outcomes
Buitendijk, Simone; Zeitlin, Jennifer; Cuttini, Marina; Langhoff-Roos, Jens; Bottu, Jean
2003-01-01
OBJECTIVE: To assess the ability of the member states of the European Union to produce the indicators recommended by the PERISTAT project on perinatal health indicators and to provide an overview of fetal and infant health outcomes for these countries according to the information now available.
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O'Driscoll, Jamie M; Bahia, Sandeep S; Gravina, Angela; Di Fino, Sara; Thompson, Matthew M; Karthikesalingam, Alan; Holt, Peter J E; Sharma, Rajan
2016-02-01
The value of performing transthoracic echocardiography (TTE) as part of the clinical assessment of patients awaiting endovascular repair of the abdominal aorta is little evaluated. We aimed to estimate the prognostic importance of information derived from TTE on long-term all-cause mortality in a selected group of patients undergoing endovascular aneurysm repair. This was a retrospective cohort study of 273 consecutive patients selected for endovascular aneurysm repair. All patients included in the analysis underwent TTE before their procedure. Multivariable Cox regression analysis was used to estimate the effect of TTE measures on all-cause mortality. Over a mean follow-up of 3.2±1.5 years, there were 78 deaths with a mean time to death of 1.28±1.16 years. A greater tubular ascending aorta (hazard ratio [HR] 5.6, 95% confidence interval [CI] 2.77-11.33), presence of mitral regurgitation (HR 8.13, 95% CI 4.09-12.16), lower left ventricular ejection fraction (HR 0.96, 95% CI 0.93-0.98), younger age (HR 0.97, 95% CI 0.95-0.99), and presence of diabetes mellitus (HR 1.46, 95% CI 1.24-1.89) were predictors of all-cause mortality. Echocardiography provides important long-term prognostic information in patients undergoing endovascular aneurysm repair. These TTE indices were more important at predicting outcome than standard conventional risk factors in this patient group. A greater tubular ascending aorta, presence of mitral regurgitation, reduced left ventricular ejection fraction, younger age, and diabetes mellitus were independently associated with long-term mortality. © 2016 American Heart Association, Inc.
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Butterly, Felicity; Percy, Carol; Ward, Gillian
2013-01-01
The aim of this study was to identify the outcomes expected and assessed by those providing service dogs to children with developmental disabilities. Seventeen registered service dog providers were invited to complete a mixed methods online survey. Five providers, who prepared dogs to work with a wide range of conditions and behaviours, mainly…
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Geographic Information Systems using CODES linked data (Crash outcome data evaluation system)
2001-04-01
This report presents information about geographic information systems (GIS) and CODES linked data. Section one provides an overview of a GIS and the benefits of linking to CODES. Section two outlines the basic issues relative to the types of map data...
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Scragg, B; Shaikh, S; Shires, G; Stein Hodgins, J; Mercer, C; Robinson, L; Wray, J
2017-08-01
Increasingly patients and clients of health services are using social media to locate information about medical procedures and outcomes. There is increasing pressure for health professionals to engage in on-line spaces to provide clear and accurate information to their patient community. Research suggests there are some anxieties on the part of practitioners to do this. This study aimed to explore the attitudes of the NHS breast screening programme workforce towards engaging in online discussions with clients about breast screening. 78 practitioners, representing a range of professional roles within the NHS Breast Screening Programme, attended one of 4 workshops. We used a Nominal Group Technique to identify and rank responses to the question: "What are the challenges that practitioners face in using SoME as part of their role?" Responses were categorised into themes. Participants were also asked to identify solutions to these challenges. Challenges: We identified two overarching themes: (1) Working within boundaries: which was further categorised into (a) Professional/legal accountability; (b) Information accuracy and (c)Time as a boundary, and (2) Support: further categorised into (a) Employer and (b) Manager. Solutions: These included: training in technical and interactional aspects of on-line communication and a responsibility to better understand employer and professional body SoMe policies. The study participants appeared willing and motivated to engage in SoMe. However, in keeping with the literature from other disciplines, a number of challenges need to be overcome for its use to be adopted more widely by breast screening professionals. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.
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Directory of Open Access Journals (Sweden)
Vincent M.B.
1997-01-01
Full Text Available Concentration-response curves of isometric tension studies on isolated blood vessels are obtained traditionally. Although parameters such as Imax, EC50 and pA2 may be readily calculated, this method does not provide information on the temporal profile of the responses or the actual nature of the reaction curves. Computerized data acquisition systems can be used to obtain average data that represent a new source of otherwise inaccessible information, since early and late responses may be observed separately in detail
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Ogawa, Masaaki
2017-11-01
In response to changing internal and external situations, we always need to adapt our behavior based on previous experiences, particularly, acquired stimulus-outcome information. The orbitofrontal cortex (OFC), a prefrontal cortical region, is critical for this type of decision-making. The current understanding of the fundamental functions of the OFC has been reviewed by introducing, as an example, how the OFC contributes to the processing of uncertain rewards. Furthermore, the importance of revealing context and temporally specific causal roles of neural circuits including the OFC in decision-making, as well as the techniques to achieve the goal, have been discussed.
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Batra, Peter; Aquilino, Mary L; Farris, Karen B
2015-01-01
To evaluate pharmacy staff perspectives of a 2-year pharmacy intervention aimed at reducing unintended pregnancy in 18- to 30-year-old women. Pharmacy staff completed a 48-item, self-administered paper survey consisting of scaled and open-ended questions. 55 community pharmacies in 12 Iowa counties. All pharmacy staff participated, including pharmacists, pharmacy technicians, and other pharmacy employees. Online continuing education (CE) training was made available to all pharmacy staff. Promotional materials including posters, brochures, and shelf talkers were displayed in all of the pharmacies. Pharmacy staff perceptions and self-reported behaviors related to displaying posters, brochures, and shelf talkers in their pharmacies and providing contraceptive information and counseling to patients/customers. A total of 192 (43% return rate) pharmacy staff responded. Only 44% of respondents consistently provided contraceptive information and counseling, yet more than 90% felt that talking with patients/customers about contraceptives was easy, and more than 50% could do so privately. The study showed increased pharmacy staff desire to make this topic a priority. Community pharmacy staff can play a key role in educating and counseling young adult women about contraceptive health and pregnancy planning. This study indicates that staff are comfortable providing this service and that patients/customers are open to receiving guidance from pharmacists. However, pharmacy staff are missing additional opportunities to provide information and counseling. There is also a need for greater attention to provision of nonprescription contraceptive education.
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Effect of Providing Information on Students' Knowledge and Concerns about Hydraulic Fracking.
Burger, Joanna; Nakata, Kimi; Liang, Laura; Pittfield, Taryn; Jeitner, Christian
2015-01-01
Governmental agencies, regulators, health professionals, and the public are faced with understanding and responding to new development practices and conditions in their local and regional environment. While hydraulic fracking (fracking) for shale gas has been practiced for over 50 years in some states, it is a relatively recent event in the northeastern United States. Providing environmental health information to the public about fracking requires understanding both the knowledge base and the perceptions of the public. The knowledge, perceptions, and concerns of college students about fracking were examined. Students were interviewed at Rutgers University in New Jersey, a state without any fracking, although fracking occurs in nearby Pennsylvania. Objectives were to determine (1) knowledge about fracking, (2) rating of concerns, (3) trusted information sources, (4) importance of fracking relative to other energy sources, and (5) the effect of a 15-min lecture and discussion on these aspects. On the second survey, students improved on their knowledge (except the components used for fracking), and their ratings changed for some concerns, perceived benefits, and trusted information sources. There was no change in support for further development of natural gas, but support for solar, wind, and wave energy decreased. Data suggest that students' knowledge and perceptions change with exposure to information, but many of these changes were due to students using the Internet to look up information immediately after the initial survey and lecture. Class discussions indicated a general lack of trust for several information sources available on the Web.
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Gries, C.; Vanderbilt, K.; Reid, D.; Melendez-Colom, E.; San Gil, I.
2013-12-01
Over the last five years several Long-Term Ecological Research (LTER) sites have collaboratively developed a standardized yet flexible approach to ecological information management based on the open source Drupal content management system. These LTER sites adopted a common data model for basic metadata necessary to describe data sets, but also used for site management and web presence. Drupal core functionality provides web forms for easy management of information stored in this data model. Custom Drupal extensions were developed to generate XML files conforming to the Ecological Metadata Language (EML) for contribution to the LTER Network Information System (NIS) and other data archives. Each LTER site then took advantage of the flexibility Drupal provides to develop its unique web presence, choosing different themes and adding additional content to the websites. By nature, information presented is highly interlinked which can easily be modeled in Drupal entities and is further supported by a sophisticated tagging system (Fig. 1). Therefore, it is possible to provide the visitor with many different entry points to the site specific information presented. For example, publications and datasets may be grouped for each scientist, for each research project, for each major research theme at the site, making the information presented more accessible for different visitors. Experience gained during the early years was recently used to launch a complete re-write for upgrading to Drupal 7. LTER sites from multiple academic institutions pooled resources in order to partner with professional Drupal developers. Highlights of the new developments are streamlined data entry, improved EML output and integrity, support of IM workflows, a faceted data set search, a highly configurable data exploration tool with intelligent filtering and data download, and, for the mobile age, a responsive web design theme. Seven custom modules and a specific installation profile were developed
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The outcome of root-canal treatments assessed by cone-beam computed tomography
Liang, Y.H.
2013-01-01
In this thesis, in-vivo and ex-vivo methods were utilized to assess the outcome of root canal treatments determined by cone-beam computed tomography (CBCT) and the reliability of the CBCT-findings. CBCT provided useful and reliable information leading to a better understanding of the outcome and
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41 CFR 102-84.15 - Why must I provide information for the Annual Real Property Inventory?
2010-07-01
...; and (2) Establish information systems, implement inventory controls and conduct surveys, in accordance... information for the Annual Real Property Inventory? 102-84.15 Section 102-84.15 Public Contracts and Property... PROPERTY 84-ANNUAL REAL PROPERTY INVENTORIES § 102-84.15 Why must I provide information for the Annual Real...
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Kaufman, Jessica; Ryan, Rebecca; Lewin, Simon; Bosch-Capblanch, Xavier; Glenton, Claire; Cliff, Julie; Oyo-Ita, Angela; Muloliwa, Artur Manuel; Oku, Afiong; Ames, Heather; Rada, Gabriel; Cartier, Yuri; Hill, Sophie
2017-08-20
Communication interventions for childhood vaccination are promising strategies to address vaccine hesitancy, but current research is limited by the outcomes measured. Most studies measure only vaccination-related outcomes, with minimal consideration of vaccine hesitancy-relevant intermediate outcomes. This impedes understanding of which interventions or elements are effective. It is also unknown which outcomes are important to the range of stakeholders affected by vaccine hesitancy. Outcome selection shapes the evidence base, informing future interventions and trials, and should reflect stakeholder priorities. Therefore, our aim was to identify which outcome domains (i.e. broad outcome categories) are most important to different stakeholders, identifying preliminary core outcome domains to inform evaluation of three common vaccination communication types: (i) communication to inform or educate, (ii) remind or recall, and (iii) enhance community ownership. We conducted a two-stage online Delphi survey, involving four stakeholder groups: parents or community members, healthcare providers, researchers, and government or non-governmental organisation representatives. Participants rated the importance of eight outcome domains for each of the three communication types. They also rated specific outcomes within one domain ("attitudes or beliefs") and provided feedback about the survey. Collectively, stakeholder groups prioritised outcome domains differently when considering the effects of different communication types. For communication that aims to (i) inform or educate, the most important outcome domain is "knowledge or understanding"; for (ii) reminder communication, "vaccination status and behaviours"; and for (iii) community engagement communication, "community participation". All stakeholder groups rated most outcome domains as very important or critical. The highest rated specific outcome within the "attitudes or beliefs" domain was "trust". This Delphi survey
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Kant, Rebecca E; Vejar, Maria; Parnes, Bennett; Mulder, Joy; Daddato, Andrea; Matlock, Daniel D; Lum, Hillary D
2018-05-03
This study explores the use of a nurse practitioner-led paramedicine program for acute, home-based care of geriatric patients. This case series describes patients, outcomes, and geriatric primary care provider perspectives related to use of this independent paramedicine program. There were 40 patient visits from August 2016-May 2017. We reviewed patient demographics, medical conditions, healthcare utilization, and communication processes and used semi-structured interviews and content analysis to explore staff perspectives. The most commonly treated diagnoses were respiratory conditions, urinary tract infections, and gastrointestinal concerns. Two patients required an immediate transfer to a higher level of care. Six patients had emergency department visits and five patients were hospitalized within two weeks. Geriatric providers identified three themes including: potential benefits to geriatric patients, importance of enhanced care coordination and communication, and considerations for the specific role of nurse practitioner-led community paramedicine programs for geriatric patient care. Published by Elsevier Inc.
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Saulnier, Bruce
2014-01-01
A paradigm is presented for student learning outcome assessment in information systems education. Successful deployment of the paradigm is illustrated using the author's home institution. The paradigm is consistent with both the scholarship of teaching and learning and the scholarship of assessment. It is concluded that the deployment of the…
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Cohen, Fred; Rogers, Deanna T.; Neagoe, Vicentiu
2008-10-14
A method and/or system and/or apparatus providing deception and/or execution alteration in an information system. In specific embodiments, deceptions and/or protections are provided by intercepting and/or modifying operation of one or more system calls of an operating system.
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2012-09-13
... Providers Grant and Per Diem Program) Activities Under OMB Review AGENCY: Veterans Health Administration... Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC 20503, (202) 395... . Please refer to ``OMB Control No. 2900-0554.'' SUPPLEMENTARY INFORMATION: Titles: a. Homeless Providers...
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Providing Data Quality Information for Remote Sensing Applications
Albrecht, F.; Blaschke, T.; Lang, S.; Abdulmutalib, H. M.; Szabó, G.; Barsi, Á.; Batini, C.; Bartsch, A.; Kugler, Zs.; Tiede, D.; Huang, G.
2018-04-01
The availability and accessibility of remote sensing (RS) data, cloud processing platforms and provided information products and services has increased the size and diversity of the RS user community. This development also generates a need for validation approaches to assess data quality. Validation approaches employ quality criteria in their assessment. Data Quality (DQ) dimensions as the basis for quality criteria have been deeply investigated in the database area and in the remote sensing domain. Several standards exist within the RS domain but a general classification - established for databases - has been adapted only recently. For an easier identification of research opportunities, a better understanding is required how quality criteria are employed in the RS lifecycle. Therefore, this research investigates how quality criteria support decisions that guide the RS lifecycle and how they relate to the measured DQ dimensions. Subsequently follows an overview of the relevant standards in the RS domain that is matched to the RS lifecycle. Conclusively, the required research needs are identified that would enable a complete understanding of the interrelationships between the RS lifecycle, the data sources and the DQ dimensions, an understanding that would be very valuable for designing validation approaches in RS.
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DEFF Research Database (Denmark)
Stolarz-Skrzypek, Katarzyna; Thijs, Lutgarde; Richart, Tom
2010-01-01
Ambulatory blood pressure (BP) monitoring provides information not only on the BP level but also on the diurnal changes in BP. In the present review, we summarized the main findings of the International Database on Ambulatory BP in relation to Cardiovascular Outcome (IDACO) with regard to risk...
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Zhou, Huixuan; Zhang, Shengfa; Zhang, Weijun; Wang, Fugang; Zhong, You; Gu, Linni; Qu, Zhiyong; Tian, Donghua
2015-02-27
The Chinese government has increased the funding for public health in 2009 and experimentally applied a contract service policy (could be seen as a counterpart to family medicine) in 15 counties to promote public health services in the rural areas in 2013. The contract service aimed to convert village doctors, who had privately practiced for decades, into general practitioners under the government management, and better control the rampant chronic diseases. This study made a rare attempt to assess the effectiveness of public health services delivered under the contract service policy, explore the influencing mechanism and draw the implications for the policy extension in the future. Three pilot counties and a non-pilot one with heterogeneity in economic and health development from east to west of China were selected by a purposive sampling method. The case study methods by document collection, non-participant observation and interviews (including key informant interview and focus group interview) with 84 health providers and 20 demanders in multiple level were applied in this study. A thematic approach was used to compare diverse outcomes and analyze mechanism in the complex adaptive systems framework. Without sufficient incentives, the public health services were not conducted effectively, regardless of the implementation of the contract policy. To appropriately increase the funding for public health by local finance and properly allocate subsidy to village doctors was one of the most effective approaches to stimulate health providers and demanders' positivity and promote the policy implementation. County health bureaus acted as the most crucial agents among the complex public health systems. Their mental models influenced by the compound and various environments around them led to the diverse outcomes. If they could provide extra incentives and make the contexts of the systems ripe enough for change, the health providers and demanders would be receptive to the
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EFFECT OF PROVIDING INFORMATION ON STUDENTS’ KNOWLEDGE AND CONCERNS ABOUT HYDRAULIC FRACKING
Burger, Joanna; Nakata, Kimi; Liang, Laura; Pittfield, Taryn; Jeitner, Christian
2015-01-01
Governmental agencies, regulators, health professionals, and the public are faced with understanding and responding to new development practices and conditions in their local and regional environment. While hydraulic fracking (fracking) for shale gas has been practiced for over 50 years in some states, it is a relatively recent event in the northeastern United States. Providing environmental health information to the public about fracking requires understanding both the knowledge base and the perceptions of the public. The knowledge, perceptions, and concerns of college students about fracking were examined. Students were interviewed at Rutgers University in New Jersey, a state without any fracking, although fracking occurs in nearby Pennsylvania. Objectives were to determine (1) knowledge about fracking, (2) rating of concerns, (3) trusted information sources, (4) importance of fracking relative to other energy sources, and (5) the effect of a 15-min lecture and discussion on these aspects. On the second survey, students improved on their knowledge (except the components used for fracking), and their ratings changed for some concerns, perceived benefits, and trusted information sources. There was no change in support for further development of natural gas, but support for solar, wind, and wave energy decreased. Data suggest that students’ knowledge and perceptions change with exposure to information, but many of these changes were due to students using the Internet to look up information immediately after the initial survey and lecture. Class discussions indicated a general lack of trust for several information sources available on the Web. PMID:25965194
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TELECOMMUTING AND HRM: A CASE STUDY OF AN INFORMATION TECHNOLOGY SERVICE PROVIDER
Directory of Open Access Journals (Sweden)
André Fernandes Bernardino
2012-08-01
Full Text Available With the development in information technology resources, a way of working has been standing out: telecommuting. This manner of working from a distance may offer a competitive advantage in attracting and retaining highly skilled professionals. The purpose of the research presented in this article is to identify guidelines for the implementation and management of telecommuting, as an alternative to overcome the shortage of qualified professionals in Information Technology (IT. The results, based on a case study of a Brazilian subsidiary of a multinational organization that provides IT services, shown that telecommuting (1 contributes to attracting and retaining qualified professionals in IT, (2 should be based on trustworthy relationships, (3 has to be supported by a strategy of decentralization of both structure and organizational assets.
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Directory of Open Access Journals (Sweden)
Katherine A Gifford
Full Text Available This study examines whether different sources of cognitive complaint (i.e., self and informant predict Alzheimer's disease (AD neuropathology in elders with mild cognitive impairment (MCI.Data were drawn from the National Alzheimer's Coordinating Center Uniform and Neuropathology Datasets (observational studies for participants with a clinical diagnosis of MCI and postmortem examination (n = 1843, 74±8 years, 52% female. Cognitive complaint (0.9±0.5 years prior to autopsy was classified into four mutually exclusive groups: no complaint, self-only, informant-only, or mutual (both self and informant complaint. Postmortem neuropathological outcomes included amyloid plaques and neurofibrillary tangles. Proportional odds regression related complaint to neuropathology, adjusting for age, sex, race, education, depressed mood, cognition, APOE4 status, and last clinical visit to death interval.Mutual complaint related to increased likelihood of meeting NIA/Reagan Institute (OR = 6.58, p = 0.004 and Consortium to Establish a Registry for Alzheimer's Disease criteria (OR = 5.82, p = 0.03, and increased neurofibrillary tangles (OR = 3.70, p = 0.03, neuritic plaques (OR = 3.52, p = 0.03, and diffuse plaques (OR = 4.35, p = 0.02. Informant-only and self-only complaint was not associated with any neuropathological outcome (all p-values>0.12.In MCI, mutual cognitive complaint relates to AD pathology whereas self-only or informant-only complaint shows no relation to pathology. Findings support cognitive complaint as a marker of unhealthy brain aging and highlight the importance of obtaining informant corroboration to increase confidence of underlying pathological processes.
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Leo, C A; Murphy, J; Hodgkinson, J D; Vaizey, C J; Maeda, Y
2018-01-01
The Internet has become an important platform for information communication. This study aim to investigate the utility of social media and search engines to disseminate faecal incontinence information. We looked into Social media platforms and search engines. There was not a direct patient recruitment and any available information from patients was already on public domain at the time of search. A quantitative analysis of types and volumes of information regarding faecal incontinence was made. Twelve valid pages were identified on Facebook: 5 (41%) pages were advertising commercial incontinence products, 4 (33%) pages were dedicated to patients support groups and 3 (25%) pages provided healthcare information. Also we found 192 Facebook posts. On Twitter, 2890 tweets were found of which 51% tweets provided healthcare information; 675 (45%) were sent by healthcare professionals to patients, 530 tweets (35.3%) were between healthcare professionals, 201 tweets (13.4%) were from medical journals or scientific books and 103 tweets (7%) were from hospitals or clinics with information about events and meetings. The second commonest type of tweets was advertising commercial incontinence products 27%. Patients tweeted to exchange information and advice between themselves (20.5%). In contrast, search engines as Google/Yahoo/Bing had a higher proportion of healthcare information (over 70%). Internet appears to have potential to be a useful platform for patients to learn about faecal incontinence and share information; however, given one lack of focus of available data, patients may struggle to identify valid and useful information.
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Chaudhary, Noami; Lucero, Catherine; Villanueva, Gerald; Poles, Michael; Gillespie, Colleen; Zabar, Sondra; Weinshel, Elizabeth
2017-07-01
Patient education is critical in ensuring patient compliance and good health outcomes. Fellows must be able to effectively communicate with their patients, delivering enough information for the patient to understand their medical problem and maximize patient compliance. We created an objective structured clinical examination (OSCE) with 4 liver disease cases to assess fellows' knowledge and ability to inform standardized patients (SPs) about their clinical condition. We developed 4 cases highlighting different aspects of liver disease and created a 4-station OSCE: hepatitis B, acute hepatitis C, new diagnosis of cirrhosis, and an end-stage cirrhotic nontransplant candidate. The SP with hepatitis B was minimizing the fact that she could not read English. The acute hepatitis C SP was a nursing student who is afraid that having hepatitis C might jeopardize her career. The SP with the new diagnosis of alcoholic cirrhosis needed to stop drinking, and the end-stage liver disease patient had to grapple with his advanced directives. Twelve fellows from 4 GI training programs participated. Our focus was to assess the fellows' knowledge about liver diseases and the Accreditation Council for Graduate Medical Education competencies of health literacy, shared decision making, advanced directives, and goals of care. The goal for the fellows was to communicate effectively with the SPs, and acknowledge that each patient had an emotionally charged issue to overcome. The SPs used a checklist to rate fellows' performance. Faculty and the SPs observed the cases and provided feedback. The fellows were surveyed on their performance regarding the case. The majority of fellows were able to successfully summarize findings and discuss a plan with the patient in the new diagnosis of cirrhosis (76.92%) and hepatitis C case (100%), but were less successful in the hepatitis B case (30.77%) and the end-of-life case (41.67%). Overall, a small percentage of fellows reflected that they did a good
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Nifadkar, Sushil S; Bauer, Talya N
2016-01-01
Previous studies of newcomer socialization have underlined the importance of newcomers' information seeking for their adjustment to the organization, and the conflict literature has consistently reported negative effects of relationship conflict with coworkers. However, to date, no study has examined the consequences of relationship conflict on newcomers' information seeking. In this study, we examined newcomers' reactions when they have relationship conflict with their coworkers, and hence cannot obtain necessary information from them. Drawing upon belongingness theory, we propose a model that moves from breach of belongingness to its proximal and distal consequences, to newcomer information seeking, and then to task-related outcomes. In particular, we propose that second paths exist-first coworker-centric and the other supervisor-centric-that may have simultaneous yet contrasting influence on newcomer adjustment. To test our model, we employ a 3-wave data collection research design with egocentric and Likert-type multisource surveys among a sample of new software engineers and their supervisors working in India. This study contributes to the field by linking the literatures on relationship conflict and newcomer information seeking and suggesting that despite conflict with coworkers, newcomers may succeed in organizations by building relationships with and obtaining information from supervisors. (c) 2016 APA, all rights reserved).
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Lewis, Morgan V.
Expanded Internet access to the Ohio Career Information System (OCIS) would provide adults in Ohio who need to or wish to make career changes with the best available information about occupations, education and training programs, and financial aid. In order to determine the feasibility of improving access without cost to users, an advisory group,…
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Pilkonis, Paul A; Yu, Lan; Dodds, Nathan E; Johnston, Kelly L; Lawrence, Suzanne M; Hilton, Thomas F; Daley, Dennis C; Patkar, Ashwin A; McCarty, Dennis
2017-08-01
There is a need to monitor patients receiving prescription opioids to detect possible signs of abuse. To address this need, we developed and calibrated an item bank for severity of abuse of prescription pain medication as part of the Patient-Reported Outcomes Measurement Information System (PROMIS ® ). Comprehensive literature searches yielded an initial bank of 5,310 items relevant to substance use and abuse, including abuse of prescription pain medication, from over 80 unique instruments. After qualitative item analysis (i.e., focus groups, cognitive interviewing, expert review, and item revision), 25 items for abuse of prescribed pain medication were included in field testing. Items were written in a first-person, past-tense format, with a three-month time frame and five response options reflecting frequency or severity. The calibration sample included 448 respondents, 367 from the general population (ascertained through an internet panel) and 81 from community treatment programs participating in the National Drug Abuse Treatment Clinical Trials Network. A final bank of 22 items was calibrated using the two-parameter graded response model from item response theory. A seven-item static short form was also developed. The test information curve showed that the PROMIS ® item bank for abuse of prescription pain medication provided substantial information in a broad range of severity. The initial psychometric characteristics of the item bank support its use as a computerized adaptive test or short form, with either version providing a brief, precise, and efficient measure relevant to both clinical and community samples. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
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Rackes, A; Ben-David, T; Waring, M S
2018-04-23
This article presents an outcome-based ventilation (OBV) framework, which combines competing ventilation impacts into a monetized loss function ($/occ/h) used to inform ventilation rate decisions. The OBV framework, developed for U.S. offices, considers six outcomes of increasing ventilation: profitable outcomes realized from improvements in occupant work performance and sick leave absenteeism; health outcomes from occupant exposure to outdoor fine particles and ozone; and energy outcomes from electricity and natural gas usage. We used the literature to set low, medium, and high reference values for OBV loss function parameters, and evaluated the framework and outcome-based ventilation rates using a simulated U.S. office stock dataset and a case study in New York City. With parameters for all outcomes set at medium values derived from literature-based central estimates, higher ventilation rates' profitable benefits dominated negative health and energy impacts, and the OBV framework suggested ventilation should be ≥45 L/s/occ, much higher than the baseline ~8.5 L/s/occ rate prescribed by ASHRAE 62.1. Only when combining very low parameter estimates for profitable impacts with very high ones for health and energy impacts were all outcomes on the same order. Even then, however, outcome-based ventilation rates were often twice the baseline rate or more. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Paxton, Elizabeth W.; Fisher, David; Li, Robert A.; Barber, Thomas C.; Singh, Jasvinder A.
2014-01-01
This study compared the total joint arthroplasty (TJA) surgical outcomes of patients who had bariatric surgery prior to TJA to TJA patients who were candidates but did not have bariatric surgery. Patients were retrospectively grouped into: Group 1 (n=69), those with bariatric surgery >2 years prior to TJA, Group 2 (n=102), those with surgery within 2 years of TJA, and Group 3 (n=11,032), those without bariatric surgery. In Group 1, 2.9% (95%CI 0.0–6.9%) had complications within 1 year compared to 5.9% (95%CI 1.3–10.4%) in Group 2, and 4.1% (95%CI 3.8–4.5%) in Group 3. 90-day readmission (7.2%, 95%CI 1.1–13.4%) and revision density (3.4/100 years of observation) was highest in Group 1. Bariatric surgery prior to TJA may not provide dramatic improvements in post-operative TJA surgical outcomes. PMID:24674730
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Williams, Wesley; McKinney, Christopher; Martinez, Larry; Benson, Carmela
2016-01-01
This study evaluated the effect of paliperidone palmitate long-acting injectable (LAI) antipsychotic on recovery-oriented mental health outcomes from the perspective of healthcare providers and patients during the treatment of patients with schizophrenia or schizoaffective disorders. Archival data for patients with a primary diagnosis of schizophrenia or schizoaffective disorder receiving ≥6 months of paliperidone palmitate LAI were retrieved from the electronic medical records system at the Mental Health Center of Denver. Mental health recovery was assessed from both a provider's (Recovery Markers Inventory [RMI]) and patient's (Consumer Recovery Measure [CRM]) perspective. A three-level hierarchical linear model (HLM) was utilized to determine changes in CRM and RMI scores by including independent variables in the models: intercept, months from treatment (slope), treatment time period (pretreatment and treatment), age, gender, primary diagnosis, substance abuse diagnosis, concurrent medications, and adherence to paliperidone palmitate LAI. A total of 219 patients were identified and included in the study. Results of the final three-level HLMs indicated an overall increase in CRM scores (p a retrospective, non-comparative design, and did not adjust for multiplicity Conclusions: The current study demonstrates that changes in recovery-oriented mental health outcomes can be detected following the administration of a specific antipsychotic treatment in persons with schizophrenia or schizoaffective disorders. Furthermore, patients receiving paliperidone palmitate LAI can effectively improve recovery-oriented outcomes, thereby supporting the drug's use as schizophrenia treatment from a recovery-oriented perspective.
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Providing Meteorological Information for Controlled Burns at the Savannah River Site
International Nuclear Information System (INIS)
Buckley, R.
1999-01-01
Regional and local weather information are important for a variety of applications at the Savannah River Site (SRS), a Department of Energy (DOE) facility covering approximately 800 square kilometers of southwest South Carolina east of the Savannah River. For example, meteorological observations and forecasts are used to assess the consequences of an accidental radiological or chemical release. Traditionally, hazards posed by SRS operations have been associated with nuclear reactors, chemical reprocessing plants, fuel fabrication, or waste-vitrification facilities. However, recent events have shown site-specific meteorology to be a valuable tool to the United States Forest Service (USFS) in mitigating potential hazards from controlled burns that are conducted at the SRS. Prescribed burns at the SRS are important for a variety of reasons. The removal of thick undergrowth allows wildlife to more easily feed and migrate, accelerates the growth of young pine stands, and controls certain diseases that affect local pine forests (e.g. Adams et al. 1973). In addition, the removal of twigs, pine needles, or leaves (a fuel source) reduces the chance of serious wildfire damage. However, the threat of smoke inhalation and reduced visibility requires careful planning on the part of the fire professionals. At the SRS, approximately 100 square kilometers of land per year are burned in a controlled manner, mainly in the spring.To reduce the potentially harmful effects to any onsite activity, it is important that USFS personnel understand current and predicted weather patterns within the area. This paper discusses two sources of meteorological information that are provided to SRS-USFS personnel for use in planning forest burns: (1) a meteorological tower system which provides current data from a series of onsite locations, and (2) an operational prognostic mesoscale model used to generate forecast information. The forecast data supplements the basic National Weather Service (NWS
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Bell, Melissa M; Newhill, Christina E
2017-07-01
Social service professionals can face challenges in the course of providing family planning information to their clients. This article reports findings from a study that developed an original 27-item measure, the Reproductive Counseling Obstacle Scale (RCOS) designed to measure such obstacles based conceptually on Bandura's social cognitive theory (1986). We examine the reliability and factor structure of the RCOS using a sample of licensed social workers (N = 197). A 20-item revised version of the RCOS was derived using principal component factor analysis. Results indicate that barriers to discussing family planning, as measured by the RCOS, appear to be best represented by a two-factor solution, reflecting self-efficacy/interest and perceived professional obligation/moral concerns. Implications for practice and future research are discussed.
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EFFECT OF PROVIDING INFORMATION ON STUDENTS’ KNOWLEDGE AND CONCERNS ABOUT HYDRAULIC FRACKING
Burger, Joanna; Nakata, Kimi; Liang, Laura; Pittfield, Taryn; Jeitner, Christian
2015-01-01
Governmental agencies, regulators, health professionals, and the public are faced with understanding and responding to new development practices and conditions in their local and regional environment. While hydraulic fracking (fracking) for shale gas has been practiced for over 50 years in some states, it is a relatively recent event in the northeastern United States. Providing environmental health information to the public about fracking requires understanding both the knowledge base and the...
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34 CFR 377.31 - What information must a grantee provide to eligible clients?
2010-07-01
... clients? 377.31 Section 377.31 Education Regulations of the Offices of the Department of Education... PROJECTS TO INCREASE CLIENT CHOICE PROGRAM What Post-Award Conditions Must Be Met by a Grantee? § 377.31 What information must a grantee provide to eligible clients? Each grantee shall advise all clients and...
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Mariaan Roos
2012-01-01
Reporting on performance was legislatively established in South Africa in terms of the Public Finance Management Act, Act 1 of 1999, section 40 (3)(a). The auditing of the reported information was legislated in the Public Audit Act, Act 25 of 2004, section 20(2) (c). The objectives of the article are firstly to provide an overview of the development and application of the reporting and secondly providing assurance on service delivery information and thirdly to reflect on challenges to the imp...
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E-mail Writing: Providing Background Information in the Core of Computer Assisted Instruction
Directory of Open Access Journals (Sweden)
Behzad NAZARI
2015-01-01
Full Text Available The present study highly supported the effective role of providing background information via e-mail by the teacher to write e-mail by the students in learners’ writing ability. A total number of 50 EFL advanced male students aged between 25 and 40 at different branches of Iran Language Institute in Tehran, Tehran. Through the placement test of Oxford English Language Placement Test (OELPT the students' proficiency level seems to be nearly the same. Participants were randomly assign into two groups of experimental and control, each consisting of 25 students. After the administration of the proficiency test, all groups were assigned to write topic 1 as the pre-test. Next, the teacher involved the learners in the new instruction (treatment. During writing topics 2, 3, 4, 5, 6, and 7 experimental group’s background knowledge was activated through e-mail before writing and e-mailing topics while the control group received no background knowledge activation through e-mail. After the treatment was given to the experimental group, the students in both groups were required to write another composition about the last topic, topic 8. Again, in this phase, none of the groups received any background information. The results indicated that providing background information via e-mail by the teacher to write e-mail by the students significantly improved learners’ writing ability.
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Vlietland, J.; Vliet, J.C.
2015-01-01
Information technology (IT)-enabled financial services are typically delivered by a network of interdependent IT service providers. Such networks need information to resolve IT incidents in their delivered IT services. The objective of this research is to identify the set of information that needs
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Adhikari, Janak; Scogings, Chris; Mathrani, Anuradha; Sofat, Indu
2017-01-01
Purpose: The purpose of this paper is to seek answers to questions on how equity of information literacy and learning outcomes have evolved with the ongoing advances in technologies in teaching and learning across schools. The authors' report on a five-year long bring your own device (BYOD) journey of one school, which was one of the earliest…
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A mine of information: can sports analytics provide wisdom from your data?
Passfield, Louis; Hopker, James G.
2017-01-01
This paper explores the notion that the availability and analysis of large datasets has the capacity to improve practice and change the nature of science in the sport and exercise setting. The increasing use of data and information technology in sport is giving rise to this change. Websites hold large data repositories and the development of wearable technology, mobile phone applications and related instruments for monitoring physical activity, training and competition, provide large data set...
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Angelini, John; Hirose, Kenichi
2004-01-01
This paper focuses on the extension of social security coverage to workers in the informal economy. In particular, the paper presents the results of surveys assessing social security needs of workers in the informal economy in both urban and rural areas. The outcome of these surveys provides primary information for the development of effective policy on social security coverage extension to these groups of workers.
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Pediatric hydrocephalus outcomes: a review
Directory of Open Access Journals (Sweden)
Vinchon Matthieu
2012-08-01
Full Text Available Abstract The outcome of pediatric hydrocephalus, including surgical complications, neurological sequelae and academic achievement, has been the matter of many studies. However, much uncertainty remains, regarding the very long-term and social outcome, and the determinants of complications and clinical outcome. In this paper, we review the different facets of outcome, including surgical outcome (shunt failure, infection and independence, and complications of endoscopy, clinical outcome (neurological, sensory, cognitive sequels, epilepsy, schooling and social integration. We then provide a brief review of the English-language literature and highlighting selected studies that provide information on the outcome and sequelae of pediatric hydrocephalus, and the impact of predictive variables on outcome. Mortality caused by hydrocephalus and its treatments is between 0 and 3%, depending on the duration of follow-up. Shunt event-free survival (EFS is about 70% at one year and 40% at ten years. The EFS after endoscopic third ventriculostomy (ETV appears better but likely benefits from selection bias and long-term figures are not available. Shunt infection affects between 5 and 8% of surgeries, and 15 to 30% of patients according to the duration of follow-up. Shunt independence can be achieved in 3 to 9% of patients, but the definition of this varies. Broad variations in the prevalence of cognitive sequelae, affecting 12 to 50% of children, and difficulties at school, affecting between 20 and 60%, attest of disparities among studies in their clinical evaluation. Epilepsy, affecting 6 to 30% of patients, has a serious impact on outcome. In adulthood, social integration is poor in a substantial number of patients but data are sparse. Few controlled prospective studies exist regarding hydrocephalus outcomes; in their absence, largely retrospective studies must be used to evaluate the long-term consequences of hydrocephalus and its treatments. This review
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Harland, Juliet; Bath, Peter
2007-09-01
The quality of health information available on the Internet has proved difficult to assess objectively. The Internet's growing popularity as a source of health information, accompanied by the lack of regulation of websites, has resulted in research that has developed and tested tools to evaluate health website quality. However, only a few studies have tested the validity and reliability of these tools. There is a lack of consensus about appropriate indicators with which to operationalize the concept of quality health information. This study aimed to contribute to this research by testing the validity and reliability of existing tools, through their application to websites that provided information about multiple sclerosis. Furthermore, a specific tool for evaluating multiple sclerosis information was developed, contributing to the debate about suitable criteria for measuring the ;quality' of health information on the web.
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Library and information services: impact on patient care quality.
Marshall, Joanne Gard; Morgan, Jennifer Craft; Thompson, Cheryl A; Wells, Amber L
2014-01-01
The purpose of this paper is to explore library and information service impact on patient care quality. A large-scale critical incident survey of physicians and residents at 56 library sites serving 118 hospitals in the USA and Canada. Respondents were asked to base their answers on a recent incident in which they had used library resources to search for information related to a specific clinical case. Of 4,520 respondents, 75 percent said that they definitely or probably handled patient care differently using information obtained through the library. In a multivariate analysis, three summary clinical outcome measures were used as value and impact indicators: first, time saved; second, patient care changes; and third, adverse events avoided. The outcomes were examined in relation to four information access methods: first, asking librarian for assistance; second, performing search in a physical library; third, searching library's web site; or fourth, searching library resources on an institutional intranet. All library access methods had consistently positive relationships with the clinical outcomes, providing evidence that library services have a positive impact on patient care quality. Electronic collections and services provided by the library and the librarian contribute to patient care quality.
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Egaga, Patrick I.; Aderibigbe, S. Akinwumi
2015-01-01
The study aimed at examining the efficacy of Information and Communication Technology (ICT) in enhancing learning outcomes of students with hearing impairment in Ibadan. The study adopted a pretest, post-test, control group quasi-experimental research design. Purposive sampling techniques was used for the selection of thirty participants…
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Directory of Open Access Journals (Sweden)
Jagannath M. Muzumdar
2015-01-01
Full Text Available Objectives: This study aimed at designing and assessing educational materials for adult immunizations through the medium of comics. The study design evaluated the effects of two vaccine information flyers (a CDC flyer vs a flyer designed in Comic medium on participants’ attitude towards the flyers. Methods: A between-group, randomized trial was used to compare the effectiveness of two vaccine information flyers on participants’ attitude towards the flyers. Upon approval from the human subjects review committee, student participants (age ≥18 years were randomly assigned either the CDC or comic flyer. They were then asked to respond to survey items developed to measure the flyers’ effect on participants’ attitude towards the flyer. Items were measured using a 7-point semantic differential scale. Cronbach’s alpha was computed for reliability testing of the study instrument. Independent-samples t-test was used to compare means of the two groups with respect to their attitudes toward the flyer. Results: A total of 170 third-year pharmacy students participated in the study (N = 91 for Comic flyer & N = 79 for CDC flyer. There was a significant difference in attitudes toward the flyer between students who read comic flyers (mean = 6.14; SD = 0.62 and those who read CDC flyers (mean = 4.93; SD = 1.20. Additional comments provided by students further confirmed the quantitative findings of the study. Student responses to the use of comics as a medium of providing information on adult immunization were constructive and encouraging. Conclusion: The study findings showed that the flyer with comics was evaluated more attractive than the CDC flyer. The positive findings of our study could provide a new direction for developing educational materials about adult immunizations. Future research on comics, as a medium of communication, could explore its use as a tool for providing healthcare information to consumers. Type: Original Research
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Mäenpää, Tiina; Asikainen, Paula; Gissler, Mika; Siponen, Kimmo; Maass, Marianne; Saranto, Kaija; Suominen, Tarja
2012-01-01
Interest in improving quality and effectiveness is the primary driver for health information exchange efforts across a health care system to improve the provision of public health care services. The aim here was to describe and identify the impact of a regional health information exchange (HIE) using quantitative statistics for 2004-2008 in one hospital district in Finland. We conducted a comparative, longitudinal 5-year follow-up study to evaluate the utilization rates of HIE, and the impact on health care delivery outcomes. The selected outcomes were total laboratory tests, radiology examinations, appointments, emergency visits, and referrals. The HIE utilization rates increased annually in all 10 federations of municipalities, and the viewing of reference information increased steadily in each professional group over the 5-year study period. In these federations, a significant connection was found to the number of laboratory tests and radiology examinations, with a statistically significant increase in the number of viewed references and use of HIE. The higher the numbers of emergency visits and appointments, the higher the numbers of emergency referrals to specialized care, viewed references, and HIE usage among the groups of different health care professionals. There is increasing interest in HIE usage through regional health information system among health professionals to improve health care delivery regionally and bring information on the patient directly to care delivery. It will be important to study which changes in working methods in the service system are explained by RHIS. Also, the experiences of the change that has taken place should be studied among the different stakeholders, administrative representatives, and patients.
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Using the Internet to provide care for persons living with HIV.
Horvath, Keith J; Courtenay-Quirk, Cari; Harwood, Eileen; Fisher, Holly; Kachur, Rachel; McFarlane, Mary; O'Leary, Ann; Rosser, B R Simon
2009-12-01
There are no published reports on ways in which caregivers use the Internet to support people living with HIV/AIDS (PLWHA). Five hundred caregivers were recruited in a 5-week period to complete an online survey of demographic characteristics, Internet use, online health-seeking self-efficacy, and ways they used the Internet to support PLWHA. Caregivers were on average 39 years old, white, heterosexual, highly educated, and Internet-savvy. Most provided informal care only (e.g., as a friend; 78%), with the remainder divided among those who provided care exclusively as part of their job (11%) or in both informally and professionally (11%). Most (72%) respondents visited a general medical website for HIV information, and 44% shared information from the Internet with PLWHA. Compared to informal caregivers, caregivers whose roles were both informal and professional had greater odds of recently sharing information from the Internet with PLWHA (odds ratio [OR] = 2.03) and ever printing off information from a website to give to PLWHA (odds ratio [OR] = 3.87). Professional caregivers had higher odds of ever printing off information from a website to give to PLWHA (OR = 1.87), but lower odds of sending an e-mail with a website link (OR = 0.32) than informal caregivers. These findings suggest that websites providing HIV-related resources should consider the various ways in which caregivers use their content, and how utilization differs by role. More research is needed to understand how people providing care for PLWHA share information and support each other and the impact that doing so has on caregiver burden and treatment outcomes for PLWHA.
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Mapping allied health evidence-based practice: providing a basis for organisational realignment.
Ziviani, Jenny; Wilkinson, Shelley A; Hinchliffe, Fiona; Feeney, Rachel
2015-06-01
Ahead of the convergence of two major paediatric services, we examined evidence-based practice (EBP) self-efficacy, outcome expectance, knowledge and use among allied health (AH) staff in two major Queensland (Qld) paediatric services. This was to determine whether any differences existed based on organisational affiliation, profession and any previous training to inform a strategy to enhance AH EBP within the new organisational setting. All AH staff from the two Brisbane (Qld) tertiary paedritic hospitals were invited to participate in the survey. Using a cross-sectional design EBP self-efficacy, outcome expectancy, knowledge and use, as well as previous EBP training, were assessed with an online survey. Background demographic information obtained included professional discipline and hospital. One hundreD and thirty-eight health practitioners completed the survey (37% respone rate). Most practioners had accessed EBP training. Mean scores for EBP attitudes (self-efficacy and outcome expectancy) and knowledge were higher than for EBP use scores. Greater variation was observed across professional disciplines than organisations. Training impacted positively on EBP measures but explained a small proportion of total variance in regression models. The results underscore the need to provide organisational supports to AH staff ro EBP implementation. Strategies other than training are requred to maximally enhance EBP attitudes. The new organisational structure provides an oppotunity for this cultural shift to occur.
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Kratov, Sergey
2018-01-01
Modern information systems designed to service a wide range of users, regardless of their subject area, are increasingly based on Web technologies and are available to users via Internet. The article discusses the issues of providing the fault-tolerant operation of such information systems, based on free and open source content management systems. The toolkit available to administrators of similar systems is shown; the scenarios for using these tools are described. Options for organizing backups and restoring the operability of systems after failures are suggested. Application of the proposed methods and approaches allows providing continuous monitoring of the state of systems, timely response to the emergence of possible problems and their prompt solution.
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What new mothers need to know: perspectives from women and providers in Georgia.
Gazmararian, Julie A; Dalmida, Safiya George; Merino, Yesenia; Blake, Sarah; Thompson, Winifred; Gaydos, Laura
2014-05-01
Identifying the educational and resource needs of new mothers is of paramount importance in developing programs to improve maternal and child health outcomes. The primary purpose of this study was to explore the educational needs of new mothers and identify opportunities to enhance healthcare providers' current educational efforts. A two-part methodology was utilized to qualitatively explore the topic of parenting information needs for new mothers in Georgia. Data collection included information from 11 focus groups with 92 first-time, new mothers and 20 interviews with healthcare providers who serve new mothers. Discussions with both new mothers and providers clearly indicated that new mothers face a significant informational deficit, especially regarding very basic, daily infant care information and health literacy challenges. Educational materials already exist; however, mothers report difficulty accessing and understanding this information. For this reason, both the mothers and the providers stressed a focus on developing programs or interventions that allow in-person education and/or alternative modalities to access information, as opposed to development of new written materials solely. Information from the focus group and interviews provided important insight regarding what improvements need to be made to help new mothers and their families during the early stages of parenthood. By improving the education of new mothers and their families, it is proposed that maternal and infant health status could be improved.
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E-Mail Writing: Providing Background Information in the Core of Computer Assisted Instruction
Nazari, Behzad; Ninknejad, Sahar
2015-01-01
The present study highly supported the effective role of providing background information via email by the teacher to write e-mail by the students in learners' writing ability. A total number of 50 EFL advanced male students aged between 25 and 40 at different branches of Iran Language Institute in Tehran, Tehran. Through the placement test of…
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Treatment outcome of Tuberculosis and HIV Co-infection at a ...
African Journals Online (AJOL)
. TB is a reemerging disease linked with HIV infections. It is necessary to compare the treatment outcome of patients with only Tuberculosis with those with HIV/AIDs co-infection. This study will also provide baseline information on treatment ...
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Sexual information seeking on web search engines.
Spink, Amanda; Koricich, Andrew; Jansen, B J; Cole, Charles
2004-02-01
Sexual information seeking is an important element within human information behavior. Seeking sexually related information on the Internet takes many forms and channels, including chat rooms discussions, accessing Websites or searching Web search engines for sexual materials. The study of sexual Web queries provides insight into sexually-related information-seeking behavior, of value to Web users and providers alike. We qualitatively analyzed queries from logs of 1,025,910 Alta Vista and AlltheWeb.com Web user queries from 2001. We compared the differences in sexually-related Web searching between Alta Vista and AlltheWeb.com users. Differences were found in session duration, query outcomes, and search term choices. Implications of the findings for sexual information seeking are discussed.
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The evaluation of a digital information literacy program
Directory of Open Access Journals (Sweden)
Anne Sieberhagen
2012-10-01
Full Text Available The article reports on the evaluation of a digital information literacy program (DILP to determine the program’s effectiveness in enhancing students’ digital information literacy skills. The DILP was originally designed and developed for the South African student, as member of Generation Y, but was adapted after identifying the demographics and characteristics of Generation Z. This information was incorporated in the existing DILP, therefore making the DILP applicable to and useful for both Generations Y and Z. New learning technologies were identified and incorporated in the DILP to enhance students’ learning experience. An analysis of reported research indicated that there is a lack in the evaluation of programs to determine their effectiveness in enhancing the digital information literacy skills of students by using an outcomes assessment instrument. The development of an outcomes assessment instrument, which is based on internationally benchmarked information literacy competency standards and their outcomes, are presented. Evidence is provided of the effectiveness of the program in order to prove its worth as an instructional program. Recommendations are made on how digital information literacy programs may be improved to be more effective in enhancing students’ digital information literacy skills
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Directory of Open Access Journals (Sweden)
M. L.S. Mataboge
2016-10-01
Full Text Available Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV and to acquired immunodeficiency syndrome (AIDS than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. The objective of this study was to explore and describe the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. Tesch's method for qualitative data analysis was used. Ethical principles guided the study, and certain strategies were followed to ensure trustworthiness. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs. The HCPs acknowledged that healthcare provision was negatively affected by policies. It was found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.
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Directory of Open Access Journals (Sweden)
M.L.S. Mataboge
2016-12-01
Full Text Available Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV and to acquired immunodeficiency syndrome (AIDS than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. The objective of this study was to explore and describe the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. Tesch's method for qualitative data analysis was used. Ethical principles guided the study, and certain strategies were followed to ensure trustworthiness. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs. The HCPs acknowledged that healthcare provision was negatively affected by policies. It was found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.
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Directory of Open Access Journals (Sweden)
Tolley C
2015-03-01
Full Text Available Chloe Tolley,1 Diana Rofail,2 Adam Gater,1 Justine K Lalonde31Adelphi Values Ltd, Bollington, UK; 2Roche Products Ltd, Welwyn Garden City, UK; 3Roche S.A.S, Paris, France Abstract: Many clinical outcome assessments (COAs were originally developed for completion via pen and paper. However, in recent years there have been movements toward electronic capture of such data in an effort to reduce missing data, provide time-stamped records, minimize administrative burden, and avoid secondary data entry errors. Although established in many patient populations, the implications of using electronic COAs in schizophrenia are unknown. In accordance with International Society for Pharmacoeconomics and Outcomes Research (ISPOR Task Force recommendations, in-depth cognitive debriefing and usability interviews were conducted with people with schizophrenia (n=12, their informal (unpaid caregivers (n=12, and research support staff (n=6 to assess the suitability of administration of various electronic COA measures using an electronic tablet device. Minimal issues were encountered by participants when completing or administering the COAs in electronic format, with many finding it easier to complete instruments in this mode than by pen and paper. The majority of issues reported were specific to the device functionality rather than the electronic mode of administration. Findings support data collection via electronic tablet in people with schizophrenia and their caregivers. The appropriateness of other forms of electronic data capture (eg, smartphones, interactive voice response systems, etc is a topic for future investigation. Keywords: ePRO, eCOA, mode of administration, electronic data capture, usability
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A Mine of Information: Can Sports Analytics Provide Wisdom From Your Data?
Passfield, Louis; Hopker, James G
2017-08-01
This paper explores the notion that the availability and analysis of large data sets have the capacity to improve practice and change the nature of science in the sport and exercise setting. The increasing use of data and information technology in sport is giving rise to this change. Web sites hold large data repositories, and the development of wearable technology, mobile phone applications, and related instruments for monitoring physical activity, training, and competition provide large data sets of extensive and detailed measurements. Innovative approaches conceived to more fully exploit these large data sets could provide a basis for more objective evaluation of coaching strategies and new approaches to how science is conducted. An emerging discipline, sports analytics, could help overcome some of the challenges involved in obtaining knowledge and wisdom from these large data sets. Examples of where large data sets have been analyzed, to evaluate the career development of elite cyclists and to characterize and optimize the training load of well-trained runners, are discussed. Careful verification of large data sets is time consuming and imperative before useful conclusions can be drawn. Consequently, it is recommended that prospective studies be preferred over retrospective analyses of data. It is concluded that rigorous analysis of large data sets could enhance our knowledge in the sport and exercise sciences, inform competitive strategies, and allow innovative new research and findings.
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MODEL OF PROVIDING WITH DEVELOPMENT STRATEGY FOR INFORMATION TECHNOLOGIES IN AN ORGANIZATION
Directory of Open Access Journals (Sweden)
A. A. Kuzkin
2015-03-01
Full Text Available Subject of research. The paper presents research and instructional tools for assessment of providing with the development strategy for information technologies in an organization. Method. The corresponding assessment model is developed which takes into consideration IT-processes equilibrium according to selected efficiency factors of information technologies application. Basic results. The model peculiarity resides in applying neuro-fuzzy approximators where the conclusion is drawn upon fuzzy logic, and membership functions are adjusted through the use of neural networks. For the adequacy testing of the suggested model, due diligence result analysis has been carried out for the IT-strategy executed in the “Navigator” group of companies at the stage of implementation and support of new technologies and production methods. Data visualization with a circle diagram is applied for the comparative evaluation of the analysis results. The chosen model adequacy is proved by the agreement between predictive assessments for IT-strategy performance targets derived by means of the fuzzy cognitive model over 12 months planning horizon and the real values of these targets upon the expiry of the given planning term. Practical significance. The developed model application gives the possibility to solve the problem of sustainability assessment for the process of providing the required IT-strategy realization level based upon the fuzzy cognitive map analysis and to reveal IT-objectives changing tendencies for an organization over the stated planning interval.
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2011-03-04
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Chapter I [Docket EPA-HQ-OW-2011-0119; FRL-9275-4] Stakeholder Input: Listening Session to Provide Information and Solicit Suggestions for Regulations... stakeholders. DATES: The listening sessions will be held at 210 Holiday Court, Annapolis, Maryland 21401, on...
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Racial disparities in reported prenatal care advice from health care providers.
Kogan, M D; Kotelchuck, M; Alexander, G R; Johnson, W E
1994-01-01
OBJECTIVES. The relationship between certain maternal behaviors and adverse pregnancy outcomes has been well documented. One method to alter these behaviors is through the advice of women's health care providers. Advice from providers may be particularly important in minority populations, who have higher rates of infant mortality and prematurity. This study examines racial disparities according to women's self-report of advice received from health care providers during pregnancy in four areas: tobacco use, alcohol consumption, drug use, and breast-feeding. METHODS. Health care providers' advice to 8310 White non-Hispanic and Black women was obtained from the National Maternal and Infant Health Survey. RESULTS. After controlling for sociodemographic, utilization, and medical factors, Black women were more likely to report not receiving advice from their prenatal care providers about smoking cessation and alcohol use. The difference between Blacks and Whites also approached significance for breast-feeding. No overall difference was noted in advice regarding cessation of drug use, although there was a significant interaction between race and marital status. CONCLUSIONS. These data suggest that Black women may be at greater risk for not receiving information that could reduce their chances of having an adverse pregnancy outcome. PMID:8279618
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Enns, Eva Andrea; Kao, Szu-Yu; Kozhimannil, Katy Backes; Kahn, Judith; Farris, Jill; Kulasingam, Shalini L
2017-10-01
Mathematical models are important tools for assessing prevention and management strategies for sexually transmitted infections. These models are usually developed for a single infection and require calibration to observed epidemiological trends in the infection of interest. Incorporating other outcomes of sexual behavior into the model, such as pregnancy, may better inform the calibration process. We developed a mathematical model of chlamydia transmission and pregnancy in Minnesota adolescents aged 15 to 19 years. We calibrated the model to statewide rates of reported chlamydia cases alone (chlamydia calibration) and in combination with pregnancy rates (dual calibration). We evaluated the impact of calibrating to different outcomes of sexual behavior on estimated input parameter values, predicted epidemiological outcomes, and predicted impact of chlamydia prevention interventions. The two calibration scenarios produced different estimates of the probability of condom use, the probability of chlamydia transmission per sex act, the proportion of asymptomatic infections, and the screening rate among men. These differences resulted in the dual calibration scenario predicting lower prevalence and incidence of chlamydia compared with calibrating to chlamydia cases alone. When evaluating the impact of a 10% increase in condom use, the dual calibration scenario predicted fewer infections averted over 5 years compared with chlamydia calibration alone [111 (6.8%) vs 158 (8.5%)]. While pregnancy and chlamydia in adolescents are often considered separately, both are outcomes of unprotected sexual activity. Incorporating both as calibration targets in a model of chlamydia transmission resulted in different parameter estimates, potentially impacting the intervention effectiveness predicted by the model.
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Understanding paediatric rehabilitation therapists' lack of use of outcome measures.
King, Gillian; Wright, Virginia; Russell, Dianne J
2011-01-01
Despite widespread educational and promotional efforts, paediatric rehabilitation therapists still do not systematically or routinely use outcome measures. A review of contextual and psychosocial factors affecting therapists' use of outcome measures was performed, incorporating information from past studies of barriers to therapists' use of measures and more recent information about measure use, knowledge brokering and expert practice. This cumulative and contextual overview provided insights into how many therapists may approach practice. Therapists' beliefs in the importance of establishing effective relationships may lead them to place less value on formal measurement, to adopt a less rigorous and more pragmatic approach to ascertaining whether outcomes are achieved, and to avoid measures that may show little improvement. A relational goal-oriented approach to practice is proposed in which therapists adopt a broader facilitative and educational role with families about the importance of the measurement process.
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Takehara, Kenji; Okamura, Makoto; Sugiura, Naomi; Suto, Maiko; Sasaki, Hatoko; Mori, Rintaro
2016-07-27
The objective of this study is to investigate the effect of the distribution of a booklet providing information to fathers during their partners' pregnancies on fathers' and mothers' postpartum mental health and quality of life (QOL), as well as on fathers' childcare participation and living situations. This randomised controlled trial will comprise 554 couples consisting of pregnant women due to give birth at an obstetric institution in Aichi Prefecture, Japan and their partners. Participants will be recruited during prenatal check-ups in the third trimester, and those who provide written consent will be allocated randomly to an intervention and a control group. The pregnant women's partners allocated to the intervention group will be given a booklet written for men containing information on childbirth and postnatal period. Its content will include matters such as what preparations the partner should make before birth and tips for housework and childcare as well as how to prevent unintentional injury to the baby. The control group will not receive any intervention. A baseline survey in the third trimester and follow-up surveys at 1 and 3 months post partum will be carried out using self-administered questionnaires. The primary outcome is the proportion of new mothers' partners at risk for paternal depression (Edinburgh Postnatal Depression Scale score ≥8). Secondary outcomes include the risk of postnatal depression in new mothers, QOL of new mothers and their partners, partners' knowledge of and engagement in housework and childcare, marital relations and parenting stress on the part of new mothers. This study has been approved by the Ethical Committee at the National Center for Child Health and Development, Tokyo, Japan. The results of the study will be widely disseminated as peer-reviewed papers and at international conferences, with the aim of improving public health services in Japan. UMIN000021475; Pre-results. Published by the BMJ Publishing Group
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Donovan, Jennifer L; Kanaan, Abir O; Gurwitz, Jerry H; Tjia, Jennifer; Cutrona, Sarah L; Garber, Lawrence; Preusse, Peggy; Field, Terry S
2016-04-01
Older adults are often transferred from hospitals to skilled nursing facilities (SNFs) for post-acute care. Patients may be at risk for adverse outcomes after SNF discharges, but little research has focused on this period. Assessment of the feasibility of a transitional care intervention based on a combination of manual information transmission and health information technology to provide automated alert messages to primary care physicians and staff; pre-post analysis to assess potential impact. A multispecialty group practice. Adults aged 65 and older, discharged from SNFs to home; comparison group drawn from SNF discharges during the previous 1.5 years, matched on facility, patient age, and sex. For the pre-post analysis, we tracked rehospitalization within 30 days after discharge and adverse drug events within 45 days. The intervention was developed and implemented with manual transmission of information between 8 SNFs and the group practice followed by entry into the electronic health record. The process required a 5-day delay during which a large portion of the adverse events occurred. Over a 1-year period, automated alert messages were delivered to physicians and staff for the 313 eligible patients discharged from the 8 SNFs to home. We compared outcomes to those of individually matched discharges from the previous 1.5 years and found similar percentages with 30-day rehospitalizations (31% vs 30%, adjusted HR 1.06, 95% CI 0.80-1.4). Within the adverse drug event (ADE) study, 30% of the discharges during the intervention period and 30% of matched discharges had ADEs within 45 days. Older adults discharged from SNFs are at high risk of adverse outcomes immediately following discharge. Simply providing alerts to outpatient physicians, especially if delivered multiple days after discharge, is unlikely to have any impact on reducing these rates. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All
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How doing a dynamical analysis of gait movement may provide information about Autism
Wu, D.; Torres, E.; Nguyen, J.; Mistry, S.; Whyatt, C.; Kalampratsidou, V.; Kolevzon, A.; Jose, J.
Individuals with Autism Spectrum Disorder (ASD) are known to have deficits in language and social skills. They also have deficits on how they move. Why individuals get ASD? It is not generally known. There is, however, one particular group of children with a SHANK3 gene deficiency (Phelan-McDermid Syndrome (PMDS)) that present symptoms similar to ASD. We have been searching for universal mechanism in ASD going beyond the usual heterogeneous ASD symptoms. We studied motions in gaits for both PMDS patients and idiopathic ASD. We have examined their motions continuously at milliseconds time scale, away from naked eye detection. Gait is a complex process, requiring a complex integration and coordination of different joints' motions. Significant information about the development and/or deficits in the sensory system is hidden in our gaits. We discovered that the speed smoothness in feet motion during gaits is a critical feature that provides a significant distinction between subjects with ASD and typical controls. The differences in appearance of the speed fluctuations suggested a different coordination mechanism in subjects with disorders. Our work provides a very important feature in gait motion that has significant physiological information.
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Comfere, Nneka I; Sokumbi, Olayemi; Montori, Victor M; LeBlanc, Annie; Prokop, Larry J; Murad, M Hassan; Tilburt, Jon C
2014-05-01
Various components of the skin biopsy requisition form (SBRF) may contribute to accurate dermatopathologic interpretation. A search of electronic databases, including those of Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Scopus, was conducted from inception to October 2011. Two authors independently screened all articles for eligibility. Inclusion criteria required material to represent original studies on skin biopsy and pathology requisition forms. Data abstracted from each article that met the inclusion criteria included details of the study characteristics, including the study location, type of pathology practice, specimen type, type of dermatoses, medical specialty of the requesting provider, suggested clinical components, and format of the SBRF. Of 32 titles and abstracts reviewed, seven articles were included. From these, we determined that dermatologists, general practitioners and surgeons completed SBRFs. Commonly included components were patient demographics and requesting clinician characteristics. Clinical information and differential diagnosis were provided in 4% (two of 48 surgeons) to 36% (18 of 50 dermatologists) of requisitions. Most SBRFs did not include information on specimen type, clinical morphology, photographs or clinical history. The limited medical literature demonstrates variation in the content of SBRFs across clinicians and practices, and suggests an important target for improvement in the quality of communication and dermatologic care by requesting clinicians and pathologists. © 2013 The International Society of Dermatology.
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Butterly, Felicity; Percy, Carol; Ward, Gillian
2013-11-01
The aim of this study was to identify the outcomes expected and assessed by those providing service dogs to children with developmental disabilities. Seventeen registered service dog providers were invited to complete a mixed methods online survey. Five providers, who prepared dogs to work with a wide range of conditions and behaviours, mainly Asperger's syndrome, autism and communication disorders, completed the survey. All five participants reported that they expected to see positive changes as a consequence of the service dog placement, in both the recipient child and their family, including improvements in attention span and language skills, as well as increased familial cohesion. Survey responses indicated that not all desired outcomes were routinely assessed. The range of assessments used were interviews, intake conversations, pre-placement questionnaires, child social diaries filled in by parents, follow up surveys after placement, and child observation by parents. No specifically named valid and reliable clinical or research measures were referred to, showing an emphasis on assessments from parents and service dog providers. It is not clear whether pre-intervention assessments are repeated systematically at follow-up, which could show robust intervention effects. There is scope for professionals in developmental disability to work with service dog providers to improve the evidence base in this field.
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2010-10-01
... claims processing and information retrieval systems. 433.127 Section 433.127 Public Health CENTERS FOR... PROGRAMS STATE FISCAL ADMINISTRATION Mechanized Claims Processing and Information Retrieval Systems § 433.127 Termination of FFP for failure to provide access to claims processing and information retrieval...
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System to provide 3D information on geological anomaly zone in deep subsea
Kim, W.; Kwon, O.; Kim, D.
2017-12-01
The study on building the ultra long and deep subsea tunnel of which length is 50km and depth is 200m at least, respectively, is underway in Korea. To analyze the geotechnical information required for designing and building subsea tunnel, topographic/geologiccal information analysis using 2D seabed geophysical prospecting and topographic, geologic, exploration and boring data were analyzed comprehensively and as a result, automation method to identify the geological structure zone under seabed which is needed to design the deep and long seabed tunnel was developed using geostatistical analysis. In addition, software using 3D visualized ground information to provide the information includes Gocad, MVS, Vulcan and DIMINE. This study is intended to analyze the geological anomaly zone for ultra deep seabed l and visualize the geological investigation result so as to develop the exclusive system for processing the ground investigation information which is convenient for the users. Particularly it's compatible depending on file of geophysical prospecting result and is realizable in Layer form and for 3D view as well. The data to be processed by 3D seabed information system includes (1) deep seabed topographic information, (2) geological anomaly zone, (3) geophysical prospecting, (4) boring investigation result and (5) 3D visualization of the section on seabed tunnel route. Each data has own characteristics depending on data and interface to allow interlocking with other data is granted. In each detail function, input data is displayed in a single space and each element is selectable to identify the further information as a project. Program creates the project when initially implemented and all output from detail information is stored by project unit. Each element representing detail information is stored in image file and is supported to store in text file as well. It also has the function to transfer, expand/reduce and rotate the model. To represent the all elements in
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Directory of Open Access Journals (Sweden)
Angus G K McNair
Full Text Available The CONSORT extension for patient reported outcomes (PROs aims to improve reporting, but guidance on the optimal integration with clinical data is lacking. This study examines in detail the reporting of PROs and clinical data from randomized controlled trials (RCTs in gastro-intestinal cancer to inform design and reporting of combined PRO and clinical data from trials to improve the 'take home' message for clinicians to use in practice.The case study was undertaken in gastro-intestinal cancer trials. Well-conducted RCTs reporting PROs with validated instruments were identified and categorized into those combining PRO and clinical data in a single paper, or those separating data into linked primary and supplemental papers. Qualitative methods were developed to examine reporting of the critical interpretation of the trial results (trial exegesis in the papers in relation of the PRO and clinical outcomes and applied to each publication category. Results were used to inform recommendations for practice.From 1917 screened abstracts, 49 high quality RCTs were identified reported in 36 combined and 15 linked primary and supplemental papers. In-depth analysis of manuscript text identified three categories for understanding trial exegesis: where authors reported a "detailed", "general", or absent PRO rationale and integrated interpretation of clinical and PRO results. A total of 11 (30% and 6 (16% combined papers reported "detailed" PRO rationale and integrated interpretation of results although only 2 (14% and 1 (7% primary papers achieved the same standard respectively. Supplemental papers provide better information with 11 (73% and 3 (20% achieving "detailed" rationale and integrated interpretation of results. Supplemental papers, however, were published a median of 20 months after the primary RCT data in lower impact factor journals (median 16.8 versus 5.2.It is recommended that single papers, with detailed PRO rationale and integrated PRO and
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Lederer, Swati; Fischer, Michael J; Gordon, Howard S; Wadhwa, Anuradha; Popli, Subhash; Gordon, Elisa J
2015-12-01
Many patients with chronic kidney disease (CKD) have insufficient knowledge about CKD, which is associated with poorer health outcomes. Effective patient-provider communication can improve CKD patients' knowledge, thereby augmenting their participation in self-care practices. However, barriers to addressing CKD patients' information needs have not been previously characterized. Adults with an estimated glomerular filtration rate (eGFR) of communication dynamics. Thirty-two patients participated. The mean age of participants was 63 years; most were male (94%) and non-Hispanic white (53%). CKD severity groups represented included CKD-3 (eGFR 30-59 mL/min/1.73 m(2); 34%), CKD-4 (eGFR 15-29 mL/min/1.73 m(2); 25%), CKD-5 (eGFR barriers to patient-provider communication based on patients' reported care at both VA and non-VA facilities, including patients perceived their role as a 'listener', reported limited CKD knowledge, did not understand physicians' explanations and were dissatisfied with the patient-provider relationship. Several barriers to patient-provider communication prevent patients from meeting their information needs and perpetuate patient passivity. Future research should evaluate whether interventions that empower CKD patients to actively participate in their care increase knowledge and improve health outcomes.
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Gutacker, Nils; Street, Andrew; Gomes, Manuel; Bojke, Chris
2015-08-01
The best practice tariff for hip and knee replacement in the English National Health Service (NHS) rewards providers based on improvements in patient-reported outcome measures (PROMs) collected before and after surgery. Providers only receive a bonus if at least 50% of their patients complete the preoperative questionnaire. We determined how many providers failed to meet this threshold prior to the policy introduction and assessed longitudinal stability of participation rates. Retrospective observational study using data from Hospital Episode Statistics and the national PROM programme from April 2009 to March 2012. We calculated participation rates based on either (a) all PROM records or (b) only those that could be linked to inpatient records; constructed confidence intervals around rates to account for sampling variation; applied precision weighting to allow for volume; and applied risk adjustment. NHS hospitals and private providers in England. NHS patients undergoing elective unilateral hip and knee replacement surgery. Number of providers with participation rates statistically significantly below 50%. Crude rates identified many providers that failed to achieve the 50% threshold but there were substantially fewer after adjusting for uncertainty and precision. While important, risk adjustment required restricting the analysis to linked data. Year-on-year correlation between provider participation rates was moderate. Participation rates have improved over time and only a small number of providers now fall below the threshold, but administering preoperative questionnaires remains problematic in some providers. We recommend that participation rates are based on linked data and take into account sampling variation. © The Royal Society of Medicine.
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Provider training and experience for people living with HIV/AIDS.
Rackal, Julia M; Tynan, Anne-Marie; Handford, Curtis D; Rzeznikiewiz, Damian; Agha, Ayda; Glazier, Richard
2011-06-15
The complexity of HIV/AIDS raises challenges for the effective delivery of care. It is important to ensure that the expertise and experience of care providers is of high quality. Training and experience of HIV/AIDS providers may impact not only individual patient outcomes but increasingly on health care costs as well. The objective of this review is to assess the effects of provider training and experience on people living with HIV/AIDS on the following outcomes: immunological (ie. viral load, CD4 count), medical (ie. mortality, proportion on antiretrovirals), psychosocial (ie. quality of life measures) and economic outcomes (ie health care costs). We searched MEDLINE, EMBASE, Dissertation Abstracts International (DAI), CINAHL, HealthStar, PsycInfo, PsycLit, Social Sciences Abstracts, and Sociological Abstracts from January 1, 1980 through May 29, 2009. Electronic searches were performed for abstracts from major international AIDS conferences. Reference lists from pertinent articles, books and review articles were retrieved and reviewed. Randomized controlled trials (RCTs), controlled clinical trials, cohort, case control, cross-sectional studies and controlled before and after designs that examined the qualifications/training and patient volume of HIV/AIDS care of providers caring for persons known to be infected with HIV/AIDS were included. At least two authors independently assessed trial quality and extracted data. Study authors were contacted for further information as required. Assessment of confounding factors was undertaken independently by two reviewers. A total of four studies (one randomized controlled trial, three non- randomized studies) involving 8488 people living with HIV/AIDS were included. The main findings of this review demonstrated a trend to improved outcomes when treated by a provider with more training/expertise in HIV/AIDS care in the outpatient (clinic) setting. Due to the heterogeneity of the included studies, we could not perform a
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Directory of Open Access Journals (Sweden)
Christine Urquhart
2001-01-01
Full Text Available The aim of the paper is to compare the philosophies of the vignette and critical incident techniques in information behaviour research, with the methodologies used in object oriented analysis such as use case scenarios and CRC (class, responsibility, collaboration cards. The principles of object oriented analysis are outlined, noting the emphasis on obtaining the "storyline" or "scripts" for information requirements analysis through use cases and CRC cards. The critical incident technique and vignettes are used to obtain valid interpretations of users" information behaviour, using a storyline approach for data collection (and analysis which is similar to that of object oriented analysis. Some examples illustrate how techniques developed in object oriented analysis could be used for data display in information behaviour studies. Concludes that the methods developed by software engineering could be adapted usefully for information behaviour research.
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Hester, Katy L M; Newton, Julia; Rapley, Tim; De Soyza, Anthony
2018-05-22
Bronchiectasis is an incurable lung disease characterised by irreversible airway dilatation. It causes symptoms including chronic productive cough, dyspnoea, and recurrent respiratory infections often requiring hospital admission. Fatigue and reductions in quality of life are also reported in bronchiectasis. Patients often require multi-modal treatments that can be burdensome, leading to issues with adherence. In this article we review the provision of, and requirement for, education and information in bronchiectasis. To date, little research has been undertaken to improve self-management in bronchiectasis in comparison to other chronic conditions, such as COPD, for which there has been a wealth of recent developments. Qualitative work has begun to establish that information deficit is one of the potential barriers to self-management, and that patients feel having credible information is fundamental when learning to live with and manage bronchiectasis. Emerging research offers some insights into ways of improving treatment adherence and approaches to self-management education; highlighting ways of addressing the specific unmet information needs of patients and their families who are living with bronchiectasis. We propose non-pharmacological recommendations to optimise patient self-management and symptom recognition; with the aim of facilitating measurable improvements in health outcomes for patients with bronchiectasis.
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Assessment of COPD-related outcomes via a national electronic medical record database.
Asche, Carl; Said, Quayyim; Joish, Vijay; Hall, Charles Oaxaca; Brixner, Diana
2008-01-01
The technology and sophistication of healthcare utilization databases have expanded over the last decade to include results of lab tests, vital signs, and other clinical information. This review provides an assessment of the methodological and analytical challenges of conducting chronic obstructive pulmonary disease (COPD) outcomes research in a national electronic medical records (EMR) dataset and its potential application towards the assessment of national health policy issues, as well as a description of the challenges or limitations. An EMR database and its application to measuring outcomes for COPD are described. The ability to measure adherence to the COPD evidence-based practice guidelines, generated by the NIH and HEDIS quality indicators, in this database was examined. Case studies, before and after their publication, were used to assess the adherence to guidelines and gauge the conformity to quality indicators. EMR was the only source of information for pulmonary function tests, but low frequency in ordering by primary care was an issue. The EMR data can be used to explore impact of variation in healthcare provision on clinical outcomes. The EMR database permits access to specific lab data and biometric information. The richness and depth of information on "real world" use of health services for large population-based analytical studies at relatively low cost render such databases an attractive resource for outcomes research. Various sources of information exist to perform outcomes research. It is important to understand the desired endpoints of such research and choose the appropriate database source.
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Directory of Open Access Journals (Sweden)
Mariaan Roos
2012-12-01
Full Text Available Reporting on performance was legislatively established in South Africa in terms of the Public Finance Management Act, Act 1 of 1999, section 40 (3(a. The auditing of the reported information was legislated in the Public Audit Act, Act 25 of 2004, section 20(2 (c. The objectives of the article are firstly to provide an overview of the development and application of the reporting and secondly providing assurance on service delivery information and thirdly to reflect on challenges to the implementation thereof in South Africa. The aim through deploying these set objectives is to formulate possible future considerations for improved governance. As central part of the methodology, review of literature on reporting and audit of non-financialwas conducted. The research included scrutiny of the different philosophies and approaches adopted by different countries to the reporting and providing assurance on service delivery information. In this respect, the research reflects a comparative element. In South Africa the Auditor-General adopted a phasing-in approach. The development of the audit approach and audit procedures has reached a stable stage, nine years after the initial process started. The audit of performance information now forms an integral part of the regularity audit process. The analysis of audit findings of the period under study indicates a considerable improvement once initiated, but stagnation persists in subsequent years. Numerous challenges remain around the application of performance reporting in South Africa including non-compliance, the lack of sufficient and appropriate audit evidence, inconsistencies between the various strategic documents and the need to improve the usefulness of performance information. In conclusion the article proposes some steps to address the challenges.
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78 FR 20900 - Agency Information Collection Activities: Submission for OMB Review; Comment Request
2013-04-08
....gov , including any personal information provided. Sensitive personal information, such as account... and empowerment programs, and practices that can improve financial decision-making skills and outcomes... BUREAU OF CONSUMER FINANCIAL PROTECTION [Docket No. CFPB-2013-0007] Agency Information Collection...
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Ahn, Jae-Young; Park, Hae-Ryun; Lee, Kiwon; Kwon, Sooyoun; Kim, Soyeong; Yang, Jihye; Song, Kyung-Hee
2015-01-01
BACKGROUND/OBJECTIVES To encourage healthier food choices for children in fast-food restaurants, many initiatives have been proposed. This study aimed to examine the effect of disclosing nutritional information on parents' meal choices for their children at fast-food restaurants in South Korea. SUBJECTS/METHODS An online experimental survey using a menu board was conducted with 242 parents of children aged 2-12 years who dined with them at fast-food restaurants at least once a month. Participants were classified into two groups: the low-calorie group (n = 41) who chose at least one of the lowest calorie meals in each menu category, and the high-calorie group (n = 201) who did not. The attributes including perceived empowerment, use of provided nutritional information, and perceived difficulties were compared between the two groups. RESULTS The low-calorie group perceived significantly higher empowerment with the nutritional information provided than did the high-calorie group (P = 0.020). Additionally, the low-calorie group was more interested in nutrition labeling (P nutritional value of menus when selecting restaurants for their children more than did the high-calorie group (P = 0.017). The low-calorie group used the nutritional information provided when choosing meals for their children significantly more than did the high-calorie group (P nutritional information provided (P = 0.012). CONCLUSIONS The results suggest that improving the empowerment of parents using nutritional information could be a strategy for promoting healthier parental food choices for their children at fast-food restaurants. PMID:26634057
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Directory of Open Access Journals (Sweden)
Basedow M
2016-08-01
Full Text Available Martin Basedow,1 Peter Hibbert,1 Tamara Hooper,1 William Runciman,1 Adrian Esterman,2 1School of Psychology, Social Work and Social Policy, 2School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia Objective: The aim of this study was to evaluate the satisfaction of Australian patients who suffer from osteoarthritis (OA with their health care providers and the perceived helpfulness of treatments and information sources. Methods: A self-administered questionnaire was conducted with a sample of 560 Australian patients who suffer from OA with questions about satisfaction with health care providers and the helpfulness of different treatment options and information sources. Logistic regression models were used to assess potential predictors of satisfaction. Thematic analysis was undertaken for attitudinal factors associated with satisfaction. Results: A total of 435 participants returned questionnaires (response rate 78%. Most respondents were highly satisfied with the care provided by their general practitioner (GP (84%, communication with their GP (88%, time spent with their GP (84%, and their ability to talk freely with their GP about their medical problem (93%, but less satisfied with their ability to talk freely about associated emotional problems (77%. Satisfaction with pharmacists (80%, rheumatologists (76%, and orthopedic surgeons (72% was high. Joint replacement surgery (91%, prescription anti-inflammatory medications (66%, aids and assistive devices (65%, intra-articular injections (63%, and prescription painkiller medications (62% were perceived as effective treatments. Less highly rated treatments were exercise (48%, physiotherapy (43%, and complementary medicines (29%. A majority of patients were satisfied with the information to manage their OA (65%. From the multivariable logistic regression analysis, four GP satisfaction factors were found to be predictors of overall satisfaction with GP care: the amount
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Walton, Marc K; Powers, John H; Hobart, Jeremy; Patrick, Donald; Marquis, Patrick; Vamvakas, Spiros; Isaac, Maria; Molsen, Elizabeth; Cano, Stefan; Burke, Laurie B
2015-09-01
An outcome assessment, the patient assessment used in an endpoint, is the measuring instrument that provides a rating or score (categorical or continuous) that is intended to represent some aspect of the patient's health status. Outcome assessments are used to define efficacy endpoints when developing a therapy for a disease or condition. Most efficacy endpoints are based on specified clinical assessments of patients. When clinical assessments are used as clinical trial outcomes, they are called clinical outcome assessments (COAs). COAs include any assessment that may be influenced by human choices, judgment, or motivation. COAs must be well-defined and possess adequate measurement properties to demonstrate (directly or indirectly) the benefits of a treatment. In contrast, a biomarker assessment is one that is subject to little, if any, patient motivational or rater judgmental influence. This is the first of two reports by the ISPOR Clinical Outcomes Assessment - Emerging Good Practices for Outcomes Research Task Force. This report provides foundational definitions important for an understanding of COA measurement principles. The foundation provided in this report includes what it means to demonstrate a beneficial effect, how assessments of patients relate to the objective of showing a treatment's benefit, and how these assessments are used in clinical trial endpoints. In addition, this report describes intrinsic attributes of patient assessments and clinical trial factors that can affect the properties of the measurements. These factors should be considered when developing or refining assessments. These considerations will aid investigators designing trials in their choice of using an existing assessment or developing a new outcome assessment. Although the focus of this report is on the development of a new COA to define endpoints in a clinical trial, these principles may be applied more generally. A critical element in appraising or developing a COA is to
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Providing Market Information for Ethiopian Farmers: Extending Participatory Design
DEFF Research Database (Denmark)
Zewge, Amanuel; Dittrich, Yvonne; Bekele, Rahel
In a developing country like Ethiopia, marketing of agricultural products is influenced by local, socioeconomic, cultural and IT infrastructure characteristics. ICT-based agriculture information systems have been proposed to support farmers with market information. However, such initiatives have...
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Providing patient information and education in practice: the role of the health librarian.
Truccolo, Ivana
2016-06-01
In this article, guest writer Ivana Truccolo presents an overview of her work at the Scientific and Patient Library of a Cancer Comprehensive Centre in Italy coordinating the patient education process. She discusses the historical evolution of the concept of patient education and how this has run alongside the role of the health librarian in the provision of consumer health information. Details are provided about various patient education programmes in place at the Centre. In particular, various activities are discussed including patient education classes, the development of patient education handouts and a narrative medicine programme which includes a literary competition. The article concludes with a specific outline of the role the health librarian can play in the provision of consumer health information and patient education. H.S. © 2016 Health Libraries Group.
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Pérez Jolles, Mónica; Martinez, Maria; Garcia, San Juanita; Stein, Gabriela L; Thomas, Kathleen C
2017-10-01
Comparative effectiveness research (CER) is supported by policymakers as a way to provide service providers and patients with evidence-based information to make better health-care decisions and ultimately improve services for patients. However, Latina/o patients are rarely involved as study advisors, and there is a lack of documentation on how their voices contribute to the research process when they are included as collaborators. The purpose of this article was to contribute to the literature by presenting concrete contributions of Latina/o parent involvement to study design, implementation and outcomes in the context of a CER study called Padres Efectivos (Parent Activation). Researchers facilitated a collaborative relationship with parents by establishing a mentor parent group. The contributions of parent involvement in the following stages of the research process are described: (i) proposal development, (ii) implementation of protocols, (iii) analysis plan and (iv) dissemination of results. Mentor parents' contributions helped tailor the content of the intervention to their needs during proposal, increased recruitment, validated the main outcome measure and added two important outcome measures, emphasized the importance of controlling for novice treatment status and developed innovative dissemination strategies. Mentor parents' guidance to the researchers has contributed to reaching recruitment goals, strengthened the study protocol, expanded findings, supported broad ownership of study implications and enriched the overall study data collection efforts. These findings can inform future research efforts seeking an active Latino parent collaboration and the timely incorporation of parent voices in each phase of the research process. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.
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Directory of Open Access Journals (Sweden)
Iryna Svistel’nik
2016-04-01
Full Text Available Purpose: to investigate the innovative forms of the informative providing of educational process in institutions of higher learning of physical culture and sport of countries: Ukraine, Republic of Belarus, Republic of Moldova, Republic of Kazakhstan, Republic of Uzbekistan, Russian Federation. Material & Methods: content-analysis of web sites and web pages of sporting institutions of higher learning of these countries. Results: the informative providing of institutions of higher learning of physical culture and sport of Ukraine, Belarus, Moldova, Kazakhstan, Uzbekistan and RF differs substantially, in spite of the fact that the specific of educating in these educational establishments is identical. Institutions of higher learning of physical culture and sport of Ukraine actively offer the innovative forms of the informative providing − give possibility to the students and teachers to take advantage of e-catalog, electronic repository, virtual bibliographic certificate, electronic delivery of document. Sporting institutions of higher learning of Belarus, Kazakhstan, Uzbekistan and Russian Federation carry out the informative providing by means of the electronic-library systems, in particular "Znanium.com" and "Rukont". The system "Rukont" is erected in the grade of the national inter-branch digital resource created on the base of state educational standard and contains the informative resource of different family: books, magazines, separate articles, and also audio, video data, multimedia. Collection of electronic versions of editions of electronic-library systems "Znanium.com" unites books, magazines, articles grouped on thematic and having a special purpose signs. The unique institute of higher of Republic of Moldova does not give electronic informative services, but uses the traditional forms of the informative providing by means of catalogues and card library indexes. Conclusions: higher educational establishments of physical culture and
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Information therapy: The strategic role of prescribed information in disease self-management.
Mettler, Molly; Kemper, Donald W
2006-01-01
Imagine this: evidence-based medical information specifically written for and prescribed to a patient with chronic illness, targeted to that patient's specific "moment in care" and designed to help that patient manage his or her illness. Imagine "information therapy" built into every clinical encounter that a patient has with a physician or other health care service. Information therapy is defined as the timely prescription and availability of evidence-based health information to meet individuals' specific needs and support sound decision making. Information therapy is a new disease management tool that provides cost-effective disease management support to a much larger portion of the chronically ill population than is generally reached. This paper is a practical presentation of information therapy, its role in predictive modeling and disease self-management, and its potential for improving the outcomes of chronic care.
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Criteria for the evaluation of a cloud-based hospital information system outsourcing provider.
Low, Chinyao; Hsueh Chen, Ya
2012-12-01
As cloud computing technology has proliferated rapidly worldwide, there has been a trend toward adopting cloud-based hospital information systems (CHISs). This study examines the critical criteria for selecting the CHISs outsourcing provider. The fuzzy Delphi method (FDM) is used to evaluate the primary indicator collected from 188 useable responses at a working hospital in Taiwan. Moreover, the fuzzy analytic hierarchy process (FAHP) is employed to calculate the weights of these criteria and establish a fuzzy multi-criteria model of CHISs outsourcing provider selection from 42 experts. The results indicate that the five most critical criteria related to CHISs outsourcing provider selection are (1) system function, (2) service quality, (3) integration, (4) professionalism, and (5) economics. This study may contribute to understanding how cloud-based hospital systems can reinforce content design and offer a way to compete in the field by developing more appropriate systems.
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Interactions between patients and dental care providers: does gender matter?
Inglehart, Marita R
2013-04-01
Research findings concerning the role of gender in patient-physician interactions can inform considerations about the role of gender in patient-dental care provider interactions. Medical research showed that gender differences in verbal and nonverbal communication in medical settings exist and that they affect the outcomes of these interactions. The process of communication is shaped by gender identities, gender stereotypes, and attitudes. Future research needs to consider the cultural complexity and diversity in which gender issues are embedded and the degree to which ongoing value change will shape gender roles and in turn interactions between dental patients and their providers. Copyright © 2013 Elsevier Inc. All rights reserved.
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Assessment of residency program outcomes via alumni surveys.
Lüer, Sonja; Aebi, Christoph
2017-01-01
One trend in medical education is outcomes-oriented training. Outcomes usually refer to individuals' acquisition of competencies, for example, during training in residency programs. However, little is known about outcomes of these programs. In order to fill this gap, human resource (HR) data were analyzed and alumni of a pediatric residency program were surveyed at the Department of Pediatrics, Bern University Hospital, Switzerland. Residency program outcomes (demographics, career choices, part-time or full-time work status, competencies, feedback) were assessed through in-house HR databases, publicly available data on the Internet (physician directory and practice homepages), and 2 alumni surveys (S1, S2). In all, 109 alumni met the inclusion criteria. Retention rate at the hospital was low (14%). Forty-six alumni (42%) in private practice were eligible for alumni surveys. Response rates were 87% (S1) and 61% (S2). Time intervals between 2 career decisions (selecting specialty of pediatrics vs selecting setting of private practice) varied widely (late-training decision to enter private practice). Mean employment level in private practice was 60% (range 20%-100%). Most valued rotation was emergency medicine; most desired competencies in future colleagues were the ability to work in a team, proficiency in pediatrics, and working economically. A broadened view on outcomes - beyond individuals' competency acquisition - provides informative insights into a training program, can allow for informed program updates, and guide future program development.
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Connecting Inspiration with Information: Studio Art Students and Information Literacy Instruction
Directory of Open Access Journals (Sweden)
Katie Greer
2015-06-01
Full Text Available This article discusses the partnership between the library and the studio art faculty at [Institution name], that led to the integration of information literacy instruction into the studio art curriculum. The author outlines the importance of information literacy to artistic practice and student success, and discusses the program of instruction and learning outcomes. Early assessment of student needs and the program’s effectiveness, using both citation analysis and anecdotal feedback, reveals that the program has contributed to the maturation of student research and inquiry skills, and positively affected the relationship between the department and the library, and provides preliminary conclusions about undergraduate studio art information behaviors. An ongoing further program of study to more fully describe the information needs of undergraduate studio art students is also outlined.
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What Is the Role of Informal Healthcare Providers in Developing Countries? A Systematic Review
Sudhinaraset, May; Ingram, Matthew; Lofthouse, Heather Kinlaw; Montagu, Dominic
2013-01-01
Informal health care providers (IPs) comprise a significant component of health systems in developing nations. Yet little is known about the most basic characteristics of performance, cost, quality, utilization, and size of this sector. To address this gap we conducted a comprehensive literature review on the informal health care sector in developing countries. We searched for studies published since 2000 through electronic databases PubMed, Google Scholar, and relevant grey literature from The New York Academy of Medicine, The World Bank, The Center for Global Development, USAID, SHOPS (formerly PSP-One), The World Health Organization, DFID, Human Resources for Health Global Resource Center. In total, 334 articles were retrieved, and 122 met inclusion criteria and chosen for data abstraction. Results indicate that IPs make up a significant portion of the healthcare sector globally, with almost half of studies (48%) from Sub-Saharan Africa. Utilization estimates from 24 studies in the literature of IP for healthcare services ranged from 9% to 90% of all healthcare interactions, depending on the country, the disease in question, and methods of measurement. IPs operate in a variety of health areas, although baseline information on quality is notably incomplete and poor quality of care is generally assumed. There was a wide variation in how quality of care is measured. The review found that IPs reported inadequate drug provision, poor adherence to clinical national guidelines, and that there were gaps in knowledge and provider practice; however, studies also found that the formal sector also reported poor provider practices. Reasons for using IPs included convenience, affordability, and social and cultural effects. Recommendations from the literature amount to a call for more engagement with the IP sector. IPs are a large component of nearly all developing country health systems. Research and policies of engagement are needed. PMID:23405101
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Directory of Open Access Journals (Sweden)
João Maurício Castaldelli-Maia
2013-12-01
Full Text Available Objective: To analyze the predictors of smoking cessation treatment outcomes in a sample with a high rate of medical and psychiatric disorders and addictions. Methods: Analysis of predictors of success of a 6-week treatment provided by an addiction care unit (CAPS-AD to 367 smokers in Brazil from 2007 to 2010. Forty variables were collected at baseline. Success was defined as abstinence from smoking for a period of at least 14 consecutive days, including the last day of treatment. Twenty variables were selected for the logistic regression model. Results: The only condition correlated with successful treatment after logistic regression was smoking one's first cigarette 5 minutes or more after waking (beta = 1.85, 95% confidence interval [95%CI] = 1.11-3.10, p = 0.018. Subjects with hypertension and alcohol use disorders and those who were undergoing psychiatric treatment showed success rates comparable to or greater than the average success rate of the sample (34.2-44.4%. Conclusions: These findings support the importance of the variable time to first cigarette in treatment outcomes for a sample with a high rate of clinical and psychiatric disorders. Good success rates were observed for pharmacological treatment, which was combined with group therapy based on cognitive-behavioral concepts and integrated into ongoing treatment of other addictions and psychiatric disorders.
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Goodall, Ken; Ward, Paul; Newman, Lareen
2010-01-01
print media from Australia and their home countries, family and acquaintances, government departments or service providers. Many expressed a preference for receiving information as printed material or directly from another person. Governments or primary healthcare organisations planning to make health information solely available via ICT should be aware that doing so may lead to an increase in 'information exclusion' and the formation of functional knowledge deficits for older migrants. At the moment at least, our participants do not perceive any functional knowledge deficits as they engage multiple sources to access the information they need for everyday life. We recommend that governments and healthcare organisations evaluate the appropriateness of using ICT to directly provide information to older migrants and consider non-digital means or the engagement of 'information brokers' when communicating with groups identified as low or non-users of ICT.
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Silarova, Barbora; Lucas, Joanne; Butterworth, Adam S; Di Angelantonio, Emanuele; Girling, Christine; Lawrence, Kathryn; Mackintosh, Stuart; Moore, Carmel; Payne, Rupert A; Sharp, Stephen J; Shefer, Guy; Tolkien, Zoe; Usher-Smith, Juliet; Walker, Matthew; Danesh, John; Griffin, Simon
2015-09-07
Cardiovascular disease (CVD) remains the leading cause of death globally. Primary prevention of CVD requires cost-effective strategies to identify individuals at high risk in order to help target preventive interventions. An integral part of this approach is the use of CVD risk scores. Limitations in previous studies have prevented reliable inference about the potential advantages and the potential harms of using CVD risk scores as part of preventive strategies. We aim to evaluate short-term effects of providing different types of information about coronary heart disease (CHD) risk, alongside lifestyle advice, on health-related behaviours. In a parallel-group, open randomised trial, we are allocating 932 male and female blood donors with no previous history of CVD aged 40-84 years in England to either no intervention (control group) or to one of three active intervention groups: i) lifestyle advice only; ii) lifestyle advice plus information on estimated 10-year CHD risk based on phenotypic characteristics; and iii) lifestyle advice plus information on estimated 10-year CHD risk based on phenotypic and genetic characteristics. The primary outcome is change in objectively measured physical activity. Secondary outcomes include: objectively measured dietary behaviours; cardiovascular risk factors; current medication and healthcare usage; perceived risk; cognitive evaluation of provision of CHD risk scores; and psychological outcomes. The follow-up assessment takes place 12 weeks after randomisation. The experiences, attitudes and concerns of a subset of participants will be also studied using individual interviews and focus groups. The INFORM study has been designed to provide robust findings about the short-term effects of providing different types of information on estimated 10-year CHD risk and lifestyle advice on health-related behaviours. Current Controlled Trials ISRCTN17721237 . Registered 12 January 2015.
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Architecture of a Framework for Providing Information Services for Public Transport
Directory of Open Access Journals (Sweden)
Gabino Padrón
2012-04-01
Full Text Available This paper presents OnRoute, a framework for developing and running ubiquitous software that provides information services to passengers of public transportation, including payment systems and on-route guidance services. To achieve a high level of interoperability, accessibility and context awareness, OnRoute uses the ubiquitous computing paradigm. To guarantee the quality of the software produced, the reliable software principles used in critical contexts, such as automotive systems, are also considered by the framework. The main components of its architecture (run-time, system services, software components and development discipline and how they are deployed in the transportation network (stations and vehicles are described in this paper. Finally, to illustrate the use of OnRoute, the development of a guidance service for travellers is explained.
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Citation analysis did not provide a reliable assessment of core outcome set uptake.
Barnes, Karen L; Kirkham, Jamie J; Clarke, Mike; Williamson, Paula R
2017-06-01
The aim of the study was to evaluate citation analysis as an approach to measuring core outcome set (COS) uptake, by assessing whether the number of citations for a COS report could be used as a surrogate measure of uptake of the COS by clinical trialists. Citation data were obtained for COS reports published before 2010 in five disease areas (systemic sclerosis, rheumatoid arthritis, eczema, sepsis and critical care, and female sexual dysfunction). Those publications identified as a report of a clinical trial were examined to identify whether or not all outcomes in the COS were measured in the trial. Clinical trials measuring the relevant COS made up a small proportion of the total number of citations for COS reports. Not all trials citing a COS report measured all the recommended outcomes. Some trials cited the COS reports for other reasons, including the definition of a condition or other trial design issues addressed by the COS report. Although citation data can be readily accessed, it should not be assumed that the citing of a COS report indicates that a trial has measured the recommended COS. Alternative methods for assessing COS uptake are needed. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
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de Jong, Catharina Carolina; Ros, Wynand Jg; Schrijvers, Guus
2014-01-16
In support of professional practice, asynchronous communication between the patient and the provider is implemented separately or in combination with Internet-based self-management interventions. This interaction occurs primarily through electronic messaging or discussion boards. There is little evidence as to whether it is a useful tool for chronically ill patients to support their self-management and increase the effectiveness of interventions. The aim of our study was to review the use and usability of patient-provider asynchronous communication for chronically ill patients and the effects of such communication on health behavior, health outcomes, and patient satisfaction. A literature search was performed using PubMed and Embase. The quality of the articles was appraised according to the National Institute for Health and Clinical Excellence (NICE) criteria. The use and usability of the asynchronous communication was analyzed by examining the frequency of use and the number of users of the interventions with asynchronous communication, as well as of separate electronic messaging. The effectiveness of asynchronous communication was analyzed by examining effects on health behavior, health outcomes, and patient satisfaction. Patients' knowledge concerning their chronic condition increased and they seemed to appreciate being able to communicate asynchronously with their providers. They not only had specific questions but also wanted to communicate about feeling ill. A decrease in visits to the physician was shown in two studies (P=.07, P=.07). Increases in self-management/self-efficacy for patients with back pain, dyspnea, and heart failure were found. Positive health outcomes were shown in 12 studies, where the clinical outcomes for diabetic patients (HbA1c level) and for asthmatic patients (forced expiratory volume [FEV]) improved. Physical symptoms improved in five studies. Five studies generated a variety of positive psychosocial outcomes. The effect of
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So, Jiyeon; Jeong, Se-Hoon; Hwang, Yoori
2017-04-01
The extant empirical research examining the effectiveness of statistical and exemplar-based health information is largely inconsistent. Under the premise that the inconsistency may be due to an unacknowledged moderator (O'Keefe, 2002), this study examined a moderating role of outcome-relevant involvement (Johnson & Eagly, 1989) in the effects of statistical and exemplified risk information on risk perception. Consistent with predictions based on elaboration likelihood model (Petty & Cacioppo, 1984), findings from an experiment (N = 237) concerning alcohol consumption risks showed that statistical risk information predicted risk perceptions of individuals with high, rather than low, involvement, while exemplified risk information predicted risk perceptions of those with low, rather than high, involvement. Moreover, statistical risk information contributed to negative attitude toward drinking via increased risk perception only for highly involved individuals, while exemplified risk information influenced the attitude through the same mechanism only for individuals with low involvement. Theoretical and practical implications for health risk communication are discussed.
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Health Care Providers' Spirit at Work Within a Restructured Workplace.
Wagner, Joan I J; Brooks, Denise; Urban, Ann-Marie
2018-01-01
Spirit at work (SAW) research emerged as a response to care provider determination to maintain a healthy and productive health care work environment, despite restructuring. The aim of this descriptive mixed-methods research is to present the care provider's perceptions of SAW. SAW is a holistic measure of care provider workplace outcomes, defined as the unique experience of individuals who are passionate about and energized by their work. A mixed group of licensed and unlicensed care providers in a continuing care workplace were surveyed. Eighteen Likert-type scale survey questions were further informed by two open-ended questions. Results indicated that unlicensed continuing care providers' perceptions of SAW are lower than licensed care providers. Responses suggest that open discussion between managers and team members, combined with structured workplace interventions, will lead to enhanced SAW and improved patient care. Further research on SAW within the continuing care workplace is required.
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Manojlovich, Milisa; Adler-Milstein, Julia; Harrod, Molly; Sales, Anne; Hofer, Timothy P; Saint, Sanjay; Krein, Sarah L
2015-06-11
Communication failures between physicians and nurses are one of the most common causes of adverse events for hospitalized patients, as well as a major root cause of all sentinel events. Communication technology (ie, the electronic medical record, computerized provider order entry, email, and pagers), which is a component of health information technology (HIT), may help reduce some communication failures but increase others because of an inadequate understanding of how communication technology is used. Increasing use of health information and communication technologies is likely to affect communication between nurses and physicians. The purpose of this study is to describe, in detail, how health information and communication technologies facilitate or hinder communication between nurses and physicians with the ultimate goal of identifying how we can optimize the use of these technologies to support effective communication. Effective communication is the process of developing shared understanding between communicators by establishing, testing, and maintaining relationships. Our theoretical model, based in communication and sociology theories, describes how health information and communication technologies affect communication through communication practices (ie, use of rich media; the location and availability of computers) and work relationships (ie, hierarchies and team stability). Therefore we seek to (1) identify the range of health information and communication technologies used in a national sample of medical-surgical acute care units, (2) describe communication practices and work relationships that may be influenced by health information and communication technologies in these same settings, and (3) explore how differences in health information and communication technologies, communication practices, and work relationships between physicians and nurses influence communication. This 4-year study uses a sequential mixed-methods design, beginning with a
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YouTube provides irrelevant information for the diagnosis and treatment of hip arthritis.
Koller, Ulrich; Waldstein, Wenzel; Schatz, Klaus-Dieter; Windhager, Reinhard
2016-10-01
YouTube is increasingly becoming a key source for people to satisfy the need for additional information concerning their medical condition. This study analyses the completeness of accurate information found on YouTube pertaining to hip arthritis. The present study analyzed 133 YouTube videos using the search terms: hip arthritis, hip arthritis symptoms, hip arthritis diagnosis, hip arthritis treatment and hip replacement. Two quality assessment checklists with a scale of 0 to 12 points were developed to evaluate available video content for the diagnosis and the treatment of hip arthritis. Videos were grouped into poor quality (grade 0-3), moderate quality (grade 4-7) and excellent quality (grade 8-12), respectively. Three independent observers assessed all videos using the new grading system and independently scored all videos. Discrepancies regarding the categories were clarified by consensus discussion. For intra-observer reliabilities, grading was performed at two occasions separated by four weeks. Eighty-four percent (n = 112) had a poor diagnostic information quality, 14% (n = 19) a moderate quality and only 2% (n = 2) an excellent quality, respectively. In 86% (n = 114), videos provided poor treatment information quality. Eleven percent (n = 15) of videos had a moderate quality and only 3% (n = 4) an excellent quality, respectively. The present study demonstrates that YouTube is a poor source for accurate information pertaining to the diagnosis and treatment of hip arthritis. These finding are of high relevance for clinicians as videos are going to become the primary source of information for patients. Therefore, high quality educational videos are needed to further guide patients on the way from the diagnosis of hip arthritis to its proper treatment.
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Russo, Carlo; Tufi, Eleonora
2016-01-01
Incomplete information in food consumption is a relevant topic in agricultural economics. This paper proposes a theoretical model describing consumer behavior, market equilibrium and public intervention in an industry where consumers must rely on the information of interested parties such as producers or associations. We provide simple game theory model showing the link between price competition and the strategic use of information. If information are unverifiable (as in the case of credence attributes) firms may have no incentive to advertise true claims and consumer decisions may be biased. Our model incorporates the opportunistic behavior of self-interested information providers. The result is a model of competition in prices and information finding a potential for market failure and public intervention. In the paper we discuss the efficiency of three possible regulations: banning false claims, subsidizing advertising campaigns, and public statement if favor of true claims. In that context, some recent patents related to both the regulatory compliance in communication and to the reduction of asymmetric information between producers and consumers have been considered. Finally, we found that the efficiency of these policy tools is affected by the reputation of trustworthiness of the firms.
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Informed consent in psychotherapy.
Beahrs, J O; Gutheil, T G
2001-01-01
The authors sought a rational approach to implementing informed consent within the practice of psychotherapy. The history of informed consent in psychotherapy was reviewed to define a common synthesis that maximizes the potential benefits and minimizes the potential hazards. The benefits of informed consent in psychotherapy include fostering a positive treatment outcome through enhancing patient autonomy, responsibility, and self-therapeutic activity; lessening the risks of regressive effects and therapist liability; and helping the practice of psychotherapy extend beyond particular parochialisms by providing checks and balances on therapist judgments. The hazards include the unpredictability of interactional outcomes and the possibilities of replacing positive expectancy with negative suggestion, replacing a therapeutic alliance with a legalistic stance, and misimplying that patients are passive recipients. Practical implementation of informed consent in psychotherapy must balance such tensions in service of optimal treatment. As a guiding principle, the authors recommend that psychotherapists convey to a prospective patient information that is material to the particular patient's decision. The level of detail needed in informed consent discussions varies directly with the cost and risks of the proposed treatment, the presence of viable alternatives and their relative grounding in scientific data and professional acceptance, and the presence of significant controversy. Unresolved is the question of how to address problematic or controversial psychotherapeutic trends that temporarily enjoy wide professional support.
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Using patient-reported outcomes in schizophrenia: the Scottish Schizophrenia Outcomes Study.
Hunter, Robert; Cameron, Rosie; Norrie, John
2009-02-01
The primary aim of the Scottish Schizophrenia Outcomes Study (SSOS) was to assess the feasibility and utility of routinely collecting outcome data in everyday clinical settings. Data were collected over three years in the Scottish National Health Service (NHS). There were two secondary aims of SSOS: first, to compare data from patient-rated, objective, and clinician-rated outcomes, and second, to describe trends in outcome data and service use across Scotland over the three years of the study (2002-2005). This study used a naturalistic, longitudinal, observational cohort design. A representative sample of 1,015 persons with ICD-10 F20-F29 diagnoses (schizophrenia, schizotypal disorders, or delusional disorders) was assessed annually using the clinician-rated measure, the Health of the Nation Outcome Scale (HoNOS), and the patient-reported assessment, the Avon Mental Health Measure (Avon). Objective outcomes data and information on services and interventions were collected. Data were analyzed with regression modeling. Of the 1,015 persons recruited, 78% of the cohort (N=789) completed the study. Over the study period, significant decreases were seen in the number of hospitalizations, incidence of attempted suicide and self-harm, and civil detentions. Avon scores indicated significant improvement on all subscales (behavior, social, access, and mental health) and on the total score. However, HoNOS scores on the behavior and symptom subscales did not change, scores on the impairment subscale increased significantly (indicating increased levels of impairment), and scores on the social subscale decreased significantly (indicating improved social functioning). This study has demonstrated that it is feasible within the Scottish NHS to routinely collect meaningful outcomes data in schizophrenia. Patient-reported assessments were also successfully collected and used in care plans. This model shows that it is possible to incorporate patient-reported assessments into routine
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Directory of Open Access Journals (Sweden)
Chad Zanocco
Full Text Available Land managers in the Great Basin are working to maintain or restore sagebrush ecosystems as climate change exacerbates existing threats. Web applications delivering climate change and climate impacts information have the potential to assist their efforts. Although many web applications containing climate information currently exist, few have been co-produced with land managers or have incorporated information specifically focused on land managers’ needs. Through surveys and interviews, we gathered detailed feedback from federal, state, and tribal sagebrush land managers in the Great Basin on climate information web applications targeting land management. We found that a managers are searching for weather and climate information they can incorporate into their current management strategies and plans; b they are willing to be educated on how to find and understand climate related web applications; c both field and administrative-type managers want data for timescales ranging from seasonal to decadal; d managers want multiple levels of climate information, from simple summaries, to detailed descriptions accessible through the application; and e managers are interested in applications that evaluate uncertainty and provide projected climate impacts. Keywords: Great Basin, Sagebrush, Land management, Climate change, Web application, Co-production
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Zhi, Ying-Jie; Zhang, Hui; Xie, Yan-Ming; Yang, Wei; Yang, Hu; Zhuang, Yan
2013-09-01
Hospital information system data of cerebral infaction patients who received parenterally administered Shuxuetong was analyzed. This provided frequency data regarding patients' conditions and related information in order to provide a clinical reference guide. In this study, HIS data from 18 hospitals was analyzed. Patients receiving parenterally administered Shuxuetong for the treatment of cerebral infarction were included. Information on age, gender, costsand route of administration were collated. The average age of patients was 66 years old. Days of hospitalization ranged from 15 to 28 days. The majority of patients were classified as having phlegm and blood stasis syndrome, which is inaccordance with the indications for this drug. The most commonly used drugs used in combination with parenterally administered Shuxuetong were: aspirin, insulin and heparin. Patients with cerebral infarction crowd using parenterally administered Shuxuetong were a mostly elderly population, with an average age of 66. Although generally use was in accordance with indications, dosage, and route of administration, there were however some discrepancies. Therefore, doctors need to pay close attention to guidelines and closely observe patients when using parenterally administered Shuxuetong and to consider both the clinical benefits and risks.
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Rees, Tom
2002-01-01
Froedtert & Medical College, an academic medical center, has adopted a proactive approach to providing consumers with reliable sources of information. The Milwaukee institution has redesigned its Web site, which first opened in 1995. The new version has simplified the navigation process and added new content. Small Stones, a health resource center, also a brick-and-mortar shop, went online Feb. 1. Online bill paying was launched in May. Pharmacy refill functions are expected to be online this summer.
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Directory of Open Access Journals (Sweden)
Nishant Patel
Full Text Available ABSTRACT Background: With a high rate of recurrence, urolithiasis is a chronic disease that impacts quality of life. The Patient Reported Outcomes Measurement Information System is an NIH validated questionnaire to assess patient quality of life. We evaluated the impact of urolithiasis on quality of life using the NIH-sponsored PROMIS-43 questionnaire. Materials and Methods: Patients reporting to the kidney stone clinic were interviewed to collect information on stone history and demographic information and were asked to complete the PROMIS-43 questionnaire. Quality of life scores were analyzed using gender and age matched groups for the general US population. Statistical comparisons were made based on demographic information and patient stone history. Statistical significance was P<0.05. Results: 103 patients completed the survey. 36% of respondents were male, the average age of the group was 52 years old, with 58% primary income earners, and 35% primary caregivers. 7% had never passed a stone or had a procedure while 17% passed 10 or more stones in their lifetime. Overall, pain and physical function were worse in patients with urolithiasis. Primary income earners had better quality of life while primary caregivers and those with other chronic medical conditions were worse. Patients on dietary and medical therapy had better quality of life scores. Conclusions: Urolithiasis patients subjectively have worse pain and physical function than the general population. The impact of pain on quality of life was greatest in those patients who had more stone episodes, underscoring the importance of preventive measures. Stone prevention measures improve quality of life.
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Katzan, Irene L; Lapin, Brittany
2018-01-01
The International Consortium for Health Outcomes Measurement recently included the 10-item PROMIS GH (Patient-Reported Outcomes Measurement Information System Global Health) scale as part of their recommended Standard Set of Stroke Outcome Measures. Before collection of PROMIS GH is broadly implemented, it is necessary to assess its performance in the stroke population. The objective of this study was to evaluate the psychometric properties of PROMIS GH in patients with ischemic stroke and intracerebral hemorrhage. PROMIS GH and 6 PROMIS domain scales measuring same/similar constructs were electronically collected on 1102 patients with ischemic and hemorrhagic strokes at various stages of recovery from their stroke who were seen in a cerebrovascular clinic from October 12, 2015, through June 2, 2017. Confirmatory factor analysis was performed to evaluate the adequacy of 2-factor structure of component scores. Test-retest reliability and convergent validity of PROMIS GH items and component scores were assessed. Discriminant validity and responsiveness were compared between PROMIS GH and PROMIS domain scales measuring the same or related constructs. Analyses were repeated stratified by stroke subtype and modified Rankin Scale score validity was good with significant correlations between all PROMIS GH items and PROMIS domain scales ( P 0.5) was demonstrated for 8 of the 10 PROMIS GH items. Reliability and validity remained consistent across stroke subtype and disability level (modified Rankin Scale, <2 versus ≥2). PROMIS GH exhibits acceptable performance in patients with stroke. Our findings support International Consortium for Health Outcomes Measurement recommendation to use PROMIS GH as part of the standard set of outcome measures in stroke. © 2017 American Heart Association, Inc.
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Outcome indicators for the evaluation of energy policy instruments and technical change
International Nuclear Information System (INIS)
Neij, Lena; Astrand, Kerstin
2006-01-01
The aim of this paper is to propose a framework for the evaluation of policy instruments designed to affect development and dissemination of new energy technologies. The evaluation approach is based on the analysis of selected outcome indicators describing the process of technical change, i.e. the development and dissemination of new energy technologies, on the basis of a socio-technical systems approach. The outcome indicators are used to analyse the effect, in terms of outcome, and outcome scope of the policy instruments as well as the extent to which the policy instruments support diversity, learning and institutional change. The analysis of two cases of evaluations, of energy efficiency policy and wind energy policy in Sweden, shows that the approach has several advantages, allowing continuous evaluation and providing important information for the redesign of policy instruments. There are also disadvantages associated with the approach, such as complexity, possible high cost and the requirement of qualified evaluators. Nevertheless, it is concluded that the information on the continuous performance of different policy instruments and their effects on the introduction and dissemination of new energy technologies, provided by this evaluation approach, is essential for an improved adaptation and implementation of energy and climate policy
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Provider and systems factors in diabetes quality of care.
Ghaznavi, Kimia; Malik, Shaista
2012-02-01
A gap exists in knowledge and the observed frequency with which patients with diabetes actually receive treatment for optimal cardiovascular risk reduction. Many interventions to improve quality of care have been targeted at the health systems level and provider organizations. Changes in several domains of care and investment in quality by organizational leaders are needed to make long-lasting improvements. In the studies reviewed, the most effective strategies often have multiple components, whereas the use of one single strategy, such as reminders only or an educational intervention, is less effective. More studies are needed to examine the effect of several care management strategies simultaneously, such as use of clinical information systems, provider financial incentives, and organizational model on processes of care and outcomes.
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van Wagenberg, Coen P A; Backus, Gé B C; van der Vorst, Jack G A J; Urlings, Bert A P
2012-11-01
The EU prescribes that food business operators must use food chain information to assist in food safety control. This study analyses usefulness of food chain information about antibiotic usage covering the 60-day period prior to delivery of pigs to slaughter in the control of antibiotic residues in pork. A dataset with 479 test results for antibiotic residues in tissue samples of finishing pigs delivered to a Dutch slaughter company was linked to information provided by pig producers about antibiotic usage in these finishing pigs. Results show that twice as many producers reported using antibiotics in the group of 82 producers with antibiotic residues (11.0%) compared to the group without antibiotic residues (5.5%) (p=0.0686). For 89% of consignments with a finishing pig with antibiotic residues, the producer reported 'did not use antibiotics'. Food chain information about antibiotic usage provided by Dutch pig producers was no guarantee for absence of antibiotic residues in delivered finishing pigs. Copyright © 2012 Elsevier B.V. All rights reserved.
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Primary prevention research: a preliminary review of program outcome studies.
Schaps, E; Churgin, S; Palley, C S; Takata, B; Cohen, A Y
1980-07-01
This article reviews 35 drug abuse prevention program evaluations employing drug-specific outcome measures. Many of these evaluations assessed the effects of "new generation" prevention strategies: affective, peer-oriented, and multidimensional approaches. Only 14 studies evaluated purely informational programs. Evaluations were analyzed to ascertain (1) characteristics of the programs under study, (2) characteristics of the research designs, and (3) patterns among findings. This review provides some evidence that the newer prevention strategies may produce more positive and fewer negative outcomes than did older drug information approaches. Over 70% of the programs using the newer strategies produced some positive effects; only 29% showed negative effects. In contrast, 46% of informational programs showed positive effects; 46% showed negative effects. These findings must be approached with great caution, since the research was frequently scientifically inadequate, and since rigor of research was negatively correlated with intensity and duration of program services.
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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.
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Effectiveness of reference services in providing students' information ...
African Journals Online (AJOL)
Data collected was analysed using descriptive statistics. ... The study recommends among other things: Effort should be geared toward recruiting ... information technologies facilities such computers and internet facilities such that students can ...
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Directory of Open Access Journals (Sweden)
Alexander A. Galushkin
2015-09-01
Full Text Available In the present article author investigates interconnected questions of information security and providing state and municipal services by means of the global information Internet. Author analyzes opinions of the number of leading Russian and foreign experts and scientists. In the summary author draws a conclusion that implementation of rules of law answering to modern realities and also fruitful work of law enforcement and supervisory authorities regarding law application practice improvement is necessary for information security and human rights protection.
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A Qualitative Study of Patient and Provider Experiences during Preoperative Care Transitions
MALLEY, ANN; YOUNG, GARY J.
2017-01-01
Aims To explore the issues and challenges of care transitions in the preoperative environment. Background Ineffective transitions play a role in a majority of serious medical errors. There is a paucity of research related to the preoperative arena and the multiple inherent transitions in care that occur there. Design Qualitative descriptive design was used. Methods Semi-structured interviews were conducted in a 975 bed academic medical center. Results 30 providers and 10 preoperative patients participated. Themes that arose were: (1) Need for clarity of purpose of preoperative care (2) Care coordination (3) Inter-professional boundaries of care (4) Inadequate time and resources. Conclusion Effective transitions in the preoperative environment require that providers bridge scope of practice barriers to promote good teamwork. Preoperative care that is a product of well-informed providers and patients can improve the entire perioperative care process and potentially influence post-operative patient outcomes. Relevance to Clinical Practice Nurses are well positioned to bridge the gaps within transitions of care and accordingly affect health outcomes. PMID:27706872
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Quality of life as an outcome measure in surgical oncology
Langenhoff, B S; Krabbe, P F; Wobbes, T; Ruers, T J
BACKGROUND: There is a growing interest in assessing the impact of a disease and the effect of a treatment on a patient's life, expressed as health-related quality of life (HRQoL). HRQoL assessment can provide essential outcome information for cancer surgery. METHODS: The core of this review is
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Donisch, Katelyn; Bray, Chris; Gewirtz, Abigail
2016-05-01
This study systematically examined child-service providers' conceptualizations of trauma-informed practice (TIP) across service systems, including child welfare, juvenile justice, mental health, and education. Eleven focus groups and nine individual interviews were conducted, totaling 126 child-service providers. Conventional content analysis was used to analyze the qualitative data with interrater reliability analyses indicating near perfect agreement between coders. Qualitative analysis revealed that child-service providers identified traumatic stress as an important common theme among children and families served as well as the interest in TIP in their service systems. At the same time, child-service providers generally felt knowledgeable about what they define TIP to be, although they articulated wide variations in the degree to which they are taught skills and strategies to respond to their traumatized clients. The results of this study suggest a need for a common lexicon and metric with which to advance TIP within and across child-service systems. © The Author(s) 2016.
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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
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Provider Agency Practices as a Source of Social Work EBP.
Blakely, Thomas J; Dziadosz, Gregory M
2016-01-01
Through this article the authors propose that agency service provider systems may be a source of evidence-based practices (EBP). One agency's design and implementation of a program entitled Community Treatment and Rehabilitation is presented as an example. The elements of this program conform to the creation of EBPs. It was formulated with consideration of clients' values and judgments through their participation at every step in the assessment and treatment process. Staff clinicians were trained in established EBP interventions, such as cognitive therapy, embedded in a system of ordered assessment, treatment, and outcome evaluation. A controlled research design was used to gather outcome data to inform clinicians' decisions about interventions that were then systematically applied with clients. The delivery system was organized for clinical supervisors to guide staff clinical practices so that all were operating on the same set of guidelines allowing for similar outcomes to occur with similar interventions. This method of developing EBPs makes them available for application immediately and successfully eliminates the delay between development and implementation that usually occurs with other sources of EBPs.
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Kratzke, Cynthia; Wilson, Susan
2014-09-01
Although growing research supports cancer survivor information-seeking, little is known about breast cancer prevention information-seeking among women. The purpose of the study was to examine differences in breast cancer risk factor knowledge, information sources, and desired mobile messages among Hispanic and non-Hispanic rural women. Women were recruited to complete a survey at an imaging center during a mammography screening visit. A total of 156 women (mean age = 61, SD = 12.07) completed the survey. Breast cancer risk factor knowledge was significantly higher for non-Hispanic women compared to Hispanic women (p = .035). Television, magazines, and Internet were the most frequent information sources. Providers were the most frequent interpersonal information source. Nearly 87 % used cell phones and 47 % used texting. Hispanic women were more likely to desire breast cancer prevention cell voice messages (p breast cancer prevention education, and best practices to manage screening appointments.
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Directory of Open Access Journals (Sweden)
Motoki Yokoyama
2017-07-01
Full Text Available The prevalence of smartphones and wireless broadband networks have been progressing as a new Railway infomration environment. According to the spread of such devices and information technology, various types of information can be obtained from databases connected to the Internet. One scenario of obtaining such a wide variety of information resources is in the phase of user’s transportation. This paper proposes an information provision system, named the Station Concierge System that matches the situation and intention of passengers. The purpose of this system is to estimate the needs of passengers like station staff or hotel concierge and to provide information resources that satisfy user’s expectations dynamically. The most important module of the system is constructed based on a new information ranking method for passenger intention prediction and service recommendation. This method has three main features, which are (1 projecting a user to semantic vector space by using her current context, (2 predicting the intention of a user based on selecting a semantic vector subspace, and (3 ranking the services by a descending order of relevant scores to the user’ intention. By comparing the predicted results of our method with those of two straightforward computation methods, the experimental studies show the effectiveness and efficiency of the proposed method. Using this system, users can obtain transit information and service map that dynamically matches their context.
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Twenty years of staffing, practice environment, and outcomes research in military nursing.
Patrician, Patricia A; Loan, Lori A; McCarthy, Mary S; Swiger, Pauline; Breckenridge-Sproat, Sara; Brosch, Laura Ruse; Jennings, Bonnie Mowinski
Two decades ago, findings from an Institute of Medicine (IOM) report sparked the urgent need for evidence supporting relationships between nurse staffing and patient outcomes. This article provides an overview of nurse staffing, practice environment, and patient outcomes research, with an emphasis on findings from military studies. Lessons learned also are enumerated. This study is a review of the entire Military Nursing Outcomes Database (MilNOD) program of research. The MilNOD, in combination with evidence from other health care studies, provides nurses and leaders with information about the associations between staffing, patient outcomes, and the professional practice environment of nursing in the military. Leaders, therefore, have useful empirical evidence to make data-driven decisions. The MilNOD studies are the basis for the current Army nursing dashboard, and care delivery framework, called the Patent CaringTouch System. Future research is needed to identify ideal staffing based on workload demands, and provide leaders with factors to consider when operationalizing staffing recommendations. Copyright © 2017 Elsevier Inc. All rights reserved.
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Shih, Ya-Chen Tina; Chien, Chun-Ru
2017-05-15
The American Society of Clinical Oncology released its first guidance statement on the cost of cancer care in August 2009, affirming that patient-physician cost communication is a critical component of high-quality care. This forward-thinking recommendation has grown increasingly important in oncology practice today as the high costs of cancer care impose tremendous financial burden to patients, their families, and the health care system. For the current review, a literature search was conducted using the PubMed and Web of Science databases to identify articles that covered 3 topics related to patient-physician cost communication: patient attitude, physician acceptance, and the associated outcomes; and 15 articles from 12 distinct studies were identified. Although most articles that addressed patient attitude suggested that cost communication is desired by >50% of patients in the respective study cohorts, only communication. When asked about whether cost communication actually took place in their practice, percentages reported by physicians varied widely from 60%. The data suggested that cost communication was associated with improved patient satisfaction, lower out-of-pocket expenses, and a higher likelihood of medication nonadherence; none of the studies established causality. Both patients and physicians expressed a strong need for accurate, accessible, and transparent information about the cost of cancer care. Cancer 2017;123:928-39. © 2016 American Cancer Society. © 2016 American Cancer Society.
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Effects of different feedback types on information integration in repeated monetary gambles
Directory of Open Access Journals (Sweden)
Peter eHaffke
2015-01-01
Full Text Available Most models of risky decision making assume that all relevant information is taken into account (e.g., Kahneman & Tversky, 1979; von Neumann & Morgenstern, 1944. However, there are also some models supposing that only part of the information is considered (e.g., Brandstätter, Gigerenzer, & Hertwig, 2006; Gigerenzer & Gaissmaier, 2011. To further investigate the amount of information that is usually used for decision making, and how the use depends on feedback, we conducted a series of three experiments in which participants choose between two lotteries and where no feedback, outcome feedback, and error feedback was provided, respectively. The result show that without feedback participants mostly chose the lottery with the higher winning probability, and largely ignored the potential gains. The same result occurred when the outcome of each decision was fed back. Only after presenting error feedback (i.e., signaling whether a choice was optimal or not, participants considered probabilities as well as gains, resulting in more optimal choices. We propose that outcome feedback was ineffective, because of its probabilistic and ambiguous nature. Participants improve information integration only if provided with a consistent and deterministic signal such as error feedback.
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20 CFR 402.175 - Fees for providing information and related services for non-program purposes.
2010-04-01
... rendered. (d) Fee for copies of printed materials. When extra copies of printed material are available, the... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Fees for providing information and related services for non-program purposes. 402.175 Section 402.175 Employees' Benefits SOCIAL SECURITY...
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Directory of Open Access Journals (Sweden)
Nadiia Pylypiv
2017-03-01
Full Text Available This article explores the impact of organization of managerial accounting on formation of informational base on the local (level of the individual enterprise, regional, disciplinary and national levels in the context of providing stable economic development for building enterprises. Based on our findings, we built a cognitive map of such an influence, which shows itself through different spheres, such as: economic, ecological and social, and will enjoy informational requests of management for improving of effectiveness of management system of such kind of enterprises. Keywords: managerial accounting, organization, provision, stable economic development, building enterprises
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A guide to performance management for the Health Information Manager.
Leggat, Sandra G
This paper provides a summary of human resource management practices that have been identified as being associated with better outcomes in performance management. In general, essential practices include transformational leadership and a coherent program of goal setting, performance monitoring and feedback. Some Health Information Managers may feel they require training assistance to develop the necessary skills in the establishment of meaningful work performance goals for staff and the provision of useful and timely feedback. This paper provides useful information to assist Health Information Managers enhance the performance of their staff.
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2013-01-01
Background Making evidence-based decisions often requires comparison of two or more options. Research-based evidence may exist which quantifies how likely the outcomes are for each option. Understanding these numeric estimates improves patients’ risk perception and leads to better informed decision making. This paper summarises current “best practices” in communication of evidence-based numeric outcomes for developers of patient decision aids (PtDAs) and other health communication tools. Method An expert consensus group of fourteen researchers from North America, Europe, and Australasia identified eleven main issues in risk communication. Two experts for each issue wrote a “state of the art” summary of best evidence, drawing on the PtDA, health, psychological, and broader scientific literature. In addition, commonly used terms were defined and a set of guiding principles and key messages derived from the results. Results The eleven key components of risk communication were: 1) Presenting the chance an event will occur; 2) Presenting changes in numeric outcomes; 3) Outcome estimates for test and screening decisions; 4) Numeric estimates in context and with evaluative labels; 5) Conveying uncertainty; 6) Visual formats; 7) Tailoring estimates; 8) Formats for understanding outcomes over time; 9) Narrative methods for conveying the chance of an event; 10) Important skills for understanding numerical estimates; and 11) Interactive web-based formats. Guiding principles from the evidence summaries advise that risk communication formats should reflect the task required of the user, should always define a relevant reference class (i.e., denominator) over time, should aim to use a consistent format throughout documents, should avoid “1 in x” formats and variable denominators, consider the magnitude of numbers used and the possibility of format bias, and should take into account the numeracy and graph literacy of the audience. Conclusion A substantial and
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Predicting IVF Outcome: A Proposed Web-based System Using Artificial Intelligence.
Siristatidis, Charalampos; Vogiatzi, Paraskevi; Pouliakis, Abraham; Trivella, Marialenna; Papantoniou, Nikolaos; Bettocchi, Stefano
2016-01-01
To propose a functional in vitro fertilization (IVF) prediction model to assist clinicians in tailoring personalized treatment of subfertile couples and improve assisted reproduction outcome. Construction and evaluation of an enhanced web-based system with a novel Artificial Neural Network (ANN) architecture and conformed input and output parameters according to the clinical and bibliographical standards, driven by a complete data set and "trained" by a network expert in an IVF setting. The system is capable to act as a routine information technology platform for the IVF unit and is capable of recalling and evaluating a vast amount of information in a rapid and automated manner to provide an objective indication on the outcome of an artificial reproductive cycle. ANNs are an exceptional candidate in providing the fertility specialist with numerical estimates to promote personalization of healthcare and adaptation of the course of treatment according to the indications. Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.
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Ripley, Elizabeth; Ramsey, Cornelia; Prorock-Ernest, Amy; Foco, Rebecca; Luckett, Solomon; Ornato, Joseph P
2012-01-01
As attention to, and motivation for, emergency medical services (EMS)-related research continues to grow, particularly exception from informed consent (EFIC) research, it is important to understand the thoughts, beliefs, and experiences of EMS providers who are actively engaged in the research. We explored the attitudes, beliefs, and experiences of EMS providers regarding their involvement in prehospital emergency research, particularly EFIC research. Using a qualitative design, 24 participants were interviewed including nationally registered paramedics and Virginia-certified emergency medical technicians employed at Richmond Ambulance Authority, the participating EMS agency. At the time of our interviews, the EMS agency was involved in an EFIC trial. Transcribed interview data were coded and analyzed for themes. Findings were presented back to the EMS agency for validation. Overall, there appeared to be support for prehospital emergency research. Participants viewed research as necessary for the advancement of the field of EMS. Improvement in patient care was identified as one of the most important benefits. A number of ethical considerations were identified: individual risk versus public good and consent. The EMS providers in our study were open to working with EMS researchers throughout the community consultation and public disclosure process. The EMS providers in our study valued research and were willing to participate in studies. Support for research was balanced with concerns and challenges regarding the role of providers in the research process.
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2010-07-01
... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What information must FAA provide to GSA on its administration of the public airport donation program? 102-37.535 Section... Donations to Public Airports § 102-37.535 What information must FAA provide to GSA on its administration of...
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Speroni, Elisabetta; Poggi, Susanna; Vinaccia, Vincenza
2013-10-01
The physician's need for medical information updates has been studied extensively in recent years but the point of view of the pharmaceutical industry on this need has rarely been considered. This paper reports the results of a retrospective analysis of the medical information service provided to Italian physicians by an important pharmaceutical company, Novartis Pharma, from 2004 to 2012. The results confirm clinicians' appreciation of a service that gives them access to tailored scientific documentation and the number of requests made to the network of medical representatives has been rising steadily, peaking whenever new drugs become available to physicians. The analysis confirms what -other international studies have ascertained, that most queries are about how to use the drugs and what their properties are. The results highlight some differences between different medical specialties: for example, proportionally, neurologists seem to be the most curious. This, as well as other interesting snippets, is worth further exploration. Despite its limits in terms of representativeness, what comes out of the study is the existence of an real unmet need for information by healthcare institutions and that the support offered by the pharmaceutical industry could be invaluable; its role could go well beyond that of a mere supplier to National Healthcare Systems, to that of being recognised as an active partner the process of ensuring balanced and evidence-based information. At the same time, closer appraisal of clinicians' needs could help the pharma industries to improve their communication and educational strategies in presenting their latest clinical research and their own products.
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Directory of Open Access Journals (Sweden)
Stefania Vignini
2015-11-01
Full Text Available The aim of our research is to verify if Italian listed companies financial statements provide adequate information about the capitalization of costs related to intangible assets and if the information provided are reliable. Moreover, we investigated if they merely comply with law or provide additional information on cost capitalization and reveal if internal control systems (especially managerial accounting systems or other information systems are applied to support the measurement process and the cost control, thus guaranteeing the verifiability and representational faithfulness of the information disclosed. This paper is an empirical analysis and is concerned to investigate the financial statements of 250 Italian listed companies.
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Beaulac, Julie; Westmacott, Robin; Walker, John R; Vardanyan, Gohar
2016-06-08
Decisions related to mental health are often complex, problems often remain undetected and untreated, information unavailable or not used, and treatment decisions frequently not informed by best practice or patient preferences. The objective of this paper was to obtain the opinions of health professionals working in primary health care settings about a Web-based information decision aid (IDA) for patients concerning treatment options for depression and the dissemination of the resources in primary care settings. Participants were recruited from primary care clinics in Winnipeg and Ottawa, Canada, and included 48 family physicians, nurses, and primary care staff. The study design was a qualitative framework analytic approach of 5 focus groups. Focus groups were conducted during regular staff meetings, were digitally recorded, and transcripts created. Analysis involved a content and theme analysis. Seven key themes emerged including the key role of the primary care provider, common questions about treatments, treatment barriers, sources of patient information, concern about quality and quantity of available information, positive opinions about the IDA, and disseminating the IDA. The most common questions mentioned were about medication and side effects and alternatives to medication. Patients have limited access to alternative treatment options owing to cost and availability. Practitioners evaluated the IDA positively. The resources were described as useful, supportive of providers' messages, and accessible for patients. There was unanimous consensus that information needs to be available electronically through the Internet.
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Singing voice outcomes following singing voice therapy.
Dastolfo-Hromack, Christina; Thomas, Tracey L; Rosen, Clark A; Gartner-Schmidt, Jackie
2016-11-01
The objectives of this study were to describe singing voice therapy (SVT), describe referred patient characteristics, and document the outcomes of SVT. Retrospective. Records of patients receiving SVT between June 2008 and June 2013 were reviewed (n = 51). All diagnoses were included. Demographic information, number of SVT sessions, and symptom severity were retrieved from the medical record. Symptom severity was measured via the 10-item Singing Voice Handicap Index (SVHI-10). Treatment outcome was analyzed by diagnosis, history of previous training, and SVHI-10. SVHI-10 scores decreased following SVT (mean change = 11, 40% decrease) (P singing lessons (n = 10) also completed an average of three SVT sessions. Primary muscle tension dysphonia (MTD1) and benign vocal fold lesion (lesion) were the most common diagnoses. Most patients (60%) had previous vocal training. SVHI-10 decrease was not significantly different between MTD and lesion. This is the first outcome-based study of SVT in a disordered population. Diagnosis of MTD or lesion did not influence treatment outcomes. Duration of SVT was short (approximately three sessions). Voice care providers are encouraged to partner with a singing voice therapist to provide optimal care for the singing voice. This study supports the use of SVT as a tool for the treatment of singing voice disorders. 4 Laryngoscope, 126:2546-2551, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.
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Curran, Vernon; Reid, Adam; Reis, Pamela; Doucet, Shelley; Price, Sheri; Alcock, Lindsay; Fitzgerald, Shari
2015-01-01
Interprofessional education (IPE) in health and human services educational and clinical settings has proliferated internationally. The use of information and communication technologies (ICTs) in the facilitation of interprofessional learning is also growing, yet reviews of the effectiveness of ICTs in the delivery of pre- and/or post-licensure IPE have been limited. The current study's purpose was to review the evaluation outcomes of IPE initiatives delivered using ICTs. Relevant electronic databases and journals from 1996 to 2013 were searched. Studies which evaluated the effectiveness of an IPE intervention using ICTs were included and analyzed using the Barr et al. modified Kirkpatrick educational outcomes typology. Fifty-five studies were identified and a majority reported evaluation findings at the level 1 (reaction/satisfaction). Analysis revealed that learners react favorably to the use of ICTs in the delivery of IPE, and ICT-mediated IPE can lead to positive attitudinal and knowledge change. A majority of the studies reported positive evaluation outcomes at the learner satisfaction level, with the use of web-based learning modalities. The limited number of studies at other levels of the outcomes typology and deficiencies in study designs indicate the need for more rigorous evaluation of outcomes in ICT-mediated IPE.
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Ancker, Jessica S; Witteman, Holly O; Hafeez, Baria; Provencher, Thierry; Van de Graaf, Mary; Wei, Esther
2015-06-04
A critical problem for patients with chronic conditions who see multiple health care providers is incomplete or inaccurate information, which can contribute to lack of care coordination, low quality of care, and medical errors. As part of a larger project on applications of consumer health information technology (HIT) and barriers to its use, we conducted a semistructured interview study with patients with multiple chronic conditions (MCC) with the objective of exploring their role in managing their personal health information. Semistructured interviews were conducted with patients and providers. Patients were eligible if they had multiple chronic conditions and were in regular care with one of two medical organizations in New York City; health care providers were eligible if they had experience caring for patients with multiple chronic conditions. Analysis was conducted from a grounded theory perspective, and recruitment was concluded when saturation was achieved. A total of 22 patients and 7 providers were interviewed; patients had an average of 3.5 (SD 1.5) chronic conditions and reported having regular relationships with an average of 5 providers. Four major themes arose: (1) Responsibility for managing medical information: some patients perceived information management and sharing as the responsibility of health care providers; others—particularly those who had had bad experiences in the past—took primary responsibility for information sharing; (2) What information should be shared: although privacy concerns did influence some patients' perceptions of sharing of medical data, decisions about what to share were also heavily influenced by their understanding of health and disease and by the degree to which they understood the health care system; (3) Methods and tools varied: those patients who did take an active role in managing their records used a variety of electronic tools, paper tools, and memory; and (4) Information management as invisible work
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Information Salience, Investor Sentiment, and Stock Returns : The Case of British Soccer Betting
Palomino, F.A.; Renneboog, L.D.R.; Zhang, C.
2008-01-01
Soccer clubs listed on the London Stock Exchange provide a unique way of testing stock price reactions to different types of news. For each firm, two pieces of information are released on a weekly basis: experts' expectations about game outcomes through the betting odds, and the game outcomes
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Information salience, investor sentiment and stock returns : The case of British soccer betting
Palomino, F.A.; Renneboog, L.D.R.; Zhang, C.
2009-01-01
Soccer clubs listed on the London Stock Exchange provide a unique way of testing stock price reactions to different types of news. For each firm, two pieces of information are released on a weekly basis: experts' expectations about game outcomes through the betting odds, and the game outcomes
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Information Salience, Investor Sentiment, and Stock Returns : The Case of British Soccer Betting
Palomino, F.A.; Renneboog, L.D.R.; Zhang, C.
2008-01-01
Soccer clubs listed on the London Stock Exchange provide a unique way of testing stock price reactions to different types of news. For each firm, two pieces of information are released on a weekly basis: experts’ expectations about game outcomes through the betting odds, and the game outcomes
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Quantum Bertrand duopoly of incomplete information
International Nuclear Information System (INIS)
Qin Gan; Chen Xi; Sun Min; Du Jiangfeng
2005-01-01
We study Bertrand's duopoly of incomplete information. It is found that the effect of quantum entanglement on the outcome of the game is dramatically changed by the uncertainty of information. In contrast with the case of complete information where the outcome increases with entanglement, when information is incomplete the outcome is maximized at some finite entanglement. As a consequence, information and entanglement are both crucial factors that determine the properties of a quantum oligopoly
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Information-provider scripts for GLUE2 and RAID configurations.
Kalimeris, Dimitrios
2014-01-01
This report will outline two projects that were done as part of a three months long summer internship at CERN. In the first project we dealt with Worldwide LHC Computing Grid (WLCG) and its information system. The information system currently conforms to a schema called GLUE and it is evolving towards a new version: GLUE2. The aim of the project was to develop and adapt the current information system of the WLCG, used by the Large Scale Storage Systems at CERN (CASTOR and EOS), to the new GLUE2 schema. During the second project we investigated different RAID configurations so that we can get performance boost from CERN's disk systems in the future. RAID 1 that is currently in use is not an option anymore because of limited performance and high cost. We tried to discover RAID configurations that will improve the performance and simultaneously decrease the cost.
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Directory of Open Access Journals (Sweden)
Anne Tsampalieros
2017-10-01
Full Text Available Background: Kidney transplantation is the best treatment option for patients with end-stage renal disease. While patient-level factors affecting survival are established, the presence of variation in the management of transplant recipients remains unknown. Objective: The objective of this study was to examine center variation in kidney transplantation and identify center and provider characteristics that may be associated with clinical outcomes. Design: This is a systematic review. Data sources: Ovid Medline, Embase, and Cochrane library from inception to June 2016 were used. Study eligibility: Any study examining the association between center or provider characteristics and graft or patient survival, quality of life, or functional status were included. Results: We identified 6327 records and 24 studies met eligibility. Most studies used data registries. Characteristics evaluated include center volume (n = 17, provider volume (n = 2, provider experience (n = 1, center type (n = 2, and location of follow-up (n = 1. Outcomes assessed included graft survival (n = 24 and patient survival (n = 9. Significant center variation was described in 12 of 15 and 5 of 7 studies for graft and patient survival. There was a significant and positive association between center volume and graft and patient survival in 8 and 2 studies, respectively. Provider experience and volume were significantly associated with less allograft loss and provider volume with lower risk of death. There was no association between graft survival and location of follow-up or center type. Limitations: There was substantial heterogeneity in the variables assessed and methodology used to analyze associations. Conclusion: This systematic review found center variation in kidney transplantation. Future studies in the current era are necessary to better evaluate this important topic.
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2010-09-27
... and reliable information on program activities and outcomes is available. Data validation is intended... handbooks provide detailed information on software installation, building and importing a validation file... DEPARTMENT OF LABOR Employment and Training Administration Comment Request for Information...
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International Nuclear Information System (INIS)
Shugart, L.R.; Adams, S.M.; Jimenez, B.D.; Talmage, S.S.; McCarthy, J.F.
1987-01-01
Epidemiologic studies of agents present in the environment seek to identify the extent to which they contribute to the causation of a specific toxic, clinical, or pathological endpoint. The multifactorial nature of disease etiology, long latency periods and the complexity of exposure, all contribute to the difficulty of establishing associations and casual relationships between a specific exposure and an adverse outcome. These barriers to studies of exposures and subsequent risk assessment cannot generally be changed. However, the appropriate use of biological markers in animal species living in a contaminated habitat can provide a measure of potential damage from that exposure and, in some instances, act as a surrogate for human environmental exposures. Quantitative predictivity of the effect of exposure to environmental pollutants is being approached by employing an appropriate array of biological end points. 34 refs., 1 fig., 6 tabs
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THE INFORMATION TECHNOLOGY AND COMMUNICATION USED BY LOGISTICS SERVICE PROVIDERS: LITERATURE REVIEW
Directory of Open Access Journals (Sweden)
Carolina Luisa dos Santos Vieira
2012-10-01
Full Text Available With the growth in the supply of logistics services, and the increase of competition, the use of information and communication technologies (ICT is now considered by logistics service providers (LSP, a source of competitive advantage. Through a literature review, this paper seeks to identify which technologies have been used by the PSL. Analyzing 47 articles on the subject, published in international journal that has the largest number of works on PSL, applications of technologies by PSL were analyzed according to a taxonomy suggested based on literature - software, hardware and networks. Among the results highlight the technologies cited by categories and greater scientific interest, such as EDI, RFID, TTS, WMS and Internet.
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School-related and social-emotional outcomes of providing mental health services in schools.
Ballard, Kristin L; Sander, Mark A; Klimes-Dougan, Bonnie
2014-02-01
This study evaluated student outcomes of an expanded school mental health (ESMH) model that placed community mental health clinicians on-site in schools to identify and treat children with mental health needs. The first aim of this study was to consider school-related outcomes (suspension rates and attendance rates) for those students who received ESMH treatment (n = 159) were compared to a matched high-risk sample that did not receive such services (n = 148). Results demonstrated differences between groups over time on measures of suspensions and attendance but not academic achievement. The second aim of this study was to evaluate change in social-emotional functioning (Strengths and Difficulties Questionnaire Scores) over time for the treatment group. Results indicated significant improvements on several parent and teacher ratings. Despite limitations of the ESMH framework examined in this study, the overall results suggest some promising advantages for students who received ESMH services.
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International Nuclear Information System (INIS)
Neben-Wittich, Michelle A.; Atherton, Pamela J.; Schwartz, David J.; Sloan, Jeff A.; Griffin, Patricia C.; Deming, Richard L.; Anders, Jon C.; Loprinzi, Charles L.; Burger, Kelli N.; Martenson, James A.; Miller, Robert C.
2011-01-01
Purpose: Considerable interobserver variability exists among providers and between providers and patients when measuring subjective symptoms. In the recently published Phase III N06C4 trial of mometasone cream vs. placebo to prevent radiation dermatitis, the primary provider-assessed (PA) endpoint, using the Common Toxicity Criteria for Adverse Events (CTCAE), was negative. However, prospectively planned secondary analyses of patient-reported outcomes (PROs), using the Skindex-16 and Skin Toxicity Assessment Tool (STAT), were positive. This study assesses the relationship between PA outcomes and PROs. Methods and Materials: Pearson correlation coefficients were calculated to compare the three tools. Statistical correlations were defined as follows: 0.7, strong. Results: CTCAE dermatitis moderately correlated with STAT erythema, and CTCAE pruritus strongly correlated with STAT itching. CTCAE pruritus had a moderate correlation with Skindex-16 itching. Comparing the 2 PRO tools, Skindex-16 itching correlated moderately with STAT itching. Skindex-16 burning, hurting, irritation, and persistence all showed the strongest correlation with STAT burning; they showed moderate correlations with STAT itching and tenderness. Conclusions: The PRO Skindex-16 correlated well with the PRO portions of STAT, but neither tool correlated well with CTCAE. PROs delineated a wider spectrum of toxicity than PA measures and provided more information on rash, redness, pruritus, and annoyance measures compared with CTCAE findings of rash and pruritus. PROs may provide a more complete measure of patient experience than single-symptom, PA endpoints in clinical trials assessing radiation skin toxicity.
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Clinical outcomes of patients living with HIV visiting ART centre at a ...
African Journals Online (AJOL)
The present retrospective study was aimed to provide information about the prevalence and clinical outcomes of patients living with HIV in Warangal District, in the Northern Telangana region, India. The national AIDS control organization and Kakatiya Medical College (KMC) Institutional Review Board reviewed and ...
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Integrated care information technology.
Rowe, Ian; Brimacombe, Phil
2003-02-21
Counties Manukau District Health Board (CMDHB) uses information technology (IT) to drive its Integrated Care strategy. IT enables the sharing of relevant health information between care providers. This information sharing is critical to closing the gaps between fragmented areas of the health system. The tragic case of James Whakaruru demonstrates how people have been falling through those gaps. The starting point of the Integrated Care strategic initiative was the transmission of electronic discharges and referral status messages from CMDHB's secondary provider, South Auckland Health (SAH), to GPs in the district. Successful pilots of a Well Child system and a diabetes disease management system embracing primary and secondary providers followed this. The improved information flowing from hospital to GPs now enables GPs to provide better management for their patients. The Well Child system pilot helped improve reported immunization rates in a high health need area from 40% to 90%. The diabetes system pilot helped reduce the proportion of patients with HbA1c rang:9 from 47% to 16%. IT has been implemented as an integral component of an overall Integrated Care strategic initiative. Within this context, Integrated Care IT has helped to achieve significant improvements in care outcomes, broken down barriers between health system silos, and contributed to the establishment of a system of care continuum that is better for patients.
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Baron, R.; Martin, L.; Gitsels-van der Wal, J.T.; Noordman, J.; Heymans, M.W.; Spelten, E.R.; Brug, J.; Hutton, E.K.
2017-01-01
OBJECTIVE: to quantify to what extent evidence-based health behaviour topics relevant for pregnancy are discussed with clients during midwife-led prenatal booking visits and to assess the association of client characteristics with the extent of information provided. DESIGN: quantitative video
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Baron, R.; Martin, L.; Gitsels-van der Wal, J.T.; Noordman, J.; Heymans, M.W.; Spelten, E.R.; Brug, J.; Hutton, E.K.
2017-01-01
Objective to quantify to what extent evidence-based health behaviour topics relevant for pregnancy are discussed with clients during midwife-led prenatal booking visits and to assess the association of client characteristics with the extent of information provided. Design quantitative video
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Baron, R.; Martin, L.; Gitsels-van der Wal, J.T.; Noordman, J.; Heymans, M.W.; Spelten, E.; Brug, J.; Hutton, E.K.
2017-01-01
Objective: to quantify to what extent evidence-based health behaviour topics relevant for pregnancy are discussed with clients during midwife-led prenatal booking visits and to assess the association of client characteristics with the extent of information provided. Design: quantitative video
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Development of a functional, internet-accessible department of surgery outcomes database.
Newcomb, William L; Lincourt, Amy E; Gersin, Keith; Kercher, Kent; Iannitti, David; Kuwada, Tim; Lyons, Cynthia; Sing, Ronald F; Hadzikadic, Mirsad; Heniford, B Todd; Rucho, Susan
2008-06-01
The need for surgical outcomes data is increasing due to pressure from insurance companies, patients, and the need for surgeons to keep their own "report card". Current data management systems are limited by inability to stratify outcomes based on patients, surgeons, and differences in surgical technique. Surgeons along with research and informatics personnel from an academic, hospital-based Department of Surgery and a state university's Department of Information Technology formed a partnership to develop a dynamic, internet-based, clinical data warehouse. A five-component model was used: data dictionary development, web application creation, participating center education and management, statistics applications, and data interpretation. A data dictionary was developed from a list of data elements to address needs of research, quality assurance, industry, and centers of excellence. A user-friendly web interface was developed with menu-driven check boxes, multiple electronic data entry points, direct downloads from hospital billing information, and web-based patient portals. Data were collected on a Health Insurance Portability and Accountability Act-compliant server with a secure firewall. Protected health information was de-identified. Data management strategies included automated auditing, on-site training, a trouble-shooting hotline, and Institutional Review Board oversight. Real-time, daily, monthly, and quarterly data reports were generated. Fifty-eight publications and 109 abstracts have been generated from the database during its development and implementation. Seven national academic departments now use the database to track patient outcomes. The development of a robust surgical outcomes database requires a combination of clinical, informatics, and research expertise. Benefits of surgeon involvement in outcomes research include: tracking individual performance, patient safety, surgical research, legal defense, and the ability to provide accurate information
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Dashboard report on performance on select quality indicators to cancer care providers.
Stattin, Pär; Sandin, Fredrik; Sandbäck, Torsten; Damber, Jan-Erik; Franck Lissbrant, Ingela; Robinson, David; Bratt, Ola; Lambe, Mats
2016-01-01
Cancer quality registers are attracting increasing attention as important, but still underutilized sources of clinical data. To optimize the use of registers in quality assurance and improvement, data have to be rapidly collected, collated and presented as actionable, at-a-glance information to the reporting departments. This article presents a dashboard performance report on select quality indicators to cancer care providers. Ten quality indicators registered on an individual patient level in the National Prostate Cancer Register of Sweden and recommended by the National Prostate Cancer Guidelines were selected. Data reported to the National Prostate Cancer Register are uploaded within 24 h to the Information Network for Cancer Care platform. Launched in 2014, "What''s Going On, Prostate Cancer" provides rapid, at-a-glance performance feedback to care providers. The indicators include time to report to the National Prostate Cancer Register, waiting times, designated clinical nurse specialist, multidisciplinary conference, adherence to guidelines for diagnostic work-up and treatment, and documentation and outcome of treatment. For each indicator, three performance levels were defined. What's Going On, a dashboard performance report on 10 selected quality indicators to cancer care providers, provides an example of how data in cancer quality registers can be transformed into condensed, at-a-glance information to be used as actionable metrics for quality assurance and improvement.
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Family benefits - Obligation to provide information
HR Department
2015-01-01
Pursuant to Article R V 1.38 of the Staff Regulations, members of the personnel are reminded that they are required to inform the Organization in writing, within 30 calendar days, of any change in their family situation (marriage, partnership, birth of a child, etc.) and of the amount of any financial benefit of a similar nature to those stipulated in the Staff Regulations (e.g. family allowance, child allowance, infant allowance, non-resident allowance or international indemnity) to which they or a member of their family may be entitled from a source other than CERN. The procedures to be followed are available in the Admin e-guide: https://admin-eguide.web.cern.ch/en/procedure/change-family-situation Members of the personnel are also reminded that any false declaration or failure to make a declaration with a view to deceiving others or achieving a gain resulting in a loss of funds or reputation for CERN constitutes fraud and may lead to disciplinary action in accordance with Article S VI 2.01 of ...
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Providing Advanced and Real-Time Travel/Traffic Information to Tourists
1998-10-01
Advanced traveler information systems (ATIS) analyze and communicate information that can enhance travel efficiency, alleviate congestion, and increase safety. In Texas, tourists (i.e., tripmakers unacquainted with the state) constitute an important ...
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International Nuclear Information System (INIS)
2010-01-01
As an answer to a mission assigned by the French Ministry of Energy, this document proposes a rather detailed report of the present status of invoicing modalities used by electricity and natural gas providers. It comments several facts and observations: almost all energy invoices contain a share of estimation which is naturally different of the actual consumption; the consumer has, in some cases, an alternative to an estimation-based invoicing; the complexity of energy invoicing is a source of misunderstanding for consumers; the number of complaints is increasing and their treatment is not satisfying. A set of recommendations is formulated to correct these problems, whether by improving the quality of estimations, or by better information of customers, or by improving the treatment of complaints or the relationship with the customer. The report is completed by several appendices containing testimonies and auditions of representatives of customer organisations and of energy providers
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Beaglehole, Ben; Frampton, Chris M; Boden, Joseph M; Mulder, Roger T; Bell, Caroline J
2017-11-01
Following the onset of the Canterbury, New Zealand earthquakes, there were widespread concerns that mental health services were under severe strain as a result of adverse consequences on mental health. We therefore examined Health of the Nation Outcome Scales data to see whether this could inform our understanding of the impact of the Canterbury earthquakes on patients attending local specialist mental health services. Health of the Nation Outcome Scales admission data were analysed for Canterbury mental health services prior to and following the Canterbury earthquakes. These findings were compared to Health of the Nation Outcome Scales admission data from seven other large District Health Boards to delineate local from national trends. Percentage changes in admission numbers were also calculated before and after the earthquakes for Canterbury and the seven other large district health boards. Admission Health of the Nation Outcome Scales scores in Canterbury increased after the earthquakes for adult inpatient and community services, old age inpatient and community services, and Child and Adolescent inpatient services compared to the seven other large district health boards. Admission Health of the Nation Outcome Scales scores for Child and Adolescent community services did not change significantly, while admission Health of the Nation Outcome Scales scores for Alcohol and Drug services in Canterbury fell compared to other large district health boards. Subscale analysis showed that the majority of Health of the Nation Outcome Scales subscales contributed to the overall increases found. Percentage changes in admission numbers for the Canterbury District Health Board and the seven other large district health boards before and after the earthquakes were largely comparable with the exception of admissions to inpatient services for the group aged 4-17 years which showed a large increase. The Canterbury earthquakes were followed by an increase in Health of the Nation
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Measuring Practicing Clinicians’ Information Literacy
Barboza, Katherine; Jensen, Ashley E.; Bennett, Katelyn J.; Sherman, Scott E.; Schwartz, Mark D.
2017-01-01
Summary Background As healthcare moves towards technology-driven population health management, clinicians must adopt complex digital platforms to access health information and document care. Objectives This study explored information literacy, a set of skills required to effectively navigate population health information systems, among primary care providers in one Veterans’ Affairs (VA) medical center. Methods Information literacy was assessed during an 8-month randomized trial that tested a population health (panel) management intervention. Providers were asked about their use and comfort with two VA digital tools for panel management at baseline, 16 weeks, and post-intervention. An 8-item scale (range 0-40) was used to measure information literacy (Cronbach’s a=0.84). Scores between study arms and provider types were compared using paired t-tests and ANOVAs. Associations between self-reported digital tool use and information literacy were measured via Pearson’s correlations. Results Providers showed moderate levels of information literacy (M= 27.4, SD 6.5). There were no significant differences in mean information literacy between physicians (M=26.4, SD 6.7) and nurses (M=30.5, SD 5.2, p=0.57 for difference), or between intervention (M=28.4, SD 6.5) and control groups (M=25.1, SD 6.2, p=0.12 for difference). Information literacy was correlated with higher rates of self-reported information system usage (r=0.547, p=0.001). Clinicians identified data access, accuracy, and interpretability as potential information literacy barriers. Conclusions While exploratory in nature, cautioning generalizability, the study suggests that measuring and improving clinicians’ information literacy may play a significant role in the implementation and use of digital information tools, as these tools are rapidly being deployed to enhance communication among care teams, improve health care outcomes, and reduce overall costs. PMID:28197620
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Harle, Christopher A; Listhaus, Alyson; Covarrubias, Constanza M; Schmidt, Siegfried Of; Mackey, Sean; Carek, Peter J; Fillingim, Roger B; Hurley, Robert W
2016-01-01
In this case report, the authors describe the implementation of a system for collecting patient-reported outcomes and integrating results in an electronic health record. The objective was to identify lessons learned in overcoming barriers to collecting and integrating patient-reported outcomes in an electronic health record. The authors analyzed qualitative data in 42 documents collected from system development meetings, written feedback from users, and clinical observations with practice staff, providers, and patients. Guided by the Unified Theory on the Adoption and Use of Information Technology, 5 emergent themes were identified. Two barriers emerged: (i) uncertain clinical benefit and (ii) time, work flow, and effort constraints. Three facilitators emerged: (iii) process automation, (iv) usable system interfaces, and (v) collecting patient-reported outcomes for the right patient at the right time. For electronic health record-integrated patient-reported outcomes to succeed as useful clinical tools, system designers must ensure the clinical relevance of the information being collected while minimizing provider, staff, and patient burden. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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Baldwin, Mike; Spong, Andrew; Doward, Lynda; Gnanasakthy, Ari
2011-01-01
Internet communication is developing. Social networking sites enable patients to publish and receive communications very easily. Many stakeholders, including patients, are using these media to find new ways to make sense of diseases, to find and discuss treatments, and to give support to patients and their caregivers. We argue for a new definition of patient-reported information (PRI), which differs from the usual patient-reported outcomes (PRO). These new emergent data from the social web have important implications for decision making, at both an individual and a population level. We discuss new emergent technologies that will help aggregate this information and discuss how this will be assessed alongside the use of PROs in randomized controlled trials and how these new emergent data will be one facet of changing the relationship between the various stakeholders in achieving better co-created health.
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Barhoum, Masad; Tobias, Samuel; Elron, Moshe; Sharon, Aviram; Heija, Tariq; Soustiel, Jean F
2015-01-01
As an expected consequence of the civil war in Syria, emergent neurosurgical care for battlefield trauma has been provided for severely head-injured Syrians transferred to Northern Israel. Sixty-six patients suffering from brain injury were brought to the border and then referred to the institution after initial resuscitation. Both the time and type of injury were recorded based on paramedic testimony, forensic material or on details provided by patients. A retrospective analysis of all medical charts and imaging material was performed. Most injuries were combat-related, either caused by blast (13.6%), shrapnel (24.2%), assault (28.8%) or gunshot wound (15.2%). Only a minority of patients (18.2%) suffered from injuries that were not directly caused by weapon. A total of 55 surgical procedures were performed in 46 out of 66 patients, including craniotomies in 40 patients, burr hole alone for placement of intraparenchymal intracranial pressure (ICP) sensor in nine instances and ventricle peritoneal shunt in two patients. Decompressive craniectomy was used only for the treatment of gunshot wound and was performed in eight out of 10 patients. The most common complication consisted in cerebrospinal fluid fistulas (16.7%). Post-operative infections occurred in seven patients (10.6%). Short-term outcomes were favourable in 60.7%, with a mortality rate of 4.5%. The present findings suggest that aggressive surgery and neuro-intensive care measures may lead to good functional results, even in the presence of seemingly devastating injuries in some selected patients.
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An exploration of clinical interventions provided by pharmacists within a complex asthma service
Lemay, Kate S.; Saini, Bandana; Bosnic-Anticevich, Sinthia; Smith, Lorraine; Stewart, Kay; Emmerton, Lynne; Burton, Deborah L.; Krass, Ines; Armour, Carol L.
2015-01-01
Background: Pharmacists in Australia are accessible health care professionals, and their provision of clinical pharmacy interventions in a range of areas has been proven to improve patient outcomes. Individual clinical pharmacy interventions in the area of asthma management have been very successful. An understanding of the nature of these interventions will inform future pharmacy services. What we do not know is when pharmacists provide a complex asthma service, what elements of that service...
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Wu, Shishi; Roychowdhury, Imara; Khan, Mishal
2017-03-01
Developing human resources capacity is vital for tuberculosis (TB) control in low- and middle-income countries. Although investments in TB healthcare provider (HCP) training programmes have increased, it is unclear whether these are robustly evaluated. The objective of this systematic review was to synthesize the methods and outcome indicators used to assess TB HCP training programmes. A systematic scoping review of publications reporting on evaluations of training programmes for TB HCPs - including doctors, nurses, paramedics, and lay health workers - was conducted through a search in three electronic databases, Google Scholar, and five websites of non-profit organizations. Data on the study location, population trained, outcomes assessed, and evaluation approach were extracted. After screening 499 unique publications, 21 were eligible for inclusion in the analysis. The majority of evaluations were conducted in Africa. The most common evaluation methods were a review of patient records (n=8, 38%) and post-training interview with trainees (n=7, 33%). In terms of outcomes, more than half of the studies (n=12, 57%) evaluated knowledge acquisition of trainees, with only six (29%) assessing on-the-job behaviour change. Even though more funds have been invested in TB HCP training, publications from robust evaluations assessing the impact on quality of care and behaviour change are limited. Copyright © 2016. Published by Elsevier Ltd.
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49 CFR 40.215 - What information about the DER do employers have to provide to BATs and STTs?
2010-10-01
... 49 Transportation 1 2010-10-01 2010-10-01 false What information about the DER do employers have to provide to BATs and STTs? 40.215 Section 40.215 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Alcohol Testing Personnel § 40.215 What information about the DER do...
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Predictors of Course Outcomes: Early Indicators of Delay in Online Classrooms
McElroy, Barbara Woods; Lubich, Bruce H.
2013-01-01
Studies have long shown that students who begin or submit their work later tend to have negative academic outcomes. The measures of procrastination used in those studies may not have provided information timely enough for instructor intervention. This article focuses on delay in the online environment among graduate students. We propose two new…
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A Qualitative Study of US Clinical Ethics Services: Objectives and Outcomes.
McClimans, Leah; Pressgrove, Geah; Rhea, James
2016-01-01
The quality of clinical ethics services in health care organizations is increasingly seen as an important aspect of the overall quality of care. But measuring this quality is difficult because there is a lack of clarity and consensus regarding the objectives of clinical ethics and the best outcome domains to measure. The aim of this qualitative study is to explore the views of experts about the objectives and outcomes of clinical ethics services in the US. We interviewed 19 experts in clinical ethics, focusing on the appropriate objectives and outcomes of a clinical ethics service (CES). Participants were selected using a purposive snowball sampling strategy. The development of the interview protocol was informed by the clinical ethics literature as well as by research and theories that inform clinical ethics practice. Interviews were conducted by phone, recorded, and transcribed for individual analysis. Analysis proceeded through the development of a codebook of categories using QDA Miner software. Our experts identified 12 objectives and nine outcomes. Some of these identifications were familiar (e.g., mediation and satisfaction) and some were novel (e.g., be of service and transformation). We found that experts are divided in their emphasis on the kinds of objectives that are most important. In terms of outcomes, our experts were concerned with the appropriateness of different proxy and direct measures. This study provides the perspectives of a select group of experts on the objectives and outcomes appropriate for a CES in the United States. The themes identified will be used in future research to inform a Delphi study to refine and obtain expert consensus.
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Assessing the quality of healthcare provided to children.
Mangione-Smith, R; McGlynn, E A
1998-10-01
pediatric population that can be most affected by variations in the quality of care. Improving the care provided to these children is likely to have the largest impact on quality of life and longevity. The low prevalence of most severe pediatric diseases also makes it difficult to evaluate the effectiveness of new treatment modalities; multi-center trials or long enrollment periods are usually required to obtain a large enough patient sample to conduct the necessary randomized controlled trials or cohort studies. Another challenge encountered when measuring quality of care for children is that, in most cases, they depend on adults to both obtain care and to report on the outcomes of that care. Parents and their children may have different perceptions of what defines health or have different levels of satisfaction with the care they receive. Children, particularly those with special needs, also depend on a broad range of services including the medical system, community intervention programs, social programs, and school-based services. Dependency on these various services adds to the difficulty of measuring and appropriately attributing health outcomes observed in children to a particular service delivery entity. Adolescents also depend on adults for access to some of their care; however, they have special needs related to confidentiality and parent-child information sharing. Adolescents commonly seek care at facilities, such as school-based clinics, that allow them to obtain confidential care. These facilities usually provide out-of-health plan care for these children, which raises special issues related to information availability for quality assessments and for assessing utilization patterns in this population. If the source of poor health outcomes is not known, quality improvement is not possible. The many challenges faced when constructing pediatric (this term will be used to refer to both children and adolescents) quality of care measures have resulted in few of these
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Friedman, Carli; Rizzolo, Mary C.
2016-01-01
The United States long-term services and supports system is built on largely unpaid (informal) labor. There are a number of benefits to allowing family caregivers to serve as paid personal care providers including better health and satisfaction outcomes, expanded workforces, and cost effectiveness. The purpose of this study was to examine how…
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Improving clinical outcomes in psychiatric care with touch-screen technology.
Newnham, Elizabeth A; Doyle, Emma L; Sng, Adelln A H; Hooke, Geoffrey R; Page, Andrew C
2012-05-01
Patient-focused research, which uses clinical characteristics to predict outcomes, is a field in which information technology has been effectively integrated with practice. The present research used touch-screen technology to monitor the daily self-report measures of 1,308 consecutive inpatients and day patients participating in a 2-week cognitive-behavioral therapy group. Providing regular feedback was effective in reducing symptoms for patients at risk of poor outcomes (Newnham, Hooke, & Page, 2010b). The use of touch screens in psychiatric monitoring encourages a collaborative dialogue between patients and therapists and promotes engagement in the process of progress monitoring and treatment evaluation.
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LENUS (Irish Health Repository)
McGee, Hannah M
2008-09-01
Data on both the provision and receipt of informal care among populations of older adults are limited. Patterns of both informal care provided and received by older adults in the Republic of Ireland (RoI) and Northern Ireland (NI) were evaluated. A cross-sectional community-based population survey was conducted. Randomly selected older people (aged 65+, n = 2033, mean age (standard deviation): 74.1 years (6.8), 43% men, 68% response rate) provided information on the provision and receipt of care, its location, and the person(s) who provided the care. Twelve per cent of the sample (251\\/2033) identified themselves as informal caregivers (8% RoI and 17% NI). Caregivers were more likely to be women, married, have less education and have less functional impairment. Forty-nine per cent (1033\\/2033, 49% RoI and 48% NI) reported receiving some form of care in the past year. Care recipients were more likely to be older, married, have more functional impairment, and poorer self-rated health. Receiving regular informal care (help at least once a week) from a non-resident relative was the most common form of help received [28% overall (578\\/2033); 27% RoI and 30% NI]. Five per cent (n = 102\\/2033) of the sample reported both providing and receiving informal care. Levels of informal care provided by community-dwelling older adults were notably higher than reported in single-item national census questions. The balance of formal and informal health and social care will become increasingly important as populations age. It is essential, therefore, to evaluate factors facilitating or impeding informal care delivery.
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Informal Caregiving for Cancer Patients
Romito, Francesca; Goldzweig, Gil; Cormio, Claudia; Hagedoorn, Mariët; Andersen, Barbara L.
2013-01-01
According to the recent worldwide estimation by the GLOBOCAN project, in total, 12.7 million new cancer cases and 7.6 million cancer deaths occurred in 2008. The worldwide number of cancer survivors within 5 years of diagnosis has been estimated at be almost 28.8 million. Informal caregivers, such as family members and close friends, provide essential support to cancer patients. The authors of this report provide an overview of issues in the study of informal caregivers for cancer patients and long-term survivors in the United States and Europe, characterizing the caregivers commonly studied; the resources currently available to them; and their unmet needs, their psychosocial outcomes, and the psychosocial interventions tailored to their special circumstances. A broad overview of the state of research and knowledge, both in Europe and the United States, and observations on the directions for future research are provided. PMID:23695928
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Improving Educational Outcomes by Providing Educational Services through Mobile Technology
Hosam Farouk El-Sofany
2013-01-01
The use of Computers, Networks, and Internet has successfully enabled educational institutions to provide their students and instructors with various online educational services. With the recent developments in M-learning and mobile technology, further possibilities are emerging to provide such services through mobile devices such as mobile phones and PDAs. By providing the educational services using wireless and mobile technologies, the educational institutions can potentially bring great co...
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Improving treatment outcome assessment in a mouse tuberculosis model.
Mourik, Bas C; Svensson, Robin J; de Knegt, Gerjo J; Bax, Hannelore I; Verbon, Annelies; Simonsson, Ulrika S H; de Steenwinkel, Jurriaan E M
2018-04-09
Preclinical treatment outcome evaluation of tuberculosis (TB) occurs primarily in mice. Current designs compare relapse rates of different regimens at selected time points, but lack information about the correlation between treatment length and treatment outcome, which is required to efficiently estimate a regimens' treatment-shortening potential. Therefore we developed a new approach. BALB/c mice were infected with a Mycobacterium tuberculosis Beijing genotype strain and were treated with rifapentine-pyrazinamide-isoniazid-ethambutol (R p ZHE), rifampicin-pyrazinamide-moxifloxacin-ethambutol (RZME) or rifampicin-pyrazinamide-moxifloxacin-isoniazid (RZMH). Treatment outcome was assessed in n = 3 mice after 9 different treatment lengths between 2-6 months. Next, we created a mathematical model that best fitted the observational data and used this for inter-regimen comparison. The observed data were best described by a sigmoidal E max model in favor over linear or conventional E max models. Estimating regimen-specific parameters showed significantly higher curative potentials for RZME and R p ZHE compared to RZMH. In conclusion, we provide a new design for treatment outcome evaluation in a mouse TB model, which (i) provides accurate tools for assessment of the relationship between treatment length and predicted cure, (ii) allows for efficient comparison between regimens and (iii) adheres to the reduction and refinement principles of laboratory animal use.
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Providing an information prescription in veterinary medical clinics: a pilot study.
Kogan, Lori R; Schoenfeld-Tacher, Regina; Gould, Lauren; Viera, Ann R; Hellyer, Peter W
2014-01-01
The study assesses the impact on client behavior and attitudes toward receiving an information prescription as part of a veterinary office visit. A random sample of veterinary clinics from a Western US metropolitan area was asked to distribute an information prescription in addition to their customary veterinary services. All clients, regardless of the reason for their visit, were presented with an information prescription: a handout that included the uniform resource locator (URL) to a general veterinary medicine website and several tips to help their clients make more informed choices about where to seek pet health information online. Nearly 40% of clients who reported that they remembered receiving the information prescription accessed the website at least once. Of the clients who reported accessing the suggested website, 86.3% reported finding it "very helpful" or "somewhat helpful." Nearly all the clients (87.9%) reported feeling the information on the site helped them make better decisions for their pets. Most clients reported that it helped them talk to their veterinarians (89.9%) and added to the information they received during their veterinary visits (83.5%). Clients appreciate and utilize veterinary prescriptions, suggesting that this is a tool that both veterinarians and librarians can use to improve animal health and client relations. The value placed on reliable Internet information by veterinary clients suggests several opportunities for librarians to become more proactive in partnering with veterinarians to facilitate the education of pet owners.
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Chung, Jae Eun
2013-01-01
Increasing numbers of people have turned to the Internet for health information. Little has been done beyond speculation to empirically investigate patients' discussion of online health information with health care professionals (HCPs) and patients' perception of HCPs' reactions to such discussion. The author analyzed data from the 2007 Health Information National Trends Survey (HINTS) to identify the characteristics of patients (a) who search for health information on the Internet, (b) who discuss the information found on the Internet with HCPs, and (c) who positively assess HCPs' reaction to the online information. Findings show that men were more likely than were women to have a conversation on online information with HCPs. It is unfortunate that patients who had trouble understanding or trusting online health information were no more likely to ask questions to or seek guidance from HCPs. Reactions of HCPs to online information were perceived as particularly negative by certain groups of patients, such as those who experienced poor health and those who had more concerns about the quality of their searched information. Results are discussed for their implications for patient empowerment and patient-HCP relationships.
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Misreporting signs of child abuse: the role of decision-making and outcome information.
Lindholm, Torun; Sjöberg, Rickard L; Memon, Amina
2014-02-01
Two studies provided evidence that a decision to report an ambiguous case of child abuse affected subsequent memory of the case information, such that participants falsely recognized details that were not presented in the original information, but that are schematically associated with child abuse. Moreover, post-decision information that the child had later died from abuse influenced the memory reports of participants who had chosen not to report the case, increasing their reports of false schema-consistent details. This suggests that false decision-consistent memories are primarily due to sense-making, schematic processing rather than the motivation to justify the decision. The present findings points to an important mechanism by which decision information can become distorted in retrospect, and emphasize the difficulties of improving future decision-making by contemplating past decisions. The results also indicate that decisions may generate false memories in the apparent absence of external suggestion or misleading information. Implications for decision-making theory, and applied practices are discussed. © 2013 Scandinavian Psychological Associations and John Wiley & Sons Ltd.
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2010-01-01
... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false What information must I provide to a higher....355 Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET GOVERNMENTWIDE GUIDANCE FOR GRANTS AND...) Responsibilities of Participants Regarding Transactions Doing Business With Other Persons Disclosing Information...
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ROLE OF INFORMATION PHARMACEUTICAL MARKET IN PROVIDING TRAFFIC CONTROL DRUG
Directory of Open Access Journals (Sweden)
O. S. Solovjov
2014-01-01
Full Text Available The controversial questions of the pharmaceutical market informatization are considered. The main principles and legal frameworks to manage population ensure with medicines based on use of information technology are proposed. The logic and conception framework of related information automatization for hospitals and population under the current legislation are discussed.
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A catalog of information systems outsourcing risks
Directory of Open Access Journals (Sweden)
Filipe Sá-Soares
2014-01-01
Full Text Available Information systems outsourcing risks are a vital component in the decision and management process associated to the provision of information systems and technology services by a provider to a customer. Although there is a rich literature on information systems outsourcing risks, the accumulated knowledge on this area is fragmented. In view of this situation, an argument is put forward on the usefulness of having a theory that integrates the various constructs related to information systems outsourcing risks. This study aims to contribute towards the synthesis of that theory, by proposing a conceptual framework for interpreting the literature and presenting a catalog of information systems outsourcing risks. The conceptual framework articulates together six key risk elements, namely dangers, negative outcomes, undesirable consequences, factors and mitigation actions. The catalog condenses and categorizes the information systems outsourcing risk elements found on the literature reviewed, both from the perspective of the outsourcing customer and from the perspective of the outsourcing provider. Proposals for subsequent work towards the generation of the theory of information systems outsourcing risk are suggested.
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International Nuclear Information System (INIS)
Azian, A.A.; Nurulazman, A.A.; Shuaib, I.L.; Mahayidin, M.; Ariff, A.R.; Naing, N.N.; Abdullah, J.
2001-01-01
Head injury is a significant economic, social and medical problem all over the world. Road accidents are the most frequent cause of head injury in Malaysia which highest risk in the young (15 to 24 years old). The associated outcomes include good recovery, possibility of death for the severely injured, which may cause disruption of the lives of their family members. It is important to predict the outcome as it will provide sound information to assist clinicians in Malaysia in providing prognostic information to patients and their families, to assess the effectiveness of different modes of treatment in promoting recovery and to document the significance of head injury as a public health problem. Results. A total of 103 cases with intracranial hemorrhage i.e. intracerebral hemorrhage, extradural hemorrhage, subdural hemorrhage, intraventricular hemorrhage, hemorrhagic contusion and subarachnoid hemorrhage, following motor vehicle accidents was undertaken to study factors contributing to either good or poor outcome according to the Glasgow outcome scale. Patients below 12 years of age were excluded. The end point of the study was taken at 24 months post injury. The selected variables were incorporated into models generated by logistic regression techniques of multivariate analysis to see the significant predictors of outcome as well as the correlation between the CT findings with GCS. Conclusion. Significant predictors of outcome were GCS on arrival in the accident emergency department, pupillary reflex and the CT scan findings. The CT predictors of outcome include ICH, EDH, IVH, present of SAH, site of ICH, volumes of EDH and SDH as well as midline shift. (author)
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Chughtai, A A; Qadeer, E; Khan, W; Hadi, H; Memon, I A
2013-03-01
To improve involvement of the private sector in the national tuberculosis (TB) programme in Pakistan various public-private mix projects were set up between 2004 and 2009. A retrospective analysis of data was made to study 6 different public-private mix models for TB control in Pakistan and estimate the contribution of the various private providers to TB case notification and treatment outcome. The number of TB cases notified through the private sector increased significantly from 77 cases in 2004 to 37,656 in 2009. Among the models, the nongovernmental organization model made the greatest contribution to case notification (58.3%), followed by the hospital-based model (18.9%). Treatment success was highest for the district-led model (94.1%) and lowest for the hospital-based model (74.2%). The private sector made an important contribution to the national data through the various public-private mix projects. Issues of sustainability and the lack of treatment supporters are discussed as reasons for lack of success of some projects.
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2012-01-01
Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN) has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services. PMID:22640939
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Directory of Open Access Journals (Sweden)
Burgess Philip
2012-05-01
Full Text Available Abstract Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services.
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Kohli, R; Tan, J K; Piontek, F A; Ziege, D E; Groot, H
1999-08-01
Changes in health care delivery, reimbursement schemes, and organizational structure have required health organizations to manage the costs of providing patient care while maintaining high levels of clinical and patient satisfaction outcomes. Today, cost information, clinical outcomes, and patient satisfaction results must become more fully integrated if strategic competitiveness and benefits are to be realized in health management decision making, especially in multi-entity organizational settings. Unfortunately, traditional administrative and financial systems are not well equipped to cater to such information needs. This article presents a framework for the acquisition, generation, analysis, and reporting of cost information with clinical outcomes and patient satisfaction in the context of evolving health management and decision-support system technology. More specifically, the article focuses on an enhanced costing methodology for determining and producing improved, integrated cost-outcomes information. Implementation issues and areas for future research in cost-information management and decision-support domains are also discussed.
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Comprehensive Civil Information Management: How to Provide It
2012-04-04
amount of graft and corruption as officials at different layers often take a “cut” and transfer cash out of the nation it was intended to reach.14...information. The Foreign Assistance Dashboard represents State’s transparency effort for American foreign aid. Foreign Assistance Dashboard includes...State, USAID, and Millennium Challenge Corporation (MCC) projects. State recently re-designed the dashboard to accept data collaboratively from other
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Directory of Open Access Journals (Sweden)
Daniel Ferreira
2013-11-01
Full Text Available The objective of this study was to assess the quality of the contents related to screening in a sample of websites providing information on breast and prostate cancer in the Portuguese language. The first 200 results of each cancer-specific Google search were considered. The accuracy of the screening contents was defined in accordance with the state of the art, and its readability was assessed. Most websites mentioned mammography as a method for breast cancer screening (80%, although only 28% referred to it as the only recommended method. Almost all websites mentioned PSA evaluation as a possible screening test, but correct information regarding its effectiveness was given in less than 10%. For both breast and prostate cancer screening contents, the potential for overdiagnosis and false positive results was seldom addressed, and the median readability index was approximately 70. There is ample margin for improving the quality of websites providing information on breast and prostate cancer in Portuguese.
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Developing a Web-Based Nursing Practice and Research Information Management System: A Pilot Study.
Choi, Jeeyae; Lapp, Cathi; Hagle, Mary E
2015-09-01
Many hospital information systems have been developed and implemented to collect clinical data from the bedside and have used the information to improve patient care. Because of a growing awareness that the use of clinical information improves quality of care and patient outcomes, measuring tools (electronic and paper based) have been developed, but most of them require multiple steps of data collection and analysis. This necessitated the development of a Web-based Nursing Practice and Research Information Management System that processes clinical nursing data to measure nurses' delivery of care and its impact on patient outcomes and provides useful information to clinicians, administrators, researchers, and policy makers at the point of care. This pilot study developed a computer algorithm based on a falls prevention protocol and programmed the prototype Web-based Nursing Practice and Research Information Management System. It successfully measured performance of nursing care delivered and its impact on patient outcomes successfully using clinical nursing data from the study site. Although Nursing Practice and Research Information Management System was tested with small data sets, results of study revealed that it has the potential to measure nurses' delivery of care and its impact on patient outcomes, while pinpointing components of nursing process in need of improvement.
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Learmonth, Yvonne C; Adamson, Brynn C; Balto, Julia M; Chiu, Chung-Yi; Molina-Guzman, Isabel M; Finlayson, Marcia; Riskin, Barry J; Motl, Robert W
2017-10-01
There is increasing recognition of the benefits of exercise in individuals with multiple sclerosis (MS), yet the MS population does not engage in sufficient amounts of exercise to accrue health benefits. There has been little qualitative inquiry to establish the preferred format and source for receiving exercise information from health-care providers among persons with MS. We sought to identify the desired and preferred format and source of exercise information for persons with MS that can be delivered through health-care providers. Participants were adults with MS who had mild or moderate disability and participated in a range of exercise levels. All participants lived in the Midwest of the United States. Fifty semi-structured interviews were conducted and analysed using thematic analysis. Two themes emerged, (i) approach for receiving exercise promotion and (ii) ideal person for promoting exercise. Persons with MS want to receive exercise information through in-person consultations with health-care providers, print media and electronic media. Persons with MS want to receive exercise promotion from health-care providers with expertise in MS (ie neurologists) and with expertise in exercise (eg physical therapists). These data support the importance of understanding how to provide exercise information to persons with MS and identifying that health-care providers including neurologists and physical therapists should be involved in exercise promotion. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.
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International Nuclear Information System (INIS)
Kleijwegt, M.C.; Mey, A.G.L. van der; Wiggers-deBruine, F.T.; Malessy, M.J.A; Osch, M.J.P. van
2016-01-01
•DSC/ASL-MRI can be acquired in growing VS with sufficient image quality.•In most patients DSC and ASL techniques provide similar qualitative scores.•These techniques can be of importance in future decision-making. DSC/ASL-MRI can be acquired in growing VS with sufficient image quality. In most patients DSC and ASL techniques provide similar qualitative scores. These techniques can be of importance in future decision-making. The added value of perfusion MRI for decision-making in vestibular schwannoma (VS) patients is unknown. MRI offers two perfusion methods: the first employing contrast agent (dynamic susceptibility contrast (DSC)-MRI) that provides information on cerebral blood volume (CBV) and cerebral blood flow (CBF), the second by magnetic labeling of blood (arterial spin labeling (ASL)-MRI), providing CBF-images. The goal of the current study is to investigate whether DSC and ASL perfusion MRI provides complimentary information to current anatomical imaging in treatment selection process of VS. Nine patients with growing VS with extrameatal diameter >9 mm were included (>2 mm/year and 20% volume expansion/year) and one patient with 23 mm extrameatal VS without growth. DSC and ASL perfusion MRI were obtained on 3 T MRI. Perfusion in VS was scored as hyperintense, hypointense or isointense compared to the contralateral region. Seven patients showed hyperintense signal on DSC and ASL sequences. Three patients showed iso- or hypointense signal on at least one perfusion map (1 patient hypointense on both DSC-MRI and ASL; 1 patient isointense on DSC-CBF; 1 patient isointense on ASL). All patients showed enhancement on post-contrast T1 anatomical scan. Perfusion MR provides additional information compared to anatomical imaging for decision-making in VS
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Schooley, Benjamin; Walczak, Steven; Hikmet, Neset; Patel, Nitin
2016-04-01
Health information technology investments continue to increase while the value derived from their implementation and use is mixed. Mobile device adoption into practice is a recent trend that has increased dramatically and formal studies are needed to investigate consequent benefits and challenges. The objective of this study is to evaluate practitioner perceptions of improvements in productivity, provider-patient communications, care provision, technology usability and other outcomes following the adoption and use of a tablet computer connected to electronic health information resources. A pilot program was initiated in June 2013 to evaluate the effect of mobile tablet computers at one health provider organization in the southeast United States. Providers were asked to volunteer for the evaluation and were each given a mobile tablet computer. A total of 42 inpatient and outpatient providers were interviewed in 2015 using a survey style questionnaire that utilized yes/no, Likert-style, and open ended questions. Each had previously used an electronic health record (EHR) system a minimum of one year outside of residency, and were regular users of personal mobile devices. Each used a mobile tablet computer in the context of their practice connected to the health system EHR. The survey results indicate that more than half of providers perceive the use of the tablet device as having a positive effect on patient communications, patient education, patient's perception of the provider, time spent interacting with patients, provider productivity, process of care, satisfaction with EHR when used together with the device, and care provision. Providers also reported feeling comfortable using the device (82.9%), would recommend the device to colleagues (69.2%), did not experience increased information security and privacy concerns (95%), and noted significant reductions in EHR login times (64.1%). Less than 25% of participants reported negative impacts on any of these areas as
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Oude Voshaar, Antonius H.; ten Klooster, Peter M.; Glas, Cornelis A.W.; Vonkeman, Harald Erwin; Krishnan, Eswar; van de Laar, Mart A F J
2014-01-01
OBJECTIVE: To evaluate and compare the measurement precision and sensitivity to change of the Health Assessment Questionnaire disability index (HAQ DI), the Short Form 36 physical functioning scale (PF-10), and simulated Patient-Reported Outcomes Measurement Information System (PROMIS) physical
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Access and use of information by primary health care providers in ...
African Journals Online (AJOL)
The study has also shown that health workers were generally active information seekers while women were mainly passive. The study concludes that the value of information, rather than needs or constraints, was the driving force behind the information processes reported. The various actions, which resulted from the value ...
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Is More Better? Outcome and Dose of a Universal Drug Prevention Effectiveness Trial
Ferrer-Wreder, Laura; Cadely, Hans Saint-Eloi; Domitrovich, Celene E.; Small, Meg L.; Caldwell, Linda L.; Cleveland, Michael J.
2010-01-01
Two evidence-based interventions, Life Skills Training and TimeWise, were combined in an effectiveness trial. Participants were predominately African American youth (N = 715; M[subscript age] = 12). The study authors provide an empirical demonstration of the implications of incorporating dosage information in intervention outcome analyses. Study…
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Directory of Open Access Journals (Sweden)
Arjunan Isaac
2011-06-01
Full Text Available Objective: To find the prevalence of diabetics, identify informal care providers for them in Kaiwara Primary Health Center (PHC area, assess the level of knowledge and skills of an informal care provider in home based long term care and improve the level of knowledge and skill of the informal care provider through a structured training capsule. Methods: A cross sectional and an interventional study was conducted on diabetics and their informal care providers in Kaiwara PHC area. Data were collected using pre-tested, structured questionnaire by an interview method. A structured training capsule was developed and implemented. Evaluation of the knowledge and skills was assessed at the beginning and at the end of the training. Student ’s paired/unpaired ‘t ’ tests and correlation analysis were done. Results: Improvement scores were calculated by subtracting the pre-evaluation scores from the post-evaluation scores. The mean improvement scores was (2.66暲0.32 and was statistically significant (P<0.001. No significant difference in mean values was found in the knowledge and skills scores in relation to the socio-demographic variables in the study. Conclusions: Knowledge and skills component of the informal care provider in home based care of diabetes could be perceived as a “felt need ”.
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Outcome dependency alters the neural substrates of impression formation
Ames, Daniel L.; Fiske, Susan T.
2015-01-01
How do people maintain consistent impressions of other people when other people are often inconsistent? The present research addresses this question by combining recent neuroscientific insights with ecologically meaningful behavioral methods. Participants formed impressions of real people whom they met in a personally involving situation. fMRI and supporting behavioral data revealed that outcome dependency (i.e., depending on another person for a desired outcome) alters previously identified neural dynamics of impression formation. Consistent with past research, a functional localizer identified a region of dorsomedial PFC previously linked to social impression formation. In the main task, this ROI revealed the predicted patterns of activity across outcome dependency conditions: greater BOLD response when information confirmed (vs. violated) social expectations if participants were outcome-independent and the reverse pattern if participants were outcome-dependent. We suggest that, although social perceivers often discount expectancy-disconfirming information as noise, being dependent on another person for a desired outcome focuses impression-formation processing on the most diagnostic information, rather than on the most tractable information. PMID:23850465
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Baji, Petra; Rubashkin, Nicholas; Szebik, Imre; Stoll, Kathrin; Vedam, Saraswathi
2017-09-01
In Central and Eastern Europe, many women make informal cash payments to ensure continuity of provider, i.e., to have a "chosen" doctor who provided their prenatal care, be present for birth. High rates of obstetric interventions and disrespectful maternity care are also common to the region. No previous study has examined the associations among informal payments, intervention rates, and quality of maternity care. We distributed an online cross-sectional survey in 2014 to a nationally representative sample of Hungarian internet-using women (N = 600) who had given birth in the last 5 years. The survey included items related to socio-demographics, type of provider, obstetric interventions, and experiences of care. Women reported if they paid informally, and how much. We built a two-part model, where a bivariate probit model was used to estimate conditional probabilities of women paying informally, and a GLM model to explore the amount of payments. We calculated marginal effects of the covariates (provider choice, interventions, respectful care). Many more women (79%) with a chosen doctor paid informally (191 euros on average) compared to 17% of women without a chosen doctor (86 euros). Based on regression analysis, the chosen doctor's presence at birth was the principal determinant of payment. Intervention and procedure rates were significantly higher for women with a chosen doctor versus without (cesareans 45% vs. 33%; inductions 32% vs. 19%; episiotomy 75% vs. 62%; epidural 13% vs. 5%), but had no direct effect on payments. Half of the sample (42% with a chosen doctor, 62% without) reported some form of disrespectful care, but this did not reduce payments. Despite reporting disrespect and higher rates of interventions, women rewarded the presence of a chosen doctor with informal payments. They may be unaware of evidence-based standards, and trust that their chosen doctor provided high quality maternity care. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Health outcome after major trauma: what are we measuring?
Hoffman, Karen; Cole, Elaine; Playford, E Diane; Grill, Eva; Soberg, Helene L; Brohi, Karim
2014-01-01
Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients. To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma. MEDLINE, EMBASE, and CINAHL (from 2006-2012) were searched for studies evaluating health outcome after traumatic injuries. Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF) were used to evaluate to what extent outcome measures captured health impacts. 34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%), functional activities (11%) and environmental factors (2%). Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.
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Role of information systems in public health services.
Hartshorne, J E; Carstens, I L
1990-07-01
The purpose of this review is to establish a conceptual framework on the role of information systems in public health care. Information is indispensable for effective management and development of health services and therefore considered as an important operational asset or resource. A Health Information System is mainly required to support management and operations at four levels: namely transactional and functional; operational control; management planning and control; and strategic planning. To provide the necessary information needs of users at these levels of management in the health care system, a structured information system coupled with appropriate information technology is required. Adequate and relevant information is needed regarding population characteristics, resources available and expended, output and outcome of health care activities. Additionally information needs to be reliable, accurate, timely, easily accessible and presented in a compact and meaningful form. With a well-planned health information system health authorities would be in a position to provide a quality, cost-effective and efficient health service for as many people as need it, optimal utilisation of resources and to maintain and improve the community's health status.
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Training clinicians in how to use patient-reported outcome measures in routine clinical practice
Santana, Maria J.; Haverman, Lotte; Absolom, Kate; Takeuchi, Elena; Feeny, David; Grootenhuis, Martha; Velikova, Galina
2015-01-01
Patient-reported outcome measures (PROs) were originally developed for comparing groups of people in clinical trials and population studies, and the results were used to support treatment recommendations or inform health policy, but there was not direct benefit for the participants providing PROs
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2010-04-01
... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Prescription drugs; reminder advertisements and reminder labeling to provide price information to consumers. 200.200 Section 200.200 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL GENERAL Prescription Drug Consumer Price Listing §...
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Directory of Open Access Journals (Sweden)
Nora E Fritz
2017-01-01
Quantitative measures of strength and walking are associated with brain corticospinal tract pathology. The addition of these quantitative measures to basic clinical information explains more of the variance in corticospinal tract fractional anisotropy and magnetization transfer ratio than the basic clinical information alone. Outcome measurement for multiple sclerosis clinical trials has been notoriously challenging; the use of quantitative measures of strength and walking along with tract-specific imaging methods may improve our ability to monitor disease change over time, with intervention, and provide needed guidelines for developing more effective targeted rehabilitation strategies.
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Herrinton, Lisa J.; Altschuler, Andrea; McMullen, Carmit K.; Bulkley, Joanna E.; Hornbrook, Mark C.; Sun, Virginia; Wendel, Christopher S.; Grant, Marcia; Baldwin, Carol M.; Demark-Wahnefried, Wendy; Temple, Larissa K.F.; Krouse, Robert S.
2017-01-01
For some low rectal cancer patients, ostomy (with elimination into a pouch) may be the only realistic surgical option. However, some patients have a choice between ostomy and sphincter-sparing surgery. Sphincter-sparing surgery has been preferred over ostomy because it offers preservation of normal bowel function. However, this surgery can cause incontinence and bowel dysfunction. Increasingly, it has become evident that certain patients eligible for sphincter-sparing surgery may not be well served by the surgery and construction of an ostomy may be better. No validated assessment tool or decision aid has been published to help newly diagnosed patients decide between the two surgeries, or to help physicians elicit long-term surgical outcomes. Furthermore, comparison of long-term outcomes and late effects following the two surgeries has not been synthesized. We therefore conducted a systematic review to examine this ? This systematic review summarizes controlled studies that compared long-term survivorship outcomes between these two surgical groups. Our goals are: 1) improve understanding and shared decision-making among surgeons, oncologists, primary care providers, patients, and caregivers; 2) increase the patient’s participation in the decision; (3) alert the primary care provider to patient challenges that could be addressed by provider attention and intervention; and 4) ultimately, improve patients’ long-term quality of life. This report includes discussion points for health care providers to use with their patients during initial discussions of ostomy and sphincter-sparing surgery, as well as questions to ask during follow-up examinations to ascertain any long-term challenges facing the patient. PMID:26999757
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Assessment of residency program outcomes via alumni surveys
Directory of Open Access Journals (Sweden)
Lüer S
2017-04-01
Full Text Available Sonja Lüer, Christoph Aebi Department of Pediatrics, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland Background: One trend in medical education is outcomes-oriented training. Outcomes usually refer to individuals’ acquisition of competencies, for example, during training in residency programs. However, little is known about outcomes of these programs. In order to fill this gap, human resource (HR data were analyzed and alumni of a pediatric residency program were surveyed at the Department of Pediatrics, Bern University Hospital, Switzerland.Methods: Residency program outcomes (demographics, career choices, part-time or full-time work status, competencies, feedback were assessed through in-house HR databases, publicly available data on the Internet (physician directory and practice homepages, and 2 alumni surveys (S1, S2. Results: In all, 109 alumni met the inclusion criteria. Retention rate at the hospital was low (14%. Forty-six alumni (42% in private practice were eligible for alumni surveys. Response rates were 87% (S1 and 61% (S2. Time intervals between 2 career decisions (selecting specialty of pediatrics vs selecting setting of private practice varied widely (late-training decision to enter private practice. Mean employment level in private practice was 60% (range 20%–100%. Most valued rotation was emergency medicine; most desired competencies in future colleagues were the ability to work in a team, proficiency in pediatrics, and working economically.Conclusion: A broadened view on outcomes – beyond individuals’ competency acquisition – provides informative insights into a training program, can allow for informed program updates, and guide future program development. Keywords: medical education, career choice, pediatrics, private practice
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Directory of Open Access Journals (Sweden)
Beth S. Russell
2014-06-01
Full Text Available Family intervention literature on adolescent parenting describes the pathways between outcomes for adolescent mothers and their children and the contexts of the pregnancy itself (e.g., poverty, low or no prenatal care, lower educational attainment. The aim of these descriptions is often to inform intervention designs that promote adaptive functioning for the child, the mother, and the dyad. Mental health services are an important component of many of these interventions; these services may be delivered by a clinician within the organization providing the intervention, or the organization may connect mothers with external mental health services in their communities. Using in-house clinicians rather than external providers may be beneficial by decreasing the high attrition rates common to this population. Although this service delivery approach is theoretically appealing, it has not been subject to rigorous empirical evaluation. In the current randomized study, we examine outcomes for teenage mothers based on two service delivery methods: Integrated Mental Health Services (IMHS and the Standard of Care (SoC which outsources clients’ mental health needs through community referrals. Information about the effectiveness of service delivery strategies can help program providers make decisions about how best to allocate limited funds to provide effective services.
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Regional brain morphometry predicts memory rehabilitation outcome after traumatic brain injury
Directory of Open Access Journals (Sweden)
Gary E Strangman
2010-10-01
Full Text Available Cognitive deficits following traumatic brain injury (TBI commonly include difficulties with memory, attention, and executive dysfunction. These deficits are amenable to cognitive rehabilitation, but optimally selecting rehabilitation programs for individual patients remains a challenge. Recent methods for quantifying regional brain morphometry allow for automated quantification of tissue volumes in numerous distinct brain structures. We hypothesized that such quantitative structural information could help identify individuals more or less likely to benefit from memory rehabilitation. Fifty individuals with TBI of all severities who reported having memory difficulties first underwent structural MRI scanning. They then participated in a 12 session memory rehabilitation program emphasizing internal memory strategies (I-MEMS. Primary outcome measures (HVLT, RBMT were collected at the time of the MRI scan, immediately following therapy, and again at one month post-therapy. Regional brain volumes were used to predict outcome, adjusting for standard predictors (e.g., injury severity, age, education, pretest scores. We identified several brain regions that provided significant predictions of rehabilitation outcome, including the volume of the hippocampus, the lateral prefrontal cortex, the thalamus, and several subregions of the cingulate cortex. The prediction range of regional brain volumes were in some cases nearly equal in magnitude to prediction ranges provided by pretest scores on the outcome variable. We conclude that specific cerebral networks including these regions may contribute to learning during I-MEMS rehabilitation, and suggest that morphometric measures may provide substantial predictive value for rehabilitation outcome in other cognitive interventions as well.
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International Nuclear Information System (INIS)
Yoshizawa, Nobuaki; Shinozaki, Tsuyoshi; Yabuta, Naohiro
2002-03-01
Investigation about the effect has so far been conducted about information spread activities aiming at brew of an understanding of the cycle mechanism's stratum disposal research and development. Enactment of the law by which the framework of the disposal enterprise last year is provided in this case, and an establishment of the chief mourner object based on this, Holding of social situations, such as specification of a fund management subject, and JNC sponsored a ''stratum disposal forum'', Based on information offer for a well-informed person or a student, by performing the follow-up survey for [, such as this forum participant,] information offer about the durability of the information offer effect about the stratum disposal research and development which the cycle mechanism has so far carried out. The validity and the subject of the information offer technique are extracted. Moreover, arrangement of the example about information offer and examination of a new technique are performed, and the proposal which is in charge of future information offer is performed. (author)
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Directory of Open Access Journals (Sweden)
Rei Yamada
2016-10-01
Full Text Available Despite U.S. mothers’ wide adoption of pumps and bottles to provide human milk (HM to their infants, mothers lack comprehensive, evidence-based guidelines for these practices. Thus, some women use online sources to seek information from each other. We aimed to characterize the information women sought online about pumping. We used data provided by ~25,000 women in an open cohort within a discussion forum about parenting. We examined 543 posts containing questions about providing pumped HM cross-sectionally and longitudinally in three time intervals: prenatal, 0 through 1.5 months postpartum, and 1.5 to 4.5 months postpartum. We used thematic analysis with Atlas.ti to analyze the content of posts. During pregnancy, women commonly asked questions about how and where to obtain pumps, both out-of-pocket and through insurance policies. Between 0–1.5 months postpartum, many mothers asked about how to handle pumped HM to ensure its safety as fed. Between 1.5–4.5 months postpartum, mothers sought strategies to overcome constraints to pumping both at home and at work and also asked about stopping pumping and providing their milk. Women’s questions related to ensuring the safety of pumped HM represent information women need from health professionals, while their questions related to obtaining pumps suggest that women may benefit from clearer guidelines from their insurance providers. The difficulties women face at home and at work identify avenues through which families and employers can support women to meet their goals for providing HM.
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Directory of Open Access Journals (Sweden)
Margaret B. Harrison
2014-09-01
Full Text Available This study followed a cohort of community-dwelling individuals receiving wound-care in a large urban-rural region. During a randomized control trial (RCT evaluating outcomes of receiving care in a nurse-clinic or at home, many approached were willing to participate if they could choose their location of care. This provided a unique opportunity to enroll them as a “choice” cohort, following them in the same manner as the trial participants but allowing them to select their setting of care. The objective was to investigate the role of preference and location of care on care outcomes, including satisfaction with care, healing, health-related quality of life (HRQL, pain, and resource use. This is a secondary analysis of a prospective cohort of 126 individuals enrolled in an RCT to receive care at home or in a nurse-clinic (Allocated group, and an additional 104 who received care at home or in a nurse-clinic based on their preference (Choice group. Mobile individuals with a leg ulcer of venous or mixed venous etiology, referred for community leg ulcer care, were eligible. Specially-trained nurses provided care to both groups using an evidence-informed protocol. Baseline data included socio-demographic, circumstance-of-living and a detailed wound assessment. Mean age of the cohort was 68 years. Satisfaction, healing, recurrence, pain, HRQL, and resource utilization did not differ between groups. If available, individuals should have an option of care venue given almost half of those approached indicated a clear preference for clinic or home. With outcomes being similar, health care planners and decision-makers, as well as individuals and their families, can feel confident that the setting of care will not impact the outcomes. However, larger studies in other contexts are needed to explore the interaction between choice and setting.
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Harrison, Margaret B; VanDenKerkhof, Elizabeth G; Hopman, Wilma M; Carley, Meg E
2014-09-19
This study followed a cohort of community-dwelling individuals receiving wound-care in a large urban-rural region. During a randomized control trial (RCT) evaluating outcomes of receiving care in a nurse-clinic or at home, many approached were willing to participate if they could choose their location of care. This provided a unique opportunity to enroll them as a "choice" cohort, following them in the same manner as the trial participants but allowing them to select their setting of care. The objective was to investigate the role of preference and location of care on care outcomes, including satisfaction with care, healing, health-related quality of life (HRQL), pain, and resource use. This is a secondary analysis of a prospective cohort of 126 individuals enrolled in an RCT to receive care at home or in a nurse-clinic (Allocated group), and an additional 104 who received care at home or in a nurse-clinic based on their preference (Choice group). Mobile individuals with a leg ulcer of venous or mixed venous etiology, referred for community leg ulcer care, were eligible. Specially-trained nurses provided care to both groups using an evidence-informed protocol. Baseline data included socio-demographic, circumstance-of-living and a detailed wound assessment. Mean age of the cohort was 68 years. Satisfaction, healing, recurrence, pain, HRQL, and resource utilization did not differ between groups. If available, individuals should have an option of care venue given almost half of those approached indicated a clear preference for clinic or home. With outcomes being similar, health care planners and decision-makers, as well as individuals and their families, can feel confident that the setting of care will not impact the outcomes. However, larger studies in other contexts are needed to explore the interaction between choice and setting.
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Patient and provider experiences with active surveillance: A scoping review.
Directory of Open Access Journals (Sweden)
Claire Kim
Full Text Available Active surveillance (AS represents a fundamental shift in managing select cancer patients that initiates treatment only upon disease progression to avoid overtreatment. Given uncertain outcomes, patient engagement could support decision-making about AS. Little is known about how to optimize patient engagement for AS decision-making. This scoping review aimed to characterize research on patient and provider communication about AS, and associated determinants and outcomes.MEDLINE, EMBASE, CINAHL, and The Cochrane Library were searched from 2006 to October 2016. English language studies that evaluated cancer patient or provider AS views, experiences or behavioural interventions were eligible. Screening and data extraction were done in duplicate. Summary statistics were used to describe study characteristics and findings.A total of 2,078 studies were identified, 1,587 were unique, and 1,243 were excluded based on titles/abstracts. Among 344 full-text articles, 73 studies were eligible: 2 ductal carcinoma in situ (DCIS, 4 chronic lymphocytic leukemia (CLL, 6 renal cell carcinoma (RCC and 61 prostate cancer. The most influential determinant of initiating AS was physician recommendation. Others included higher socioeconomic status, smaller tumor size, comorbid disease, older age, and preference to avoid adverse treatment effects. AS patients desired more information about AS and reassurance about future treatment options, involvement in decision-making and assessment of illness uncertainty and supportive care needs during follow-up. Only three studies of prostate cancer evaluated interventions to improve AS communication or experience.This study revealed a paucity of research on AS communication for DCIS, RCC and CLL, but generated insight on how to optimize AS discussions in the context of routine care or clinical trials from research on AS for prostate cancer. Further research is needed on AS for patients with DCIS, RCC and CLL, and to evaluate
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A modified cutaneous ureterostomy provides satisfactory short and midterm outcomes in select cases.
Yadav, Priyank; Mittal, Varun; Gaur, Pankaj; Srivastava, Devarshi; Sureka, Sanjoy Kumar; Mandhani, Anil
2018-03-06
We present the outcomes of modification of cutaneous ureterostomy by extreme lateralization of the stoma and use of skin flap for formation of ureterostomy. Between June 2012 and June 2016, 36 patients had modified cutaneous ureterostomy for ureteral obstruction due to pelvic malignancy or genitourinary tuberculosis. Transureteroureterostomy was made with cutaneous stoma at anterior axillary line between iliac crest and lower rib cage, instead of spinoumbilical line. To prevent stenosis a 'V' shaped skin was fed into the stoma. Double J stents were used in all patients for 6 weeks. Perioperative morbidity and mortality were evaluated. All patients were followed up at 3 month intervals. Of 36 patients, 22 had radical cystoprostatectomy (including nephroureterectomy in 2 patients) and 7 had palliative cystectomy. Others had locally advanced prostate cancer (n=1), locally advanced cervical cancer (n=3), ovarian cancer (n=1) and genitourinary tuberculosis with small capacity bladder along with a large vesicovaginal fistula (n=1). One patient developed ureteral necrosis requiring conversion to ileal conduit. Three patients developed stomal stenosis: two were managed by self-dilatation while one required revision of stoma. Thirteen patients died of the disease at a median follow up of 6 months with functioning stoma. Remaining 19 patients survived without any complications at a median follow-up of 20.5 months (5.5-43.5 months). None of the patients had any problem related to ureterostomy bag application. Modified lateral cutaneous ureterostomy provides relatively straighter and shorter retroperitoneal course of ureter with acceptable morbidity and avoids use of bowel in selected patients.
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Hooker, Stephanie A; Grigsby, Megan E; Riegel, Barbara; Bekelman, David B
2015-01-01
Relationships can have positive and negative impacts on health and well-being. Dyadic relationships between heart failure (HF) patients and their informal family caregivers may affect both patient and caregiver outcomes. The aim of this study is to synthesize the literature to date on the associations between HF patient-caregiver relationship quality and communication and patient and caregiver health outcomes. An integrative review of the literature was conducted. Computerized literature searches in Medline, PsycInfo, CINAHL, Web of Science, and EMBASE yielded 13 articles of HF patients and caregivers. Included articles were reviewed and double-coded by 2 independent coders. Included articles measured relationship quality or aspects of communication within an HF patient-caregiver dyad and used both cross-sectional and longitudinal designs. Results of the longest prospective study suggested that better relationship quality between HF patients and their informal family caregivers was related to a reduced risk for mortality in patients. Results of 11 of the 12 other studies were consistent to the reference study, suggesting that better relationship quality and communication were related to reduced mortality, increased health status, less distress, and lower caregiver burden. Relationship quality and communication seem to matter in the health and well-being of both HF patients and their informal family caregivers. More research is needed to elucidate mechanisms and to design effective relationship-focused interventions.
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Matthews, Lynda R; Hanley, Francine; Lewis, Virginia; Howe, Caroline
2015-01-01
With social and economic costs of workplace injury on the increase, efficient payment models that deliver quality rehabilitation outcomes are of increasing interest. This paper provides a perspective on the issue informed by both refereed literature and published research material not available commercially (gray literature). A review of payment models, workers' compensation and compensable injury identified relevant peer-reviewed and gray literature that informed our discussion. Fee-for-service and performance-based payment models dominate the health and rehabilitation literature, each described as having benefits and challenges to achieving quality outcomes for consumers. There appears to be a movement toward performance-based payments in compensable workplace injury settings as they are perceived to promote time-efficient services and support innovation in rehabilitation practice. However, it appears that the challenges that arise for workplace-based rehabilitation providers and professionals when working under the various payment models, such as staff retention and quality of client-practitioner relationship, are absent from the literature and this could lead to flawed policy decisions. Robust evidence of the benefits and costs associated with different payment models - from the perspectives of clients/consumers, funders and service providers - is needed to inform best practice in rehabilitation of compensable workplace injuries. Available but limited evidence suggests that payment models providing financial incentives for stakeholder-agreed vocational rehabilitation outcomes tend to improve service effectiveness in workers' compensation settings, although there is little evidence of service quality or client satisfaction. Working in a system that identifies payments for stakeholder-agreed outcomes may be more satisfying for rehabilitation practitioners in workers' compensation settings by allowing more clinical autonomy and innovative practice. Researchers
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Xu, Ye; Liu, Yuanli; Shu, Ting; Yang, Wei; Liang, Minghui
2015-01-01
Public hospitals deliver over ninety percent of all outpatient and inpatient services in China. Their quality is graded into three levels (A, B, and C) largely based on structural resources, but empirical evidence on the quality of process and outcome of care is extremely scarce. As expectations for quality care rise with higher living standards and cost of care, such evidence is urgently needed and vital to improve care and to inform future health reforms. We compiled and analyzed a multicenter database of over 4 million inpatient discharge summary records to provide a comprehensive assessment of the level and variations in clinical outcomes of hospitalization at 39 tertiary hospitals in Beijing. We assessed six outcome measures of clinical quality: in-hospital mortality rates (RSMR) for AMI, stroke, pneumonia and CABG, post-procedural complication rate (RS-CR), and failure-to-rescue rate (RS-FTR). The measures were adjusted for pre-admission patient case-mix using indirect standardization method with hierarchical linear mixed models. We found good overall quality with large variations by hospital and condition (mean/range, in %): RSMR-AMI: 6.23 (2.37-14.48), RSMR-stroke: 4.18 (3.58-4.44), RSMR-pneumonia: 7.78 (7.20-8.59), RSMR-CABG: 1.93 (1.55-2.23), RS-CR: 11.38 (9.9-12.88), and RS-FTR: 6.41 (5.17-7.58). Hospital grade was not significantly associated with any risk-adjusted outcome measures. Going to a higher grade public hospital does not always lead to better patient outcome because hospital grade only contains information about hospital structural resources. A hospital report card with some outcome measures of quality would provide valuable information to patients in choosing providers, and for regulators to identify gaps in health care quality. Reducing the variations in clinical practice and patient outcome should be a focus for policy makers in the next round of health sector reforms in China.
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Directory of Open Access Journals (Sweden)
Irene Searles McClatchey
2017-09-01
Full Text Available Background: Studies on posttraumatic growth (PTG among bereaved youth are rare; outcome studies on how to facilitate PTG among this population are even more scarce. Objectives: This study examined the addition of trauma-informed care to bereavement interventions to foster PTG in youth attending a weekend-long bereavement camp. Method: A total of 105 participants completed standardized measures of posttraumatic growth and posttraumatic stress disorder after which 52 of the participants took part in a camp session. Ninety-five of the participants from both groups were post-tested four weeks after the camp session. Results: Multiple Regression showed that PTG scores were significantly greater at posttest for the treatment group. No significant changes in PTSD were found in either group, although the presence of dissociative symptoms decreased significantly among campers in the treatment group. Conclusions: Findings suggest trauma-informed care may increase posttraumatic growth among youth coping with loss. Implications for future studies and clinical practice are discussed
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2010-01-01
... information to the Finance Board and the Office of Finance. 989.3 Section 989.3 Banks and Banking FEDERAL HOUSING FINANCE BOARD OFFICE OF FINANCE FINANCIAL STATEMENTS OF THE BANKS § 989.3 Requirement to provide financial and other information to the Finance Board and the Office of Finance. In order to facilitate the...
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Zito, Sarah; Paterson, Mandy; Vankan, Dianne; Morton, John; Bennett, Pauleen; Phillips, Clive
2015-01-01
Simple Summary Commonly, more adult cats than kittens are euthanized in animal shelters. We surveyed 382 cat adopters to assess adoption outcomes and potential determinants of adopters’ choice of cat age group and price. Most adopters had benevolent motivations for adopting from the shelter and had put considerable thought into the adoption and responsible ownership requirements. However, adult cat adopters were more likely to have been influenced by price than kitten adopters. Adoption outcomes were generally positive in all age and adoption price groups. This study provides evidence to inform the design of strategies to encourage adult cat adoptions. Abstract The percentage of adult cats euthanized in animal shelters is greater than that of kittens because adult cats are less likely to be adopted. This study aimed to provide evidence to inform the design of strategies to encourage adult cat adoptions. One such strategy is to discount adoption prices, but there are concerns that this may result in poor adoption outcomes. We surveyed 382 cat adopters at the time of adoption, to assess potential determinants of adopters’ cat age group choice (adult or kitten) and, for adult cat adopters, the price they are willing to pay. The same respondents were surveyed again 6–12 months after the adoption to compare outcomes between cat age groups and between adult cats in two price categories. Most adopters had benevolent motivations for adopting from the shelter and had put considerable thought into the adoption and requirements for responsible ownership. However, adult cat adopters were more likely to have been influenced by price than kitten adopters. Adoption outcomes were generally positive for both adult cats and kittens and for adult cats adopted at low prices. The latter finding alleviates concerns about the outcomes of “low-cost” adoptions in populations, such as the study population, and lends support for the use of “low-cost” adoptions as an option for
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Adaptive Information Dissemination Control to Provide Diffdelay for the Internet of Things.
Liu, Xiao; Liu, Anfeng; Huang, Changqin
2017-01-12
Applications running on the Internet of Things, such as the Wireless Sensor and Actuator Networks (WSANs) platform, generally have different quality of service (QoS) requirements. For urgent events, it is crucial that information be reported to the actuator quickly, and the communication cost is the second factor. However, for interesting events, communication costs, network lifetime and time all become important factors. In most situations, these different requirements cannot be satisfied simultaneously. In this paper, an adaptive communication control based on a differentiated delay (ACCDS) scheme is proposed to resolve this conflict. In an ACCDS, source nodes of events adaptively send various searching actuators routings (SARs) based on the degree of sensitivity to delay while maintaining the network lifetime. For a delay-sensitive event, the source node sends a large number of SARs to actuators to identify and inform the actuators in an extremely short time; thus, action can be taken quickly but at higher communication costs. For delay-insensitive events, the source node sends fewer SARs to reduce communication costs and improve network lifetime. Therefore, an ACCDS can meet the QoS requirements of different events using a differentiated delay framework. Theoretical analysis simulation results indicate that an ACCDS provides delay and communication costs and differentiated services; an ACCDS scheme can reduce the network delay by 11.111%-53.684% for a delay-sensitive event and reduce the communication costs by 5%-22.308% for interesting events, and reduce the network lifetime by about 28.713%.
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Bukowinski, Anna T; Conlin, Ava Marie S; Gumbs, Gia R; Khodr, Zeina G; Chang, Richard N; Faix, Dennis J
2017-11-01
Established following a 1998 directive, the Department of Defense Birth and Infant Health Registry (Registry) team conducts surveillance of select reproductive health outcomes among military families. Data are compiled from the Military Health System Data Repository and Defense Manpower Data Center to define the Registry cohort and outcomes of interest. Outcomes are defined using ICD-9/ICD-10 and Current Procedural Terminology codes, and include: pregnancy outcomes (e.g., live births, losses), birth defects, preterm births, and male:female infant sex ratio. This report includes data from 2003-2014 on 1,304,406 infants among military families and 258,332 pregnancies among active duty women. Rates of common adverse infant and pregnancy outcomes were comparable to or lower than those in the general US population. These observations, along with prior Registry analyses, provide reassurance that military service is not independently associated with increased risks for select adverse reproductive health outcomes. The Registry's diverse research portfolio demonstrates its unique capabilities to answer a wide range of questions related to reproductive health. These data provide the military community with information to identify successes and areas for improvement in prevention and care.
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Hinds, Richard M; Klifto, Christopher S; Naik, Amish A; Sapienza, Anthony; Capo, John T
2016-08-01
The Internet is a common resource for applicants of hand surgery fellowships, however, the quality and accessibility of fellowship online information is unknown. The objectives of this study were to evaluate the accessibility of hand surgery fellowship Web sites and to assess the quality of information provided via program Web sites. Hand fellowship Web site accessibility was evaluated by reviewing the American Society for Surgery of the Hand (ASSH) on November 16, 2014 and the National Resident Matching Program (NRMP) fellowship directories on February 12, 2015, and performing an independent Google search on November 25, 2014. Accessible Web sites were then assessed for quality of the presented information. A total of 81 programs were identified with the ASSH directory featuring direct links to 32% of program Web sites and the NRMP directory directly linking to 0%. A Google search yielded direct links to 86% of program Web sites. The quality of presented information varied greatly among the 72 accessible Web sites. Program description (100%), fellowship application requirements (97%), program contact email address (85%), and research requirements (75%) were the most commonly presented components of fellowship information. Hand fellowship program Web sites can be accessed from the ASSH directory and, to a lesser extent, the NRMP directory. However, a Google search is the most reliable method to access online fellowship information. Of assessable programs, all featured a program description though the quality of the remaining information was variable. Hand surgery fellowship applicants may face some difficulties when attempting to gather program information online. Future efforts should focus on improving the accessibility and content quality on hand surgery fellowship program Web sites.
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Directory of Open Access Journals (Sweden)
Dilpreet Kaur
2015-12-01
Full Text Available Background: Decreased core stability displaces center of gravity away from base of support reducing activity participation of athlete. Present study was conducted to study the effect of core stabilization exercises after reconstruction surgery of ACL on functional outcomes. Methods: 30 subjects following 5 months of ACL reconstruction were randomly assigned to either group that performed (study group or did not performed (control group additional core stabilization exercises in conjugation with standard rehabilitation protocol. Outcome measures were: activity level using Tegnar activity level scale and functional performance using triple hop test. Outcome measures were compared at day 1 and day 42 of the treatment. Result: Significant improvement was seen in the study group for Tegnar score with mean difference changing from 4.5 to 1.5 from day 1 to day 42 of treatment (p=0.039 while the control group showed improvement in mean difference changing from 3.8 to 1.4 (p=.045 from day 1 to day 42 of treatment. Highly significant improvement was seen in the study group for triple hop test with mean difference changing from 25 to 6.7 (p<.001 compared to the control group with mean difference changing from 15.2 to 9.7(p=.005 from day 1 to day 42 of treatment. Conclusions: Both the groups showed improvement for activity level and functional performance but highly significant improvement was seen in the study group for functional performance. Core stabilization exercises in conjugation with the standard ACL rehabilitation protocol results better improvement in the triple hop test.
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42 CFR 410.146 - Diabetes outcome measurements.
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Diabetes outcome measurements. 410.146 Section 410.146 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Training and Diabetes Outcome Measurements § 410.146 Diabetes outcome measurements. (a) Information...
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Contingency management: perspectives of Australian service providers.
Cameron, Jacqui; Ritter, Alison
2007-03-01
Given the very positive and extensive research evidence demonstrating efficacy and effectiveness of contingency management, it is important that Australia explore whether contingency management has a role to play in our own treatment context. Qualitative interviews were conducted with 30 experienced alcohol and drug practitioners, service managers and policy-makers in Victoria. Interviewees were selected to represent the range of drug treatment services types and included rural representation. A semi-structured interview schedule, covering their perceptions and practices of contingency management was used. All interviews were transcribed verbatim and analysed using N2 qualitative data analysis program. The majority of key informants were positively inclined toward contingency management, notwithstanding some concerns about the philosophical underpinnings. Concerns were raised in relation to the use of monetary rewards. Examples of the use of contingency management provided by key informants demonstrated an over-inclusive definition: all the examples did not adhere to the key principles of contingency management. This may create problems if a structured contingency management were to be introduced in Australia. Contingency management is an important adjunctive treatment intervention and its use in Australia has the potential to enhance treatment outcomes. No unmanageable barriers were identified in this study.
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Pinto, Ana Catarina; Ferreira-Santos, Fernando; Lago, Lissandra Dal; de Azambuja, Evandro; Pimentel, Francisco Luís; Piccart-Gebhart, Martine; Razavi, Darius
2014-01-01
Background Information is vital to cancer patients. Physician–patient communication in oncology presents specific challenges. The aim of this study was to evaluate self-reported information of cancer patients in ambulatory care at a comprehensive cancer centre and examine its possible association with patients’ demographic and clinical characteristics. Patients and methods This study included adult patients with solid tumours undergoing chemotherapy at the Institute Jules Bordet’s Day Hospital over a ten-day period. EORTC QLQ-C30 and QLQ-INFO25 questionnaires were administered. Demographic and clinical data were collected. Descriptive and inferential statistics were used. Results 101 (99%) fully completed the questionnaires. They were mostly Belgian (74.3%), female (78.2%), with a mean age of 56.9 ± 12.8 years. The most frequent tumour was breast cancer (58.4%). Patients were well-informed about the disease and treatments, but presented unmet information domains. The Jules Bordet patients desired more information on treatment side effects, long-term outcome, nutrition, and recurrence symptoms. Patients on clinical trials reported having received less information about their disease and less written information than patients outside clinical trials. Higher information levels were associated with higher quality of life (QoL) scores and higher patient satisfaction. Conclusion Patients were satisfied with the information they received and this correlated with higher QoL, but they still expressed unmet information wishes. Additional studies are required to investigate the quality of the information received by patients enrolled in clinical trials. PMID:24834120
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Analyses of stomach contents provide information on prey of ...
African Journals Online (AJOL)
spamer
example. In this paper, information is presented on the cephalopods eaten by four species of shark. Initial studies had ..... Their prey selection supports sighting .... 18(1): 27 – 40. KLIMLEY, A. P. 1993 — Highly directional swimming by scal-.
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Markup of temporal information in electronic health records.
Hyun, Sookyung; Bakken, Suzanne; Johnson, Stephen B
2006-01-01
Temporal information plays a critical role in the understanding of clinical narrative (i.e., free text). We developed a representation for marking up temporal information in a narrative, consisting of five elements: 1) reference point, 2) direction, 3) number, 4) time unit, and 5) pattern. We identified 254 temporal expressions from 50 discharge summaries and represented them using our scheme. The overall inter-rater reliability among raters applying the representation model was 75 percent agreement. The model can contribute to temporal reasoning in computer systems for decision support, data mining, and process and outcomes analyses by providing structured temporal information.
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Klosky, James L; Wang, Fang; Russell, Kathryn M; Zhang, Hui; Flynn, Jessica S; Huang, Lu; Wasilewski-Masker, Karen; Landier, Wendy; Leonard, Marcia; Albritton, Karen H; Gupta, Abha A; Casillas, Jacqueline; Colte, Paul; Kutteh, William H; Schover, Leslie R
2017-12-01
Purpose To estimate the prevalence of sperm banking among adolescent males newly diagnosed with cancer and to identify factors associated with banking outcomes. Patients and Methods A prospective, single-group, observational study design was used to test the contribution of sociodemographic, medical, psychological/health belief, communication, and developmental factors to fertility preservation outcomes. At-risk adolescent males (N = 146; age 13.00 to 21.99 years; Tanner stage ≥ 3), their parents, and medical providers from eight leading pediatric oncology centers across the United States and Canada completed self-report questionnaires within 1 week of treatment initiation. Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% CIs for specified banking outcomes (collection attempt v no attempt and successful completion of banking v no banking). Results Among adolescents (mean age, 16.49 years; standard deviation, 2.02 years), 53.4% (78 of 146) made a collection attempt, with 43.8% (64 of 146) successfully banking sperm (82.1% of attempters). The overall attempt model revealed adolescent consultation with a fertility specialist (OR, 29.96; 95% CI, 2.48 to 361.41; P = .007), parent recommendation to bank (OR, 12.30; 95% CI, 2.01 to 75.94; P = .007), and higher Tanner stage (OR, 5.42; 95% CI, 1.75 to 16.78; P = .003) were associated with an increased likelihood of a collection attempt. Adolescent history of masturbation (OR, 5.99; 95% CI, 1.25 to 28.50; P = .025), banking self-efficacy (OR, 1.23; 95% CI, 1.05 to 1.45; P = .012), and parent (OR, 4.62; 95% CI, 1.46 to 14.73; P = .010) or medical team (OR, 4.26; 95% CI, 1.45 to 12.43; P = .008) recommendation to bank were associated with increased likelihood of sperm banking completion. Conclusion Although findings suggest that banking is underutilized, modifiable adolescent, parent, and provider factors associated with banking outcomes were identified and should be targeted in future
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Effects of librarian-provided services in healthcare settings: a systematic review.
Perrier, Laure; Farrell, Ann; Ayala, A Patricia; Lightfoot, David; Kenny, Tim; Aaronson, Ellen; Allee, Nancy; Brigham, Tara; Connor, Elizabeth; Constantinescu, Teodora; Muellenbach, Joanne; Epstein, Helen-Ann Brown; Weiss, Ardis
2014-01-01
To assess the effects of librarian-provided services in healthcare settings on patient, healthcare provider, and researcher outcomes. Medline, CINAHL, ERIC, LISA (Library and Information Science Abstracts), and the Cochrane Central Register of Controlled Trials were searched from inception to June 2013. Studies involving librarian-provided services for patients encountering the healthcare system, healthcare providers, or researchers were eligible for inclusion. All librarian-provided services in healthcare settings were considered as an intervention, including hospitals, primary care settings, or public health clinics. Twenty-five articles fulfilled our eligibility criteria, including 22 primary publications and three companion reports. The majority of studies (15/22 primary publications) examined librarians providing instruction in literature searching to healthcare trainees, and measured literature searching proficiency. Other studies analyzed librarian-provided literature searching services and instruction in question formulation as well as the impact of librarian-provided services on patient length of stay in hospital. No studies were found that investigated librarians providing direct services to researchers or patients in healthcare settings. Librarian-provided services directed to participants in training programs (eg, students, residents) improve skills in searching the literature to facilitate the integration of research evidence into clinical decision-making. Services provided to clinicians were shown to be effective in saving time for health professionals and providing relevant information for decision-making. Two studies indicated patient length of stay was reduced when clinicians requested literature searches related to a patient's case. 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.
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Wittwehr, Clemens; Aladjov, Hristo; Ankley, Gerald; Byrne, Hugh J; de Knecht, Joop; Heinzle, Elmar; Klambauer, Günter; Landesmann, Brigitte; Luijten, Mirjam; MacKay, Cameron; Maxwell, Gavin; Meek, M E Bette; Paini, Alicia; Perkins, Edward; Sobanski, Tomasz; Villeneuve, Dan; Waters, Katrina M; Whelan, Maurice
2017-02-01
Efforts are underway to transform regulatory toxicology and chemical safety assessment from a largely empirical science based on direct observation of apical toxicity outcomes in whole organism toxicity tests to a predictive one in which outcomes and risk are inferred from accumulated mechanistic understanding. The adverse outcome pathway (AOP) framework provides a systematic approach for organizing knowledge that may support such inference. Likewise, computational models of biological systems at various scales provide another means and platform to integrate current biological understanding to facilitate inference and extrapolation. We argue that the systematic organization of knowledge into AOP frameworks can inform and help direct the design and development of computational prediction models that can further enhance the utility of mechanistic and in silico data for chemical safety assessment. This concept was explored as part of a workshop on AOP-Informed Predictive Modeling Approaches for Regulatory Toxicology held September 24-25, 2015. Examples of AOP-informed model development and its application to the assessment of chemicals for skin sensitization and multiple modes of endocrine disruption are provided. The role of problem formulation, not only as a critical phase of risk assessment, but also as guide for both AOP and complementary model development is described. Finally, a proposal for actively engaging the modeling community in AOP-informed computational model development is made. The contents serve as a vision for how AOPs can be leveraged to facilitate development of computational prediction models needed to support the next generation of chemical safety assessment. © The Author 2016. Published by Oxford University Press on behalf of the Society of Toxicology.
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Noh, Younghee
2015-12-01
This study proposed to define the role and duties of librarians who provide health information service in public and medical libraries. Appropriate education, career experience and starting salary for this position are also presented. This study analysed previous research and job advertisements to understand the current needs for this position. Almost all job advertisements studied were eventually retrieved from Salary.com (US job posting site). Public libraries seeking to fill health informationist positions were even more difficult to find in any of the above locations. Therefore, the researcher attempted to find cases using various search engines, including Google, and noticed that public libraries usually post job advertisements on their website. Finally, 32 job postings were selected as suitable. Fifty-four public and medical librarians were surveyed to validate the results in Korea. Public librarians chose 'health information librarian' as the most appropriate title for this position, while medical librarians answered 'medical librarian'. Therefore, librarians providing health information service in public libraries should be called 'health information librarians', while the position in medical libraries should be called 'medical librarian'. Accordingly, job postings and academic articles will be easily accessible. Both groups marked that the position should require a bachelor's degree in both LIS and a health science field, 2 years library experience and health-related user training. Other requirements included knowledge of health resources and medical terminology, search capabilities and a focus on user-centric service. For required duties, public librarians chose accessing information resources, while medical librarians selected collection management. Health information librarians will play a vital role in the future and must therefore be educated accordingly. © 2015 Health Libraries Group.
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Canzona, Mollie Rose; Garcia, David; Fisher, Carla L; Raleigh, Meghan; Kalish, Virginia; Ledford, Christy J W
2016-11-01
Breast cancer survivors experience a range of sexual health (SH) issues. Communication problems between patient and provider can prevent survivors from pursuing SH goals and can negatively influence biopsychosocial outcomes. The primary aims of this study were to identify provider communication behaviors that facilitate or impede clinical interactions regarding SH (according to survivors and providers) and to highlight discrepancies that affect care. Forty breast cancer survivors and forty health care providers from a variety of specialties participated in semi-structured interviews informed by the Critical Incident Technique. Transcripts were thematically analyzed using the constant comparative method. Survivors and providers discussed the importance of honoring individual patient needs and conveying compassionate messages. However, accounts varied significantly regarding the appropriate timing and method of initiating SH discussions and the helpfulness of certain support behaviors and linguistic devices. Provider and survivor accounts of what constitutes helpful and unhelpful provider communication behaviors when discussing SH concerns are misaligned in nuanced and meaningful ways. These discrepancies reveal potential areas for educational intervention. SH discussions require providers to examine assumptions about patients' communication preferences and information needs. Patients may benefit from frank yet sensitive discussions earlier in the cancer continuum. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
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Whiteneck, Gale G; Gassaway, Julie
2013-04-01
To describe the application of practice-based evidence (PBE) methodology to spinal cord injury (SCI) rehabilitation in the SCIRehab study, and to summarize associations of patient characteristics and treatment interventions to outcomes. Prospective observational study. Six SCI rehabilitation centers. Patients with traumatic SCI (N=1376) admitted for first rehabilitation. Not applicable. FIM and residence at discharge, and FIM, residence, Craig Handicap Assessment and Reporting Technique, work/school status, Patient Health Questionnaire-9, Diener Satisfaction with Life Scale, rehospitalization, and presence of pressure ulcers at 1 year postinjury. Patient demographic and injury characteristics explained significant variation in rehabilitation outcomes, particularly functional outcomes. Regression modeling also identified a large number of significant associations with outcomes when total time in each discipline was modeled and when models were developed for each discipline, examining time spent in the many specific interventions provided by each discipline. The application of PBE methodology in the SCIRehab study provided extensive information about the process of inpatient SCI rehabilitation. While patient demographic and injury characteristics explain substantial variation in rehabilitation outcomes, particularly functional outcomes, significant relations also were found between the type and quantity of treatment interventions delivered by each rehabilitation discipline and a broad range of outcomes. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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Hudson, Jennifer L; Lester, Kathryn J; Lewis, Cathryn M; Tropeano, Maria; Creswell, Cathy; Collier, David A; Cooper, Peter; Lyneham, Heidi J; Morris, Talia; Rapee, Ronald M; Roberts, Susanna; Donald, Jennifer A; Eley, Thalia C
2013-01-01
Background. Within a therapeutic gene by environment (GxE) framework, we recently demonstrated that variation in \\ud the Serotonin Transporter Promoter Polymorphism; 5HTTLPR and marker rs6330 in Nerve Growth Factor gene; NGF is \\ud associated with poorer outcomes following cognitive behaviour therapy (CBT) for child anxiety disorders. The aim of this \\ud study was to explore one potential means of extending the translational reach of G×E data in a way that may be clinically \\ud informative. W...
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Information literacy skills of undergraduate medical radiation students
Energy Technology Data Exchange (ETDEWEB)
Shanahan, Madeleine C. [Medical Radiations, School of Medical Sciences, RMIT University, PO Box 71, Bundoora, Victoria (Australia)]. E-mail: mshanahan@rmit.edu.au
2007-08-15
Undergraduate education is undergoing a shift away from the traditional transmission of a fixed body of knowledge to a learning approach where the emphasis is on supporting learners to learn. Central to this change is recognition that undergraduate education programmes should aim to develop independent learners who become effective lifelong learning practitioners. Successful independent learning as an undergraduate student or as a lifelong learner requires the learner to have well developed information literacy skills. An Online Electronic Information Skills (OEIS) intervention was designed to develop the information literacy skills in a cohort of second year undergraduate radiography students. An evaluation focused on learning outcomes was used to provide evidence of development of information literacy within the undergraduate course. The evaluation clearly demonstrated substantial skill development in students' ability to access scholarly information in their discipline area. The reported continued use of database searching by this cohort of students seven months after the OEIS intervention provides evidence that they are continuing to access and use scholarly information, information literacy skills necessary for their future work context.
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Information literacy skills of undergraduate medical radiation students
International Nuclear Information System (INIS)
Shanahan, Madeleine C.
2007-01-01
Undergraduate education is undergoing a shift away from the traditional transmission of a fixed body of knowledge to a learning approach where the emphasis is on supporting learners to learn. Central to this change is recognition that undergraduate education programmes should aim to develop independent learners who become effective lifelong learning practitioners. Successful independent learning as an undergraduate student or as a lifelong learner requires the learner to have well developed information literacy skills. An Online Electronic Information Skills (OEIS) intervention was designed to develop the information literacy skills in a cohort of second year undergraduate radiography students. An evaluation focused on learning outcomes was used to provide evidence of development of information literacy within the undergraduate course. The evaluation clearly demonstrated substantial skill development in students' ability to access scholarly information in their discipline area. The reported continued use of database searching by this cohort of students seven months after the OEIS intervention provides evidence that they are continuing to access and use scholarly information, information literacy skills necessary for their future work context